Journal of Pathology and Translational Medicine

Case Study

Intravascular NK/T-cell lymphoma: a case report and literature review: Ji Min Na, Wookjae Jung, Minhye Kim, Yun-Hong Cheon, Jong Sil Lee, Dae Hyun Song, Jung Wook Yang; J Pathol Transl Med. 2023;57(6):332-336. Published online November 14, 2023; DOI: https://doi.org/10.4132/jptm.2023.10.30

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Intravascular lymphoma is characterized by an exclusively intravascular distribution of tumor cells. Intravascular natural killer/T-cell lymphoma (IVNKTL) is extremely rare, highly aggressive, commonly Epstein-Barr virus (EBV)–positive, and predominantly affects the skin and central nervous system. Here we report a case of IVNKTL diagnosed in a 67-year-old female, presenting with persistent intermittent fever and skin rashes throughout the body. Incisional biopsy of an erythematous lesion on the chest exhibited aggregation of medium to large-sized atypical lymphoid cells confined to the lumen of small vessels that were positive for CD3, granzyme B, and CD56 on immunohistochemistry and EBV-encoded RNA in situ hybridization. EBV DNA was also detected in serum after diagnosis. With a review of 26 cases of IVNKTL to date, we suggest that active biopsy based on EBV DNA detection may facilitate early diagnosis of IVNKTL.

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Mimicry in the vasculature: a review of diagnostic clues in cutaneous intravascular lymphoid proliferations
MA Faraz, S Tu Zahra, F Ocampo-Gonzalez, SC Shalin, Aadil Ahmed
Diagnostic Histopathology.2026;[Epub] CrossRef
Intravascular Lymphoma: A Unique Pattern Underlying a Protean Disease
Mario Della Mura, Joana Sorino, Filippo Emanuele Angiuli, Gerardo Cazzato, Francesco Gaudio, Giuseppe Ingravallo
Cancers.2025; 17(14): 2355. CrossRef
Cutaneous Intravascular Hematolymphoid Entities: A Review
Emily Hatheway Marshall, Bethany Brumbaugh, Allison Holt, Steven T. Chen, Mai P. Hoang
Diagnostics.2024; 14(7): 679. CrossRef
CD30- and CD56-positive atypical intravascular lymphocytes of the uterine cervix, mimicking intravascular lymphoma: A case report and review of the literature
Daisuke Yamashita, Munemichi Otani, Hayato Maruoka, Takuya Aoki, Shigeo Hara
Journal of Clinical and Experimental Hematopathology.2024; 64(4): 328. CrossRef

Review

Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies: Jiwon Koh, Sun Ah Shin, Ji Ae Lee, Yoon Kyung Jeon; J Pathol Transl Med. 2022;56(4):173-186. Published online July 4, 2022; DOI: https://doi.org/10.4132/jptm.2022.05.16

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Abstract PDF

Lymphocyte-rich effusions represent benign reactive process or neoplastic condition. Involvement of lymphoproliferative disease in body cavity is not uncommon, and it often causes diagnostic challenge. In this review, we suggest a practical diagnostic approach toward lymphocyte-rich effusions, share representative cases, and discuss the utility of ancillary tests. Cytomorphologic features favoring neoplastic condition include high cellularity, cellular atypia/pleomorphism, monomorphic cell population, and frequent apoptosis, whereas lack of atypia, polymorphic cell population, and predominance of small T cells usually represent benign reactive process. Involvement of non-hematolymphoid malignant cells in body fluid should be ruled out first, followed by categorization of the samples into either small/medium-sized cell dominant or large-sized cell dominant fluid. Small/medium-sized cell dominant effusions require ancillary tests when either cellular atypia or history/clinical suspicion of lymphoproliferative disease is present. Large-sized cell dominant effusions usually suggest neoplastic condition, however, in the settings of initial presentation or low overall cellularity, ancillary studies are helpful for more clarification. Ancillary tests including immunocytochemistry, in situ hybridization, clonality test, and next-generation sequencing can be performed using cytologic preparations. Throughout the diagnostic process, proper review of clinical history, cytomorphologic examination, and application of adequate ancillary tests are key elements for successful diagnosis.

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Renu Singh, Md Ali Osama, Rachana Meena, Shailaja Shukla, Jagdish Chandra
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Immunocytochemistry on frozen-embedded cell block for the diagnosis of hematolymphoid cytology specimen: a straightforward alternative to the conventional cell block
Youjeong Seo, Sanzida Alam Prome, Lucia Kim, Jee Young Han, Joon Mee Kim, Suk Jin Choi
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Original Articles

Clinicopathologic implication of PD-L1 gene alteration in primary adrenal diffuse large B cell lymphoma: Ki Rim Lee, Jiwon Koh, Yoon Kyung Jeon, Hyun Jung Kwon, Jeong-Ok Lee, Jin Ho Paik; J Pathol Transl Med. 2022;56(1):32-39. Published online November 16, 2021; DOI: https://doi.org/10.4132/jptm.2021.10.05

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Abstract PDF: Background
Primary adrenal (PA) diffuse large B cell lymphoma (DLBCL) was previously reported as an aggressive subset of DLBCL, but its genetic features were not sufficiently characterized. From our previous study of DLBCL with programmed death-ligand 1 (PD-L1) gene alterations, we focused on PD-L1 gene alterations in PA-DLBCL with clinicopathologic implications.
Methods
We performed fluorescence in situ hybridization for PD-L1 gene translocation and amplification in PA-DLBCL (n = 18) and comparatively analyzed clinicopathologic characteristics with systemic non-adrenal (NA)-DLBCL (n = 90).
Results
PA-DLBCL harbored distinctive features (vs. NADLBCL), including high international prognostic index score (3–5) (72% [13/18] vs. 38% [34/90], p = .007), poor Eastern Cooperative Oncology Group performance score (≥ 2) (47% [7/15] vs. 11% [10/90], p = .003), elevated serum lactate dehydrogenase (LDH) (78% [14/18] vs. 51% [44/87], p = .035) and MUM1 expression (87% [13/15] vs. 60% [54/90], p = .047). Moreover, PA-DLBCL showed frequent PD-L1 gene alterations (vs. NA-DLBCL) (39% [7/18] vs. 6% [5/86], p = .001), including translocation (22% [4/18] vs. 3% [3/87], p = .016) and amplification (17% [3/18] vs. 2% [2/87], p = .034). Within the PA-DLBCL group, PD-L1 gene–altered cases (vs. non-altered cases) tended to have B symptoms (p = .145) and elevated LDH (p = .119) but less frequent bulky disease (≥ 10 cm) (p = .119). In the survival analysis, PA-DLBCL had a poor prognosis for overall survival (OS) and progression-free survival (PFS) (vs. NA-DLBCL; p = .014 and p = .004). Within the PA-DLBCL group, PD-L1 translocation was associated with shorter OS and PFS (p < .001 and p = .012).
Conclusions
PA-DLBCL is a clinically aggressive and distinct subset of DLBCL with frequent PD-L1 gene alterations. PD-L1 gene translocation was associated with poor prognosis in PA-DLBCL.

Can BAP1 expression loss in mesothelial cells be an indicator of malignancy?: Hanife Gulnihal Ozdemir, Sermin Coban Kokten, Nagehan Ozdemir Barisik; J Pathol Transl Med. 2020;54(6):497-503. Published online November 9, 2020; DOI: https://doi.org/10.4132/jptm.2020.09.14

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Abstract PDF

Background
Malignant mesothelioma is a highly aggressive tumor that can be confused with a benign mesothelial lesion, especially cytomorphologic lesions. BRCA1-associated protein 1 (BAP1) acts as a tumor suppressor. In this study, we aim to investigate the value of BAP1 staining of malignant mesothelioma cases with expression loss and diagnosis in cell block and biopsy tissue.
Methods
Between January 2009 and March 2017, 64 mesotheliomas, 117 reactive mesothelial hyperplasias, and 20 fibrinous pleuritis/pericarditis were diagnosed with morphologic and immunohistochemical findings in our pathology clinic and were included in the study. Formalin-fixed, paraffin-embedded tissues were immunohistochemically examined for BAP1. Inflammatory and stromal cells were used as positive internal controls. BAP1 was assessed for nuclear staining in mesothelial cells.
Results
Examinations of the relationship between patient diagnosis and BAP1 biopsy status showed that the BAP1 loss rate (76.6%) was significantly higher in malignant mesothelioma cases than in other benign diseases (0%) (p<.001). Sensitivity and specificity were 76.56% and 100%, respectively, for biopsy tissue from malignant mesothelioma. Sensitivity and specificity were both 100% for BAP1 test on cell block tissue. Furthermore, the consistency between BAP1 cell block and biopsy results was excellent (ĸ=0.90) and the correlation was significant (p<.001).
Conclusions
This study shows that BAP1 expression loss in both cytology and biopsy tissue in biopsy-confirmed malignant mesothelioma cases is an essential parameter for malignant mesothelioma diagnosis.

