Journal of Pathology and Translational Medicine

Case Study

Chronic lymphocytic leukemia and concurrent seminoma in the same testis: Kosuke Miyai, Fumihisa Kumazawa, Kimiya Sato, Hitoshi Tsuda; J Pathol Transl Med. 2022;56(1):48-52. Published online October 22, 2021; DOI: https://doi.org/10.4132/jptm.2021.09.10

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Abstract PDF: A 59-year-old man presented with a painless testicular mass and underwent a radical orchiectomy. The resected specimen showed a 5-cm-sized, white-yellow and homogenous solid mass in the testicular parenchyma. Histologically, the central part of the tumor exhibited typical features of seminoma. The peripheral part of the tumor exhibited diffuse infiltration of small, monotonous lymphoid cells involving the tunica albuginea. The monotonous lymphoid cells were immunoreactive for CD20, CD79a, CD5, and CD23, and negative for CD3, CD10, and cyclin D1. Kappa light chain restriction was detected on flow cytometry using the resected specimen. Considering the circulating lymphoid cell count of >5.0×10³/µL, we diagnosed the peripheral component of the tumor as an infiltration of chronic lymphocytic leukemia. This extremely rare combination of seminoma and lymphoid neoplasm should be considered in the differential diagnosis of classic seminoma with extensive lymphoid reaction in tumors arising in elderly patients.

Review

Standardization of the pathologic diagnosis of appendiceal mucinous neoplasms: Dong-Wook Kang, Baek-hui Kim, Joon Mee Kim, Jihun Kim, Hee Jin Chang, Mee Soo Chang, Jin-Hee Sohn, Mee-Yon Cho, So-Young Jin, Hee Kyung Chang, Hye Seung Han, Jung Yeon Kim, Hee Sung Kim, Do Youn Park, Ha Young Park, So Jeong Lee, Wonae Lee, Hye Seung Lee, Yoo Na Kang, Younghee Choi; J Pathol Transl Med. 2021;55(4):247-264. Published online July 8, 2021; DOI: https://doi.org/10.4132/jptm.2021.05.28

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Although the understanding of appendiceal mucinous neoplasms (AMNs) and their relationship with disseminated peritoneal mucinous disease have advanced, the diagnosis, classification, and treatment of AMNs are still confusing for pathologists and clinicians. The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists (GPSG-KSP) proposed a multicenter study and held a workshop for the “Standardization of the Pathologic Diagnosis of the Appendiceal Mucinous Neoplasm” to overcome the controversy and potential conflicts. The present article is focused on the diagnostic criteria, terminologies, tumor grading, pathologic staging, biologic behavior, treatment, and prognosis of AMNs and disseminated peritoneal mucinous disease. In addition, GPSG-KSP proposes a checklist of standard data elements of appendiceal epithelial neoplasms to standardize pathologic diagnosis. We hope the present article will provide pathologists with updated knowledge on how to handle and diagnose AMNs and disseminated peritoneal mucinous disease.

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Predicting Survival in Mucinous Adenocarcinoma of the Appendix: Demographics, Disease Presentation, and Treatment Methodology
Paul H. McClelland, Stephanie N. Gregory, Shirley K. Nah, Jonathan M. Hernandez, Jeremy L. Davis, Andrew M. Blakely
Annals of Surgical Oncology.2024; 31(9): 6237. CrossRef
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Histoséminaire biopsies péritonéales tumorales. Cas no 2
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Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation
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Muzinöse Tumoren des Peritoneums
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Landscape of Genetic Mutations in Appendiceal Cancers
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Unearthing novel fusions as therapeutic targets in solid tumors using targeted RNA sequencing
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Case Study

Concurrent Anti-glomerular Basement Membrane Nephritis and IgA Nephropathy: Kwang-Sun Suh, Song-Yi Choi, Go Eun Bae, Dae Eun Choi, Min-kyung Yeo; J Pathol Transl Med. 2019;53(6):399-402. Published online September 16, 2019; DOI: https://doi.org/10.4132/jptm.2019.08.05

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Abstract PDF Supplementary Material

Anti–glomerular basement membrane (GBM) nephritis is characterized by circulating anti-GBM antibodies and crescentic glomerulonephritis (GN) with deposition of IgG along the GBM. In a limited number of cases, glomerular immune complexes have been identified in anti-GBM nephritis. A 38-year-old female presented azotemia, hematuria, and proteinuria without any pulmonary symptoms. A renal biopsy showed crescentic GN with linear IgG deposition along the GBM and mesangial IgA deposition. The patient was diagnosed as concurrent anti-GBM nephritis and IgA nephropathy. Therapies with pulse methylprednisolone and cyclophosphamide administration were effective. Concurrent cases of both anti-GBM nephritis and IgA nephropathy are rare among cases of anti-GBM diseases with deposition of immune complexes. This rare case of concurrent anti-GBM nephritis and IgA nephropathy with literature review is noteworthy.

