Journal of Pathology and Translational Medicine

Original Article

A multicenter study of interobserver variability in pathologic diagnosis of papillary breast lesions on core needle biopsy with WHO classification: Hye Ju Kang, Sun Young Kwon, Ahrong Kim, Woo Gyeong Kim, Eun Kyung Kim, Ae Ree Kim, Chungyeul Kim, Soo Kee Min, So Young Park, Sun Hee Sung, Hye Kyoung Yoon, Ahwon Lee, Ji Shin Lee, Hyang Im Lee, Ho Chang Lee, Sung Chul Lim, Sun Young Jun, Min Jung Jung, Chang Won Jung, Soo Youn Cho, Eun Yoon Cho, Hye Jeong Choi, So Yeon Park, Jee Yeon Kim, In Ae Park, Youngmee Kwon; J Pathol Transl Med. 2021;55(6):380-387. Published online October 6, 2021; DOI: https://doi.org/10.4132/jptm.2021.07.29

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Background
Papillary breast lesions (PBLs) comprise diverse entities from benign and atypical lesions to malignant tumors. Although PBLs are characterized by a papillary growth pattern, it is challenging to achieve high diagnostic accuracy and reproducibility. Thus, we investigated the diagnostic reproducibility of PBLs in core needle biopsy (CNB) specimens with World Health Organization (WHO) classification.
Methods
Diagnostic reproducibility was assessed using interobserver variability (kappa value, κ) and agreement rate in the pathologic diagnosis of 60 PBL cases on CNB among 20 breast pathologists affiliated with 20 medical institutions in Korea. This analysis was performed using hematoxylin and eosin (H&E) staining and immunohistochemical (IHC) staining for cytokeratin 5 (CK5) and p63. The pathologic diagnosis of PBLs was based on WHO classification, which was used to establish simple classifications (4-tier, 3-tier, and 2-tier).
Results
On WHO classification, H&E staining exhibited ‘fair agreement’ (κ = 0.21) with a 47.0% agreement rate. Simple classifications presented improvement in interobserver variability and agreement rate. IHC staining increased the kappa value and agreement rate in all the classifications. Despite IHC staining, the encapsulated/solid papillary carcinoma (EPC/SPC) subgroup (κ = 0.16) exhibited lower agreement compared to the non-EPC/SPC subgroup (κ = 0.35) with WHO classification, which was similar to the results of any other classification systems.
Conclusions
Although the use of IHC staining for CK5 and p63 increased the diagnostic agreement of PBLs in CNB specimens, WHO classification exhibited a higher discordance rate compared to any other classifications. Therefore, this result warrants further intensive consensus studies to improve the diagnostic reproducibility of PBLs with WHO classification.

Citations

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Beyond the benign: A rare case report of myxoid pleomorphic liposarcoma
Arslan Ahmad, Muhammad Ammar, Muhammad Hasnain Saleem Choudary, Muhammad Nouman Sadiq, Rana Uzair Ahmad, Nouman Aziz
Radiology Case Reports.2025; 20(5): 2500. CrossRef
Invasive papillary carcinoma of the breast
Shijing Wang, Qingfu Zhang, Xiaoyun Mao
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Recommendations for Performance Evaluation of Machine Learning in Pathology: A Concept Paper From the College of American Pathologists
Matthew G. Hanna, Niels H. Olson, Mark Zarella, Rajesh C. Dash, Markus D. Herrmann, Larissa V. Furtado, Michelle N. Stram, Patricia M. Raciti, Lewis Hassell, Alex Mays, Liron Pantanowitz, Joseph S. Sirintrapun, Savitri Krishnamurthy, Anil Parwani, Giovann
Archives of Pathology & Laboratory Medicine.2024; 148(10): e335. CrossRef
Encapsulated papillary carcinoma of the breast: A single institution experience
Liang Xu, Qixin Mao, Qiuming Liu, Yufeng Gao, Lihua Luo, Chungen Guo, Wei Qu, Ningning Yan, Yali Cao
Oncology Letters.2023;[Epub] CrossRef
High-risk and selected benign breast lesions diagnosed on core needle biopsy: Evidence for and against immediate surgical excision
Aparna Harbhajanka, Hannah L. Gilmore, Benjamin C. Calhoun
Modern Pathology.2022; 35(11): 1500. CrossRef

Review

Standardized pathology report for breast cancer: Soo Youn Cho, So Yeon Park, Young Kyung Bae, Jee Yeon Kim, Eun Kyung Kim, Woo Gyeong Kim, Youngmee Kwon, Ahwon Lee, Hee Jin Lee, Ji Shin Lee, Jee Young Park, Gyungyub Gong, Hye Kyoung Yoon; J Pathol Transl Med. 2021;55(1):1-15. Published online January 11, 2021; DOI: https://doi.org/10.4132/jptm.2020.11.20

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Abstract PDF Supplementary Material

Given the recent advances in management and understanding of breast cancer, a standardized pathology report reflecting these changes is critical. To meet this need, the Breast Pathology Study Group of the Korean Society of Pathologists has developed a standardized pathology reporting format for breast cancer, consisting of ‘standard data elements,’ ‘conditional data elements,’ and a biomarker report form. The ‘standard data elements’ consist of the basic pathologic features used for prognostication, while other factors related to prognosis or diagnosis are described in the ‘conditional data elements.’ In addition to standard data elements, all recommended issues are also presented. We expect that this standardized pathology report for breast cancer will improve diagnostic concordance and communication between pathologists and clinicians, as well as between pathologists inter-institutionally.

Citations

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Adenoid Cystic Carcinoma of Breast Associated With an Incidental Radial Scar: A Cyto‐Histopathology Correlation
Rallapalli Rajyalakshmi, Valasapalli Rajani, Tanuku Sreedhar, Kollabathula Arpitha
Diagnostic Cytopathology.2026;[Epub] CrossRef
Navigating discrepancies: The assessment of residual lymphovascular invasion in breast carcinoma after neoadjuvant treatment
Anikó Kovács, Åsa Rundgren-Sellei, Gunilla Rask, Annette Bauer, Anna Bodén, Johannes van Brakel, Eugenia Colón-Cervantes, Anna Ehinger, Johan Hartman, Balazs Acs
The Breast.2025; 82: 104519. CrossRef
Residual pure intralymphatic carcinoma component only (lymphovascular tumor emboli without invasive carcinoma) after neoadjuvant chemotherapy is associated with poor outcome: Not pathologic complete response
Hyunwoo Lee, Yunjeong Jang, Yoon Ah Cho, Eun Yoon Cho
Human Pathology.2024; 145: 1. CrossRef
Sentinel lymph node biopsy in patients with ductal carcinomain situ: systematic review and meta-analysis
Matthew G. Davey, Colm O’Flaherty, Eoin F. Cleere, Aoife Nohilly, James Phelan, Evan Ronane, Aoife J. Lowery, Michael J. Kerin
BJS Open.2022;[Epub] CrossRef

Brief Case Report

Collagenous Spherulosis Associated with Lobular Carcinoma In Situ of the Breast: Two Case Reports: Ga-Eon Kim, Nah Ihm Kim, Ji Shin Lee, Min Ho Park; J Pathol Transl Med. 2018;52(6):420-424. Published online March 29, 2018; DOI: https://doi.org/10.4132/jptm.2018.03.29

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Citations

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Immunohistochemical marker profiles for the differentiation of collagenous spherulosis from adenoid cystic carcinoma of the breast
Henriette L. Warm, Leonie D. Kandt, Nora Schaumann, Christopher Werlein, Malte Gronewold, Henriette Christgen, Malin Hellmann, Marcel Lafos, Bernd Auber, Peter Hillemanns, Hans Kreipe, Matthias Christgen
Human Pathology.2024; 148: 7. CrossRef
Collagenous Spherulosis in Benign Lichenoid Keratosis—Breaking the Monopoly of Breast Lesions
Anurag Sharma, Jeremy Brozyna, Daniel Knabel, Wilma F. Bergfeld
The American Journal of Dermatopathology.2020; 42(8): 620. CrossRef