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Diagnostic Challenges in the Pathological Approach to Pleural Mesothelioma
Stefano Lucà, Giovanna Pignata, Alessandro Cioce, Cecilia Salzillo, Rossella De Cecio, Gerardo Ferrara, Carminia Maria Della Corte, Floriana Morgillo, Alfonso Fiorelli, Marco Montella, Renato Franco
Cancers.2025; 17(3): 481. CrossRef
Thrombocytosis as a paraneoplastic syndrome in metastatic malignant peritoneal mesothelioma of biphasic morphology mimicking ovarian adenocarcinoma: A case report
Moustafa S. Alhamadh, Rakan B. Alanazi, Osama Mohaamad Wadaan, Abdulrahman Yousef Alhabeeb, Mohammad Alkaiyat, Ohoud Zaid Aljarbou, Fouad Sabatin
Clinical Case Reports.2023;[Epub] CrossRef
Primary cardiac mesothelioma presenting with fulminant recurrent pericarditis: a case report
Shmuel Schwartzenberg, Yaron Shapira, Victor Rubachevski, Ram Sharony, Harry Klimis, Domenico Filomena, Edgar Francisco Carrizales Sepulveda, Nikolaos Spinthakis, Jonathan Senior
European Heart Journal - Case Reports.2023;[Epub] CrossRef

Case Study

Morphologic variant of follicular lymphoma reminiscent of hyaline-vascular Castleman disease: Jiwon Koh, Yoon Kyung Jeon; J Pathol Transl Med. 2020;54(3):253-257. Published online February 5, 2020; DOI: https://doi.org/10.4132/jptm.2019.12.17

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Abstract PDF

Follicular lymphoma (FL) with hyaline-vascular Castleman disease (FL-HVCD)-like features is a rare morphologic variant, with fewer than 20 cases in the literature. Herein, we report a case of FL-HVCD in a 37-year-old female who presented with isolated neck lymph node enlargement. The excised lymph node showed features reminiscent of HVCD, including regressed germinal centers (GCs) surrounded by onion skin-like mantle zones, lollipop lesions composed of hyalinized blood vessels penetrating into regressed GCs, and hyalinized interfollicular stroma. In addition, focal areas of abnormally conglomerated GCs composed of homogeneous, small centrocytes with strong BCL2, CD10, and BCL6 expression were observed, indicating partial involvement of the FL. Several other lymphoid follicles showed features of in situ follicular neoplasia. Based on the observations, a diagnosis of FL-HVCD was made. Although FLHVCD is very rare, the possibility of this variant should be considered in cases resembling CD. Identification of abnormal, neoplastic follicles and ancillary immunostaining are helpful for proper diagnosis.

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Unicentric Castleman Disease: Illustration of Its Morphologic Spectrum and Review of the Differential Diagnosis
Siba El Hussein, Andrew G. Evans, Hong Fang, Wei Wang, L. Jeffrey Medeiros
Archives of Pathology & Laboratory Medicine.2024; 148(1): 99. CrossRef
Finding a Needle in the Haystack
Hung-Yu Lin, Yi-Jen Peng, Yi-Ying Wu, Ping-Ying Chang
Journal of Medical Sciences.2023; 43(6): 292. CrossRef
Analysis of immunophenotypic features in hyaline vascular type Castleman disease
Yu Chang, Yu Ma, Chen Chang, Wensheng Li
Diagnostic Pathology.2023;[Epub] CrossRef
In‐situ follicular neoplasia: a clinicopathological spectrum
Gurdip S Tamber, Myriam Chévarie‐Davis, Margaret Warner, Chantal Séguin, Carole Caron, René P Michel
Histopathology.2021; 79(6): 1072. CrossRef

Original Article

Uterine Malignant Mixed Müllerian Tumors Following Treatment with Selective Estrogen Receptor Modulators in Patients with Breast Cancer: A Report of 13 Cases and Their Clinicopathologic Characteristics: Byung-Kwan Jeong, Chang O. Sung, Kyu-Rae Kim; J Pathol Transl Med. 2019;53(1):31-39. Published online December 18, 2018; DOI: https://doi.org/10.4132/jptm.2018.11.16

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Abstract PDF

Background
Breast cancer treatment with selective estrogen receptor modulators (SERMs) increasesthe incidence of uterine malignant mixed Müllerian tumors (uMMMTs). We examine clinicopathologiccharacteristics and prognosis of SERM-associated uMMMTs (S-uMMMTs) and discusspossible pathogenetic mechanisms.
Methods
Among 28,104 patients with breast cancer, clinicopathologicfeatures and incidence of uMMMT were compared between patients who underwentSERM treatment and those who did not. Of 92 uMMMT cases that occurred during the same period,incidence, dose, and duration of SERM treatment, as well as overall survival rate, were comparedfor patients with breast cancer who underwent SERM treatment and those who did not (S-uMMMTvs NS-uMMMT) and for patients without breast cancer (de novo-uMMMT). Histopathologicalfindings and immunophenotypes for myogenin, desmin, p53, WT-1, estrogen receptor (ER) α, ERβ,progesterone receptor, and GATA-3 were compared between S-uMMMT and de novo-uMMMT.
Results
The incidence of S-uMMMT was significantly higher than that of NS-uMMMT (6.35-fold).All patients with SERM were postmenopausal and received daily 20–40 mg SERM. CumulativeSERM dose ranged from 21.9 to 73.0 g (mean, 46.0) over 39–192 months (mean, 107). Clinicopathologicfeatures, such as International Federation of Gynecology and Obstetrics stage andoverall survival, were not significantly different between patients with S-uMMMT and NS-uMMMTor between patients with S-uMMMT and de novo-uMMMT. All 11 S-uMMMT cases available forimmunostaining exhibited strong overexpression/null expression of p53 protein and significantlyincreased ERβ expression in carcinomatous and sarcomatous components.
Conclusions
SERMtherapy seemingly increases risk of S-uMMMT development; however, clinicopathologic featureswere similar in all uMMMTs from different backgrounds. p53 mutation and increased ERβ expressionmight be involved in the etiology of S-uMMMT.

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Uterine carcinosarcomas: A case series of 9 cases from a low-income country
Boubacar Efared, Halidou Hamadou Koura, Aïchatou Balaraba Abani Bako, Idrissa Boubacar, Habiba Salifou Boureima, Garba Mahamadou, Hassan Nouhou
Medicine.2024; 103(40): e39773. CrossRef
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Mohan Shankar Gopinatha Pillai, Pallab Shaw, Arpan Dey Bhowmik, Resham Bhattacharya, Geeta Rao, Shailendra Kumar Dhar Dwivedi
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Case Studies

Primary Malignant Melanoma of the Breast: A Report of Two Cases: Jiwon Koh, Jihyeon Lee, So Youn Jung, Han Sung Kang, Tak Yun, Youngmee Kwon; J Pathol Transl Med. 2019;53(2):119-124. Published online November 26, 2018; DOI: https://doi.org/10.4132/jptm.2018.10.18

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Abstract PDF Supplementary Material

Primary malignant melanoma of the breast (PMMB) is a rare tumor with only a few case reports available in the literature. We report two cases of PMMB, one derived from the breast parenchyma and the other from the breast skin. The first case consisted of atypical epithelioid cells without overt melanocytic differentiation like melanin pigments. The tumor cells showed diffuse positivity for S100 protein, tyrosinase, and BRAF V600E. However, the tumor cells were negative for cytokeratin, epithelial membrane antigen, and HMB-45. The second case showed atypical melanocytic proliferation with heavy melanin pigmentation. The tumor cells were positive for S100 protein, HMB-45, tyrosinase, and BRAF V600E. These two cases represent two distinct presentations of PMMB in terms of skin involvement, melanin pigmentation, and HMB-45 positivity. Although PMMB is very rare, the possibility of this entity should be considered in malignant epithelioid neoplasms in the breast parenchyma.

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Ana García‐Urbina, Denis Espinoza‐Vásquez, Johanna Obregón‐Silva, Arlin Montoya Rodríguez
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Lucia Giudice, Sofia Vidali, Pietro Antonini, Elena Nucci, Federica Di Naro, Ludovica Anna Incardona, Vania Vezzosi, Vincenzo De Giorgi, Jacopo Nori
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Comprehensive Literature Review on Melanoma of Unknown Primary Site Triggered by an Intriguing Case Report
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Alejandro Caballero, Mario Perez, Issis Rodriguez
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Hyung In Choi, You Me Kim, Junwon Min, Yong Moon Lee, Hee Jeong Kim
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Juee Meghe, Yeshwant Lamture, Varsha Gajhbhiye, Pankaj Gharde, Akash Inamdar
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Aikaterini Mastoraki, Dimitrios Schizas, Ilias Giannakodimos, Athanasios Rebakos, Ioannis Margaris, Ioannis Katsaros, Ilias Vagios, Pantelis Vassiliu, Emmanouil Pikoulis
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Matías Chacón, Yanina Pfluger, Martín Angel, Federico Waisberg, Diego Enrico
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Emma Snashall, Tamara Kiernan, Aenone Harper-Machin, Rieka Taghizadeh
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Malignant Pleural Effusion from Metastatic Prostate Cancer: A Case Report with Unusual Cytologic Findings: Jinyoung Jeon, Tae-Jung Kim, Hong Sik Park, Kyo-Young Lee; J Pathol Transl Med. 2018;52(4):257-261. Published online June 7, 2018; DOI: https://doi.org/10.4132/jptm.2018.05.08

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Abstract PDF

We present a case of 55-year-old man who complained of dyspnea and sputum for a month. He was an ex-smoker with a history of prostate cancer and pulmonary tuberculosis. Chest radiographs revealed bilateral pleural effusions of a small to moderate amount. Pigtail catheters were inserted for drainage. The pleural fluid consisted of large clusters and tightly cohesive groups of malignant cells, which however could not be ascribed to prostate cancer with certainty. We performed immunocytochemical panel studies to determine the origin of cancer metastasis. The immunostaining results were positive for prostate-specific antigen, alpha-methylacyl-coenzyme A racemase, and Nkx 3.1, consistent with prostate cancer. Pleural effusion associated with prostate cancer is rare. To our knowledge, this is the first case report in Korea to describe cytologic features of malignant pleural effusion associated with prostate cancer.

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Review

Molecular Testing of Lymphoproliferative Disorders: Current Status and Perspectives: Yoon Kyung Jeon, Sun Och Yoon, Jin Ho Paik, Young A Kim, Bong Kyung Shin, Hyun-Jung Kim, Hee Jeong Cha, Ji Eun Kim, Jooryung Huh, Young-Hyeh Ko; J Pathol Transl Med. 2017;51(3):224-241. Published online May 10, 2017; DOI: https://doi.org/10.4132/jptm.2017.04.09

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Abstract PDF

Molecular pathologic testing plays an important role for the diagnosis, prognostication and decision of treatment strategy in lymphoproliferative disease. Here, we briefly review the molecular tests currently used for lymphoproliferative disease and those which will be implicated in clinical practice in the near future. Specifically, this guideline addresses the clonality test for B- and T-cell proliferative lesions, molecular cytogenetic tests for malignant lymphoma, determination of cell-of-origin in diffuse large B-cell lymphoma, and molecular genetic alterations incorporated in the 2016 revision of the World Health Organization classification of lymphoid neoplasms. Finally, a new perspective on the next-generation sequencing for diagnostic, prognostic, and therapeutic purpose in malignant lymphoma will be summarized.

