Journal of Pathology and Translational Medicine

Original Article

Expression of prostate-specific membrane antigen in the neovasculature of primary tumors and lymph node metastasis of laryngeal squamous cell carcinomas: Gamze Erkılınç, Hasan Yasan, Yusuf Çağda Kumbul, Mehmet Emre Sivrice, Meltem Durgun; J Pathol Transl Med. 2022;56(3):134-143. Published online May 3, 2022; DOI: https://doi.org/10.4132/jptm.2022.02.22

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Background
Prostate-specific membrane antigen (PSMA) expression is encountered in tumor-associated neovascularization.
Methods
PSMA-antibody was applied to the paraffin blocks of 51 patients who were diagnosed with squamous cell carcinoma of the larynx and underwent laryngectomy and one who underwent lymph node dissection. The percentage of vascular expression in tumoral and extratumoral stroma and lymph nodes and intensity score in tumoral epithelium were evaluated and divided into groups according to the level of PSMA expression. Final PSMA expression was determined by multiplying intensity and percentage scores.
Results
The mean age was 61±10 years. Patients with perineural invasion, cartilage invasion, and local invasion exhibited higher PSMA expression scores. Age, tumor differentiation, tumor diameter, perineural invasion, tumor localization, capsular invasion, depth of invasion, surgical margin status, local invasion, nodal metastasis, TNM classification, and stage were similar in high and low PSMA expression groups. There was no PSMA expression in extratumoral vascular stroma. Significantly higher PSMA expression was observed in the vascular endothelium of metastatic lymph nodes compared with reactive lymph nodes. Patients with advanced-stage disease exhibited higher PSMA vascular expression scores compared to those with earlier stages (p<.001). PSMA expression was not correlated with overall survival, disease-specific survival, or disease-free survival (p>.05).
Conclusions
Our study suggests that higher PSMA expression is associated with cartilage invasion, local invasion, and advanced-stage of disease. PSMA expression can be utilized for detection of lymph node metastasis and has some predictive role in cases of neck metastasis.

Citations

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Concomitant laryngeal squamous cell carcinoma and prostate cancer on 18F-FDG PET/CT and 18F-PSMA-1007 PET/CT
Yongzhu Pu, Ran Xie, Zhiyong Deng, Long Chen
European Journal of Nuclear Medicine and Molecular Imaging.2025;[Epub] CrossRef
A Practical Guide to the Pearls and Pitfalls of PSMA PET Imaging
Andrew F. Voter, Rudolf A. Werner, Hatice Savas, Andrei Gafita, Ashley E. Ross, Michael A. Gorin, Lilja B. Solnes, Martin G. Pomper, Steven P. Rowe, Sara Sheikhbahaei
Seminars in Nuclear Medicine.2024; 54(1): 119. CrossRef
p53 and PTEN expression evaluation with molecular evident recent criteria in laryngeal carcinoma
Ayca Tan, Gorkem Eskiizmir, Ugur Kamiloglu, Sulen Sarioglu
Medicine.2023; 102(19): e33676. CrossRef
Diagnostic, Prognostic, and Therapeutic Role for Angiogenesis Markers in Head and Neck Squamous Cell Carcinoma: A Narrative Review
Lara Alessandrini, Laura Astolfi, Antonio Daloiso, Marta Sbaraglia, Tiziana Mondello, Elisabetta Zanoletti, Leonardo Franz, Gino Marioni
International Journal of Molecular Sciences.2023; 24(13): 10733. CrossRef

Case Study

Erdheim-Chester Disease Involving Lymph Nodes and Liver Clinically Mimicking Lymphoma: A Case Report: Yeoun Eun Sung, Yoon Seo Lee, Jieun Lee, Kyo Young Lee; J Pathol Transl Med. 2018;52(3):183-190. Published online December 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.10.16

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Abstract PDF

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis and multisystem disease. First described in 1930, there are no more than 750 cases reported. The etiology remains unknown, but a majority of cases of ECD and Langerhans cell histiocytosis were found to have clonal mutations involving genes of the mitogen-activated protein kinase pathway. We recently encountered a 53-year-old male patient with extensive ECD involving the systemic lymph nodes, pleura, liver, and long bones clinically mimicking malignant lymphoma. Biopsies were performed at multiple sites, including a pleural mass, an external iliac lymph node, bone marrow, and the liver. Based on histopathological and immunohistochemical findings of positivity for CD68 and negativity for CD1a and S-100, the patient was diagnosed with ECD. Interferon-α was administered as the first-line treatment, but the patient rapidly progressed to hepatic failure after 2 months of treatment. We report this rare case of ECD clinically mimicking malignant lymphoma and diagnosed by careful pathological review.