Case Study

Metaplastic Carcinoma with Chondroid Differentiation Arising in Microglandular Adenosis: Ga-Eon Kim, Nah Ihm Kim, Ji Shin Lee, Min Ho Park; J Pathol Transl Med. 2017;51(4):418-421. Published online April 4, 2017; DOI: https://doi.org/10.4132/jptm.2016.10.06

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Abstract PDF

Microglandular adenosis (MGA) of the breast is a rare, benign proliferative lesion but with a significant rate of associated carcinoma. Herein, we report an unusual case of metaplastic carcinoma with chondroid differentiation associated with typical MGA. Histologically, MGA showed a direct transition to metaplastic carcinoma without an intervening atypical MGA or ductal carcinoma in situ component. The immunohistochemical profile of the metaplastic carcinoma was mostly similar to that of MGA. In both areas, all the epithelial cells were positive for S-100 protein, but negative for estrogen receptor, progesterone receptor, HER2/neu, and epidermal growth factor receptor. An increase in the Ki-67 and p53 labelling index was observed from MGA to invasive carcinoma. To the best of our knowledge, this is the first case of metaplastic carcinoma with chondroid differentiation arising in MGA in Korea. This case supports the hypothesis that a subset of MGA may be a non-obligate morphologic precursor of breast carcinoma, especially the triple-negative subtype.

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Two similar but distinct types of breast acinar cell carcinoma: evidence from histological, immunohistochemical and molecular features
Mingfang Sun, Lin Fu, Hongjiu Ren, Jian Wang, Xuyong Lin, Qingfu Zhang
Histopathology.2025; 87(6): 904. CrossRef
Elucidating the nature of acinic cell carcinoma of the breast with high-grade morphology: evidence from case report
Yunjie Ge, Xianping Wei, Jing-Nan Liu, Ping-Li Sun, Hongwen Gao
Diagnostic Pathology.2024;[Epub] CrossRef
New insights into acinic cell carcinoma of the breast: clinicopathology, origin of histology, molecular features, prognosis, and treatment
Yunjie Ge, Xianping Wei, Jing-Nan Liu, Ping-Li Sun, Hongwen Gao
Frontiers in Oncology.2024;[Epub] CrossRef
Metaplastic Matrix-Producing Carcinoma and Apocrine Lobular Carcinoma In Situ Associated with Microglandular Adenosis: A Unique Case Report
Nektarios Koufopoulos, Dionysios Dimas, Foteini Antoniadou, Kyparissia Sitara, Dimitrios Balalis, Ioannis Boutas, Alina Roxana Gouloumis, Adamantia Kontogeorgi, Lubna Khaldi
Diagnostics.2022; 12(6): 1458. CrossRef
Salivary gland-type mammary carcinoma arising in microglandular adenosis: A case report and clinicopathological review of the literature
Victoria Rico, Yukiko Shibahara, Marjorie Monteiro, Elzbieta Slodkowska, Samantha Tam, Pearl Zaki, Carlo De Angelis, Edward Chow, Katarzyna Joanna Jerzak
Cancer Treatment and Research Communications.2020; 24: 100178. CrossRef
Microglandular adenosis is an advanced precursor breast lesion with evidence of molecular progression to matrix-producing metaplastic carcinoma
Christopher J. Schwartz, Igor Dolgalev, Esther Yoon, Iman Osman, Adriana Heguy, Eleazar C. Vega-Saenz de Miera, Diana Nimeh, George Jour, Farbod Darvishian
Human Pathology.2019; 85: 65. CrossRef

Brief Case Report

Inflammatory Myofibroblastic Tumor of the Thyroid Gland: A Brief Case Report: Hye Jeong Kim, Jong In Na, Ji Shin Lee, Dong Hyeok Cho, Jin Seong Cho; Korean J Pathol. 2014;48(4):319-322. Published online August 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.4.319

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Novel ALK gene mutation in inflammatory myofibroblastic tumor of the thyroid: a case report
Yang Guangxu, Li Yao, Xie Jing, Liu Hongsheng
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Inflammatory myofibroblastic tumor of the thyroid gland
Yiyang Zhang, Jia Liu
Frontiers in Endocrinology.2023;[Epub] CrossRef
ALK-1-positive inflammatory myofibroblastic tumor of the thyroid complicated by Hashimoto’s thyroiditis: report of a rare case and a literature review
Cheng-fang Li, Xing-long Wu, Jin-jing Wang, Kai Wang, Su-yuan Zhang, Jia-jia Huang, Han-zhong Hu, Hong Zheng
Diagnostic Pathology.2020;[Epub] CrossRef
Plasma Cell Granuloma of the Thyroid: Review of an Uncommon Entity
Pallavi A. Patil, Ronald A. DeLellis
Archives of Pathology & Laboratory Medicine.2018; 142(8): 998. CrossRef

Case Reports

Melanotic Oncocytic Metaplasia of the Nasopharynx: A Report of Three Cases and Review of the Literature: Joo Young Na, Yeong Hui Kim, Yoo Duk Choi, Ji Shin Lee; Korean J Pathol. 2012;46(2):201-204. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.201

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Abstract PDF

Melanotic oncocytic metaplasia of the nasopharynx is a rare condition which is characterized by the presence of usually a small, brown to black colored pigmented lesion around the Eustachian tube opening. Although it is a benign lesion, it may be clinically misdiagnosed as malignant melanoma. Microscopically, melanotic oncocytic metaplasia is a combination of oncocytic metaplasia of the epithelium of the gland and melanin pigmentation in its cytoplasm. In our present study, we report three cases of melanotic oncocytic metaplasia of the nasopharynx. All the three cases occurred in men and were presented as multiple black pigmented lesions around the torus tubarius. Microscopically, mucous glands with diffuse oncocytic metaplasia and numerous black pigments were observed. No cellular atypia was observed. Immunohistochemically, the scattering of S-100 protein-positive, and human melanoma black 45-negative dendritic melanocytes was evident. This is the first report of cases of melanotic oncocytic metaplasia of the nasopharynx in Korea.

Citations

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A Case of Melanotic Oncocytic Metaplasia of the Nasopharynx
Yurino Nagata, Kazuaki Chikamatsu
Practica Oto-Rhino-Laryngologica.2025; 118(3): 195. CrossRef
Lesions that mimic malignant tumors in nasopharyngeal biopsies: case series of 10 years
Mine Ozsen, Ozlem Saraydaroglu, Selin Yirmibes, H. Hakan Coskun
Tumori Journal.2022; 108(2): 119. CrossRef
Melanotic Oncocytic Metaplasia of the Nasopharynx Seen as a Rare Form of Cystic Mass: A Case Report and Review of the Literature
Keun-Ik Yi, Yong-Wan Kim
Journal of Clinical Otolaryngology Head and Neck Surgery.2022; 33(1): 23. CrossRef
Melanotic Oncocytic Metaplasia of the Nasopharynx: A Case Report With Review of Literature
Hsing-Yu Chen, Mpendulo Felix Gule, I-Wei Chang
Ear, Nose & Throat Journal.2021; 100(5_suppl): 771S. CrossRef
Malignant Mucosal Melanoma of the Eustachian Tube With Extension Into the Ipsilateral External Ear Canal: A Case Report and Review of the Literature
Lifeng Li, Nyall R. London, Xiaohong Chen
Ear, Nose & Throat Journal.2021; 100(5_suppl): 730S. CrossRef
Melanotic oncocytic metaplasia of the nasopharynx: A case report discussing the pathogenesis of a lesion
Shina Sakaguchi, Hiromasa Takakura, Shin-ichi Hayashi, Akira Noguchi, Hirohiko Tachino, Hideo Shojaku, Johji Imura
Otolaryngology Case Reports.2021; 20: 100276. CrossRef
Oncocytic Cysts of the Nasopharynx: A Case Report
Joshua C. Hwang, Raj D. Dedhia, Joan E. Bernard, Toby O. Steele
Allergy & Rhinology.2020; 11: 215265672095659. CrossRef
Melanotic Oncocytic Metaplasia of the Nasopharynx in the Patient with Suspicious Hemoptysis: Case Report
Taek Yoon Cheong, Han Seong Kim, Ick Soo Choi
Journal of Rhinology.2020; 27(2): 140. CrossRef
Clinicopathological features of melanotic and non-melanotic oncocytic lesions of the nasopharynx
Joshua J.X. Li, Joanna K.M. Ng, Amy B.W. Chan
Pathology.2019; 51(6): 600. CrossRef
Melanotic oncocytic metaplasia of the nasopharynx
Keiichiro Uehara, Yu Usami, Yukihiro Imai, Michio Shimizu
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Exuberant Smooth Muscle Cells in Fibroadenoma of the Breast: A Case Report.: Ga Eon Kim, Young Kim, Eun Hui Jeong, Jo Heon Kim, Min Ho Park, Ji Shin Lee; Korean J Pathol. 2010;44(4):431-434.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.431