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Lymphoproliferative disorder involving body fluid: diagnostic approaches and roles of ancillary studies
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Case Studies

Malignant Solitary Fibrous Tumor with Heterologous Rhabdomyosarcomatous Differentiation: A Case Report: Jeong-Hwa Kwon, Joon Seon Song, Hye Won Jung, Jong-Seok Lee, Kyung-Ja Cho; J Pathol Transl Med. 2017;51(2):171-175. Published online February 3, 2017; DOI: https://doi.org/10.4132/jptm.2016.08.29

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Abstract PDF

Malignant solitary fibrous tumor (MSFT) is a well-described entity, from which heterologous differentiation is extremely rare. We encountered a case of MSFT with rhabdomyosarcomatous differentiation in a 56-year-old man. This patient presented with a large mass in his posterior thigh. He had been treated with chemoradiation for sarcoma involving the cervical spine, right femoral head, and both lungs 6 months earlier. A wide excision was performed. The mass measured 10.6 cm and showed a fish-flesh cut surface with necrotic foci. Microscopically, the tumor showed heterogeneous cellularity with a hemangiopericytic vascular pattern. A hypercellular area showed spindle cells or epithelioid cells with high mitotic activity (63/10 high-power fields) and immunoreactivity for CD34 and CD99. A hypocellular area and a cystic area showed pleomorphic rhabdoid cells with immunoreactivity for desmin and myogenin. This is a report of a rare case of MSFT with rhabdomyosarcomatous differentiation and presents new histologic features of MSFT.

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Recurrent malignant solitary fibrous tumor of the scalp: a case report and literature review
Ahmed Rabie, Abdulkarim Hasan, Yasein Mohammed, Ayman Abdelmaksoud, Ali A. Rabaan
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Follicular Proliferative Lesion Arising in Struma Ovarii: Min Jee Park, Min A Kim, Mi Kyung Shin, Hye Sook Min; J Pathol Transl Med. 2015;49(3):262-266. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.26

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Malignant struma ovarii is extremely rare and difficult to diagnose histologically, particularly in cases of follicular carcinoma. This case study is intended to describe three cases of follicular proliferative lesion arising in struma ovarii that we experienced. The first case was clearly malignant given the clinical picture of multiple recurrences, but there was little histological evidence of malignancy. Our second case featured architectural and cellular atypia and necrosis and was diagnosed as malignant despite the absence of vascular and stromal invasion. Our third case exhibit-ed solid microfollicular proliferation without any definite evidence of malignancy (even the molecular data was negative); however, we could not completely exclude malignant potential after conducting a literature review. In cases such as our third case, it has been previously suggested that a diagnostic term recognizing the low-grade malignant potential, such as “proliferative stromal ovarii” or “follicular proliferative lesion arising in the stromal ovarii” would be appropriate.

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Role of gene sequencing in classifying struma ovarii: BRAF p.G469A mutation and TERT promoter alterations favour malignant struma ovarii
Sophie Neyrand, Alexis Trecourt, Jonathan Lopez, Pierre Alexandre Just, Françoise Descotes, Françoise Borson‐Chazot, Isabelle Ray‐Coquard, Myriam Decaussin‐Petrucci, Mojgan Devouassoux‐Shisheboran
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Malignant struma ovarii: next-generation sequencing of six cases revealed Nras, Braf, and Jak3 mutations
Roberta Poli, Maria Scatolini, Enrico Grosso, Francesca Maletta, Marco Gallo, Daniele Liscia, Anna Nelva, Flora Cesario, Giuseppe Forte, Jasna Metovic, Marco Volante, Emanuela Arvat, Mauro Papotti
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Proliferative struma ovarii: A rare case report
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Malignant struma ovarii presenting with follicular carcinoma: A case report with molecular analysis
Takafumi Tsukada, Hiroshi Yoshida, Mitsuya Ishikawa, Yuka Asami, Kouya Shiraishi, Tomoyasu Kato
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A Rare Case: Struma Ovarii in a 14-Year-Old Girl
Elif Iltar, Isin Ureyen, Tayfun Toptas, Melike Savas, Sema Çekiç, Aysel Uysal
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Brief Case Report

A Rare Case of Mesothelioma Showing Micropapillary and Small Cell Differentiation with Aggressive Behavior: Yoon Jin Cha, Binnari Kim, Joungho Han, Chin A Yi, Jae Ill Zo; Korean J Pathol. 2014;48(6):466-468. Published online December 31, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.466

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Small cell mesothelioma: A rare entity and diagnostic pitfall mimicking small cell lung carcinoma on fine‐needle aspiration
Yanhong Zhang, Alaa Afify, Regina F. Gandour‐Edwards, John W. Bishop, Eric C. Huang
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A Biphasic Pleural Tumor with Features of an Epithelioid and Small Cell Mesothelioma: Morphologic and Molecular Findings
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Review

Pathologic Review of Cystic and Cavitary Lung Diseases: Na Rae Kim, Joungho Han; Korean J Pathol. 2012;46(5):407-414. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.407

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Abstract PDF

Pulmonary cystic and cavitary lesions caused by diverse etiologies are commonly encountered in chest imaging. The terms "cyst" and "cavity" are used to describe air-filled regions in the center of a nodule or consolidation of the lung. To date, only radiologic aspects of these lesions have been addressed. The morphologies of pulmonary cystic and cavitary lesions exhibit a broad spectrum, ranging from benign to malignant pulmonary diseases of acquired or congenital origin, including variable infectious diseases. In this review, we summarized the differential diagnosis of pathological entities to provide pathologists and radiologists with an overview of the diseases most commonly associated with pulmonary cystic and cavitary lesions in adults and children. The results showed slightly different patterns in the distribution of the diseases in the two groups. The most common causes of cavitary lesions include malignancy and infection in adults, and congenital malformation in children. Therefore, identification of pathologic entities correlating with the radiologic findings, clinical course, and location of the lesion is important in the evaluation of cystic and cavitary lung lesions in order to avoid unnecessary surgical procedures or delayed treatment.

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Original Article

Fine needle aspiration cytology of malignant thymoma: two cases of invasive thymoma and thymic carcinoma.: Mee Yon Cho, Young Nyun Park, Kwang Gil Lee; J Pathol Transl Med. 1991;2(1):36-42.

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Abstract PDF: We report 4 cases of malignant thymoma which were composed of 2 cases of invasive thymoma and 2 cases of thymic carcinoma. The cytologic findings of invasive thymoma were similar to those of benign thymoma. The distinctive cytologic features of thymic carcinoma were necrotic background, irregular clusters and individually scattered arrangement of anaplastic epithelial cells, and some scattered mature small lymphocytes. These findings may be found in the Hodgkin'slymphoma, seminoma, and metastatic squamous cell carcinoma, undifferentiated carcinoma, and large cell carcinoma of the. lung. But, the feature of irregular clustering of anaplastic epithelial cell having scanty cytoplasm was different from Hodgkin'slymphoma and seminoma. Clinical and radiologic findings as well as cytologic finding were helpful in differential diagnosis of thymic carcinoma from metastatic carcinoma.

Case Report

Osteoclast-like Giant Cell Tumor of the Parotid Gland Accompanied with Carcinoma ex Pleomorphic Adenoma.: Mi Jung Kwon, Eun Sook Nam, Seong Jin Cho, Hyung Sik Shin, Ji Hyun Kwon, Young Soo Rho; Korean J Pathol. 2011;45:S84-S88.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S84

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Abstract PDF

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.

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Giant cell tumour of the parotid gland: a rare, unusual entity
Erna Ahsan, Kranthi Kumar Jandrasupalli, Prashant Durgapal, Divya Yadav
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Original Articles

WHO Classification of Malignant Lymphomas in Korea: Report of the Third Nationwide Study.: Jin Man Kim, Young Hyeh Ko, Seung Sook Lee, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2011;45(3):254-260.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.254

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Abstract PDF

BACKGROUND
The aim of study was to determine the relative frequency of malignant lymphoma according to World Health Organization (WHO) classification in Korea.
METHODS
A total of 3,998 cases diagnosed at 31 institutes between 2005 and 2006 were enrolled. Information including age, gender, pathologic diagnosis, site of involvement and immunophenotypes were obtained.
RESULTS
The relative frequency of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) was 95.4% and 4.6%, respectively. B-cell lymphomas accounted for 77.6% of all NHL, while T/natural killer (T/NK)-cell lymphomas accounted for 22.4%. The most frequent subtypes of NHL were diffuse large B-cell lymphoma (42.7%), extranodal marginal zone B-cell lymphoma (MZBCL) of mucosa-associated lymphoid tissue (19.0%), NK/T-cell lymphoma (6.3%) and peripheral T-cell lymphoma (PTCL), unspecified (6.3%), in decreasing order. The relative frequency of HL was nodular sclerosis (47.4%), mixed cellularity (30.6%), and nodular lymphocyte predominant (12.1%) subtypes. Compared with a previous study in 1998, increase in gastric MZBCL and nodular sclerosis HL, and slight decrease of follicular lymphoma, PTCL, and NK/T-cell lymphoma were observed.
CONCLUSIONS
Korea had lower rates of HL and follicular lymphoma, and higher rates of extranodal NHL, extranodal MZBCL, and NK/T-cell lymphoma of nasal type compared with Western countries. Changes in the relative frequency of lymphoma subtypes are likely ascribed to refined diagnostic criteria and a change in national health care policy.