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Erdheim Chester Disease Mimicking Lymphoma: A Case Report
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Erdheim–Chester Disease with Isolated CNS Involvement: A Systematic Review of the Literature
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Erdheim‐Chester disease with long‐standing diabetes insipidus and generalized edema
Faezeh Sadat Naji, Minoo Sadat Hajmiri, Zahra Mazari, Faeze Salahshour, Vahid Soleimani, Manouchehr Nakhjavani, Mahboobeh Hemmatabadi
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Kevin C.J. Yuen, Vera Popovic, Peter J. Trainer
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Primary Necrobiotic Xanthogranulomatous Sialadenitis with Submandibular Gland Localization without Skin Involvement
Myunghee Kang, Na Rae Kim, Dong Hae Chung, Jae Yeon Seok, Dong Young Kim
Journal of Pathology and Translational Medicine.2019; 53(4): 261. CrossRef
Interferon-α

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Original Articles

Programmed Death-Ligand 1 Expression and Its Correlation with Lymph Node Metastasis in Papillary Thyroid Carcinoma: Hyo Jung An, Gyung Hyuck Ko, Jeong-Hee Lee, Jong Sil Lee, Dong Chul Kim, Jung Wook Yang, Min Hye Kim, Jin Pyeong Kim, Eun Jung Jung, Dae Hyun Song; J Pathol Transl Med. 2018;52(1):9-13. Published online October 3, 2017; DOI: https://doi.org/10.4132/jptm.2017.07.26

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Abstract PDF

Background
The immunotherapeutic role of programmed death-ligand 1 (PD-L1) in life expectancy in many cancers has been highlighted. However, data regarding PD-L1 expression in papillary thyroid carcinoma (PTC) are limited. In this study, we describe the PD-L1 and programmed cell death protein 1 (PD-1) expressions in PTC and analyze their correlation with lymph node (LN) metastasis.
Methods
Clinicopathological data were obtained from 116 patients with PTC who were treated in Gyeongsang National University Hospital, Jinju, Korea in 2009. Tissue microarray blocks were made using representative paraffin blocks of classical PTCs excluding follicular variants. Two pathologists graded the proportion and intensity of PD-L1 and PD-1 expression in both tumor and inflammatory cells. According to their proportions, positive PTC cells were scored as negative (0%), grade 1 (1%–50%), and grade 2 (51%–100%). Similarly, positive inflammatory cells were graded as negative (0%), grade 1 (1%–10%), and grade 2 (11%–20%). The intensity of each protein expression was simplified as positive or negative.
Results
A statistically significant correlation exists between the proportions of PD-1 and PD-L1 expression both in papillary carcinoma (p=.001) and peritumoral lymphoid cells in the thyroid (p<.001). In addition, the proportion of PD-L1 expression in PTC cells was closely related to metastatic LNs (p=.036).
Conclusions
PD-L1 is a valuable predictive marker for LN metastasis in PTC. Immunomodulating therapies that inhibit PD-L1 might be an option for patients with LN metastasis.

