Journal of Pathology and Translational Medicine

Case Study

Malignant potential of neuroendocrine microtumor of the pancreas harboring high-grade transformation: lesson learned from a patient with von Hippel-Lindau syndrome: Jongwon Lee, Kyung Jin Lee, Dae Wook Hwang, Seung-Mo Hong; J Pathol Transl Med. 2024;58(2):91-97. Published online March 13, 2024; DOI: https://doi.org/10.4132/jptm.2024.02.13

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Pancreatic neuroendocrine microtumor (PNEMT) is a neuroendocrine tumor (NET) < 0.5 cm in diameter, and it is considered benign. We report a PNEMT with high-grade transformation (HGT). A man in his 60s with von Hippel-Lindau syndrome underwent surgical resection of a NET. A second sub-centimeter nodule with a nodule-in-nodule pattern was discovered. The 0.4 cm outer nodule contained clear columnar cells with round nuclei and indistinct nucleoli, while the 0.1 cm inner nodule had eosinophilic cells with an increased nuclear to cytoplasmic ratio, vesicular nuclei, and prominent nucleoli. Tumor cells in the outer and inner nodules were synaptophysin and chromogranin positive. Only the inner nodule was p53 positive, while the outer nodule was exclusively positive for carbonic anhydrase 9 and vimentin. The Ki-67 labeling indices for the outer and inner nodules were 2.1% (grade 1) and 44.3% (grade 3), respectively. This nodule was determined to be a PNEMT with HGT. Our findings suggest that a PNEMT may not always be benign and can undergo HGT.

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Molecular Basis of Pancreatic Neuroendocrine Tumors
Alesia Maluchenko, Denis Maksimov, Zoia Antysheva, Julia Krupinova, Ekaterina Avsievich, Olga Glazova, Natalia Bodunova, Nikolay Karnaukhov, Ilia Feidorov, Diana Salimgereeva, Mark Voloshin, Pavel Volchkov
International Journal of Molecular Sciences.2024; 25(20): 11017. CrossRef

Original Article

Extremely well-differentiated adenocarcinoma of the stomach: diagnostic pitfalls in endoscopic biopsy: Jongwon Lee, In-Seob Lee, Ji Yong Ahn, Young Soo Park, Jihun Kim; J Pathol Transl Med. 2022;56(2):63-72. Published online November 16, 2021; DOI: https://doi.org/10.4132/jptm.2021.10.12

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Abstract PDF Supplementary Material

Background
Extremely well-differentiated adenocarcinoma (EWDA) is a deceptively bland-looking adenocarcinoma of the stomach. It often causes diagnostic problems, especially in endoscopic biopsy samples. To better recognize this deceptively bland lesion, we carefully reviewed a series of EWDAs treated at our institution.
Methods
A total of 55 specimens from 19 patients were obtained. Endoscopic, gross and microscopic features defining EWDA were described and documented. For comparison, hyperplastic polyp specimens were randomly selected and analyzed.
Results
Most cases (18 of 19, 94.7%) were advanced gastric cancer (AGC) and primarily located in the body of the stomach (15 of 19, 79.0%). The majority of AGCs were non-ulcerated (11 of 18, 61.1%) with an undermining growth pattern and a relatively small mucosal involvement. Specific histologic features included an irregular glandular shape, an undulating apical cytoplasmic border, disproportionately large glands, a variably distended mucinous cytoplasm. Classical features, such as small infiltrating glands or desmoplastic reactions, were barely observed. Identification of irregularly spaced nuclei and disruption of the foveolar epithelial structure, along with atypical features described above were helpful in making a diagnosis especially in gastric forceps biopsies.
Conclusions
Awareness of the histomorphologic characteristics described in this report would lead to timely diagnosis and prevent repeated endoscopic procedures.

Citations

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Unusual or Uncommon Histology of Gastric Cancer
Jinho Shin, Young Soo Park
Journal of Gastric Cancer.2024; 24(1): 69. CrossRef
A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
Kaiho Hirata, Shusuke Yagi, Hideki Miyazaki, Kazuhiko Yamada, Naoki Akazawa, Naoki Enomoto, Kyoko Nohara, Chizu Yokoi, Toru Igari, Norihiro Kokudo
Surgical Case Reports.2024;[Epub] CrossRef
Gastric-type extremely well-differentiated adenocarcinoma of the stomach: A rare tumor with diagnostic difficulties and high inter-observer variation in endoscopic pinch biopsies
Soomin Ahn, Sujin Park, Hyun Hee Koh, Han Gyeol Kim, Hyunjin Kim, Jae Yeong Son, Boram Lee, Hyunwoo Lee, Soohyun Hwang, Junhun Cho, Yun Kyung Lee, Ryoji Kushima, Amitabh Srivastava, Kyoung-Mee Kim
Pathology - Research and Practice.2024; 263: 155599. CrossRef

Brief Case Report

Breast implant–associated anaplastic large cell lymphoma: the first South Korean case: Jongwon Lee, Hyungwoo Cho, Dok Hyun Yoon, Eun Key Kim, Gyungyub Gong, Cheolwon Suh, Joo-ryung Huh; J Pathol Transl Med. 2020;54(5):432-434. Published online August 18, 2020; DOI: https://doi.org/10.4132/jptm.2020.07.01

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Citations

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Breast Reconstruction after Breast Implant-Associated Anaplastic Large Cell Lymphoma Treatment: A Case Report and Literature Review
Won-Seob Lee, Tae-Gon Kim, Jun-Ho Lee, Il-Kug Kim
Journal of Clinical Medicine.2023; 12(5): 1885. CrossRef
Breast filler granuloma mistaken for implant rupture: A case report
Yong Seon Hwang, Je Yeon Byeon, Jun Hyuk Kim, Hwan Jun Choi, Mee Hye Oh, Da Woon Lee
Medicine.2023; 102(22): e33785. CrossRef
Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis
Martina Vittorietti, Sergio Mazzola, Claudio Costantino, Daniele Domenico De Bella, Santo Fruscione, Nicole Bonaccorso, Martina Sciortino, Davide Costanza, Miriam Belluzzo, Alessandra Savatteri, Fabio Tramuto, Paolo Contiero, Giovanna Tagliabue, Palmira I
Frontiers in Oncology.2023;[Epub] CrossRef
Breast implant-associated anaplastic large cell lymphoma: a case report with a history of spontaneously resolved late seroma
Do Yeon Kim, Joon Hur, Woo Yeon Han, Kyunghyun Min, Jong Won Lee, Jin Sup Eom, Hyun Ho Han, Eun Key Kim
Archives of Aesthetic Plastic Surgery.2021; 27(4): 143. CrossRef
Comment on “Breast implant-associated anaplastic large cell lymphoma: the first South Korean case”
Il-Kug Kim, Tae Gon Kim
Journal of Pathology and Translational Medicine.2021; 55(6): 419. CrossRef

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