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Jeongkuk Seo, Won Seog Kim, Jin Seok Kim, Seok Jin Kim, Jae Hoon Lee, Jun Shik Hong, Gyeong-Won Lee, Sung Yong Oh, Ji-Hyun Lee, Dok Hyun Yoon, Won-Sik Lee, Hyo Jung Kim, Jae-Yong Kwak, Hye Jin Kang, Jae-Cheol Jo, Yong Park, Ho Sup Lee, Hyo-Jin Kim, Cheolw
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Hee Hyun Park, Sea-Won Lee, Soo Yoon Sung, Byung Ock Choi
Radiation Oncology Journal.2017; 35(3): 249. CrossRef
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Oncotarget.2017; 8(54): 92289. CrossRef
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Leukemia & Lymphoma.2016; 57(6): 1406. CrossRef
Diffuse Large B-Cell Lymphoma of the Peri-Implant Mucosa Mimicking Peri-Implantitis
Seong-Ho Jin, Gyeongsin Park, Youngkyung Ko, Jun-Beom Park
Journal of Oral Implantology.2016; 42(2): 220. CrossRef
The Roles of Radiotherapy and Chemotherapy in the Era of Multimodal Treatment for Early-Stage Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma
Tae Hyung Kim, Jin Seok Kim, Yang-Gun Suh, Jaeho Cho, Woo-Ick Yang, Chang-Ok Suh
Yonsei Medical Journal.2016; 57(4): 846. CrossRef
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Ji Young Lee, Sang Min Lee, Moon Young Choi, Ki Hyang Kim, Young Don Joo, Sung Nam Im, Won Sik Lee
Blood Research.2016; 51(3): 187. CrossRef
Immune reconstitution inflammatory syndrome versus non-immune reconstitution inflammatory syndrome lymphoma in HIV patients on antiretroviral therapy
Pyoeng Gyun Choe, Jinyong Park, Wan Beom Park, Tae Min Kim, Kyoung-Ho Song, Ji Hwan Bang, Eu Suk Kim, Sang Won Park, Hong Bin Kim, Nam Joong Kim, Myoung-don Oh, Kang Won Choe
International Journal of STD & AIDS.2016; 27(11): 1013. CrossRef
Clinical outcome and prognosis of patients with primary sinonasal tract diffuse large B-cell lymphoma treated with rituximab-cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy: a study by the Consortium for Improving Survival of Lympho
Gyeong-Won Lee, Se-Il Go, Seok-Hyun Kim, Junshik Hong, Yu Ri Kim, Sukjoong Oh, Sung-Yong Kim, Young Rok Do, Hyewon Lee, Soon Il Lee, Sung Hwa Bae, Sung Yong Oh, Moo Kon Song, Won-Sik Lee, Bohee Lee, Jin Seok Kim, Min Kyoung Kim, Hye Jin Kang, Jae-Sook Ahn
Leukemia & Lymphoma.2015; 56(4): 1020. CrossRef
Therapeutic comparison of Surgery combined with chemotherapy and chemotherapy alone for Primary Gastrointestinal Lymphoma: A single center study
Je Hun Kim, Ho Sup Lee, Jun Seop Lee, Jin Young Lee, Su Young Kim, Cheol Su Kim, Joung Wook Yang, Ga In You
Kosin Medical Journal.2015; 30(1): 29. CrossRef
A Case of Simultaneous Primary Gastric and Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma after Therapeutic Endoscopy
Sun Hee Park, Jae Young Jang, Min A Park, Hyuck Kim, Young Woon Chang
Korean Journal of Medicine.2015; 89(1): 64. CrossRef
Clinicopathologic Study of Chromosomal Aberrations in Ocular Adnexal Lymphomas of Korean Patients
Hokyung Choung, Young A Kim, Namju Kim, Min Joung Lee, Sang In Khwarg
Korean Journal of Ophthalmology.2015; 29(5): 285. CrossRef
A Rare Case of Malignant Lymphoma Occurred at Spinal Epidural Space: A Case Report
Hyun-Jun Cho, Jang-Bo Lee, Junseok W. Hur, Sung-Won Jin, Tai-Hyoung Cho, Jung-Yul Park
Korean Journal of Spine.2015; 12(3): 177. CrossRef
Radiotherapy as an effective treatment modality for follicular lymphoma: a single institution experience
Seo Hee Choi, Jaeho Cho, Jin Seok Kim, June-Won Cheong, Chang-Ok Suh
Radiation Oncology Journal.2015; 33(4): 310. CrossRef
Current therapy of choice for cutaneous lymphomas: Complementary to the Japanese Dermatological Association/Japanese Skin Cancer Society guidelines
Keiji Iwatsuki, Toshihisa Hamada
The Journal of Dermatology.2014; 41(1): 43. CrossRef
The Role of Radiotherapy in the Treatment of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
Taek-Keun Nam, Jae-Sook Ahn, Yoo-Duk Choi, Jae-Uk Jeong, Yong-Hyeob Kim, Mee Sun Yoon, Ju-Young Song, Sung-Ja Ahn, Woong-Ki Chung
Cancer Research and Treatment.2014; 46(1): 33. CrossRef
Current Concepts in Primary Effusion Lymphoma and Other Effusion-Based Lymphomas
Yoonjung Kim, Chan Jeong Park, Jin Roh, Jooryung Huh
Korean Journal of Pathology.2014; 48(2): 81. CrossRef
Benign Indolent CD56-Positive NK-Cell Lymphoproliferative Lesion Involving Gastrointestinal Tract in an Adolescent
Jaemoon Koh, Heounjeong Go, Won Ae Lee, Yoon Kyung Jeon
Korean Journal of Pathology.2014; 48(1): 73. CrossRef
Peripheral T cell lymphoma in Asia
Sanghui Park, Young Hyeh Ko
International Journal of Hematology.2014; 99(3): 227. CrossRef
Characteristics of Cutaneous Lymphomas in Korea According to the New WHO-EORTC Classification: Report of a Nationwide Study
Jae Ho Han, Young-Hyeh Ko, Yun Kyung Kang, Wan-Seop Kim, Yoon Jung Kim, Insun Kim, Hyun-Jung Kim, Soo Kee Min, Chan-Kum Park, Chan-Sik Park, Bong-Kyung Shin, Woo Ick Yang, Young-Ha Oh, Jong Sil Lee, Juhie Lee, Tae Hui Lee, Hyekyung Lee, Ho Jung Lee, Yoon
Korean Journal of Pathology.2014; 48(2): 126. CrossRef
Epstein–Barr virus‐associated T/natural killer‐cell lymphoproliferative disorders
Sanghui Park, Young H. Ko
The Journal of Dermatology.2014; 41(1): 29. CrossRef
Overexpression of sphingosine-1-phosphate receptor 1 and phospho-signal transducer and activator of transcription 3 is associated with poor prognosis in rituximab-treated diffuse large B-cell lymphomas
Jin Ho Paik, Soo Jeong Nam, Tae Min Kim, Dae Seog Heo, Chul-Woo Kim, Yoon Kyung Jeon
BMC Cancer.2014;[Epub] CrossRef
Clinicopathologic implication of A20/TNFAIP3 deletion in diffuse large B-cell lymphoma: an analysis according to immunohistochemical subgroups and rituximab treatment
Jin Ho Paik, Heounjeong Go, Soo Jeong Nam, Tae Min Kim, Dae Seog Heo, Chul-Woo Kim, Yoon Kyung Jeon
Leukemia & Lymphoma.2013; 54(9): 1934. CrossRef
Clinical features and survival outcomes of patients with diffuse large B-cell lymphoma: analysis of web-based data from the Korean Lymphoma Working Party Registry
Hyeon Gyu Yi, Jin Seok Kim, Cheolwon Suh, Won Seog Kim, Jae-Yong Kwak, Jong-Seok Lee, Yang Soo Kim, Young Don Joo, Yoo Hong Min, Hong Ghi Lee, Sung-Soo Yoon, Jong-Ho Won, Seonyang Park, Hugh Chul Kim, Chul Soo Kim
Blood Research.2013; 48(2): 115. CrossRef
Epidemiologic overview of malignant lymphoma
Jooryung Huh
The Korean Journal of Hematology.2012; 47(2): 92. CrossRef
Gastrointestinal Lymphoma
Yoon Jung Lee, Jun Haeng Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2012; 12(3): 158. CrossRef
Transformation of CD5-Negative Follicular Lymphoma into CD5-Positive Diffuse Large B-Cell Lymphoma: A Case Report
Hyeong Kug Kim, In Sung Cho, Hye Kyung Lee, Yong Hun Choi, Seong Min Cho, Hyun Jin Moon, Jin A Lee
Korean Journal of Medicine.2012; 83(2): 263. CrossRef
The Role of Radiotherapy for the Treatment of Gastric MALT Lymphoma
Jae-Sook Ahn, Taek-Keun Nam
Korean Journal of Medicine.2012; 83(6): 712. CrossRef
Pathophysiology of Gastric MALT Lymphoma
Gyeongsin Park, Chang Suk Kang
Korean Journal of Medicine.2012; 83(6): 689. CrossRef
CD44s and CD44v6 Are Predominantly Expressed in the Non-germinal Center B-Cell-like Type of Diffuse Large B-Cell Lymphomas
Kyueng-Whan Min, Young-Ha Oh, Chan-Kum Park, So-Dug Lim, Wan-Seop Kim
The Korean Journal of Pathology.2011; 45(6): 589. CrossRef

Alteration of Apoptosis-Related Proteins (Apaf-1, Caspase-9, Bcl-2, p53, and Survivin) According to Malignant Progression in Cutaneous Melanocytic Lesions.: Yeo Ju Kang, Ji Han Jung, Kwnag Il Yim, Kyo Young Lee, Youn Soo Lee, Seok Jin Kang, Chang Suk Kang, Si Yong Kim; Korean J Pathol. 2011;45(3):247-253.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.247

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Abstract PDF: BACKGROUND
Apoptosis protease activating factor-1 (Apaf-1), caspase-9, Bcl-2, p53, and survivin are important factors in the pathway of apoptosis, but their clinicopathologic significance remains unclear in human cutaneous melanoma. We investigated the expression of these proteins and their clinical value in human cutaneous melanocytic lesions.
METHODS
We performed an immunohistochemical analysis to examine the expression and distribution of Apaf-1, caspase-9, Bcl-2, p53, and survivin in 36 cases of malignant melanoma (22 cases of primary melanoma and 14 cases of metastatic melanoma) and 41 cases of melanocytic nevus.
RESULTS
The expression of p53 was significantly higher in malignant melanoma than in melanocytic nevus (p<0.01), however the expressions of Apaf-1 and caspase-9 were significantly lower in malignant melanoma compared with melanocytic nevus (p<0.01 and p=0.027, respectively). Also, there was a significant difference for Bcl-2 staining between primary melanomas and metastatic lesions (p=0.004). Nuclear staining for survivin were absent in nevus, but were positive in 14 of 36 melanomas (p<0.01).
CONCLUSIONS
The altered expression of Apaf-1, caspase-9, p53, and survivin are considered to be related to malignant progression in human cutaneous melanocytic lesions. Loss of Bcl-2 can be considered as a prognostic marker of malignant melanomas.