Citations

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Chronic Lymphocytic Thyroiditis with Oncocytic Metaplasia Influences PD-L1 Expression in Papillary Thyroid Carcinoma
Vitor Barreto Santana, Vitória Machado Krüger, Maria Cristina Yunes Abrahão, Pietru Lentz Martins Cantú, Rosicler Luzia Brackmann, Gisele Moroni Pandolfi, Liane Scheffler Marisco, Gabriela Remonatto, Luciana Adolfo Ferreira, Marcia Silveira Graudenz
Head and Neck Pathology.2024;[Epub] CrossRef
Exploring markers of immunoresponsiveness in papillary thyroid carcinoma and future treatment strategies
Atish Mohanty, Michelle Afkhami, Amanda Reyes, Rebecca Pharaon, Holly Yin, Haiqing Li, Dana Do, Diana Bell, Arin Nam, Sue Chang, Thomas Gernon, Robert Kang, Arya Amini, Sagus Sampath, Prakash Kulkarni, Raju Pillai, Vicky Villaflor, Ravi Salgia, Ellie Magh
Journal for ImmunoTherapy of Cancer.2024; 12(7): e008505. CrossRef
Update regarding the role of PD-L1 in oncocytic thyroid lesions on cytological samples
Marco Dell'Aquila, Pietro Tralongo, Alessia Granitto, Maurizio Martini, Sara Capodimonti, Mariangela Curatolo, Vincenzo Fiorentino, Alfredo Pontecorvi, Guido Fadda, Celestino Pio Lombardi, Maco Raffaelli, Liron Pantanowitz, Luigi Maria Larocca, Esther Dia
Journal of Clinical Pathology.2023; 76(10): 671. CrossRef
Analysis of anti‐apoptotic PVT1 oncogene and apoptosis‐related proteins (p53, Bcl2, PD‐1, and PD‐L1) expression in thyroid carcinoma
Afaf T. Ibrahiem, Amin K. Makhdoom, Khalid S. Alanazi, Abdulaziz M. Alanazi, Abdulaziz M. Mukhlef, Saad H. Elshafey, Eman A. Toraih, Manal S. Fawzy
Journal of Clinical Laboratory Analysis.2022;[Epub] CrossRef
EphA10 drives tumor progression and immune evasion by regulating the MAPK/ERK cascade in lung adenocarcinoma
Wenyue Zhao, Lu Liu, Xuehao Li, Shun Xu
International Immunopharmacology.2022; 110: 109031. CrossRef
Hashimoto’s Thyroiditis Minimizes Lymph Node Metastasis in BRAF Mutant Papillary Thyroid Carcinomas
Peter P. Issa, Mahmoud Omar, Yusef Buti, Chad P. Issa, Bert Chabot, Christopher J. Carnabatu, Ruhul Munshi, Mohammad Hussein, Mohamed Aboueisha, Mohamed Shama, Ralph L. Corsetti, Eman Toraih, Emad Kandil
Biomedicines.2022; 10(8): 2051. CrossRef
Expression of β-Catenin in Thyroid Neoplasms (Histopathological and Immunohistochemical Study)
Mohamed Sherif Ismail, Amr Mousa Abdel Gawad Mousa, Mohammed Faisal Darwish, M. Mostafa Salem, Randa Said
Open Access Macedonian Journal of Medical Sciences.2022; 10(A): 1565. CrossRef
Identification and validation of an immune-related prognostic signature and key gene in papillary thyroid carcinoma
Rujia Qin, Chunyan Li, Xuemin Wang, Zhaoming Zhong, Chuanzheng Sun
Cancer Cell International.2021;[Epub] CrossRef
PD‐L1 and thyroid cytology: A possible diagnostic and prognostic marker
Marco Dell’Aquila, Alessia Granitto, Maurizio Martini, Sara Capodimonti, Alessandra Cocomazzi, Teresa Musarra, Vincenzo Fiorentino, Alfredo Pontecorvi, Celestino Pio Lombardi, Guido Fadda, Liron Pantanowitz, Luigi Maria Larocca, Esther Diana Rossi
Cancer Cytopathology.2020; 128(3): 177. CrossRef
Programmed Death-Ligand 1 (PD-L1) Is a Potential Biomarker of Disease-Free Survival in Papillary Thyroid Carcinoma: a Systematic Review and Meta-Analysis of PD-L1 Immunoexpression in Follicular Epithelial Derived Thyroid Carcinoma
Ilaria Girolami, Liron Pantanowitz, Ozgur Mete, Matteo Brunelli, Stefano Marletta, Chiara Colato, Pierpaolo Trimboli, Anna Crescenzi, Massimo Bongiovanni, Mattia Barbareschi, Albino Eccher
Endocrine Pathology.2020; 31(3): 291. CrossRef
Regression of Papillary Thyroid Cancer during Nivolumab for Renal Cell Cancer
Andrea Palermo, Andrea Napolitano, Daria Maggi, Anda Mihaela Naciu, Gaia Tabacco, Silvia Manfrini, Anna Crescenzi, Chiara Taffon, Francesco Pantano, Bruno Vincenzi, Guiseppe Tonini, Daniele Santini
European Thyroid Journal.2020; 9(3): 157. CrossRef
A potential biomarker hsa-miR-200a-5p distinguishing between benign thyroid tumors with papillary hyperplasia and papillary thyroid carcinoma
Xian Wang, Shan Huang, Xiaocan Li, Dongrui Jiang, Hongzhen Yu, Qiang Wu, Chaobing Gao, Zhengsheng Wu, Yi-Hsien Hsieh
PLOS ONE.2018; 13(7): e0200290. CrossRef
Papillary Thyroid Carcinoma Emerging from Hashimoto Thyroiditis Demonstrates Increased PD-L1 Expression, Which Persists with Metastasis
Daniel Lubin, Ezra Baraban, Amanda Lisby, Sahar Jalali-Farahani, Paul Zhang, Virginia Livolsi
Endocrine Pathology.2018; 29(4): 317. CrossRef
Chemotherapeutic Treatments Increase PD-L1 Expression in Esophageal Squamous Cell Carcinoma through EGFR/ERK Activation
Hoi Yan Ng, Jian Li, Lihua Tao, Alfred King-Yin Lam, Kwok Wah Chan, Josephine Mun Yee Ko, Valen Zhuoyou Yu, Michael Wong, Benjamin Li, Maria Li Lung
Translational Oncology.2018; 11(6): 1323. CrossRef

