Journal of Pathology and Translational Medicine

Case Report

Tumor Budding and Recurrence in Submucosal Invasive Colorectal Cancers of Favorable Histology: Case Reports of Two Early Colorectal Cancers with Advanced Recurrences: Heae Surng Park, Hee Jin Chang, Ji Won Park, Byung Chang Kim, Dae Kyung Sohn, Chang Won Hong, Ji-Yeon Baek, Sun Young Kim, Hyo Seong Choi, Jae Hwan Oh; Korean J Pathol. 2012;46(3):272-277. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.272

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Complete resection of submucosal invasive colorectal cancer (SICC) showing favorable histology is regarded as curative. We report on two cases of SICC showing recurrence within 5 years despite complete resection. The first patient was a 68-year-old woman with well differentiated rectal adenocarcinoma invading the superficial submucosa, which recurred after 4.7 years. The second patient was a 53-year-old man with pT1N0 moderately differentiated colonic adenocarcinoma. He developed widespread tumor recurrence after 3.9 years. Retrospective pathologic review of the original tumors showed multiple foci of tumor budding at the invasive front. Immunohistochemical staining for D2-40 of deeper levels of the paraffin blocks showed rare foci of small lymphatic invasion. Tumor budding at the invasive front may be an important indicator for SICC aggressiveness or may reflect early lymphatic invasion. More aggressive pathologic examination and follow-up is required for patients with SICC showing tumor budding, even in the absence of unfavorable histologic findings.

Citations

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Estudio de factores histológicos predictivos de metástasis ganglionar locorregional en adenocarcinoma colorrectal mínimamente invasivo pT1
Isidro Machado, Miriam Valera-Alberni, Fernando Martínez de Juan, José A. López-Guerrero, Alfonso García Fadrique, Julia Cruz, Carmen Martínez Lapiedra, Fernanda Maia de Alcantara, Ricardo Yaya, Jorge Campos, Carlos Fernández-Martos, Rafael Estevan
Gastroenterología y Hepatología.2016; 39(1): 1. CrossRef
Histological factors predicting loco-regional lymph node metastasis in early invasive colorectal adenocarcinoma pT1
Isidro Machado, Miriam Valera-Alberni, Fernando Martínez de Juan, José A. López-Guerrero, Alfonso García Fadrique, Julia Cruz, Carmen Martínez Lapiedra, Fernanda Maia de Alcantara, Ricardo Yaya, Jorge Campos, Carlos Fernández-Martos, Rafael Estevan
Gastroenterología y Hepatología (English Edition).2016; 39(1): 1. CrossRef
Tumor budding in the clinical management of colon and rectal cancer
Viktor H Koelzer, Inti Zlobec, Alessandro Lugli
Colorectal Cancer.2014; 3(4): 387. CrossRef

Original Article

Fine Needle Aspiration Cytologic Features of Schwannomas .: Sun Young Kim, Hae Joo Nam, Jung Hee Kim, Young Rok Cho, Yu Na Kang, Sang Sook Lee; Korean J Cytopathol. 1999;10(1):55-60.

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Abstract PDF: Schwannoma is a benign encapsulated nerve sheath tumor and is histologically characterized by a mixture of Antoni type A and B tissue. A preoperative diagnosis of schwannoma by fine needle aspiration cytology or by any other means is important to preserve clinically important nerves. Therefore, it is necessary to make a specific cytological diagnosis of nerve sheath tumor. However, there are a few reports regarding cytological features of schwannoma in Korea. We experienced seven cases of solitary schwannoma and here we report their characteristic cytological features with a review of literatures. The characteristic features of schwannoma on cytology were the presence of both Antoni type A and B tissue. The cytologic findings common to all cases of schwannoma generally corresponded to the histologic findings of Antoni type A tissue, consisting of fragments of tightly cohesive fascicles with variable cellularity. Dense fibrillary substances were found, along with palisading nuclei and Verocay bodies. Individual tumor cells consisted of cohesive cells having spindle or oval nuclei, with pointed ends and indistinct cell borders. Variation in nuclear size and shape was also present. The Antoni type B consisted of scattered wavy or short spindle cells and some histiocytes and lymphocytes in the abundant myxoid background with formation of microcysts. Immunohistochemistry for S-100 protein revealed a uniformly strong positive reaction and was helpful to make more accurate diagnosis of schwannoma.