Case Reports

Malignant Fibrous Histiocytoma Arising in a Mature Cystic Teratoma of the Ovary: A Case Report.: Soyoung Im, Sun Mi Lee, Ji Han Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2010;44(3):322-325.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.322

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Abstract PDF: A 50-year-old female patient presented with anorexia and weight loss. Pelvic computed tomography revealed a 12.5 x 7.3 cm heterogeneous mass in the left ovary. About 30% of the tumor was occupied by a mature cystic teratoma. The remaining solid portion was composed of fibrous and histiocytic elements, arranged in storiform patterns admixed with bizarre giant cells. The mitotic index was 8 per 10 high power fields, including atypical mitoses. The only immunopositivity was for vimentin. The tumor was diagnosed as a malignant fibrous histiocytoma arising in a mature cystic teratoma. To the best of our knowledge, this is only the third such case in the English language literature.

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.

Citations

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Myelomatous pleural effusion: A rare case in posttransplant myeloma
Sudha Madhuri Kandikanti, Poojitha Reddy Byreddy
RMC Global Journal.2025; 1: 94. CrossRef
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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
Revista Clínica Española (English Edition).2018; 218(2): 89. CrossRef
A 76-Year-Old Man With Anemia, Bone Pain, and Progressive Dyspnea
Thitiporn Suwatanapongched, Prapaporn Pornsuriyasak, Wasana Kanoksil, Thotsaporn Morasert, Warapat Virayavanich
Chest.2014; 145(4): 913. CrossRef

The Cytology of Metastatic Angiosarcoma in Pleural Fluid : A Case Report.: Na Rae Kim, Dong Hae Chung, Hyun Yee Cho; Korean J Pathol. 2009;43(3):285-259.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.285

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Abstract PDF

A 74-year-old woman presented with an abrupt onset of dyspnea that she had experienced for a week. She had been suffering from cutaneous nodules in the scalp for a year. Thoracentesis of the pleural fluid was performed. The Papanicolaou-stained smears, Thin prep and cell block preparations revealed clusters of oval-shaped cells concentrically layered about amorphous acellular cores, i.e., there was microacinar lumen formation as well as singly scattered atypical cells. The cells occasionally demonstrated intracytoplasmic vacuoles and hemosiderin deposits. Those cells stained for CD31 and they were negative for pancytokeratin. Punch biopsy from the scalp nodules revealed angiosarcoma. There are currently few reported cases of angiosarcoma in an exfoliative pleural effusion. Angiosarcoma has diverse, heterogeneous cytologic features. Making the cytologic diagnosis of metastatic angiosarcoma in pleural fluid is a challenge for pathologists. Knowledge of the clinical history is of great help for diagnosing this tumor when it appears in rare sites. Immunopanels with CD31, pancytokeratin and TTF-1 are helpful for making the differential diagnosis. The pathologists should look for clues suggesting the presence of vascular differentiation in the exfoliative cytologic materials when a diagnosis of angiosarcoma is suspected.

Citations

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Metastatic pleural angiosarcoma: A diagnostic pitfall might be overcome by morphologic clues and clinical correlation
Ok Ran Shin, Uiju Cho, Eundeok Chang, Kyung Jin Seo
Diagnostic Cytopathology.2015; 43(8): 669. CrossRef
Pleural fluid cytology in metastatic uterine angiosarcoma—A case report—
Shiho KURODA, Shioto SUZUKI, Akira KURITA, Mari MURAKI, Fumihiko TANIOKA
The Journal of the Japanese Society of Clinical Cytology.2014; 53(6): 498. CrossRef
Intranasal delivery of biologics to the central nervous system
Jeffrey J. Lochhead, Robert G. Thorne
Advanced Drug Delivery Reviews.2012; 64(7): 614. CrossRef
Fine Needle Aspiration Cytologic Findings of Angiosarcoma - Report of Two Cases -
Jin Xian Ji, Young Chae Chu, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim, Kyu Ho Kim, Ju Young Song
The Korean Journal of Pathology.2011; 45(2): 217. CrossRef

Original Articles

Human Papillomavirus Infection and Its Relationship to Cervical Intraepithelial Neoplasia: An immunohistochemical, histopathological and Cytological Study.: Mi Jin Kim, Won Hee Choi, Tae Sook Lee; Korean J Pathol. 1989;23(2):240-253.

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Abstract PDF: It has suggested that a significant proportion of intraepithelial lesion of the cervix may be related to the influence of human papillomaviurs (HPV). Its etiological relation with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma has recently been proposed. The 131 cases of CIN and 6 condyloma acuminata were stained by immunoperoxidase technique for HPV anigen. The results are as follows: The 18 cases (13.1%) exhibited positive staining, localized in nuclei of koilocytotic cells confined to superficial and intermediate layer of epithelium. HPV antigen was found in 1 case (16.7) of 6 condyloma acuminata, 4 cases (12.5%) of 32 mild dysplasia, 3 cases (13.6%) of 22 moderate dysplasia, 2 cases (14.3%) of 14 severe dysplasia and 8 cases (12.7%) of 63 carcinoma in situ. In the positive cases of mild and moderate dysplasia, HPV antigen was localized directly within the lesion, while those cases of severe dysplaia and carcinoma in situ contained positive cells in areas of mild or moderate dysplasia adjacent to the lesion. Of three distinct morphologic patterns, flat type was most common and papillary type was least. Histologically condylomatous lesions were present in 67 cases (51.1%) out of 131 cases of CIN. The histological and cytological feature encountered most frequently was koilocytotic arypia. Other main histological features are bi- or multinucleation, exocytosis of inflammatory cells, acanthosis, mitotic figures, dyskeratosis and epithelial pearl. On the cervical smear, the evidence of condyloma was proved in 50.0%. Cytologically in the condyloma with high degree of CIN, the nuclear atypia was so prominent that the differentiation from dysplasia or carcinoma in situ was very difficult, although the chromatin appeared somewhat smudged. The mean age of 18 cases was 42.4 years which is older than previous study. The results of this study provide common association with HPV and CIN and add great weight to the suggestion that the infection with HPV plays an important part in genesis of cervical cancer.

Polymorphic Reticulosis.: Duck Hwan Kim, Jin Hee Sohn, Sung Suk Paeng, Kyung Ha Kang, Jung Il Suh; Korean J Pathol. 1995;29(3):296-302.

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Abstract PDF: Polymorphic reticulosis(PMR) is a unique clinicopathological entity of unknown etiology, which commonly present as an aggressive, necrotizing lesion of the upper respiratory tract. It is a separate nosologic entity from Wegener's granulomatosis and idiopathic mildine destructive disease. The origin of the cells composing polymorphic reticulosis has been controversial. We reviewed 15 cases of polymorphic reticulosis with respect to clinical and histologic bases, and immunohistochemical studies were done using UCHLI (CD45RO), as a T cell marker, CD-20 as a B cell marker and alpha- I -antichymotrypsin as a histiocytic marker. Almost all cases showed characteristic histologic and immunohistochemical features similar to those of peripheral T cell lymphoma. Thus, this study indidcated that polymorphic reticulosis is a type of malignant lymphoma of T cell lineage.

Case Reports

Pathologic Study of Primitive Neuroectodermal Tumor: Report of 5 cases.: Sook Nyo Lee, Jong Eun Joo, Dong Soo Suk, Hyung Dong Kim, Soo Hyu Kim, Jae Hong Sim, Je G Chi; Korean J Pathol. 1989;23(3):331-341.

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Abstract PDF: Primitive neuroectodermal tumor (PNET) occuring in the brain (especially in the cereburm) of young individuals is a rare and highly malignant neoplasm. The authors analyzed 5 cases of primitive neuroectodermal tumor, operated from January 1986 to September 1987. They had characteristic clinical, radiologic and pathologic features. Patient's age ranged from 2 years to 14 years old (mean 8.2 years old) and there were 3 boys and 2 girls. They were rapidly growing tumor, with a brief duration of symptoms taking a rapidly progessive course. Computerized tomographic findings were characteristic, revealing the large, irregular, typically iso-to hyper-dense mass lesions with calcification and cystic or necrotic areas, and showing dense heterogeneous contrast enhancement of the mass in the cerebral hemisphere. Grossly all of the 5 cases showed hemorrhage and necrosis with sharp border and 2 cases showed calcification and cystic change grossly. Microscopically, they were predominantly composed of undifferentiated small dark cells with evidence of focal differentiation along glial and or neuronal lines. Four cases showed glial differentiation and three cases showed neuronal differentiation. Mesenchymal components were predominant in 3 cases.

Non-Hodgkin's Lymphoma of the Uterine Cervix: 3 cases report.: Chan Pil Park, Young Hyeh Ko, Jung Dal Lee, Moon Il Park, Kyung Tai Kim, Sam Hyun Cho; Korean J Pathol. 1995;29(3):368-373.