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Abstract PDF

Smooth muscle cell metaplasia is an extremely rare form of stromal differentiation in fibroadenomas. We describe a case of fibroadenoma with exuberant smooth muscle cells in a 72-year-old woman. The mass was located in the upper central portion of the left breast. It was well circumscribed and its greatest dimension was 3 cm. Histologically, the glandular elements resembled the appearance of fibroadenoma, but the stromal elements were composed of spindle cell bundles with abundant eosinophilic cytoplasm and elongated cigar-shaped nuclei. Neither mitotic activity nor cellular atypia was seen. The stromal cells were immunohistochemically positive for smooth muscle actin, calponin, desmin, and estrogen receptor-beta, but negative for CD34, S-100 protein, p63, CD10, estrogen receptor-alpha, progesterone receptor and cytokeratin. These results proved that the stromal cells showed features of smooth muscle cells.

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Fibroadenomatoid Hyperplasia of the Breast with Prominent Smooth Muscle Component: An Uncommon Histopathological Encounter
Seetu Palo, Divya Donepudi, Shrinivas Bheemrao Somalwar
Journal of Mid-life Health.2025; 16(2): 226. CrossRef
Unusual Myoid Differentiation in a Canine Benign Mixed Mammary Tumour
Barbara Brunetti, Luisa Vera Muscatello, Louis J. DeTolla, Giancarlo Avallone, Isabel Pires
Case Reports in Veterinary Medicine.2021; 2021: 1. CrossRef

Original Articles

Utility of Promoter Hypermethylation for Differentiating Malignant and Benign Effusions in Liquid-Based Cytology Specimens.: Ga Eon Kim, Jo Heon Kim, Yeong Hui Kim, Chan Choi, Ji Shin Lee; Korean J Pathol. 2010;44(3):315-321.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.315

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Abstract PDF

BACKGROUND
Making the cytologic differentiation between benign and malignant effusions can be difficult. Because promoter hypermethylation of tumor suppressor genes is a frequent epigenetic event in many human cancers, it could serve as a marker for the diagnosis of cancer. The aim of this study was to investigate the feasibility of detecting promoter hypermethylation as a diagnostic tool with using liquid-based cytology samples for differentiating between malignant and benign effusions.
METHODS
A multiplex, nested, methylation-specific polymerase chain reaction analysis was used to examine promoter methylation of 4 genes (retinoic acid receptor-beta, [RAR-beta], adenomatous polyposis coli [APC], Twist and high in normal-1 [HIN-1]) in malignant (n = 85) and benign (n = 31) liquid-based cytology samples.
RESULTS
The frequencies of hypermethylation of RAR-beta, APC, Twist and HIN-1 were significantly higher in the malignant effusions than in the benign effusions (p < 0.001 for each). On the receiver-operating characteristic analysis, the area under the curve (AUC) for APC was the greatest. The AUC for the best two-gene combination (APC/HIN-1) was not statistically different from the AUC for the best individual tumor suppressor gene (APC).
CONCLUSIONS
This study suggests that promoter methylation analysis on residual liquid-based effusion samples may be a feasible approach to detect malignant effusions, and that APC is the best marker for differentiating between malignant and benign effusions.

Citations

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A comparative analysis of conventional cytopreparatory and liquid based cytological techniques (Sure Path) in evaluation of serous effusion fluids
Hrishikesh Dadhich, Pampa Ch Toi, Neelaiah Siddaraju, Kalidas Sevvanthi
Diagnostic Cytopathology.2016; 44(11): 874. CrossRef

DNA Methylation Profiles of MGMT, DAPK1, hMLH1, CDH1, SHP1, and HIC1 in B-Cell Lymphomas.: Sung Sun Kim, Young Hyo Choi, Chang Woo Han, Yoo Duk Choi, Youngkyu Park, Je Jung Lee, Hyeoung Joon Kim, Il Kwon Lee, Ji Shin Lee, Sang Woo Juhng, Chan Choi; Korean J Pathol. 2009;43(5):420-427.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.420

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Abstract PDF

BACKGROUND
This study was designed to examine the prevalence of aberrant promoter methylation in a selected panel of genes potentially involved in lymphoid tumors.
METHODS
The promoter hypermethylation status of MGMT, DAPK1, hMLH1, CDH1, SHP1, and HIC1 was measured by methylation-specific PCR for 82 cases of B-cell lymphoma. Immunohistochemical staining using MGMT and SHP1 antibodies was conducted on 43 out of 82 cases.
RESULTS
The number of MGMT aberrant methylations was lower in diffuse large B-cell lymphoma (DLBCL) than in other malignant lymphomas. The methylation of DAPK1 was frequently detected in follicular lymphoma (FL), marginal zone B-cell lymphoma (MZL) and DLBCL. With one exception, methylation of hMLH1 was not observed in B-cell lymphomas. The methylation frequency of CDH1, and HIC1 was similar in B-cell lymphomas. However, the methylation of SHP1 gene was more frequently observed in cases of FL, DLBCL, and MZL than in chronic lymphocytic lymphoma. MGMT and SHP1 promoter methylation were inversely correlated with the protein expression observed upon immunohistochemical staining.
CONCLUSIONS
Aberrant promoter methylation of multiple genes occurs with variable frequency throughout the B-cell lymphomas, and methylation of hMLH1 is rarely observed in B-cell lymphomas.

Citations

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Plasma DNA methylation of p16 and shp1 in patients with B cell non-Hodgkin lymphoma
Kai Ding, Xiaoshuang Chen, Yihao Wang, Hui Liu, Wenjing Song, Lijuan Li, Guojin Wang, Jia Song, Zonghong Shao, Rong Fu
International Journal of Clinical Oncology.2017; 22(3): 585. CrossRef
Hypermethylation of p15 Gene in Diffuse – Large B‐Cell Lymphoma: Association with Less Aggressiveness of the Disease
Milena Krajnović, Maja Peruničić Jovanović, Biljana Mihaljević, Boško Anđelić, Olivera Tarabar, Slavica Knežević‐Ušaj, Koviljka Krtolica
Clinical and Translational Science.2014; 7(5): 384. CrossRef

Case Report

Cytologic Diagnosis of Malignant Pleural Effusion in Multiple Myeloma: Two Case Reports.: Yoo Duk Choi, Sung Sun Kim, Chang Woo Han, Ji Shin Lee, Jong Hee Nam, Sang Woo Juhng, Chan Choi; Korean J Pathol. 2009;43(4):382-385.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.382

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Abstract PDF

Malignant pleural effusion in multiple myeloma (MM) is extremely rare and is associated with poor prognosis. We experienced two cases of MM IgA type with malignant pleural effusion. The diagnoses were based on characteristic cytology and CD138 immunocytochemistry. The patients received several cycles of combination chemotherapy, since symptoms were more aggressive with an uncontrolled pleural effusion. We review the clinical features of these cases and literature concerning myelomatous pleural effusion.

