Journal of Pathology and Translational Medicine

Original Articles

Clinicopathological differences in radiation-induced organizing hematomas of the brain based on type of radiation treatment and primary lesions: Myung Sun Kim, Se Hoon Kim, Jong-Hee Chang, Mina Park, Yoon Jin Cha; J Pathol Transl Med. 2022;56(1):16-21. Published online October 15, 2021; DOI: https://doi.org/10.4132/jptm.2021.08.30

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Background
Radiation-induced organizing hematoma (RIOH) is a sporadic form of cavernous hemangioma (CH) that occurs after cerebral radiation. RIOH lesions are distinct histologically from de novo CH; however, detailed research on this subject is lacking. In the present study, the clinical and histological features of RIOHs were evaluated based on causative lesions.
Methods
The present study included 37 RIOHs confirmed by surgical excision from January 2009, to May 2020, in Yonsei Severance Hospital. All cases were divided into subgroups based on type of radiation treatment (gamma knife surgery [GKS], n = 24 vs. conventional radiation therapy [RT], n = 13) and pathology of the original lesion (arteriovenous malformation, n = 14; glioma, n = 12; metastasis, n = 4; other tumors, n = 7). The clinicopathological results were compared between the groups.
Results
Clinical data of multiplicity, latency, and size and wall thickness of the original tumors and RIOHs were analyzed. The GKS group showed shorter latency (5.85 ± 4.06 years vs. 11.15 ± 8.27 years, p = .046) and thicker tumor wall (693.7 ± 565.7 μm vs. 406.9 ± 519.7 μm, p = .049) than the conventional RT group. Significant difference was not found based on original pathology.
Conclusions
RIOH is more likely to occur earlier with thick tumor wall in subjects who underwent GKS than in patients who underwent conventional RT. These results indicate the clinical course of RIOH differs based on type of treatment and might help determine the duration of follow-up.

Citations

Citations to this article as recorded by

End-stage ADPKD with a low-frequency PKD1 mosaic variant accelerated by chemoradiotherapy
Hiroaki Hanafusa, Hiroshi Yamaguchi, Naoya Morisada, Ming Juan YE, Riki Matsumoto, Hiroaki Nagase, Kandai Nozu
Human Genome Variation.2024;[Epub] CrossRef
Recapitulating the Key Advances in the Diagnosis and Prognosis of High-Grade Gliomas: Second Half of 2021 Update
Guido Frosina
International Journal of Molecular Sciences.2023; 24(7): 6375. CrossRef
Earlier Age at Surgery for Brain Cavernous Angioma-Related Epilepsy May Achieve Complete Seizure Freedom without Aid of Anti-Seizure Medication
Ayataka Fujimoto, Hideo Enoki, Keisuke Hatano, Keishiro Sato, Tohru Okanishi
Brain Sciences.2022; 12(3): 403. CrossRef

Analysis of Surgical Pathology Data in the HIRA Database: Emphasis on Current Status and Endoscopic Submucosal Dissection Specimens: Sun-ju Byeon, Woo Ho Kim; J Pathol Transl Med. 2016;50(3):204-210. Published online April 4, 2016; DOI: https://doi.org/10.4132/jptm.2016.03.04

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Abstract PDF

Background
In Korea, medical institutions make claims for insurance reimbursement to the Health Insurance Review and Assessment Service (HIRA). Thus, HIRA databases reflect the general medical services that are provided in Korea. We conducted two pathology-related studies using a HIRA national patient sample (NPS) data (selection probability, 0.03). First, we evaluated the current status of general pathologic examination in Korea. Second, we evaluated pathologic issues associated with endoscopic submucosal dissection (ESD).
Methods
The sample data used in this study was HIRA-NPS-2013-0094.
Results
In the NPS dataset, 163,372 pathologic examinations were performed in 103,528 patients during the year 2013. Considering sampling weight (33.3), it is estimated that 5,440,288 (163,372 × 33.3) pathologic examinations were performed. Internal medicine and general surgery were the most common departments requesting pathologic examinations. The region performing pathologic examinations were different according to type of medical institution. In total, 490 patients underwent ESD, and 43.4% (213/490) underwent ESD due to gastric carcinoma. The results of the ESD led to a change in disease code for 10.5% (29/277) of non-gastric carcinoma patients. In addition, 21 patients (4.3%) underwent surgery following the ESD. The average period between ESD and surgery was 44 days.
Conclusions
HIRA sample data provide the nation-wide landscape of specific procedure. However, in order to reduce the statistical error, further studies using entire HIRA data are needed.