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Abstract PDF: Three patients with primary non-Hodgkin's lymphoma of the uterine cervix are reported and the literature is reviewed. All the three patients in the current study presented with vaginal bleeding. They were found to have diffuse large cleaved cell lymphoma, one of which was multilobated variant with marked sclerosis. Histologically, differential diagnsis from undifferentiated small cell carcinoma, endometrial stromal sarcoma & other sarcomas was difficult and requires special stains including immunobistochemical study. Vaginal pap smears were diagnosed as 'class V; malignant lymphoma' in only one patient. Immunologically, two cases were beta-cell lineage and one case was T-cell lineage. All the patients were treated with chemotherapy only and showed good responses.

A Case of Malignant Lymphoma Misdiagnosed as Focal Lymphoid Hyperplasia in the Esophagus.: Sook Keum Chung, Young Hyeh Ko, Chan Keum Park, Jung Dal Lee; Korean J Pathol. 1995;29(3):393-398.

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Abstract PDF: Esophageal involvement by malignant lymphoma is extremely rare. A case of follicular lymphoma of the esophagus, misdiagnosed as focal lymphoid hyperplasia (pseudolymphoma) in a 72-year-old man is presented. The esophagogram revealed diffuse narrowing of the lumen in the middle and distal portion without ulceration. The resected esophagus showed mural thickening without any remarkable mucosal change. Microscopically, the esophagus showed scattered follicular lymphoid aggregates in the submucosa, extending into periadventitial fat tissue. Most follicles were devoid of germinal center and consisted of loosely aggregated small cleaved cells without atypia. The surrounding stroma of the submucosa showed dense fibrosis entrapping the infiltrating small lymphocytes in a "indian-file" appearance. There were some reactive follicles with germinal center. In the lamina propria, many plasma cells and a few eosinophils were infiltrated. The gene rearrangement study showed rearranged band for Jk probe which confirmed monoclonal B-cell nature of infiltrated small lymphoid cells. The small cleaved lymphocytes arranged in follicles were positive for L26 and bcl-2 protein. This case demonstrated the necessity of immunophenotypic and gene rearrangement study in the diagnosis of pseudolymphoma in the digestive tract.

Malignant Glomus Tumor Arising in Benign Glomus Tumor.: Seung Sam Paik, Eun Sun Kim, Young Chun Moon, Chan Kum Park, Moon Hyang Park, Jung Dal Lee; Korean J Pathol. 1997;31(3):280-283.

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Abstract PDF: The glomus tumor is a distinct neoplasm composed of modified perivascular smooth-muscle cells identical to those described in the glomus body. Malignant glomus tumor, also referred to as glomangiosarcoma, is exceedingly rare. It has been subdivided into locally infiltrative glomus tumor, glomangiosarcoma arising in a benign glomus tumor, and glomangiosarcoma arising in de novo. A few cases of malignant glomus tumor arising in a benign glomus tumor have been reported. A 55-year-old man underwent resection of a solitary nodule in the right shoulder area. The tumor was biphasic with a typical benign glomus tumor at the periphery and the central sarcomatous area composed of oval to elongated pleomorphic cells with a single prominent nucleolus and occasional mitotic figures. Both tumor components showed intense staining for vimentin, smooth muscle actin, and muscle specific actin. Herein, we report a case of a malignant glomus tumor arising in a benign glomus tumor with an immunohistochemical study and a review of literatures.

Original Article

Application of Gene Rearrangement Analysis for Diagnosis of Malignant Lymphoma.: Kyung Soo Kim, Chan Choi; Korean J Pathol. 1995;29(4):415-422.

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Abstract PDF: To evaluate the utility of gene rearrangement analysis, eight cases of malignant lymphoma, one case of Hodgkin's disease, two cases of angioiminunoblastic lymphadenopathy (AILD) and two cases of non-specific lymphadenitis were studied by immunohistochemical and genetic analysis. Southern blot analysis was perfon-ned by a using vacuum transfer system and a biotin labelled probe. This method was faster, safer, and more convenient than conventional methods. Gene rearrangement study showed rearranged novel bands in five of six cases of B cell lymphoma, in all cases of T cell lymphoma, and in all cases of AILD. No rearrangement of the B cell receptor(BCR) or of the T cell receptor(TCR) was seen in Hodgkin's disease or in nonspecific lymphadenitis. These results suggest that gene rearrangement analysis of BCR and TCR is a recommended method for the diagnosis of clonality in lymphoproliferative disorders. It would allow pathologists to differentiate lymphoma from polyclonal lymphoid proliferation and to provide information for cell lineage.

Case Reports

Primary Transitional Cell Carcinoma of the Ovary: A case report.: Eun Kyung Kim, Sung Ran Hong, Jae Uk Shim, Hy Sook Kim; Korean J Pathol. 1993;27(1):78-80.

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Abstract PDF: Primary ovarian transitional cell carcinoma(TCC) is a recently described, distinct subtype of ovarian carcinoma resembling TCC of the urinary bladder. TCC differs from malignant Brenner tumor(MBT) by absence of benign or proliferative Brenner component and prominent stromal calcification. TCC also represents a high-stage tumor with more aggressive biologic behavior than MBT, but it has a relatively favorable response to chemotherapy. TCC may arise from the pluripotential surface epithelium of the ovary or from the cells with urothelial differentiation, rather than from a benign or proliferative Brenner tumor precursors. We report a case of pure form of primary TCC presenting as a left ovarian mass in 45-year-old woman.

Bronchial Brushing and Bronchial Washing Cytologic Features of Primary Malignant Fibrous Histiocytoma of the Lung: A Case Report .: Mi Ok Park, Wook Su Ahn; J Pathol Transl Med. 1999;10(2):151-155.

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Abstract PDF: A case of primary malignant fibrous histiocytoma(MFH) of the lung occurring in a 62-year-old man is presented. After preoperative bronchial brushing and washing cytologic diagnosis of poorly differentiated carcinoma, surgical resection and lymph nodes dissection were performed. Subsequent histologic examination revealed a primary MFH. The diagnosis was confirmed by electron microscopic and immunohistochemical examinations. The review of the bronchial brushing and washing cytologic features disclosed many bipolar and a few unipolar spindle tumor cells with a "comet" configuration, mainly single cells, but also forming loose clusters. The nuclei were elongated and hyperchromatic and contained one or more irregular nucleoli. Scattered bizarre, multinucleated tumor giant cells were also present.

Malignant Solitary Fibrous Tumor of the Pleura in Mediastinum.: Yun Kyung Kang, Hyun Joo Yoo, Ho Kee Yum, Hong Sup Lee; Korean J Pathol. 1997;31(4):351-356.

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Abstract PDF: Solitary fibrous tumors (SFTs) most often involve the pleura and also may encompass the peritoneum and nonserosal sites. They occur as solitary encapsulated tumors and pursue a relatively benign clinical course. The usual criteria for malignancy are high cellularity, mitotic activity (more than 4 per 10 high-power fields), cellular pleomorphism, hemorrhage and necrosis as well as infiltrative growth. We report a case of malignant SFT of pleura who presented with an anterior mediastinal mass. Grossly, it was a 10x8x6.5 cm sized, encapsulated and well-demarcated, solid neoplasm with areas of extensive necrosis. Microscopically, parallel or haphazard arrangement of spindle cells with variable degrees of collagenous background were noted. Storiform fascicle formation, hemangiopericytoma-like pattern, and epithelioid cell clusters were often intermingled. Nodular areas with high cellularity and mitotic activity (> or =10/10 HPFs) were scattered throughout the neoplasm, however no definite cellular pleomorphism was encountered. Tumor cells were immunoreactive for vimentin and CD-34, which distinguished them from the mesothelial cells. Electron microscopically, they revealed fibroblastic and myofibroblastic differentiation.

Original Articles

Lymphoproliferativ Lesions of the Orbit and Conjunctiva: Histopathologic Study on 20 cases including 5 cases analyzed by Immunophenotyping.: Chul Woo Kim, Na Hye Myong, Je G Chi; Korean J Pathol. 1993;27(2):152-163.

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Abstract PDF: Lymphoid lesions of the orbit and conjunctiva may be divided histologically into three groups: monomorphous and cytologically atypical malignant lymphomas, benign reactive follicular hyperplasia or inflammatory pseudotumor, and borderline lymphoid lesions mainly composed of small, non-atypical lymphocytes with or without evidence of plasmacytic differentiation or germinal centers which are difficult to clarify its nature by histologic criteria alone. From 1984 to 1992 at Seoul National University Hospital, 20 cases of orbital lymphoid infiltrates were reviewed to find out histopathologic characteristics of malignant lymphomas and try to classify them properly. Also, we sought histologic findings helpful for differential diagnosis between malignant and borderline cases. Histologic examination of malignant lesions usually revealed the features of low-grade B cell lymphomas of mucosa-associated lymphoid tissue(MALT) origin, which predominantly consist of centrocyte-like(CCL) cells. Among 13 primary orbital lymphomas, six cases were classified as MALT lymphomas of Isaacson, six were more apt to be the type of immunocytoma by kiel classification, and remaining one showed mixed pattern of both types in areas. The one case of malignant lymphoma with diffuse large cell type was confirmed by secondary involvement of intestinal lymphoma. Five cases were confirmed by immunoglobulin k-light chain monoclonality on flow cytometry and immunofluorescence study. The histologic findings such as Dutcher bodies, hemosiderin, deposits and polykaryocytes tended to be more frequently encountered in malignant lymphoma rather than indeterminate lesions and were thought to be helpful ones in making differential diagnosis between malignant and benign lesions. With above findings, we assume that the principal neoplastic cells in the low grade lymphoma arising in the orbit and conjunctiva are CCL cells, which might be originated from the localized memory B cells, and also several kinds of B lymphocytes in on-going differentiation stages such as medium-sized monocytoid B cell, lymphoplasmacytoid cell, plasma cell, and mature small lymphocyte also contribute to the tumor progression.

ras Gene Mutations in Malignant Fibrous Histiocytoma.: Jinyoung Yoo, Ah Won Lee, Seok Jin Kang, Byung Kee Kim; Korean J Pathol. 2001;35(3):232-237.