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Myelomatous pleural effusion: A rare case in posttransplant myeloma
Sudha Madhuri Kandikanti, Poojitha Reddy Byreddy
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V. Riveiro, L. Ferreiro, M.E. Toubes, A. Lama, J.M. Álvarez-Dobaño, L. Valdés
Revista Clínica Española.2018; 218(2): 89. CrossRef
Characteristics of patients with myelomatous pleural effusion. A systematic review
V. Riveiro, L. Ferreiro, M.E. Toubes, A. Lama, J.M. Álvarez-Dobaño, L. Valdés
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Original Articles

Analysis of HPV-other Samples by Performing HPV DNA Sequencing.: Yoo Duk Choi, Chang Woo Han, Woon Jae Chung, Woon Won Jung, Ji Shin Lee, Jong Hee Nam, Min Cheol Lee, Sang Woo Juhng, Ho Sun Choi, Chang Soo Park; Korean J Pathol. 2009;43(3):250-253.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.250

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Abstract PDF

BACKGROUND
HPV-other samples are designated as being positive on HPV-PCR, but negative when using specific HPV hybridization probes. We wanted to determine the types on the HPV-other samples by performing sequencing, and to know the pathologic status of the uterine cervix according to the HPV type detected on sequencing.
METHODS
For HPV genotying, we used the commercially available HPV DNA Chip test, which contains 15 types of high-risk HPV and 9 types of low-risk HPV. The HPV DNA sequencing was performed for the HPV-other samples of 209 patients who subsequently underwent cervical biopsy.
RESULTS
For 204 of the 209 samples, the HPV types detected by sequencing were absent types at used HPV DNA chip. For the remaining 5 samples, sequencing was impossible due to mixed peaks. HPV-81 (19.6%), HPV-61 (18.6%), HPV-62 (16.7%) and HPV-84 (13.9%) were frequently detected. For the HPV-81, -62, -71, and -72 samples, most of the samples displayed normal or LSIL. However, HPV-84 and -61 were more associated with HSIL or worse, as compared to the other types.
Conclusion
HPV-81, -61, -62 and -84 were frequently found on sequencing analysis of the HPV-other samples. The pathologic status was diverse, according to the HPV type detected on sequencing.

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Changes in microbial composition and interaction patterns of female urogenital tract and rectum in response to HPV infection
Yong-Hong Dong, Yu-Hua Luo, Chen-Jian Liu, Wen-Yu Huang, Lin Feng, Xing-Yuan Zou, Jin-Yan Zhou, Xiao-Ran Li
Journal of Translational Medicine.2024;[Epub] CrossRef
Cervical Dysplasia, Infection, and Phylogeny of Human Papillomavirus in HIV‐Infected and HIV‐Uninfected Women at a Reproductive Health Clinic in Nairobi, Kenya
Agnes Omire, Nancy L. M. Budambula, Leah Kirumbi, Hillary Langat, Danvas Kerosi, Washingtone Ochieng, Raphael Lwembe, Jorge F. Quarleri
BioMed Research International.2020;[Epub] CrossRef
Molecular characterisation of genital human papillomavirus among women in Southwestern, Nigeria
Yewande T. Nejo, David O. Olaleye, Georgina N. Odaibo, Jason Blackard
PLOS ONE.2019; 14(11): e0224748. CrossRef
Sequencing analysis of HPV-other type on an HPV DNA chip
Min-Jeong Kim, Jin Ju Kim, Sunmie Kim
Obstetrics & Gynecology Science.2018; 61(2): 235. CrossRef
Molecular epidemiology and genotype distribution of Human Papillomavirus (HPV) among Arab women in the state of Qatar
Devendra Bansal, Asha A Elmi, Sini Skariah, Pascale Haddad, Laith J Abu-Raddad, Aysha H Al Hamadi, Nady Mohamed-Nady, Nahla M Affifi, Randa Ghedira, Elham Hassen, Asma AJ Al-Thani, Afaf AHM Al-Ansari, Ali A Sultan
Journal of Translational Medicine.2014;[Epub] CrossRef
HPV Prevalence and Detection of Rare HPV Genotypes in Hong Kong Women from Southern China with Cytological Abnormalities
Ngai Na Chloe Co, Lai-On Chu, Joseph K. F. Chow, Joseph W. O. Tam, Enders K. O. Ng
ISRN Virology.2013; 2013: 1. CrossRef
Type-specific prevalence of high-risk human papillomavirus by cervical cytology and age: Data from the health check-ups of 7,014 Korean women
Min-Jeong Kim, Jin Ju Kim, Sunmie Kim
Obstetrics & Gynecology Science.2013; 56(2): 110. CrossRef

The Study of Proliferating Cell Nuclear Antigen in Colorectal Carcinoma.: Ho Soo Choi, Bok Soog Yang, Ji Shin Lee, Min Cheol Lee; Korean J Pathol. 1995;29(3):311-320.

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Abstract PDF: The determination of proliferative activity in the colorectal mucosa has been used for different purposes as the estimation of cancer risk and the assessment of disease activity in ulcerative colitis. But the prognostic significance of proliferative activity in colorectal carcinomas remains controversial. To investigate the prognostic significance of proliferative activity in colorectal carcinomas, the author estimated the proliferative activity immunohisto chemically using the monoclonal antibody PCNA and compared with clinicopathological data in 62 colorectal carcinomas. The results were as follows: 1) The reactivity of PCNA was more pronounced at the infiltrative margins of the tumors and tumor cells within the vascular or lymphatic channels. 2) The mean PCNA index of colorectal carcinomas was 40.5?0.4%. PCNA indices had positive correlations with lymph node invasion(p<0.05), liver, metastasis(p<0.05), Dukes' stage(p<0.01) and TNM classification(p<0.01), and didn't correlated with location of tumor, size of tumor, histological type and lymphtic or vascular invasion. 3) The patients with high PCNA index(more than 45%) represented higher recurrence or metastasis rate(37.5%) than those with low PCNA index (less than 45%)(19.3%) in Dukes B or C colorectal carcinomas during the follow-up periods, but not significant statistically. These results suggested that the reactivity of PCNA may be a useful prognostic factors in colorectal carcinomas.

Case Report

Invasive Lobular Carcinoma of the Breast Associated with Mixed Lobular and Ductal Carcinoma In Situ: A Case Report.: Ji Shin Lee, Hyung Seok Kim, Jong Jae Jung, Young Bog Kim, Dong Sug Kim; Korean J Pathol. 2001;35(1):89-91.

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Abstract PDF: Mixed lobular and ductal carcinoma in situ is very rare. We recently experienced a case of invasive lobular carcinoma associated with mixed lobular and ductal carcinoma in situ in a 50-year-old female. The infiltrating portions of lobular carcinoma revealed thread-like strands of tumor cells. Lobular carcinoma in situ with pagetoid spread into the ducts and ductal carcinoma in situ of the predominantly papillary type were also noted in the same mass.

Original Articles

An Immunohistochemical Study of Angiogenesis in Tumor Emboli.: Jo Heon Kim, Chan Choi, Jae Hyuk Lee, Ji Shin Lee, Sung Sun Kim, Chang Woo Han, Sang Woo Juhng; Korean J Pathol. 2007;41(4):252-257.

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Abstract PDF: BACKGROUND
Angiogenesis, which is essential for tumor growth, is known to occur in the extravascular stroma. However, vascular structures were noted in intravascular tumor emboli in surgical specimens. This prompted our investigation of the frequency and morphology of angiogenesis in tumor emboli.
METHODS
Hematoxylin-eosin stained specimens were reviewed for tumor emboli, in 21 cases of stomach adenocarcinoma and 22 cases of colon adenocarcinoma. The cases were examined with immunohistochemistry using antibodies against epithelial antigen (cytokeratin), endothelial antigens (CD31, CD34), lymphatic endothelial antigen (D2-40), and proliferation-associated antigen (MIB1).
RESULTS
Endothelial cells were observed in 16 tumor emboli among four (19.1%) of the 21 cases of stomach adenocarcinoma and in 32 tumor emboli among four (18.2%) of the 22 cases of colon adenocarcinoma. The endothelial cells in the tumor emboli showed papillary ingrowth from the vessel wall, formation of vascular lumens, scattered distribution, or surface coating of the emboli. Some of the endothelial cells in the tumor emboli were D2-40-positive, and some were MIB1- positive.
CONCLUSIONS
These findings demonstrated that angiogenesis occurs in intravascular tumor emboli as well as in the extravascular stroma. Angiogenesis in the tumor emboli may reflect an active process and may facilitate tumor growth.