Extrapulmonary Lymphangioleiomyoma: Clinicopathological Analysis of 4 Cases: Dae Hyun Song, In Ho Choi, Sang Yun Ha, Kang Min Han, Jae Jun Lee, Min Eui Hong, Yoon-La Choi, Kee-Taek Jang, Sang Yong Song, Chin A Yi, Joungho Han; Korean J Pathol. 2014;48(3):188-192. Published online June 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.3.188

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Abstract PDF

Background

Lymphangioleiomyomatosis (LAM) is a slowly progressive neoplastic disease that predominantly affects females. Usually, LAM affects the lung; it can also affect extrapulmonary sites, such as the mediastinum, the retroperitoneum, or the lymph nodes, although these locations are rare. A localized form of LAM can manifest as extrapulmonary lesions; this form is referred to as extrapulmonary lymphangioleiomyoma (E-LAM). Due to the rare occurrence of E-LAM and its variable, atypical location, E-LAM is often difficult to diagnose. Herein, we report the clinicopathological information from four E-LAM cases, and also review previous articles investigating this disease.

Methods

Four patients with E-LAM were identified at the Samsung Medical Center (Seoul, Korea) from 1995 to 2012. All E-LAM lesions underwent surgical excision.

Results

All patients were females within the age range of 43 to 47 years. Two patients had para-aortic retroperitoneal masses, while the other two patients had pelvic lesions; two out of the four patients also had accompanying pulmonary LAM. In addition, no patient displayed any evidence of tuberous sclerosis. Histologically, two patients exhibited nuclear atypism with cytologic degeneration.

Conclusions

E-LAM should be considered in the differential diagnosis of patients presenting with pelvic or para-aortic masses. We also conclude that further clinical and pathological evaluation is needed in patients with E-LAM and nuclear atypism.

Citations

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Aleksandra Marciniak, Jolanta Nawrocka-Rutkowska, Agnieszka Brodowska, Andrzej Starczewski, Iwona Szydłowska
Journal of Personalized Medicine.2023; 13(11): 1598. CrossRef
A case of lymphangioleiomyomatosis with endometrial cancer diagnosed by retroperitoneoscopic para-aortic lymph node dissection
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JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY.2022; 38(1): 158. CrossRef
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Extrapulmonary uterine lymphangioleiomyomatosis (LAM) and dysfunctional uterine bleeding: the first presentation of LAM in a tuberous sclerosis complex patient
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Joseph T. Rabban, Brandie Firetag, Ankur R. Sangoi, Miriam D. Post, Charles J. Zaloudek
American Journal of Surgical Pathology.2015; 39(8): 1015. CrossRef

Case Study

Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review: Na Rae Kim, Soyi Lim, Juhyeon Jeong, Hyun Yee Cho; Korean J Pathol. 2013;47(6):587-591. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.587

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Abstract PDF

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.