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Abstract PDF: BACKGROUND
ras gene mutations have been described in various human malignancies, suggesting that their activation may play a role in oncogenesis. However, there are few reports concerning ras gene alterations in malignant fibrous histiocytomas. We therefore designed a study to determine the prevalence and type of mutations in the first exons of H-ras and K-ras genes in these tumors.
METHODS
Twenty-seven malignant fibrous histiocytomas were investigated by direct sequencing analysis with the automated DNA sequencing of polymerase chain reaction-amplified ras sequences.
RESULTS
Twenty-four mutations were found in 18 (67%) of the tumors: GGC to GAC transition mutations at codon 13 of K-ras (coding for aspartic acid instead of glycine) in 18 of the samples and GGC to GTC transversions at codon 12 of H-ras (coding for valine instead of glycine) in six of the lesions.
CONCLUSIONS
Our data suggest an involvement of the ras gene mutation in conjunction with other yet unknown events in the tumorigenesis and/or progression of malignant fibrous histiocytomas. The K-ras gene activation predominated in these tumors by a mutation at codon 13. It is noteworthy that H-ras mutations were detected only in association with the lesions containing K-ras mutated genes, the significance of which remains to be determined.

Case Reports

Non-Hodgkin's Malignant Lymphoma Arising in the Appendix: A case report.: Yun Sin Kim, Mi Sook Lee, Kwang Seok Lee Lee, Sung Chul Lim, Ho Jong Jeon; Korean J Pathol. 1995;29(4):524-526.

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Abstract PDF: Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.

Malignant Deciduoid Mesothelioma: A Case Report.: Jung Uee Lee, Bum Kyeong Kim, Yoon Mee Kim, Hae Joung Sul, Kyung Bok Lee, Hoi Young Lee; Korean J Pathol. 2007;41(6):416-419.

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Abstract PDF: Malignant deciduoid mesothelioma is a rare malignant neoplasm occurring in the peritoneum of young women. We report a case of malignant deciduoid mesothelioma that occurred in the omentum of a 47-year-old woman. The patient had never exposed to asbestos and had no history of cesarean section. The lesions were multiple infiltrative nodules affected the peritoneal cavity, omentum, and surface of the uterus with both ovaries. Microscopically, the nodules were composed of mesothelial cells similar to decidual cells

Original Article

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.

Case Reports

A Case of Intracranial Malignant Teratoma.: Bong Kwon Chun, Hee Kyung Chang, Man Ha Huh; Korean J Pathol. 1990;24(1):85-90.

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Abstract PDF: The authors report a case of malignant teratoma in a 3-year-old girl who suffered from occipital headache and vomiting for about 2 months. The tumor occupied left cerebellopontine angle resulting in a moderate degree of hydorcephalus. Histologically, the tumor consisted mainly of neuroepithelial tissues showing varying degrees of differentiation, with areas of epidermis, mature fat tissue, connective tissue, gastrointestinal glands and smooth muscle bundles containing ganglions. Also noted are groups pf polygonal or spindle cells representing immature mesodermal tissue. In contrast to two malignant intracranial teratomas previously reported in Korean literatures, this case is characterized by the presence of predominent neuroepithelial components and by uncommon tumor location, the posterior fossa far from middle line of the body.

Analysis of Pulmonary Asbestos Body in Malignant Mesothelioma: A case report.: Hoon Kyu Oh, Jae Yoe Ro, Chul Jong Yoon, Je Geun Chi; Korean J Pathol. 1999;33(5):361-366.

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Abstract PDF: The association between occupational asbestos exposure and the subsequent development of malignant mesothelioma of pleura is well recognized. We analyzed an asbestos body by energy dispersive X-ray analyser in a case of malignant mesothelioma of pleura who had a history of asbestos exposure 30 years ago. In transmission electron microscope, the asbestos body was composed of a core of refractile thin asbestos fiber bundle and beaded masses of electron-dense iron and protein complex. The core fibers were analyzed as an amphibole type crocidolite fiber [(Na2Fe3Fe2(Si8O22)(OH)2] which composed of high content of silicon, iron and sodium.

Original Articles

Morphometric Analysis of Malignant Lymphoma.: In Sook Kim, Eun Kyung Hong, Jong Dal Lee; Korean J Pathol. 1990;24(2):128-136.

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Abstract PDF: Nuclear morphology and size are important in the diagnosis and classification of non-Hodgkin's lymphoma. The recognition of morphologic features of the lymphoma cells and their interpretation are somewhat subjective and often difficult. We apply the morphometric study in touch imprints from 22 cases of non-Hodgkin's lymphoma classified by Working formulation. Determination of the exact size of the tumor cells and substantial diagnostic value of this method compared with histology are proposed. Morphometric parameters, including nuclear area, perimeter, maximal diameter (D-max), diameter of an equivalent circle for a measured area (D-circle), circularity factor (From PE) and regularity factor (Form AR) are measured, using Kontron, user-controlled image analyser (IBAS-1). The correlation between morphometric and histologic diagnosis is relatively good, except for 2 cases of Burkitt's lymphoma, measured as large cell and 2 cases of large cell lymphoma measured as medium cell. The most reliable parameter of the nuclear size is D-circle. The parameters for the nuclear shape, Form PE and Form AR, also reflect the nuclear cleavage and polymorphous pattern. The large cell group shows more wide standard deviation than small and medium cell groups, reflecting heterogeneity and variability in unclear size of large cell group. We suggests the morphometric analysis using touch imprints is complementary diagnostic tool for more accurate and reproducible diagnosis.

Clinicopathological Analysis on the 104 Cases of Malignant Melanoma.: Kye Yong Song, Kyeong Cheon Jung, Kwang Hyun Cho, Je Geun Chi, Eui Geun Ham; Korean J Pathol. 1997;31(6):566-573.

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Abstract PDF: The cliniopathological analysis was done on the 104 cases of malignant melanoma diagnosed at the Seoul National University Hospital (SNUH) from 1984 to 1993. The basic clinical data and the pathological items were based on the New Mexico Melanoma Registry Worksheet. The results were as follows. The male to female ratio was 1 : 0.79. Primary cutaneous melanoma was more common in the male (M : F=1 : 0.56) but primary extracutaneous melanoma with slight female dominancy (M : F=1 : 1.25). The peak age was the 6th decade in both cutaneous and extracutaneous malignant melanoma. In 66% (35 cases) of primary cutaneous malignant melanoma, the primary site was located in the acral area (including cases of acral lentiginous and nodular type), of which 63% (41% of total cutaneous melanoma) was acral lentiginous type. Major components of tumor cells were epithelioid. Clark's level of tumor was III or more at the time of the first visit in the majority of the cases (85%). The incidence rate of extracutaneous melanoma was 34.6% (36 cases) among the primary melanoma, and the eyeball (17.3%) was the most prevalent organ. All these features suggest that the racial difference between the Korean and the Caucasian is evident and also that etiologic role of sun damage is not quite marked in the Korean. We also suggest that an early detection program is very important to cure this malignant tumor.

Characterization of Principal Component Cell of DMBA induced Rat Malignant Fibrous Histiocytoma With Cell Culture and Cloning.: Myeng Sun Park, Hae Jin Jeong, Man Ha Huh; Korean J Pathol. 1997;31(6):574-585.

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Abstract PDF: This experiment was performed to elucidate the cytologic origin of chemically induced MFH in Wistar rats. The tumor was produced by injections of DMBA(9,10-dimethyl-1,2-benzanthracene). With the produced MFH, cell culture and cloning were performed, followed by establishment of a cell strain, which was investigated by immunohistochemical and electron microscopic studies. The results were as follows. A) By immunohistochemistry of the tumor tissue, fibroblastic cells were positive for MEP-1(specific antibody for fibroblastlike cell of MFH, Takeya, 1993) and Anti-hPH(beta)(Anti-prolyl 4-hydroxylase beta), but negative for TRPM-3 and F4/80. Histiocytelike cells were positive for TRPM-3 and F4/80, but negative for MEP-1 and Anti-hPH(beta). In immunoelectron microscopy, normal spleen macrophage showed linear reactivity in cell membrane for TRPM-3, whereas histiocytelike cells of the tumor disclosed negative reaction. B) At 5 weeks of the primary tumor cell culture, the cells exhibited typical storiform pattern of MFH. C) The established cell strain revealed immunoreactivity for MEP-1 and Anti-hPH(beta), but negative for TRPM-3. The cloned tumor cells showed morphologic characteristics of undifferentiated fibroblastic cell. Latex particle (0.80 micrometer size) phagocytosis was negative in the cloned cell strain. The results of the current study support the concept that principal component cells of MFH is of fibroblastic cell origin.

Case Report

Fine Needle Aspiration Cytology of Primary Malignant Lymphoma of the Thyroid Gland: A Case Report.: Mi Seon Kwon, Seung Sook Lee, Jae Soo Koh, Jin Haeng Chung, Kyo Young Lee; J Pathol Transl Med. 2001;12(1):67-71.

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Abstract: Primary malignant lymphoma of the thyroid gland is uncommon malignancies. Its fine needle aspiration cytology (FNAC) findings are rarely described in the literature. This article highlights the FNAC diagnosis of primary malignant lymphoma of the thyroid gland. A 70-year-old female presented with a rapidly enlarging thyroid mass of five months' duration. FNAC smears showed low cellularity consisting of predominantly atypical enlarged lymphoid cells admixed with a few small lymphocytes, plasma cells, and oncocytic cells. Some disrupted lymphoid cells were also present. The tumor cells infiltrated into the thyroid follicular epithelium forming lymphoepithelial lesion. The cytologic appearance showed a diffuse mixture of cell types with only a few small, mature lymphocytes and many enlarged lymphoid cells. The enlarged lymphoid cells were atypical and pleomorphic with nuclear clefting and irregularities. Grossly, the left lobe of the thyroid was nearly replaced by a diffuse firm to soft solid mass with smooth tan fish-flesh homogeneous cut surface. Histological diagnosis was diffuse large B-cell lymphoma with areas of marginal zone B-cell lymphoma of MALT type.