An Image Analytical Study on the Structural Spectrum of Intestinal Metaplasia-Dysplasia-Carcinoma of the Stomach.: Sang Woo Juhng, Dong Ha Park, Ji Shin Lee, Kyu Hyuk Cho; Korean J Pathol. 1993;27(1):50-57.

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Abstract PDF: Intestinal metaplasia and dysplasia of the stomach have been stressed as precursors of gastric carcinoma of the intestinal type, although their preneoplastic nature is still debated. In this study, the cytomorphometric and cytokinetic spectra of the suggested preneoplastic and neoplastic lesions of the stomach were investigated. From the resected stomachs of early gastric carcinoma of intestinal type, areas of normal, intestinal metaplasia, dysplasia, and carcinoma were selected. They were immunostained for proliferating cell nuclear antigen, counterstained with propidium iodide, and various nuclear parameters were measured by image analysis. Normal and intestinal metaplastic mucosae differed by the localization of proliferation zone, but not by nuclear profile area, circular shape factor, and proliferation index. In dysplasia, proliferation zone covered large parts of the dysplastic area. Nuclear profile area and proliferation index were larger whereas circular shape factor was smaller than in normal or intestinal metaplasia. Carcinomatous lesion had diffuse proliferation activity, the largest nuclear profile area and proliferating index, and circular shape factor in-between those of normal or intestinal metaplasia and dysplasia. The above results showed a structural spectrum among normal of intestinal metaplasia, dysplasia, and carcinoma of intestinal type in cytomorphometric and cytokinetic terms. The structural spectrum raises the possibility that dysplasia of the stomach is a preneoplastic lesion.

DNA ploidy and Cellular Proliferation Activity in Experimentally Induced Malignant Fibrous Histiocytoma.: Ji Shin Lee, Jong Tae Park, Sang Woo Juhng, Hong Ran Choi, Kyu Hyuk Cho; Korean J Pathol. 1993;27(3):205-216.

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Abstract PDF: To fine out the changes of DNA ploidy and cellular proliferation activity during carcinogenesis and evaluate correlation between flow cytometrically determined S-phase fraction and proportion of proliferation cell nuclear antigen(PCNA, PC10) immunoreactive cells, the authors studied on malignant fibrous histocytoma induced by intra-articular injection of 9, 10-dimethy1-1, 2-benzanthracene(DMBA) in the rats. Forty Wistar rats were used. The results obtained were as follows. 1) Firstly, tumors were palpated 5 weeks after the last injection of DMBA and formed in 27 rats at sacrificed. Histologically, these lesions showed storiform, indicative of malignant fibrous histiocytoma. 2) Three cases of DNA aneuploidy were observed at 4 and 5 months after the last injection of DBMA and one of them, which was DNA diploidy at main mass, was found at daughter mass. 3) Flow cytometrically determined S-phase fraction and proportion of PCNA(PC10) immunoreactive cells in malignant fibrous histiocytoma induced by DMBA were much higher than in control groups and slightly increased according to sequential changes after formation of mass. The comparison of flow cytometrically determined S-phase fraction and proportion of PCNA(PC10) immunoreactive cells showed significant correlation(r=0.6092, p<0.001). Above results strongly suggest that ploidy pattern may evolve into aneuploid type during the development of tumor and proliferation activity increases during the carcinogenesis.

Correlation between Expression of c-erbB-2 Oncogene and Various Prognostic Factors in the Colorectal Carcinoma.: Wan Kim, Hong Ran Choi, Ji Shin Lee, Jong Tae Park, Chang Soo Park, Kyu Hyuk Cho; Korean J Pathol. 1993;27(3):217-225.

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Abstract PDF: The c-erbB-2 oncogene, which is a new human proto-oncogene similar to EGFR structurally, generates a glycoprotein of tyrosine kinase family with a molecular weight of 185,000 To evaluate the prognostic significance of c-erbB-2 oncogene expression in colorectal carcinoma, We analysed 73 colorectal carcinomas in paraffin sections immunohistochemically, using the monoclonal antibody specific for the c-erbB-2 oncogene product and correlated with clinicopathological data. The results were as follows 1) The immunoreactivity for c-erbB-2 oncogene was localized to cell membrane of the tumor cells and occasionally observed within the cytoplasm. 2) The positivity of c-erbB-2 oncogene expression was 71.2%(52/73) of the colorectal carcinomas overall. According to the histological types, the positivity of c-erbB-2 oncogene in adenocarcinoma(77.4%) was higher than that in mucinous carcinoma(36.4%)(p<0.05). 3) Expression of c-erbB-2 oncogene was significantly correlated with lymph node metastasis or distant metastasis(p=0.0117), Dukes stage(p=0.0432), and TNM classification(p=0.0102). These results suggest that c-erbB-2 oncogene expression may be used as a prognostic factor of colorectal carcinoma because of its correlation with other clinicopathological prognostic factors.

Case Report

Infantile Hemangioendothelioma of the Liver: Brief case report.: Hyang Jeong Jo, Ki Jung Yun, Jae Kyu Lee, Ji Shin Lee, Hyung Bae Moon; Korean J Pathol. 1997;31(6):586-588.

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Abstract PDF: Infantile hemangioendothelioma of the liver is a common vascular tumor in infancy. The tumor is usually multinodular or diffuse and classified into two types. We present a case of infantile hemangioendothelioma of the liver, which predominantly consists of type 2. A 4-month-old female was admitted for an evaulation of an abdominal distension. A CT scan of the liver showed a multinodular mass. The right lobectomy was done. Grossly, the mass consisted of round nodules ranging from 2cm to 5cm in diameter. Microscopically, the tumor revealed proliferation of small vascular channels lined by endothelial cells. Bizarre cells and mitotic cells were frequently noted. Vesicular nuclei and multilayering of the endothelial cells were also noted.

Original Article

A Study on the Expression of p53 Oncogene Products, PCNA Index and DNA Ploidy in Renal Cell Carcinoma.: Jong Jae Jung, Ji Shin Lee, Chan Choi; Korean J Pathol. 1997;31(7):672-682.

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Abstract PDF: Mutant p53 is associated with the advanced stages of some human tumor but there is a wide variation in the reported incidence of p53 mutation in renal cell carcinoma and its prognostic significances. We designed this study to assess the expression of p53 in renal cell carcinomas and to compare with the established prognostic factors. Immunoreactivity for p53 protein and proliferating cell nuclear antigen (PCNA) were assessed in 44 cases of primary renal cell carcinoma, and flow cytometric analysis of DNA ploidy was perfon-ned in 37 of those cases. p53 protein was over-expressed in 16/44 (36.4%) renal cell carcinomas and 5 rumors had more than 10 immunoreactive tumor cells. The expression of p53 protein was positively related to nuclear grade (p=0.007) and PCNA index (p=0.002), but was independent of stage and DNA ploidy. In univariate survival analysis, stage (p<0.001), nuclear grade (p=0.017), DNA ploidy (p=0.045) and PCNA index (p<0.001) were significantly associated with patient survival. However, considering the stage, all of the last three factors had no prognostic influence. Cases showing strong positivity of p53 expression had worse prognosis than those with no or weak p53 expression, especially in early lesions (stage I,II) (p<0.001).