Case Reports

Ewing's Sarcoma/PNET of the Talus: Report of a Case.: Sun Young Kim, Hyuck Po Kwon, Jae Su Roh, Hyoun Oh Cho; Korean J Cytopathol. 2004;15(2):120-125.

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Abstract PDF: Ewing's sarcoma (ES)/PNET is common in both axial and appendicular skeletons, but is extremely rare in the talus. Here, we report a case of ES/PNET of the left talus in a 29-year-old male patient diagnosed by fine needle aspiration cytology, and review the literature on similar cases. The cytological smears were composed of individually dispersed small round cells and occasional clusters of loosely cohesive cells. The tumor cells were fragile, frequently exhibiting naked nuclei. Two distinct types of cells were observed. The light (chief) cells displayed round or slightly oval nuclei with frequent indentations, generally inconspicuous nucleoli, and a thin rim of cytoplasm, which sometimes harbored small vacuoles. The dark cells were smaller, displaying scanty cytoplasm with dense hyperchromatic nuclei, intermixed with chief cells, and often manifesting as small molded groups. However, no significant nuclear pleomorphisms or mitoses were noted. Tumor cells in the cell block revealed positive cytoplasmic glycogen, as determined by a PAS stain with diastase control, and also exhibited positive immunoreactivity for CD99.

Fine Needle Aspiration Cytology of Granular Cell Tumor of the Lower Leg: Report of a Case.: Sun Young Kim, Jin Seok Hwang, Hyuck Po Kwon, Ju Heon Yang, Jae Su Roh, Wan Suk Yang; Korean J Cytopathol. 2004;15(2):126-130.

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Abstract PDF: Granular cell tumor is characterized by large eosinophilic cells with granular appearances. These are mostly benign. Approximately 1~2% are malignant, and establishment of reliable criteria for diagnosing malignant granular cell tumor has been difficult to establish because of the rarity. Reports on the cytologic features of this neoplasm are hardly found in Korea. We report a case of rarely-occurring granular cell tumor in the lower leg of a 40-year-old male, diagnosed on fine needle aspiration cytology, together with a review of the literature regarding significant adverse histology and prognostic factors. The aspirates revealed cellular smears of isolated cells, syncytial clusters, and occasionally stripped nuclei in a fine, bluish-purple, granular background. Tumor cells were polygonal, rounded, or slightly spindled, and showed ill-defined granular cytoplasm. Nuclei were small and round or oval, with inconspicuous or small, prominent nucleoli. The nuclei showed rare intranuclear cytoplasmic invagination. Occasionally, there were mild to moderate nuclear pleomorphisms with vesicular nuclei, with large, prominent nucleoi, but no mitosis. The immunocytochemical stain for S-100 was strongly positive in the cytoplasm of tumor cells with occasional nuclei.

Neuromuscular Choristoma of the Sciatic Nerve: A Case Report.: Sun Young Kim, Hyuck Po Kwon, Kyoung Duck Kwak, Kee Baek Ahn; Korean J Pathol. 2005;39(3):192-196.

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Abstract PDF: Neuromuscular choristoma is a rare benign tumor of the peripheral nerves. To the best of our knowledge, 21 cases have been reported to date. We describe here a 20-day-old female infant who presented with a buttock mass (4.5 x 4.1 x 3.2 cm on MRI) arising from the left sciatic nerve. Microscopically, it was characterized by an intimately disorganized mixture of nerve fibers and striated muscle fibers that were occasionally surrounded by the perineurium and separated by fibrous bands of varying thickness. In some areas, there appeared to be some cells in transitional forms between nerve fibers and muscle fibers, revealing variously positive expressions for S-100 protein in the muscular components. These findings are consistent with the hypothesis that neuroectodermal-derived Schwann cells can give rise to mature skeletal muscle. It appears that the fibrosis may be related to the degeneration of the neural components. The size of the mass on MRI has been unchanged during the 3-year follow-up period.

Original Article

Apoptosis Induced by Adriamycin in HeLa Cells.: Sun Young Kim, Sang Sook Lee; Korean J Pathol. 1993;27(5):433-442.