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Coexistence of anti-glomerular basement membrane disease and IgA nephropathy: an illustrative case and comprehensive literature review
Zewei Chen, Dechao Xu, Fangzheng Cui, Huihui Hou, Zhiguo Mao, Xiang Gao
Renal Failure.2024;[Epub] CrossRef
Clinical features and prognosis of patients with anti-GBM disease combined with mesangial IgA deposition
Wei Ning, Ya-fei Zhao, Ya-ru Liu, Yuan-yuan Qi, Zhan-zheng Zhao
Frontiers in Immunology.2024;[Epub] CrossRef
Anti-glomerular basement membrane vasculitis
Claudio Ponticelli, Marta Calatroni, Gabriella Moroni
Autoimmunity Reviews.2023; 22(1): 103212. CrossRef
High-frequency plasma exchange therapy for immunocompromised, type I crescentic glomerulonephritis complicated with IgA nephropathy: A case report and literature review
Huihui Chen, Jingjing Jin, Mei Juan Cheng, Lei He, Wei Zhou, Liping Guo, Zhe Zhe Niu, Xiang Nan Liang, Rong Fang Zhu, Yaling Bai, Jin Sheng Xu
Medicine.2023; 102(3): e32698. CrossRef
Clinical and immunological characteristics of patients with combined anti-glomerular basement membrane disease and IgA nephropathy
Cong-rong Shen, Xiao-yu Jia, Zhao Cui, Xiao-juan Yu, Ming-hui Zhao
Clinical Kidney Journal.2023; 16(9): 1480. CrossRef
Anti-glomerular basement membrane disease with IgA nephropathy: A case report
Chuan Guo, Ming Ye, Shen Li, Ting-Ting Zhu, Xiang-Rong Rao
World Journal of Clinical Cases.2022; 10(12): 3916. CrossRef
Case Report: Coexistence of Anti-Glomerular Basement Membrane Disease, Membranous Nephropathy, and IgA Nephropathy in a Female PatientWith Preserved Renal Function
Wei Qu, Nan Liu, Tianhua Xu, Binyao Tian, Meng Wang, Yanqiu Li, Jianfei Ma, Li Yao
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Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report
Fu Shaojie, Su Sensen, Huang Jingda, Wang Luyu, Zhang Fei, Yu Jinyu, Xu Zhonggao, Wu Hao
Medicine.2022; 101(37): e30686. CrossRef
Serodiagnosis of Anti-glomerular Basement Membrane Disease Using a Newly Developed Chemiluminescence Immunoassay
Alexander Kühnl, Lea Hartwig, Cornelia Dähnrich, Wolfgang Schlumberger
Frontiers in Medicine.2022;[Epub] CrossRef
PATHOLOGY AND RENAL OUTCOME OF THREE UNCOMMON FACES OF CRESCENTRIC GLOMERULONEPHRITIS
Keya Basu, Dipankar Sircar, Manimoy Bandopadhyay
INDIAN JOURNAL OF APPLIED RESEARCH.2021; : 7. CrossRef
Pneumocystis pneumonia secondary to intensive immunosuppression treatment for anti-GBM disease complicated with IgA nephropathy
Manyu Zhang, Dingwei Yang, Weixiu Wang, Fuhao Zhao, Xiaoxiao Zhang, Xue Li
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Original Article

Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset: Sun-ju Byeon; J Pathol Transl Med. 2017;51(2):137-147. Published online February 22, 2017; DOI: https://doi.org/10.4132/jptm.2016.12.30

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Abstract PDF Supplementary Material