Case Reports

Recurrent Malignant Phyllodes Tumor with Liposarcoma.: Ji Shin Lee, Hyung Seok Kim, Jong Jae Jung, Chong Dug Cho; Korean J Pathol. 2001;35(6):558-560.

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Abstract: Phyllodes tumors are an uncommon mammary tumors composed of benign epithelial elements and cellular, spindle cell stroma. Adipose differentiation is an uncommon stromal alteration in phyllodes tumors. Herein, a case of recurrent phyllodes tumors with liposarcomatous stroma is described. A 30-year-old female presented with a left breast mass. Histologic examination showed a phyllodes tumor with low-grade malignant potential exhibiting a few mitoses and moderate cellularity. It also contained mature adipose tissue as well as a well-differentiated liposarcomatous area. This tumor recurred 43 months later. The recurrent tumor had a higher cellular density and more mitoses than the primary tumor.

Fine Needle Aspiration Cytology of Tubulolobular Carcinoma of the Breast: A Case Report.: Ji Shin Lee, Young Bog Kim; J Pathol Transl Med. 2002;13(2):84-87.

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Abstract PDF: Tubulolobular carcinoma is a tumor of the breast that shares histologic features of both tubular and lobular carcinoma of the breast. The cytologic features of this neoplasm have not been reported in Korea. We described a case of tubulolobular carcinoma diagnosed by fine needle aspiration cytology in a 46-year-old female. The tumor contained several cytologic features of both tubular and lobuar carcinoma, including tubular structures, single filing of cells, intracytoplasmic vacuoles, and low nuclear grade.

Fibromatosis of the Breast: A Case Report.: Hyun Joong Kim, Kyung Hwa Lee, Jo Heon Kim, Min Keun Shim, Ji Shin Lee, Chan Choi; Korean J Pathol. 2005;39(2):137-139.

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Abstract PDF: Fibromatosis of the breast is a rare tumor. We describe here a case of mammary fibromatosis in a 37-year-old woman. The mass from the right breast was 3 cm at the greatest dimension. The lesion was poorly circumscribed, firm and white-gray on the cut surface. Histologically, the lesion infiltrated into the lobules of the breast, and the tumor was composed of relatively uniform fibroblasts and collagen. Neither mitotic activity nor cellular atypia was seen. On the immunohistochemistry, the cells were positive for vimentin and they were focally positive for smooth muscle actin. Staining results for estrogen receptor and progesterone receptor were negative.

Original Articles

Tumor Angiogenesis in Renal Cell Carcinoma.: Ji Shin Lee, Jong Jae Jung, Chang Soo Park; Korean J Pathol. 1999;33(11):1055-1060.

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Abstract PDF: Angiogenesis is essential for the growth of solid tumors. Microvessel counts, which represent a measure of tumor angiogenesis, have been correlated with the overall survival of patients with a variety of malignancies. However, the significance of angiogenesis in renal cell carcinoma remains controversial. To determine whether angiogenesis correlates with prognosis of patients with renal cell carcinoma, we counted the microvessels within the primary tumors and compared their numbers with patients' prognosis. Tumor specimens from 42 patients were investigated. Microvessels were stained with anti-CD34 and anti-factor VIII-related antigen monoclonal antibodies. Significant correlation between microvessel counts for two antibodies was observed (r=0.875, p<0.01), although microvessel counts for CD34 were approximately two times higher. Microvessel counts were higher in clear cell than in non-clear cell carcinoma (p<0.05). These results suggest that immunostaining with anti-CD34 antibody may provide a more sensitive and accurate measure of tumor angiogenesis. There was no correlation between microvessel counts and nuclear grade, or TNM stage. In univariate analyses, nuclear grade and TNM stage were significantly associated with patient survival (p<0.01). But further studies on tumor angiogenesis of renal cell carcinoma are needed before it can be adopted as a prognostic marker.

Fine Needle Aspiration Cytology of Anaplastic Carcinoma with Osteoclastlike Giant Cells of the Thyroid.: Ji Shin Lee, Hyang Mi Ko, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; J Pathol Transl Med. 1994;5(2):172-175.

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Abstract PDF: Anaplastic carcinoma of the thyroid is one of the most malignant tumors and survival for longer than three years after diagnosis is exceptional. Multinucleated giant cells of osteoclastlike appearances are seen in some of the anaplastic carcinoma, but only three cases in which the diagnosis was made by fine needle aspiration(FNA) cytology are reported in the international literature. We experienced a case of anaplastic carcinoma with osteoclastlike giant cells in a 66-yr-old female, diagnosed by FNA cytology. The smears revealed two cell populations; multinucleated giant cells and large polygonal or spindle shaped malignant cells. The FNA cytodiagnosis of anaplastic thyroid carcinoma containing osteoclastilke giant cells was substantiated by subsequent biopsy.

A Case of Orbital Meningioma Diagnosed by Fine Needle Aspiration Biopsy.: Ji Shin Lee, Kyung Soo Kim, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; J Pathol Transl Med. 1994;5(2):176-179.

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Abstract PDF: Orbital meningioma is a rare neoplasm that, even when suspected by CT or echographic examination, requires careful histologic study for precise identification. Fine needle aspiration(FNA) biopsy has become the diagnostic technique of choice in recent years for investigating orbital masses. There have been a few previous reports on FNA biopsy of orbital menigioma. We experienced a case of orbital meningioma in a 11-yr-old boy, diagnosed by FNA biopsy. The cytohistologic features of aspirated material(intranuclear inclusions. psammoma bodies, and cells arranged in whorls) made it easy to diagnose a meningioma.

Case Report

Fine Needle Aspiration Cytology of Primay Malignant Lymphoma of the Breast: A Case Report.: Hyun Joong Kim, Kyung Hwa Lee, Jo Heon Kim, Min Keun Shim, Ji Shin Lee, Chan Choi; J Pathol Transl Med. 2004;15(2):112-115.

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Abstract PDF: Lymphoproliferative disorders, manifesting either as a primary lesion or as part of a generalized process, rarely involve the breast. The primary malignant lymphoma of the breast is rare. The cytologic features of this neoplasm have not been reported in Korea thus far. We described a case of primary malignant lymphoma of the breast, as diagnosed by fine needle aspiration cytology (FNAC) in an 84-year-old female. FNAC smears showed high cellularity. The main cytologic feature observed was a carpeting of monotonous, atypical, enlarged lymphoid cells. These lymphocytes showed relatively round elliptical nuclei with some indentation. One or more prominent nucleoli were seen. Biopy from the breast mass revealed diagnostic features of non-Hodgkin's lymphoma, diffuse large B-cell type.

Original Article

DNA Ploidy in Anaplastic Carcinoma of the Thyroid Gland by Image Analysis.: Ji Shin Lee, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; J Pathol Transl Med. 1995;6(1):10-17.

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Abstract PDF: Anaplastic carcinoma of the thyroid gland is one of the most malignant tumors. Recently, DNA ploidy measured by flow cytometry and image analysis has been suggested as an additional useful indicator of tumor behavior. Studies on the occurrence and clinical significance of DNA aneuploidy in anaplastic carcinoma of the thyroid are rare. In this study, the pattern of DNA ploidy was measured by image analysis on Papanicolaou stained slides in four cases of anaplastic carcinoma and also measured by flow cytometry using paraffin blocks in two cases. In all cases of anaplastic carcinoma. DNA aneuploidy was found by image analaysis. By flow cytometry, one case had a diploid peak and the other case had an arieuploid peak. According to the above results, we conclude that anaplastic carcinoma of the thyroid glands have a high incidence of DNA aneuploidy and image analysis using Papanicolaou stained slides is a useful method in detecting DNA aneuploidy.

Case Reports

Cytopathologic Features of Primary Bronchial Adenoid Cystic Carcinoma: A Case Report.: Ji Shin Lee, Jong Soon Kim, Bok Sook Yang, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; J Pathol Transl Med. 1995;6(1):67-70.