Original Articles

Immunocytochemical Expression of E-cadherin in Cell Blocks of Serous Effusions.: Byung Heon Kim, O Jun Kwon; J Pathol Transl Med. 2001;12(2):81-88.

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Abstract PDF: The differentiation between reactive mesothelial and carcinoma cells in serous effusion cytology can be a diagnostic challenge based on morphology alone. The expression of some cell adhesion molecules may be helpful in the differential diagnosis. This study evaluated the usefulness of E-cadherin immunocytochemistry for discrimination of carcinoma cells from reactive mesothelial cells. Alcohol fixed, paraffin embedded cell blocks taken from 42 reactive and 102 malignant serous effusions with histologically confirmed diagnoses were immunostained with monoclonal antibody to E-cadherin by LSAB method. E-cadherin expression was identified in only 2 benign reactive serous effusions(5%) whereas 91 malignant serous effusions(89%) expressed E-cadherin. The differences in immunostaining for E-cadherin between reactive and malignant serous effusions were statistically significant(p<0.001). The sensitivity and specificity of the E-cadherin immunostaining for carcinoma cells were 89% and 95%, respectively. In conclusion, E-cadherin is a useful diagnostic adjunct for differentiation between reactive mesothelial and carcinoma cells in serous effusions.

Utility of Calretinin in Distinction between Benign Reactive Mesothelial and Carcinoma Cells in Serous Effusions.: Byung Heon Kim; J Pathol Transl Med. 2001;12(2):89-96.

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Abstract PDF: The cytological distinction of carcinoma cells from reactive mesothelial cells in serous effusions may be difficult or impossible based on morphology alone, especially in specimens containing reactive mesothelial cells which form glandular or ball- or papillary-shaped conglomerates or which mimic malignant nuclear features. Calretinin is a newly reported immunocytochemical marker for mesothelial cells, which can potentially be utilized for facilitating this distinction. This study evaluated the usefulness of calretinin for the discrimination between reactive mesothelial and metastatic carcinoma cells in serous effusion. Immunocytochemical staining was undertaken on 33 benign reactive and 87 malignant serous effusion specimens with histologically confirmed diagnoses. The specimens including smears and cell blocks were stained with polyclonal antibody to calretinin by labelled streptavidin-biotin method. The positive expression of calretinin was noted in 32(97.0%) of 33 benign reactive effusions and 9(10.3%) of 87 malignant effusions. The sensitivity and specificity of the calretinin immunostaining for reactive mesothelial cells was 97.0% and 89.7%, respectively. In conclusion, calretinin is a useful marker for distinguishing between reactive mesothelial cells and carcinoma cells in serous effusions.

Case Reports

Malignant Myoepithelioma Arising in a Recurrent Pleomorphic Adenoma: A case report.: Jeong Yu Kyung, Yeon Lim Suh; Korean J Pathol. 1999;33(7):517-520.

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Abstract PDF: Malignant myoepithelioma is a rare neoplasm of salivary gland which may either arise de novo or develop in a pre-existing pleomorphic adenoma. The malignant myoepithelioma occurs in 0.45% of major salivary gland tumors. Malignant myoepitheliomas arising in the pleomorphic adenoma number less than 20 in English literature and 1 in Korea. We describe a case of malignant myoepithelioma arising in a recurrent pleomorphic adenoma of the left parotid gland of a 61-year-old man. The tumor was ill-defined and composed of polygonal or plasmacytoid myoepithelial cells. Infiltration to surrounding tissue, hemorrhage, necrosis, increased mitotic activity and vascular tumor emboli indicated its malignant nature. There were several satellite nodules with histologic features of typical pleomorphic adenoma. Immunohistochemically, tumor cells were reactive for S-100 protein, AE1/AE3, vimentin, smooth muscle actin and glial fibrillary acid protein.

Juvenile Granulosa Cell Tumor of the Ovary: Report of a Case of Malignant Form with Unusual Pleomorphism.: Chong Jai Kim, Jin Suk Suh, Sung Hye Park, Je G Chi; Korean J Pathol. 1990;24(3):316-320.

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Abstract PDF: A case of Juvenile Granulosa Cell Tumor (JGCT) of the ovary with unusual pleomorphic histologic and malignant biologic behaviour is described. The tumor occurred in a 10-year-old girl and was associated with clinical features of isosexual pseudoprecosity and a marked elevation of serum estradiol. The mass manifested initially in the right ovary and subsequently involved the contralateral ovary. A multi-organ metastasis developed during a 6-month-interval despite chemotherapy. She received two operations at 6-month interval, and tissues were obtained from the tumor mass. A marked histologic difference was observed between these two samples. The second biopsy showed profound cellular pleomorphism with numerous multinucleated tumor giant cell formation and hyaline bodies. The differential diagnosis from germ cell tumor and the possible factors for the pleomorphism are discussed.

Fine Needle Aspiration Cytology of Malignant Myoepithelioma of the Salivary Gland: A Case Report.: Jae Hwa Lee, Jean Kyung Park, Bang Hur; J Pathol Transl Med. 2002;13(1):28-32.

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Abstract PDF: Malignant myoepithelioma (myoepithelial carcinoma), is a very rare malignant epithelial neoplasm accounting for less than 1% of all salivary gland tumors and has an intermediate malignant potential. We report a case of malignant myoepithelioma arising in the left parotid gland in a 54-year-old man, which was difficult to differentiate from pleomorphic adenoma and other malignant salivary gland neoplasms. Fine needle aspiration cytology of the parotid gland showed cellular smear, composed of overlapped sheets and clusters or individually scattered tumor cells without any acinic or ductal structures. The tumor cells were rather uniform, with distinct cell borders and moderate amount of cytoplasm. The eccentrically located nuclei were oval to round and pleomorphic and showed prominent nucleoli. A few clear cells were noted in the cellular aggregates. Metachromatic matrix was seen between individual tumor cells in a lacelike fashion, resembling pleomorphic adenoma. According to the immunohistochemical staining, we recognized that the component cells are myoepithelial in nature, showing reactivity for the S-100 protein, vimentin, and actin.

Balloon Cell Malignant Melanoma: A case report.: Ji Young Seo, Soon Young Kim, Jeong Hee Kang, Young Ok Kim, Bang Hur; Korean J Pathol. 1999;33(7):537-539.

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Abstract PDF: Balloon cell malignant melanoma (BCMM) is a rare histologic variant of malignant melanoma, which is composed either predominantly or entirely of large clear or foamy cells. The incidence of balloon cell malignant melanoma is about 0.15% of all cutaneous malignant melanomas. Recently, we experienced a case of cutaneous balloon cell malignant melanoma in the right lower abdomen with right inguinal and both axillary lymph node metastasis in a 56-year-old man. The cutaneous lesion was 4.5 3.5 cm in size, a well-demarcated black nodular mass, involving abdominal skin and subcutaneous tissue. The tumor was histologically composed of two types of tumor cells: predominant clear cell and focal, pigmented spindle cell. The nodal lesion was composed entirely of clear cells. Both clear and spindle cells showed positive reaction for S-100 protein and HMB-45 on immunohistochemistry.

Primary Malignant Melanoma arising in Mucosa of the Palatine Tonsil: A case report.: Ki Jung Yun, Hyang Jeong Jo, Hyung Bae Moon, Sang Won Yoon; Korean J Pathol. 1996;30(1):65-67.

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Abstract PDF: Maligant melanomas of the oral or nasal cavity, and the vulvovaginal area are relatively common among the melanomas of non-ocular mucosa. But, primary malignant melanoma arising in the mucosa of the palatine tonsil is rare. We present a case of primary malignant melanoma arising in the mucosa of the palatine tonsil. A 36-year-old male was admitted for evaluation of a recurrent sore throat. Tonsillectomy was performed on the basis of clinical suspicion of chronic tonsillitis. Grossly, the left tonsil was focally dark. Microscopically, the tonsillar mucosa was diffusely infiltrated with tumor cells. Tumor cells revealed numerous melanin pigments. Intraepithelial nests of tumor cells were noted, but pagetoid spread of tumor cells was not found. Tumor cells were positive for S-100 protein and HMB45 stain. There was no evidence of melanoma in the skin or eye.

Original Article

Histopathologic and Immunohistochemical observation on Malignant Schwannoma.: Tae Sook Hwang, Seong Hoe Park, Eui Keun Ham; Korean J Pathol. 1990;24(4):446-455.

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Abstract PDF: Histopathologic and immunohistochemical analysis using antibodies for S-100 protein and keratin has been conducted on 21 cases of malignant schwannomas. The 21 cases were divided into the following three groups Group A: tumors originating from the nerve trunk or neurofibroma; Group B: tumors related to von Recklinghausen's disease; and Group C: other tumors not belonging to the above groups but histologically diagnosed as malignant schwannoma. The commonest histological pattern consisted of either closely packed or loosely arranged interlacing fascicles of slender spindle cells with wavy fibrillar cytoplasm, followed by myxoid change, perithelial pattern, hyaline change of the blood vessels, and hyalinlzed cords or nodules. Nine out of 12 cases of malignant schwannomas in group A and B, and 7 out of 9 cases of group C were positive for S-100 protein. None of the above cases showed positive staining reaction for keratin. Since 7 of 9 malignant schwannomas in Group C stained with S-100 protein, we can conclude that careful histological analysis supplemented by immunohistichemical study can make a conclusive diagnosis in most of the cases of malignant schwannomas even in cases that do not fulfil the traditional strict criteria.

Case Report

Malignant Eccrine Acrospiroma: A case report.: Gil Ro Han, In Sun Kim, Kye Yong Song, Ki Duck Kim, Beom Woo Yeom, Jong Sang Choi; Korean J Pathol. 1993;27(5):538-541.

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Abstract PDF: A case of malignant eccrine acrospiroma of the anterior chest wall is reported. This mass had been present for 20 years and during rescent 5 years it showed frequent ulceration and bleeding suggesting malignant transformation. Microscopically, several foci malignant transformation from preexisting benign eccrine acrospiroma are seen and in immunohistochemical staining, the tumor cells both benign and malignant portion, show positive reaction to cytokeratin.

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