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Abstract PDF: This study was carried out to demonstrate the mode of ADR-induced cell death(apoptosis) on the light and electron microscopic features, to measure the apoptotic index dependent on various doses of ADR, to investigate the possible mechanism of apoptosis induced by ADR, and to evaluate ISNT method for the detection of DNA strand break. HeLa cells were treated with various doses of ADR 0.1~100.0 microgram/ml and observed under the light and transmission electron microscopes at 6 hours, 1 day and 3 days after ADR treatment. In addition, DNA strand breaks induced by ADR were detected in HeLa cells using the in situ nick translation(ISNT) method. The results were as follows: 1) The cell viability of HeLa cells decreased and the apoptotic index increased following exposure to ADR in a dose-dependent manner, resulting in about 44% of apoptotic index at 100.0 microgram/ml of ADR treatment. 2) Light microscopically, HeLa cells treated with ADR showed shrinkage or condensation of nucleus and cytoplasm. There were various unclear changes showing irregular, large, delineated masses of condensed chromatin abutting on the nuclear envelopes. Later stage of apoptosis revealed contracted and condensed cytoplasm with irregular cell membrane. Electron microscopically, margination of condensed chromatin, dilatation of endoplasmic reticulum under the plasma membrane, aggregation of cytoplasmic organelles with morphologically intact mitochondria, and irregular cell surface with blebbing were observed. 3) ISNT using biotinylated dUTP exhibited strong positive nuclear staining in HeLa cells treated with ADR. There was a marked response at 10.0~20.0 microgram/ml of ADR treatment. It is concluded from the above results that the death of HeLa cells induced by ADR was apoptotic in type based on light and electron microscopic appearance. The apoptotic index correlated with the increasing dose of ADR. ISNT with biotinylated dUTP led to visible evidence of DNA strand breaks following ADR treatment of HeLa cells. ISNT can be used for detection of DNA degradation, caused by activation of endogenous endonuclease, which is an early and specific characteristic of apoptosis.

Case Report

Keratinizing Desquamative Squamous Metaplasia of the Upper Urinary Tract: A case report.: Soo Min Kang, Sun Young Kim; Korean J Pathol. 1991;25(1):76-80.

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Abstract PDF: Keratinizing desquamative squamous metaplasia of the transitional epithelium occurs rarely in the upper urinary tract, especially in the ureter. It is associated in most cases with long-standing chronic inflammation but the exact pathogenesis is unknown, and the relationship to cancer has continued to be controversial. More cases should be accumulated for a better assessmnt of this lesion. Recently, we experienced a case of keratinizing desquamative squamous metaplasia in the renal pelvis, adjacent calyces and ureter following acute and chronic pyelonephritis. Herein, we are presenting our case with a review of literatures.

Original Article

Multiple Primary Malignant Tumors: 39 cases.: Sun Young Kim, Sang Pyo Kim, Jong Min Chae, Sang Sook Lee, Eun Sook Chang, Chai Hong Chung; Korean J Pathol. 1987;21(2):67-74.

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Abstract PDF: Thirty nine cases of multiple primary malignant tumors examined at the Department of Pathology, Keimyung University School of Medicine during the period from November 1974 through March 1986 were analysed clinicopathologically. The findings are as follows: 1) Thirty nine cases had synchronous lesion and six cases metachronous lesion. The second primary malignancy occurred mean 4.7 years after the first malignancy in patients with metachronous lesion. 2) The age at diagnosis of the first malignancy ranged from 26 to 76 years, the average being 51.8 years. The male-female ratio was slightly less than 1:1.2. 3) The most commonly involved site in multicentric origin was gastrointestinal tract (44.4%) with all adenocarcinoma and the second urogenital system (29.6%). In cases of different tissues or organs (11 cases), ovary was the most frequent site (5 cases), followed by cervix (4 cases). 4) Multiple primary malignant tumors of urogenital system were all eight cases and six cases among them (75%) had smoking and drinking habits. 5) The detailed informations about possible environmental, familial and host factors necessary for the investigation of multiple primary tumors were lacking in most cases. Therefore, the history taking with special attention to these factors must be carefully recorded. And also, we suggest that in the high-risk individuals, careful follow-up and thorough search for early cancer detection or prevention should be taken.

Case Report

Carcinosarcoma of the gallbladder: Report of a case.: Sun Young Kim, Sang Sook Lee, Jong Min Chae, Chai Hong Chung; Korean J Pathol. 1986;20(3):362-368.

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Abstract: Carcinosarcoma, often referred to as "malignant mixed tumor" is a rare neoplasm, but this tumor occurs in various organs, including the gallbladder. We report herein a carcinosarcoma of the gallbladder which consisted of adenocarcinomatous and undifferentiated sarcomatous ares, the latter differentiating towards abundant osteoid and calcified but nonlamellated bony trabeculae formation. There are 18 reported cases of this type tumor of the gallbladder in the literature.

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