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Abstract PDF: Adenoid cystic carcinoma arising from the submucosal glands of the trachea and bronchial tree is rare. The histopathology and natural history of bronchial adenoid cystic carcinoma have been well documented, but detailed descriptions of its cytomor- phology are few. We report a case of primary bronchial adenoid cystic carcinoma in a 20-year-old female, diagnosed by bronchial brushing cytology. The cytologic specimens showed large clusters of small cells arranged around cystlike spaces containing globular basophilic material.

Fine Needle Aspiration Cytology of Parapharyngeal Ganglioneuroma: A Case Report.: Ji Shin Lee, Hyang Jeong Cho, Ki Jung Yun, Hyung Bae Moon; J Pathol Transl Med. 1995;6(2):179-182.

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Abstract PDF: Ganglioneuromas are a fully differentiated tumor that contains no immature elements. The majority of ganglioneuromas are diagnosed in patients older than 10 years and are most often located in the posterior mediastinum, followed by the retroperitoneum. The location of these tumors in the parapharyngeal region is extremely uncommon and there are only a few reports on the cytologic appearance of the tumor. We report a case of ganglioneuroma presenting in a parapharyngeal location in a 4 year-old boy, diagnosed by fine needle aspiration cytology. The smears revealed scattered large oval to polygonal cells with voluminous, granular cytoplasms. The nuclei were one to two in number and had a prominent nucleolus. Clusters of benign spindie-shaped cells were also present.

Thyroid Papillary Carcinoma with Exuberant Nodular Fasciitis-like Stroma: A Case Report.: Kyung Hwa Lee, Jae Hun Chung, Jung Han Yoon, Kyung Whan Min, Chan Choi, Ji Shin Lee; Korean J Pathol. 2006;40(1):76-79.

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Abstract PDF: Thyroid papillary carcinoma (TPC) with exuberant nodular fasciitis-like stroma is one of the rare variants of TPC. To date, only 19 cases have been reported in the English medical literature. We report here on the the first Korean case of TPC that contained a prominent nodular fasciitis-like stroma. A 40-year-old female presented with a hard painless right neck mass that had been present for two months. Total thyroidectomy disclosed a solitary nodule in the mid portion of the right lobe that measured 25 x 20 mm. The tumor was well delineated, but it was not encapsulated. Microscopically, the tumor was a typical papillary carcinoma except that large areas of the tumor were occupied by a stroma composed of irregular fascicular spindle cells. The stromal component accounted for 60% of the tumor mass. The spindle cells exhibited neither atypism nor mitosis, and the tumor's extensive stromal cell proliferation resembled the appearance of nodular fasciitis of the soft tissues. Immunohistochemically, the spindle cells were positive for vimentin and alpha-smooth muscle actin, but they were negative for thyroglobulin, thyroid transcription factor-1, S-100 protein, CD34 and desmin, and this represents myofibroblastic features.

Original Articles

The Study of Proliferating Cell Nuclear Antigen (PCNA) Reactivity in Fibrohistiocytic Tumors.: Jae Hyuk Lee, Yong Han Park, Hyang Mi Ko, Ji Shin Lee, Chang Soo Park; Korean J Pathol. 1994;28(4):350-357.

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Abstract PDF: Fibrohistiocytic tumors are a diverse group of benign and malignant soft tissue lesions, including dermatofibroma, dermatofibrosarcomaprotuberans, and malignant fibrous histiocytoma. On the clinical point of view, the distinction between benign and malignant lesions and malignancy grading is far more important. Therefore, we investigated 23 fibrohistiocytic tumors, using PCNA (PC10) which was a useful marker of proliferating activity, to differentiate the benign lesions from the malignant and correlate with other prognostic factors including tumor necrosis. cellularity, histologic grade, and mitotic counts. The results obtained were as follows 1) Positive tumor cells were clearly identified by the characteristic diffuse or granular nuclear staining. 2) The number of PCNA-positive tumor cells were 2.16+/-2.39% in dermatofibroma, 16.12+/-7.38% in dermatofibrosacoma protuberans, and 28.02+/-17.47% in the malignant fibrous histiocytoma. The numbers of PCNA-positive tumor cells in the malignant lesions higher than in the benign (p<0.001). 3) Deep seated, large size (>5 cm) and recurred or metastatic cases of MFH were more the high PCNA index (more than 20%) than the low index (less than 20%) groups. 4) PCNA index in MFHs had positive correlation with the number of mitotic counts (r=0.7582, p<0.001), cellularity (r=0.5908, p<0.05) and histologic grade (r=0.4164, p<0.05). These results suggested that reactivity on PCNA might assist in the distinction between benign and malignant lesions in fibrohistiocytic tumors, and could be a useful prognostic factor in the patients with malignant fibrous histiocytoma.

Epidermal Growth Factor Receptor Expression and Cell Proliferation in Renal Cell Carcinoma.: Ji Shin Lee, Jong Jae Jung, Min Cheol Lee, Chang Soo Park; Korean J Pathol. 2000;34(4):273-279.

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Abstract PDF: The epidermal growth factor receptor (EGFR) is a transmembrane glycoprotein whose expression is a possible cause of increased tumor cell proliferation and has recently been proposed as a prognostic parameter in some tumors. Expression of EGFR was studied immunohistochemically in 62 cases of human renal cell carcinomas to evaluate their possible prognostic roles. We also examined the correlation between EGFR expression and cell proliferation by immunohistochemical staining for proliferating cell nuclear antigen (PCNA). Fifty-six cases (90.3%) expressed EGFR, with staining largely confined to the cell membrane and cytoplasm. Staining intensity of EGFR was directly correlated with nuclear grade (p=0.000) and TNM stage (p=0.015). PCNA index was significantly higher in EGFR-positive tumors than in EGFR- negative tumors. There was a statistically significant positive correlation between PCNA index and increasing staining intensity of EGFR (p=0.000). In univariate survival analysis, EGFR expression was significantly associated with shortened survival. However, EGFR expression was not an independent prognostic factor by multivariate analysis. These findings suggest that EGFR expression may be an important cause of tumor cell proliferation in renal cell carcinoma and further studies are needed to evaluate whether EGFR expression analysis provides independent prognostic information.

Case Report

Pseudosarcomatous Metaplastic Carcinoma of the Breast with Extensive Cystic Change: A case report.: Ji Shin Lee, Jong Jae Jung, Dong Sug Kim; Korean J Pathol. 2000;34(4):314-317.

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Abstract PDF: Metaplastic carcinomas (carcinomas with metaplasia) of the breast are difficult to accurately diagnose and classify because of their rarity and varied histologic patterns. Cystic change can be encountered in mammary carcinoma, especially in carcinoma with squamous metaplasia, but are rare in pseudosarcomatous metaplastic carcinoma. We recently experienced a case of pseduosarcomatous metaplastic carcinoma in a 69-year-old female who had an extensive cystic change in radiologic and histopathologic findings. The precise cell type that gives rise to metaplastic carcinomas remains uncertain. Immunohistochemical findings raised the possibility of the myoepithelial nature of the tumor.

Original Article

The Study of p53 Expression and DNA Ploidy in Colorectal Carcinoma.: Ji Shin Lee, Kwang Soo Cheon, Chang Soo Park; Korean J Pathol. 1996;30(9):775-783.

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Abstract PDF: Mutation of the p53 gene frequently results in overexpression of the p53 protein and loss of its tumor-suppressing properties. The overexpression of the p53 gene could be an indicator of rapid proliferation, poor differentiation, advanced stages, or poor prognosis. The prognostic value of the overexpression of the p53 gene in colorectal carcinoma is equivocal. The presence of DNA aneuploidy has been described as a powerful adverse prognostic indicator in relation to survival. To investigate the prognostic significance of p53 expression, and the relationship with DNA ploidy, 92 cases of colorectal carcinomas were analyzed. The overexpression of p53 gene product was present in 50(54.4%) of 92 cases. p53 expression only correlated with recurrence or metastasis during the follow-up periods (p=0.045). DNA aneuploidy was observed in 32(39.1%) of 82 cases. DNA ploidy was strongly associated with lymph node invasion(p=0.005), Dukes' stage(p=0.003), TNM classification (p=0.003), and recurrence or metastasis during the follow-up periods (p=0.045). The frequency of DNA aneuploidy was higher in the p53-positive colorectal carcinomas(58.3%) than in the p53-negative colorectal carcinomas (21.6%) (p=0.003). p53-positive colorectal carcinomas had a higher rate of cell proliferation than p53-negative cases(p<0.001). These results suggest that checking the p53 expression and DNA ploidy could be useful prognostic indicators of colorectal carcinoma.