Citations

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Mimics of primary ovarian cancer and primary peritoneal carcinomatosis – A pictorial review
B. Lawson, I. Rajendran, J. Smith, A. Shakur, V. Sadler, T.J. Sadler, H.C. Addley, S. Freeman
Clinical Radiology.2024; 79(10): 736. CrossRef
Ovarian Immature Teratoma With Nodal Gliomatosis: A Case Report and Literature Review
Marwa Alna’irat, W. Glenn McCluggage, Maysa Al-Hussaini
International Journal of Gynecological Pathology.2023; 42(6): 627. CrossRef
Germ Cell Tumors of the Ovary: A Review
Preetha Ramalingam
Seminars in Diagnostic Pathology.2023; 40(1): 22. CrossRef
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Isheeta Ahuja, Ruchi Rathore, Neerja Bhatla, Sandeep R. Mathur
Indian Journal of Gynecologic Oncology.2023;[Epub] CrossRef
Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review
Sijian Li, Na Su, Congwei Jia, Xinyue Zhang, Min Yin, Jiaxin Yang
Current Oncology.2022; 29(9): 6364. CrossRef
Extratesticular gliomatosis peritonei after mesenteric teratoma: a case report and literature review
Jiaqiang Li, Shoulin Li, Dong Xiao, Jiaming Song, Jianxiong Mao, Jianchun Yin
Journal of International Medical Research.2021;[Epub] CrossRef
Germ Cell Tumors of the Female Genital Tract
Elizabeth D. Euscher
Surgical Pathology Clinics.2019; 12(2): 621. CrossRef
Gliomatosis peritonei: a series of eight cases and review of the literature
Dan Wang, Cong-wei Jia, Rui-e Feng, Hong-hui Shi, Juan Sun
Journal of Ovarian Research.2016;[Epub] CrossRef

Original Article

Histopathologic Predictors of Lymph Node Metastasis and Prognosis in Tonsillar Squamous Cell Carcinoma: Dong Jin Lee, Mi Jung Kwon, Eun Sook Nam, Ji Hyun Kwon, Jin Hwan Kim, Young-Soo Rho, Hyung Sik Shin, Seong Jin Cho; Korean J Pathol. 2013;47(3):203-210. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.203

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Abstract PDF

Background

Risk factors for lymph node metastasis in tonsillar squamous cell carcinoma (TSCC) need to be established to determine the degree of surgery required to achieve high curative rates. However, little is known currently about the histopathological features predicting prognosis, specifically in TSCC.

Methods

This study included 53 patients who underwent surgical resection with neck dissection. Clinicopathological factors investigated included age, gender, alcohol use, tobacco consumption, tumor stage, adjacent structure involvement, cell differentiation, squamous dysplasia, in situ carcinoma associated with primary invasive cancer, carcinoma in situ skip lesions, necrosis, invasive front, depth of invasion, and lymphatic, muscle, or perineural invasion.

Results

Contralateral cervical metastasis was associated with higher T stages and soft palate invasion. Lymphatic and muscle invasion were associated with ipsilateral cervical metastasis. Advanced T stage, invasion to the base of tongue, and skip lesions were associated with decreased disease-free survival. Advanced T stage and skip lesions were associated with worse overall survival.

Conclusions

Advanced T stage and soft palate invasion may predict a high risk of contralateral nodal metastasis. T stage and skip lesion are worse prognostic factors in TSCC and should be commented in pathology reports.

Citations

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A Systematic Review of Occult Contralateral Neck Metastasis in Tonsillar Squamous Cell Carcinoma
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Comprehensive Transcriptome Analysis Reveals the Distinct Gene Expression Patterns of Tumor Microenvironment in HPV-Associated and HPV-Non Associated Tonsillar Squamous Cell Carcinoma
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Masanari G. Kato, Mark A. Ellis, Shaun A. Nguyen, Terry A. Day
Head & Neck.2018; 40(2): 338. CrossRef
Clinical implication of programmed cell death-1 ligand-1 expression in tonsillar squamous cell carcinoma in association with intratumoral heterogeneity, human papillomavirus, and epithelial-to-mesenchymal transition
Mi Jung Kwon, Young-Soo Rho, Eun Sook Nam, Seong Jin Cho, Hye-Rim Park, Soo Kee Min, Jinwon Seo, Ji-Young Choe, Eun Soo Kim, Bumjung Park, Mineui Hong, Kyueng-Whan Min
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World Journal of Clinical Oncology.2018; 9(7): 148. CrossRef
HIPK2 Overexpression and Its Prognostic Role in Human Papillomavirus-Positive Tonsillar Squamous Cell Carcinoma
Mi Jung Kwon, So Young Kang, Eun Sook Nam, Seong Jin Cho, Young-Soo Rho
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Frequent hepatocyte growth factor overexpression and low frequency of c-Met gene amplification in human papillomavirus–negative tonsillar squamous cell carcinoma and their prognostic significances
Mi Jung Kwon, Dong Hoon Kim, Hye-Rim Park, Hyung Sik Shin, Ji Hyun Kwon, Dong Jin Lee, Jin Hwan Kim, Seong Jin Cho, Eun Sook Nam
Human Pathology.2014; 45(7): 1327. CrossRef
CT and MR imaging findings of palatal tumors
Hiroki Kato, Masayuki Kanematsu, Hiroki Makita, Keizo Kato, Daijiro Hatakeyama, Toshiyuki Shibata, Keisuke Mizuta, Mitsuhiro Aoki
European Journal of Radiology.2014; 83(3): e137. CrossRef

