Journal of Pathology and Translational Medicine

Case Report

Decubitoma: A Pseudosarcoma in Decubitus: Report of a case.: Hye Seung Han, Yong Il Kim, Jeong Wook Seo; Korean J Pathol. 1996;30(11):1060-1064.

Abstract PDF: Decubitus ulcer is often seen in the skin and underlying tissue of debilitated or immobilized patients as the result of prolonged pressure and impaired circulation. It manifests chiefly as an ulcer over bony prominences, but tumefaction is an extremely unusual presentation. A 53-year old male, a paralytic of the lower extremity for 18 years, developed a recurrent decubital ulcer despite repeated surgical repair, from which a rapidly growing, large fungating mass grew within a month. The last resected mass was bosselated and measured 15x9x3 cm with a major area of cicatrix-like induration, interdigitated with skeletal muscle bundles at the central area. Microscopically, the mass was composed of an upper half of active granulation tissue layer and a deeper half of dense, poorly cellular, fibrocollagenous bundles admixed with florid proliferation of atypical fibroblasts, but the absence of mitosis and the multifocal admixture of active inflammatory process-granulation tissue formation seemed to help exclude genuine fibromatosis, nodular fasciitis or proliferative myositis. We assume that this rapidly growing pseudofibromatosis is an additional manifestation of a prolonged decubitus ulcer, possibly related to the modified reparative process of decubitus ulcer following repeated excisions, for which we propose a term of decubitoma.

Original Article

Pseudosarcomatous Variant of Transitional Cell Carcinoma of the Renal Pelvis.: Yun Kyung Kang, Ta Jin Kim, Yong Il Kim, Si Whang Kim; Korean J Pathol. 1992;26(6):610-614.

Abstract PDF: We report a case of pseudosarcomatous variant of transitional cell carcinoma of the renal pelvis which showed grossly and microscopically the distinct biphasic growth patterns. Grossly, most part of the tumor showed solid growth protruding into the renal pelvic cavity as well as infiltrating into the parenchyma of lower pole. The overlying pelvic mucosa was replaced by a diffuse, papillary transitional cell carcinoma, and the solid mass was composed of pleomorphic spindle cell sarcomatoid component with frequent myxoid change and a few foci of osteoid deposit. Ultrastructural study of the spindle cells revealed epithelial differentiation featured with rich cytoplasmic organelles, basal lamina and basement membrane-like structures, although immunohistochemistry failed to detect epithelial differentiation.

Case Reports

Carcinosarcoma of the Esophagus: A report of case.: Sug Hyung Lee, Won Sang Park, Young Jin Choi, An Hee Lee, Sun Moo Kim; Korean J Pathol. 1992;26(2):191-196.

Abstract PDF: Carcinosarcoma of the esophagus is a rare neoplasm composed of both carcinoma and spindle sarcomatous area. Usually the carcinoma component is a squamous cell carcinoma but rarely adenocarcinoma or undifferentiated carcinoma is found. The histogenesis of the sarcomatous component is still unknown. A case of ulcerated polypoid lesion with a stalk in esophagus was reported. Microscopically it was composed of spindle shaped cells interminled with squamous cell carcinoma and small cell carcinoma nests. No distinct transition between spindle shaped cells and carcinoma are was observed. Immunoreactivity to cytokeratin was observed in both carcinomatous and spindle cell component, but electron microscopic examination failed to demonstrated desmosome or tonofilaments in spindle cells. Undifferentiated small cell nests were reactive to neuron specific enolase and contained membrane bounded secretory granule in electron microscopy.

Nodular fasciitis (13 cases analysis).: Jung Ran Kim, Je G Chi; Korean J Pathol. 1988;22(2):190-194.

Abstract PDF: Nodular fasciitis is a rare and benign soft tissue tumor that can easily confused microscopically to spindle cell sarcoma. Therefore it is very important disease to the surgical pathologists. However, this lesion has been seldom reported or described in Korean literature. This paper deals with 13 Korean cases of nodular fasciitis diagnosed microscopically. It's pertinent clinicopathologic findings are described. The youngest patients among 13 cases was 18 years and the oldest was 63 years with the mean of 34 years. Nine were males and 4 were females. Pathologically, the size of the lesion at the time of diagnosis ranged from 0.7 cm to 4.0 cm in the maximum extent. Two were smaller than 1.0 cm and 8 cases were between 1.0~3.0 cm. The site distibution was; trunk(5) upper extremitiy (4), lower extremity (2) and head (2). All the lesions were located in the subcutaneous tissue. The history of recent rapid growth was noted in nearly half of the cases. Mass and tenderness were two common manifestations. In one case, multiple nodules were found in the right breast and in flank. All of the lesions except one were managed by local excision. In one case, a wide excision was done under the impression of malignant fibrous histiocytoma of frozen section. Follow up observation of all cases did not show any evidence of recurrence in all.

Pseudosarcoma of the Esophagus: A case report with mapping, immunohistochemical and ultrastructural studies.: Soon Hee Jung, Young Bae Kim, Tai Seung Kim, Sang Ok Kwon, Soo Yong Kim; Korean J Pathol. 1987;21(1):26-33.

Abstract PDF: So called pseudosarcoma of the esophagus is an extremely rare polypoid malignant tumor and a number of cases, totaling 19 cases have been reported in world literatures until 1985. The presenting case is an unique one of pseudosarcoma of the esophagus and we illustrated all microscopic features with mapping, immunoperoxidase stain for cytokeratin and electron microscopic findings to clarify the histogenesis of spindle cells. It is postulated that the spindle cells of pseudosarcoma are transformed from squamous carcinoma cells based on (1) morphological similarity between squamous epithelial cells and spindle cells, (2) positive reaction of immunoperoxidase staining for cytokeratin in the adjacent normal esophageal mucosa, squamous cell carcinoma, spindle cells and giant cells and (3) presence of transformation zone.

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