Case Report

Cystic Adenomyoepithelioma of the Breast: A Case Report.: Ji Shin Lee, Myung Sook Choi; Korean J Pathol. 2003;37(2):134-136.

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Abstract PDF: Adenomyoepithelioma of the female breast is a rare tumor. With rare exceptions, the tumor is uniformly solid. We describe a large grossly cystic adenomyoepithelioma in a 67-year-old female. The tumor was histologically benign. The characteristic microscopic finding was the proliferation of rounded tubules lined by both epithelial and myoepithelial cells. Immunohistochemical findings confirmed the presence of two cell population.

Original Article

Diagnostic Value of Flow Cytometric DNA Analysis in the Evaluation of Effusions .: Ji Shin Lee, Sang Woo Juhng; J Pathol Transl Med. 1997;8(1):20-26.

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Abstract PDF: The specificity of cytologic examination in effusions is high but the sensitivity is low. Therefore, various ancillary methods for the detection of malignant cells in effusions have been proposed. The presence of an aneuploid cell population is generally considered diagnostic of malignancy. The purpose of this study is to determine whether the routine use of flow cytometry adds to standard cytologic evaluation in effusions. We did flow cytometric DNA analysis in 76 effusions(28 malignant and 48 benign fluids). All the 48 benign effusions were diploid. There were 12(42.9%) aneuploid and 16(67.1%) diploid malignant effusions. Based on these results flow cytometric DNA analysis had a sensitivity of 42.9% and a specificity of 100%. These results suggest that flow cytometric DNA analysis may be a useful adjunct to conventional cytology, but its principal limitation is its relatively low sensitivity.

Case Reports

Fibroadenoma with Formation of Epidermal Cyst: A case report.: Jong Jae Jung, Ji Shin Lee, Seung Hyun; Korean J Pathol. 2000;34(7):537-539.

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Abstract PDF: Epidermal cyst in the fibroadenoma of the breast is very rare. A 29-year-old woman presented with a lump in the upper outer quadrant of the right breast. Clinically it was a fibroadenoma and the excisional specimen showed an encapsulated, firm lobulated lesion with a cystic area on cut surface. The cystic area showed squamous metaplasia of the ductal epithelium and keratinous cyst formation in the fibroadenoma. We report this unusual case with review of literatures.

Dedifferentiated Liposarcoma with a Peculiar Whorling Pattern: A Case Report.: Ji Shin Lee, Young Bog Kim; Korean J Pathol. 2003;37(5):362-364.

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Abstract PDF: A dedifferentiated liposarcoma is a uncommon neoplasm characterized by the coexistence of a well-differentiated liposarcoma and non-lipogenic sarcomas. A peculiar neural-like or meningothelial-like whorling pattern of dedifferentiation has recently been reported. We report a case of dedifferentiated liposarcoma with a peculiar whorling pattern in the scrotum of a 76-year-old man. Histologically, the tumor consisted of areas of a well differentiated liposarcoma admixed with areas of a morphologically non-lipogenic sarcoma. The whorls were scattered throughout the tumor. The cells in the whorls and dedifferentiated area showed a significant nuclear PCNA and p53 protein reactivity.

Original Article

Tetranucleotide Repeat Microsatellite Instability in Uterine Cervical Carcinomas.: Yoo Duk Choi, Ji Shin Lee, Chan Choi, Chang Soo Park, Sang Woo Juhng, Ho Sun Choi, Jong Hee Nam; Korean J Pathol. 2007;41(1):30-37.

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Abstract PDF: BACKGROUND
Elevated levels of microsatellite alterations at selected tetranucleotide repeat regions (EMAST) have been recently described, and they are a distinct type of microsatellite instability (MSI). We investigated the prevalence of EMAST in squamous cell carcinoma (SCC) of the uterine cervix and we determined the correlation between EMAST and the clinicopathologic parameters, HPV infection and the p53 mutation.
METHODS
We examined the 3 mono-, 3 di-, and 5 tetranucleotide repeat markers in 47 cases of SCC, and we performed immunohistochemical staining for p53. HPV detection and genotyping was performed using a commercially available HPV DNA chip.
RESULTS
Thirteen out of 47 cases (27.7%) were EMAST(+) with at least one of five tetranucleotide repeat markers. However, MSI at mono- and dinucleo- tide markers was noted in only one case (2.1%). EMAST was not related with stage, size, lymph node metastasis, vascular/lymphatic invasion or the depth of invasion. Positive immunostaining for p53 was significantly more common in EMAST(+) tumors than in the EMAST(-) tumors (p=0.04). HPV-infection was positive in 32 cases. EMAST was not correlated with the state of HPV infection state or the HPV genotype.
CONCLUSIONS
27.7% of the invasive SCCs of the uterine cervix exhibited EMAST, and EMAST in the SCC of the uterine cervix was significantly associated with the p53 mutation.

Case Report

Cytomegalovirus Infection In a Patient with Hypersensitivity Angiitis due to H-S Purpura: A case report.: Ji Shin Lee, Hyang Mi Ko, Kyung Soo Kim, Chang Soo Park, J Sang Woo uhng; Korean J Pathol. 1995;29(1):119-121.

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Abstract PDF: Gastrointestinal cytomegalovirus(CMV) infection in adults is observed as a part of a generalized or localized infection in patients who are immunocompromized. We report a case of CMV infection of the small intestine. The patient is a 34 year-old woman who has complained of palpable purpura in the lower extremities and buttocks, and arthralgia of large joints. The skin biopsy showed fibrinoid necrosis and neutrophils with leukocytoclasis, which findings are compatible with hypersensitivity angiitis. The patient received steroid and cyclophosphamide. During the follow-up period, generalized edema and bloody stool were detected. Resected specimen of small bowel has multiple aphthous ulcer. Microscopically, cytomegalic cells are observed along the endothelial cells and mesenchymal cells. In situ hybridization using DNA probes against CMV revealed positive staining in the cytomegalic inclusions in vascular endothelial and mesenchymal cells.

Original Article

Immunohistochemical Evaluation of HMB-45 and S-100 Protein in Melanocytic Tumors.: Chang Soo Park, Hwan Kim, Hyang Mi Ko, Kyung Soo Kim, Ji Shin Lee; Korean J Pathol. 1995;29(2):189-196.

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Abstract PDF: Immunohistochemical staining on paraffin sections for S-100 protein improved diagnostic accuracy for melanocytic tumor. But specificity of S-100 protein in the diagnosis of melanocytic tumor is very low, because S-100 protein was also expressed in neurogenic tumor and salivary gland tumor. To investigate a specific tumor marker for the malignant melanoma, immunohistochemical staining for HMB-45 and S-100 protein was performed on the paraffin sections of 25 cases of malignant melanoma and 46 cases of nevi. Positive reaction for HMB-45 and S-100 protein was diffusely identified in the cytoplasm of tumor cells. Positive ratio for HMB-45 was 100% in malignant melanoma, 92% in junctional component of compound nevus and 0% in intradermal nevus. Positive ratio for S-100 protein was 92% in malignant melanoma, 100% in compound nevus and 100% in intradermal nevus. The sensitivity and specificity for HMB-45 in malignant melanoma were 100%, but those for S-100 protein were 92% in sensitivity and 86.7% in specificity. These results indicate that HMB-45 has a high sensitivity and specificity for malignant melanoma cells and it can be quite useful for the histopathological diagnosis of malignant melanoma.

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