Case Report

Angiomyomatous Hamartoma of Popliteal Lymph Nodes Occurring in Association with Diffuse Pigmented Villonodular Synovitis of Knee.: Hyun Soo Kim, Ki Yong Na, Jae Hoon Lee, Nam Su Cho, Gou Young Kim, Sung Jig Lim; Korean J Pathol. 2011;45:S58-S61.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S58

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Abstract PDF: We report the first case of an angiomyomatous hamartoma (AH) of the popliteal lymph nodes (LNs) occurring in association with diffuse pigmented villonodular synovitis (PVNS) of the knee. AH is a rare benign vascular disease with a predisposition for the LNs of the inguinal region. Twenty-five cases of AH have been reported to date; however, the precise pathogenesis is still undetermined. In the present case, an open synovectomy revealed two of three popliteal LNs in close proximity to the extra-articular component of diffuse PVNS. These LNs demonstrated irregularly distributed thick-walled blood vessels in the hilum. These vessels extended into the medulla and cortex and were associated with haphazardly arranged smooth muscle cells in the sclerotic stroma. These findings are compatible with an AH. Our observations raise the possibility that AH of the popliteal LNs may represent an abnormal proliferative reaction against the inflammatory process caused by PVNS of the knee.

Original Article

Fine-Needle Aspiration Cytology of the Nodal Marginal Zone Lymphoma.: Seung Kyu Choi, Ji Eun Kwon, Young Hyeh Ko; Korean J Pathol. 2011;45(4):406-411.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.406

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Abstract PDF: BACKGROUND
Nodal marginal zone lymphoma (NMZL) is a rare B-cell neoplasm consisting of heterogeneous cellular components and residual B-cell follicles. Because of such histological features, it is difficult to diagnose NMZL by fine needle aspiration (FNA) cytology. We reviewed FNA cytology of NMZL to identify a cytological clue to avoid misdiagnosing NMZL.
METHODS
Histological, cytological, and clinical findings of seven cases of NMZL were reviewed.
RESULTS
Most cases showed nodular aggregates of lymphohistiocytes derived from the germinal center irrespective of histological pattern. The cellular components were heterogeneous and composed of mature small lymphocytes, intermediate and large lymphocytes, immunoblasts, tingible body macrophages, and follicular dendritic cells. Intermediate-sized neoplastic cells with a pale nucleus were observed but difficult to identify because of admixed non-neoplastic cells, which outnumbered neoplastic cells. Except for one case with a high proportion of intermediate-sized cells, the other six cases were initially diagnosed as reactive hyperplasia. A flow cytometric analysis was performed in two cases and failed to demonstrate a monoclonal B-cell population.
CONCLUSIONS
The FNA showing a reactive hyperplasia-like smear pattern should be carefully observed by experienced cytopathologists to identify intermediate-sized neoplastic cells. Clinical information including the size of the lymph nodes is important to avoid a misdiagnosis.

Case Reports

Langerhans Cell Sarcoma Arising in a Lymph Node: A Case Report and Review of the Literature.: Dong Wook Kang, Hyun Jin Son, Tae Hwa Baek, Hye Kyung Lee, Joo Ryung Huh, Joo Heon Kim, Mee Ja Park; Korean J Pathol. 2011;45(1):101-105.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.101

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Abstract PDF: We report a case of Langerhans cell sarcoma presented as a solitary mass in the left supraclavicular area in a 31-year-old woman. Computed tomography revealed a relatively well-defined and lightly enhancing mass in the left supraclavicular area, measuring 5.5x4.5x3.2 cm. Excision was subsequently performed. Microscopically, the specimen consisted of an enlarged and partially effaced lymph node. Nests of different size composed of atypical tumor cells were located in the paracortex and the medulla of the lymph node. The tumor cells exhibited abundant eosinophilic or clear cytoplasm and displayed marked nuclear atypia and increased mitotic figures. Infiltration of many eosinophils was identified in the periphery and between the tumor cells. The tumor cells were reactive for CD1a and S100 protein. Ultrastructually, they were found to have Birbeck granules in the cytoplasm.