Background
Pathologic examinations play an important role in medical services. Until recently, the overall status of pathologic examinations in Korea has not been identified. I conducted a nationwide survey of pathologic examination status using the insurance reimbursements (IRs) dataset from the Health Insurance Review and Assessment Service (HIRA). The aims of this study were to estimate current pathologic examination status in Korea and to provide information for future resource arrangement in the pathology area. Methods: I asked HIRA to provide data on IR requests, including pathologic examinations from 2011 to 2015. Pathologic examination status was investigated according to the following categories: annual statistics, requesting department, type of medical institution, administrative district, and location at which pathologic examinations were performed. Results: Histologic mapping, immunohistochemistry, and cervicovaginal examinations have increased in the last 5 years. Internal medicine, general surgery, obstetrics/gynecology, and urology were the most common medical departments requesting pathologic examinations. The majority of pathologic examinations were frequently performed in tertiary hospitals. About 60.3% of pathologic examinations were requested in medical institutions located in Seoul, Gyeonggi-do, and Busan. More than half of the biopsies and aspiration cytologic examinations were performed using outside services. The mean period between IR requests and 99 percentile IR request completion inspections was 6.2 months. Conclusions: This survey was based on the HIRA dataset, which is one of the largest medical datasets in Korea. The trends of some pathologic examinations were reflected in the policies and needs for detailed diagnosis. The numbers and proportions of pathologic examinations were correlated with the population and medical institutions of the area, as well as patient preference. These data will be helpful for future resource arrangement in the pathology area.

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Validation of the pathological prognostic staging system proposed in the revised eighth edition of the AJCC staging manual in different molecular subtypes of breast cancer
Nuri Jang, Jung Eun Choi, Su Hwan Kang, Young Kyung Bae
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Case Study

Thymoma and Synchronous Primary Mediastinal Seminomas with Florid Follicular Lymphoid Hyperplasia in the Anterior Mediastinum: A Case Report and Review of the Literature: Hyang-im Lee, In-seok Jang, Kyung Nyeo Jeon, Gyung Hyuck Ko, Jong Sil Lee, Dong Chul Kim, Dae Hyun Song, Jeong-Hee Lee; J Pathol Transl Med. 2017;51(2):165-170. Published online February 2, 2017; DOI: https://doi.org/10.4132/jptm.2016.08.24

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Abstract PDF

Thymoma is the most common neoplasm of the anterior mediastinum and has malignant potential. Germ cell tumors (GCTs) found in the anterior mediastinum are usually benign, and malignant GCTs, such as seminomas, are rare. Histologically, mediastinal seminoma is indistinguishable from testicular seminoma except for site-associated morphological features such as lymphoid follicular hyperplasia. Therefore, excluding metastasis is very important. Recently, we treated a young adult patient with multiple thymic masses that occurred simultaneously. The patient underwent a thymectomy for the removal of the mediastinal masses, one of which was diagnosed as type B2 invasive thymoma, and two of which were diagnosed as primary mediastinal seminomas with massive follicular hyperplasia. The patient received adjuvant chemotherapy after surgical resection. To our knowledge, this is the first description of a thymoma and a mediastinal seminoma occurring simultaneously in the thymus. We present this case along with a literature review.

Citations

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Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges
Alexander Fichtner, Alexander Marx, Philipp Ströbel, Felix Bremmer
Histopathology.2024; 84(1): 216. CrossRef
Combined type A thymoma and yolk sac tumour of the mediastinum
Dong Sheng, Yu-Chen Han
Pathology.2024; 56(6): 927. CrossRef
Combined Thymic Epithelial Neoplasms – a Review
Annikka Weissferdt
International Journal of Surgical Pathology.2023; 31(6): 917. CrossRef
Primary mediastinal seminoma presenting with paraneoplastic anti-Hu encephalitis: a case report and literature review
Chelsey M. Williams, Derek B. Allison, Adam B. Coleman, Roshmita Bardhan, Jordan D. Miller, Zin W. Myint
Frontiers in Oncology.2023;[Epub] CrossRef
Primary mediastinal seminoma with florid follicular lymphoid hyperplasia: a case report and review of the literature
Charlotte Holmes, Peh Sun Loo, Sion Barnard
Diagnostic Pathology.2021;[Epub] CrossRef

Review

Dysembryoplastic Neuroepithelial Tumors: Yeon-Lim Suh; J Pathol Transl Med. 2015;49(6):438-449. Published online October 23, 2015; DOI: https://doi.org/10.4132/jptm.2015.10.05