Citations

Citations to this article as recorded by

Impact of the COVID-19 Pandemic on Esophagogastroduodenoscopy and Gastric Cancer Claims in South Korea: A Nationwide, Population-Based Study
Min Ah Suh, Su Bee Park, Min Seob Kwak, Jin Young Yoon, Jae Myung Cha
Yonsei Medical Journal.2023; 64(9): 549. CrossRef
Using big data to see the forest and the trees: endoscopic submucosal dissection of early gastric cancer in Korea
Chang Seok Bang, Gwang Ho Baik
The Korean Journal of Internal Medicine.2019; 34(4): 772. CrossRef
Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset
Sun-ju Byeon
Journal of Pathology and Translational Medicine.2017; 51(2): 137. CrossRef

Pathologic Analysis of 39 Cases of Epilepsy Surgery.: Young Mee Cho, Joong Koo Kang, Youn Mee Hwang, Jung Kyo Lee, Ghee Young Choe; Korean J Pathol. 1996;30(5):388-395.

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Abstract PDF: Pharmacologic therapy is still the primary management for epilpsy; however, surgical treatment is a reasonable therapeutic option for patients suffering from medically intractable seizures, especially temporal lobe epilepsy having a documented unilateral epileptogenic area. Thirty nine patients with pharmaco-resistant complex partial seizures underwent anterior temporal lobectomy and hippocampectomy in 38 cases and frontal cortisectomy in one case. On pathological examination, hippocampal sclerosis was a predominent pathologic finding and was identified in 18 cases. Other non-neoplastic lesions consisted of 5 cases of vascular lesions(2 cavernous angiomas, 2 arteriovenous malformations and 1 angiomatosis), 3 cases of fibrous nodule, 2 cases of cicatrical changes of cerebral cortex, and 1 case of parasitic infection. Neoplasms including two cases of oligodendroglioma and one case of anaplastic astrocytoma were also noted. In seven cases, there was no detectable lesion on gross and microscopic examination. On post-operative follow-up, seizures were completely terminated in most cases(31 cases, 79%). The rest of the patients also displayed marked alleviation of symptoms. The seizures tended to recur more aften among the patients with neoplasm or no pathologically detectable lesion. In order to detect any minute pathological lesion, thorough gross and microcsopic examinations are considered to be essential.

Directional, Vacuum-Assisted Stereotactic Biopsy of Nonpalpable Breast Lesions with Surgical Correlation.: Sung Chul Lim, Young Sook Kim, Sneige Nour; Korean J Pathol. 2002;36(5):314-322.

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Abstract PDF: BACKGROUND
The vacuum suction probe is an alternative to the 14-gauge needle and automatic gun for performing stereotactic core needle biopsies. This study assesses the accuracy of the directional, vacuum-assisted stereotactic biopsy (DVAB) of nonpalpable breast lesions. Materials and METHODS: Four hundred and thirty DVABs were performed on 412 patients between January 1998 and December 2000. Using 11-gauge or 14-gauge needles, six to 22 core samples (mean=13) per lesion were obtained. One hundred and fifty-five lesions were subsequently excised, and 223 patients with benign diagnoses had mammographic follow-ups. The results of the DVABs and surgeries were reviewed and correlated.
RESULTS
The results of the DVABs and surgeries were concordant in 98 of 113 cases and discordant in 15 cases, including 15 cases for which DVAB results indicated ductal carcinoma in situ (DCIS) but surgery yielded invasive carcinoma. The overall sensitivity, specificity, and positive and negative predictive values of the DVABs were 99.3%, 100%, 100%, and 99.7%, respectively. The positive predictive value for the presence of invasion was 100% and the negative predictive value was 81%. Histologic comparison was performed in 19 of 31 atypical ductal hyperplasias (ADHs) diagnosed with DVAB. Of the 19 ADHs, histologic findings showed DCIS in one, ADH in 9, atypical lobular hyperplasia in one, and no residual lesions in 8. Cases with less than 3 lobules were involved with ADH, or cases with more than 50% of microcalcification retrieved were all adequately diagnosed. Only 17 of 240 benign lesions diagnosed with DVAB were subsequently excised. These were confirmed to be ADH in three of the cases, and other benign diagnoses were confirmed in 14 of the cases. The others were confirmed to be benign lesions upon mammographic follow-up. Lesions less than 1.0 cm in maximal diameter can be removed completely by DVAB.
CONCLUSION
DVAB reduced the number of underestimated infiltrating tumors, but still, significant cases were found to be invasive. ADH diagnosed with DVAB does not require subsequent surgery for a rule-out diagnosis of carcinoma, if the sampling is adequate and less than 3 lobules are involved with ADH. Lesions less than 1.0 cm in maximal diameter can be removed completely by DVAB. Benign lesions diagnosed with DVAB did not require subsequent surgery, so DVAB can reduce the probability of unnecessary surgery for benign lesions and/or small lesions.

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