Metastases from Rectum and Thyroid Cancers in Same Cervical Lymph Node: A Case Report.: Bulent Yildiz, Abdulkadir Reis, Evren Fidan, Feyyaz Ozdemir, Halil Kavgaci, Fazil Aydin; Korean J Pathol. 2010;44(5):551-553.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.551

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An excisional biopsy targeting a cervical lymph node was performed on a 49-year-old female patient with metastatic rectal cancer. The biopsy revealed rectal and papillary thyroid cancer metastasis in the same lymph node. A thin-needle thyroid aspiration biopsy was performed, and the result was papillary thyroid carcinoma. The patient, who received chemotherapy for the metastatic rectal cancer, died due to disease progression about 5 months after a secondary primary tumor was detected. Metastasis of multiple malignancies in the same lymph node is extremely rare. A metastases of rectal and thyroid cancers to the same lymph node has not been reported until now. Our patient is the first case in the literature.

Citations

Citations to this article as recorded by

Tumor-to-tumor metastases: systematic review and meta-analysis of 685 reported cases
Michał Kunc, Paulina Skrzypkowska, Rafał Pęksa, Wojciech Biernat
Clinical & Experimental Metastasis.2025;[Epub] CrossRef

Cytology of Follicular Dendritic Cell Sarcoma on Intraoperative Touch Imprint Smears: A Case Report.: Ju Young Song, Xian Ji Jin, Jee Young Han, Lucia Kim, In Suh Park, Joon Mee Kim, Young Chae Chu, Suk Jin Choi; Korean J Pathol. 2009;43(6):589-593.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.589

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Abstract PDF

Follicular dendritic cell (FDC) sarcoma is a neoplastic proliferation of FDCs. Because its cytologic findings can vary widely, both the cytomorphology and histopathology of FDC sarcoma can impose a significant diagnostic dilemma. We present cytologic features of FDC sarcoma assessed by intraoperative touch imprint. Intra-abdominal lymphadenopathies were noted in 54-year-old male with hepatitis B-virus associated liver cirrhosis. In contrast to cytologic features of classical FDC sarcoma, the tumor cells featured a large epithelioid or Reed-Sternberg cell-like shape scattered in a background with abundant inflammatory cells, which led to a mistaken diagnosis of malignant lymphoma. However, in accordance with cytologic features previously described in the literature, the tumor cells were characterized by a fragile cytoplasm with cytoplasmic processes in dendritic or reticulated patterns reminiscent of the ultrastructural features of FDC. Cytoplasmic features rendering nuclei with a tendency to form clusters or syncytial aggregates associated with reactive lymphocytes appear to be the most valuable finding in diagnosis of FDC sarcoma.

Citations

Citations to this article as recorded by

Cytomorphology of follicular dendritic cell sarcoma: a report of 7 cases with an emphasis on the diagnostic challenges
Cody Weimholt, Jalal B. Jalaly, Cedric Bailey
Journal of the American Society of Cytopathology.2023; 12(3): 229. CrossRef
A Cytological Review of Follicular Dendritic Cell-Derived Tumors with Emphasis on Follicular Dendritic Cell Sarcoma and Unicentric Castleman Disease
José A. Jiménez-Heffernan, Cristina Díaz del Arco, Magdalena Adrados
Diagnostics.2022; 12(2): 406. CrossRef
Cytological diagnosis of follicular dendritic cell sarcoma: A case report and review of literature
A. Dutta, P. Arun, P. Roy, I. Arun
Cytopathology.2018; 29(5): 461. CrossRef

Nevus Cell Inclusions in the Lymph Node: A Report of Two Cases.: Ji Sun Song, Tae Woong Noh, Yoon Mee Kim, Sang Ho Cho, Kwang Gil Lee; Korean J Pathol. 2001;35(3):245-247.