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Abstract PDF

Dysembryoplastic neuroepithelial tumor (DNT) is a benign glioneuronal neoplasm that most commonly occurs in children and young adults and may present with medically intractable, chronic seizures. Radiologically, this tumor is characterized by a cortical topography and lack of mass effect or perilesional edema. Partial complex seizures are the most common presentation. Three histologic subtypes of DNTs have been described. Histologically, the recognition of a unique, specific glioneuronal element in brain tumor samples from patients with medically intractable, chronic epilepsy serves as a diagnostic feature for complex or simple DNT types. However, nonspecific DNT has diagnostic difficulty because its histology is indistinguishable from conventional gliomas and because a specific glioneuronal element and/or multinodularity are absent. This review will focus on the clinical, radiographic, histopathological, and immunohistochemical features as well as the molecular genetics of all three variants of DNTs. The histological and cytological differential diagnoses for this lesion, especially the nonspecific variant, will be discussed.

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Original Articles

KIT/PDGFRA Expression and Mutation in Testicular Seminoma and Ovarian Dysgerminoma.: Song Yi Choi, Kwang Sun Suh, Yong Beom Kim, Hyun Jeong Lee, Eun Sun Kim, Mee Ja Park; Korean J Pathol. 2009;43(6):528-534.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.528

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Abstract PDF

BACKGROUND
KIT and PDGFRA are tyrosine kinase receptors. Stem cell factor/KIT-mediated signaling plays a role in normal spermatogenesis, and the alteration of KIT is important in the pathogenesis of seminomas/dysgerminomas (SD). METHODS: To determine the role of expression and mutation of the KIT and PDGFRA genes, we analyzed 16 seminoma cases, 4 spermatocytic seminoma (SS) cases and 8 dysgerminoma cases for KIT and PDGFRA expression and mutation of KIT (exons 9, 11, 13, and 17) and PDGFRA (exons 12 and 18) using PCR-SSCP methods. RESULTS: KIT was immunohistochemically positive in all 24 SD cases, and one of four (25%) SS cases. PDGFRA was immunohistochemically evident in 16 of the 24 (66.6%) SD cases, and two of the four (50%) SS cases. KIT expression was significantly reduced in SS compared with seminoma (p=0.0035). Four cases (14.3%) displayed mutation in KIT exon 17 or PDGFRA exon 12. Distant metastasis was present in three cases (10.7%), one of which had a nonsense mutation in KIT. CONCLUSIONS: These results indicate that KIT is expressed in the majority of SD cases, but not in most SS cases. However, there was no significant correlation between the clinicopathologic features and mutation or expression of KIT and PDGFRA.

Citations

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Expression of DOG1, PDGFRA, and p16 in Gastrointestinal Stromal Tumors
Sung Hee Jung, Kwang Sun Suh, Dae Young Kang, Dong Wook Kang, Young-Beum Kim, Eun-Sun Kim
Gut and Liver.2011; 5(2): 171. CrossRef

An Anion Site Change of the Glomerular Basement Membrane on Various Glomerular Diseases.: Yu Na Kang, Kwan Kyu Park, Seung Pil Kim, Sung Bae Park, Hyun Chul Kim, Eun Sook Chang, In Soo Suh; Korean J Pathol. 1997;31(8):765-772.

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Abstract PDF: We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.

Ultrastructural Feature of Proximal Convoluted Tubular Cells of Rat Induced by Gentamicin.: Byoung Yuk Lee, Tae Jung Shon, Jong Min Chae; Korean J Pathol. 1998;32(1):43-50.

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Abstract PDF: Myeloid body formation is an ultrastructural feature of gentamicin induced nephrotoxicity in human being and experimental animals. The origin of the myeloid body is not satisfactorily understood and morphological verification of the developing process of this structure is not fully accomplished. We injected 100 mg/kg/12 hour of gentamicin in 20 Spraque-Dawley rats and examined the ultrastructural feature of the proximal convoluted tubular cells of the kidney every 30 minutes in the first 4 hours, and in 5 hours, 6 hours, 12 hours, 24 hours and 48 hours after injection of gentamicin, with a TEM and a SEM. Myeloid bodies were noted as concentric layers of membranous structures of degenerated endoplasmic reticulum and mitochondria in the lysosome. The number and size of the myeloid body containing lysosomes were increased with time. We can deduce from this observation that injured cell organelles by diffusible gentamicin within the cells are autophagocytosed by lysosomes which were also injured by the drug from pinocytotic vesicles, and incompletely digested organellar remnants are retained in the lysosomes as myeloid bodies. So we think that the myeloid body formation is a result of an exaggerated and a pathologic autophagocytic process due to cell injury induced by gentamicin.

The Role of MIB-1 Expression and Apoptosis in Experimental Crescentic Glomerulonephritis.: Nam Hoon Kim, Wan Seop Kim, Jung Woo Noh, Moon Hyang Park; Korean J Pathol. 1999;33(4):231-242.

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Abstract PDF: It has been postulated that programmed cell death via apoptosis may be critical for remodelling of glomeruli after inflammatory injury. To understand the regulatory mechanism of apoptosis in experimental crescentic glomerulonephritis (CGN), we examined the MIB-1 score (proliferation index, PI) and apoptotic index during the progression of experimental CGN to end-stage renal failure. CGN was induced in New Zealand White rabbits by administration of guinea pig anti-GBM IgG after sensitization with guinea pig IgG and their kidneys were analyzed for the development of crescents through sequential renal biopsies. Serum creatinine levels progressively increased in a time course until day 45. The PI in glomeruli, tubular epithelial cells, and interstitium progressively increased during the progression of experimental CGN. The mean numbers of MIB-1 positive intraglomerular nuclei (PI) were significantly correlated with degrees of crescent formation and the numbers of apoptotic cells in the glomeruli, tubules, and interstitium. Significant apoptosis was present from day 1 (15.8 10.16 cells/glomerular cross section) and increased in number with the proliferative lesions as glomerular inflammation continued. Moreover, apoptosis increased during the resolution of the glomerular inflammation, and many apoptotic cells were present in the sclerotic lesions in day 17 (18.6 12.99 cells/glomerular cross section). As glomerular inflammation subsided, cellular crescents progressed to fibrous crescents with a reduction of cellularity by day 45. On day 45, the glomerular PI and the numbers of apoptotic cells were markedly decreased. The correlations found in CGN between the creatinine level and the percentage of crescents, between the percentage of crescent and PI, and between the PI and number of apoptotic cells support the hypothesis that there is a change in the glomerular and tubulo-interstitial apoptosis under pathologic conditions. These findings indicate that apoptosis plays an essential role in the resolution of intra- and extraglomerular inflammation and in the elimination of glomerular cells within the sclerotic regions for progressive CGN. The regulation of the apoptotic phenomenon and increased PI during CGN may be important in the progression of glomerular inflammation and the development of pathologic glomerular sclerosis.

Case Reports

Emphysematous Pyelonephritis in Diabetic Nephropathy A report of two cases.: Jae Ho Han, Lucia Kim, Sung Eun Kim, Soon Won Hong, Hyeon Joo Jeong; Korean J Pathol. 1999;33(5):367-370.

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Abstract PDF: Diabetic nephropathy is characterized by one or a combination of the following lesions: (1) glomerular involvement with three distinctive patterns: diffuse glomerulosclerosis, nodular glomerulosclerosis, and exudative lesions; (2) arteriolo sclerosis; (3) urinary tract bacterial infection with pyelonephritis and sometimes emphysematous pyelonephritis. Emphysematous pyelonephritis is an uncommon life-threatening and acute suppurative infection of the kidney, and usually occurs in diabetic female patients. It is characterized by the production of intraparenchymal gas. Glucose fermentation has been considered the main cause of the gas formation. We presented two illustrative nephrectomy cases of emphysematous pyelonephritis in addition to the typical pathologic features of diabetic nephropathy.

Multicystic Renal Dysplasia with Ipsilateral Ectopic Ureteral Orifice and Seminal Vesicle Cyst: A case report.: Hyun Jin Son, Joo Heon Kim, Myoung Jae Kang; Korean J Pathol. 2000;34(4):310-313.

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Abstract PDF: Renal dysplasia results from aberrant metanephric histogenesis caused fundamentally by a defect in inducer tissue or responding tissue. Dysplastic kidneys vary tremendously in gross and microscopic appearance but are characterized by abnormal organization and a mixed population of primitive structures, such as fetal or immature cartilage, dysplastic ducts, immature tubules, and undifferentiated mesenchyme. We report a case of unilateral multicystic renal dysplasia associated with an ipsilateral ectopic ureteral orifice entering a seminal vesicle cyst in a 33-year-old man. He was admitted due to primary infertility which had developed three years ago. The his semen analysis revealed oligospermia. No evidence of a family history of renal dysplasia was reported. Microscopic examination showed that the entire kidney was composed of cysts lined by flattened cells, dysplastic ducts and immature tubules surrounded by collars of spindle cells, primitive mesenchyme, and a few aberrantly formed glomeruli.