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Abstract PDF: Nevus cell inclusion in the lymph node is an uncommon histologic finding and usually is an incidental finding in the capsule, fibrous trabeculae, perinodal adipose tissue, and parenchyma of the axillary, inguinal, or cervical lymph nodes which are removed as part of cancer diagnostic or therapeutic procedures. The aggregated pigmented nevus cells in the lymph node resemble the cells of the cutaneous nevi. It is important to differentiate them from metastatic carcinoma or malignant melanoma. The characteristic features of nevus cell inclusions are presence of nevus cells within the capsule and supporting stroma, without presence in the marginal sinus of the lymph node, and the absence of cytological atypia or mitosis of nevus cells. We report two cases of nevus cell inclusions, in the axillary lymph nodes in a patient with breast carcinoma and in an enlarged inguinal lymph node in a patient without a malignant tumor.

Original Articles

Metastatic Carcinoma in Lymph Nodes of Neck: Analysis of 221 Cases Diagnosed by Fine Needle Aspiration Cytology.: Duck Hwan Kim, Youn Ju Kim, Seung Eun Yang, Sung Suk Paeng, Hee Jin Chang, Jin Hee Sohn, Jung Il Suh; Korean J Cytopathol. 1995;6(1):41-47.

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Abstract PDF: Two hundreds and twenty one consecutive patients with enlarged lymph nodes of neck areas were diagnosed as metastatic carcinoma by fine needle aspiration. The metastatic carcinomas were most frequent in the supraclavicular lymph nodes(p<0.05). As a primary site, lung, stomach, upper respiratory tract and breast were common sites in descending order of frequency. In overall cytologic types, squamous cell carcinoma was the most common in males(43%) while adenocarcinoma was the most common in females(72%) (p<0.05). While carcinomas of the esophagogastro -intestinal tract showed a tendency to metastasis to the left supraclavicular lymph nodes, the metastatic carcinomas of lung and breast usually metastasized to the same side primary cancers with predilection for the supraclavicular lymph nodes. The submandibular lymph nodes were frequently involved by the carcinoma of upper and lower respiratory tract, in which squamous cell carcinoma is the most prevalent cytologic type. diagnosis by fine needle aspiration cytology is the first step in the workup of patients with nodal enlargement suspicious for malignancy, particularly in metastatic carcinoma.

The Clinicopathologic Analysis of Kikuchi's Lymphadenitis.: Jung Woo Choi, Ji Hye Lee, Ju Han Lee, Yang Seok Chae, Insun Kim; Korean J Pathol. 2004;38(5):289-294.

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Abstract PDF: BACKGROUND
Kikuchi's disease has been known as a self-limiting lymphadenitis mostly affecting the cervical lymph nodes of young women.
METHODS
We retrospectively reviewed the clinical data of 77 cases of Kikuchi's lymphadenitis from 1996 to 2003 at Korea University Medical Center.
RESULTS
Histologically, 69 available cases were classified into three types: proliferative (60.8%), necrotizing (33.3%), and xanthomatous type (5.7%). These three types differed in terms of their clinical features, showing tenderness most predominantly in the necrotizing type. In spite of the insufficient numbers of cases, the data on the duration of the disease well correlated with the possible progression of the three histologic types (Kikuch's disease begins as proliferative type, then progress into necrotizing type and finally resolves into xanthomatous type). During the ten-month period of the mean follow-up, the recurrence rate was 7.0%. Three and two patients developed into pulmonary tuberculosis and systemic lupus erythematosus, respectively, but there were no prognostic differences among the three types.
CONCLUSIONS
Our results confirmed that Kikuchi's lymphadenitis is a self-limiting necrotizing lymphadenitis with a low rate of recurrence. Here, we suggest that the classification of histologic types have some meanings because of their differences in certain clinical aspects and possible sequential disease progression.

Case Report

Pseudofungi Associated with a Granulomatous Response in a Lymph Node: A Case Report.: Haeryoung Kim, Ja Seung Koo, Hyosup Shim, Gijong Yi, Sang Ho Cho; Korean J Pathol. 2004;38(1):64-67.

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Abstract PDF: . We present herein a case of pseudofungi incidentally found in the mediastinal lymph nodes of a 31-year-old woman who had a left pneumonectomy for a pulmonary blastoma. The pseudofungi were located in the subcapsular sinuses of the lymph nodes with an associated granulomatous reaction. They revealed yellowish-brown hyphae-like structures with pseudosepta and irregular branching at various angles intermingled with round yeast-like forms. These structures stained positively with periodic acid-Schiff and Gomori methenamine silver, but also stained strongly positive for Prussian blue suggesting that they contain iron. The characteristic morphological features of pseudofungi are discussed with emphasis on the features that distinguish them from true fungal organisms.

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