Original Article

Glomerular Basement Membrane Thickness in Minimal Change Disease.: Yoon Mee Kim, Soon Hee Jung, Hyeon Joo Jeong; Korean J Pathol. 2000;34(12):994-1000.

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Abstract PDF: The thickness of the glomerular basement membrane may vary not only in glomerular disease, but also in normal persons according to age and sex. But there has been no data on the normal thickness of the basement membrane in Korea. This study was designed to determine the glomerular basement membrane thickness as a reference value according to age and sex, in 50 cases of minimal change disease obtained from patients aged 2~67 years. Measurement of glomerular basement membrane was made on electron micrograph using an image analyzer. The thickness of each case was estimated by the arithmetic and harmonic mean methods. The mean thickness of the glomerular basement membrane was 291.9 47.9 nm by harmonic mean method and 284.2 43.7 nm by arithmetic mean method. And the harmonic mean thickness of the glomerular basement membrane according to age was 249.1 32.5 nm (1~5 years), 256.6 45.3 nm (6~10 years), 279.2 57.9 nm (11~15 years), 303.2 43.8 nm (16~20 years), 335.3 37.5 nm (21~30 years), and 291.1 22.5 nm (over 30 years), respectively. There was a trend that the thickness of glomerular basement membranes increased with the age till 30 years of age. There was no significant sex-related difference. In conclusion, the mean glomerular basement membrane thickness is comparable to the data from western people and shows a trend of increasing thickness according to the age.

Case Reports

Cytologic Features of Metastatic Retroperitoneal Seminoma: A Case Report.: Mi Seon Kwon, Eun Joo Seo, Young Shin Kim, Chang Suk Kang, Sang In Shim; Korean J Cytopathol. 1995;6(1):71-75.

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Abstract PDF: A fine needle aspiration biopsy specimen of a retroperitoneal mass in a 26-year-old man who had had an orchiectomy for seminoma was submitted for cytologic evaluation. Cytologic features of the specimen included uniform neoplastic cells found singly or in groups of several cells intermingled with lymphocytes in a characteristic foamy, lacelike background. These cells varied from 10 to 20 m in diameter. The nuclei were round to ovoid with fine or reticular chromatin and one or more prominent nucleoli. The poorly defined cytoplasm stained pale-blue or blue with cytoplasmic vacuoles. The cytologic appearance was consistent with seminoma. Documented reports of the cytological appearance of seminoma are rare. The diagnosis of primary gonadal seminoma by fine needle aspiration biopsy is probably not indicated since the treatment of a primary gonadal tumor, regardless of its histogenesis, requires surgical resection. However, fine needle aspiration biopsy is extremely valuable in the diagnosis of extragonadal as well as metastic and recurrent seminoma.

Fine Needle Aspiration Cytology of Metastatic Pulmonary Seminoma: A Cese Report.: Hwa Sook Jeong, Geon Kook Lee, Wun Jae Kim, Jae Ho Earm, Hyung Geun Song; Korean J Cytopathol. 1996;7(1):97-102.

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Abstract PDF: Fine needle aspiration cytologyof a pulmonary mass was performed on a 51-year-old man who had a left testicular mass. Cytologic features were composed of a homogeneous population of malignant cells associated with a background of foamy and lacelike material. The cellular features were characterized by monomorphous cell proliferation of relatively regular large cells, generally isolated or grouped. Occasionally, fine branching stroma with large tumor cells and scanty lymphocytes were noted. The tumor cells had a round, regular nucleus, prominent round nucleoli, and a thin rim of cytoplasm containing large vacuoles or lacunae filled with glycogen. The fine needle aspiration cytologic diagnosis was highly consistent with metastatic seminoma from testis and less likely primary or other metastatic carcinoma. The diagnosis of resected testicular mass was classic seminoma. Despite the fact that cytopathologists were not familiar with diagnosis of seminoma due to clinician's lack of interest in fine needle aspiration cytology of germ cell tumors including seminoma, it appears that a diagnosis of this tumor should not be problematic in cytologic material if specific histologic criteria are applied.

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