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Case Study
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Morule-like features in pulmonary adenocarcinoma associated with epidermal growth factor receptor mutations: two case reports with targeted next-generation sequencing analysis
Yoo Jin Lee, Harim Oh, Eojin Kim, Bokyung Ahn, Jeong Hyeon Lee, Youngseok Lee, Yang Seok Chae, Chul Hwan Kim
J Pathol Transl Med. 2020;54(1):119-122.   Published online November 1, 2019
DOI: https://doi.org/10.4132/jptm.2019.09.30
  • 4,726 View
  • 128 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Morules, or morule-like features, can be identified in benign and malignant lesions in various organs. Morular features are unusual in pulmonary adenocarcinoma cases with only 26 cases reported to date. Here, we describe two cases of pulmonary adenocarcinoma with morule-like features in Korean women. One patient had a non-mucinous-type adenocarcinoma in situ and the other had an acinarpredominant adenocarcinoma with a micropapillary component. Both patients showed multiple intra-alveolar, nodular, whorled proliferative foci composed of atypical spindle cells with eosinophilic cytoplasm. Targeted next-generation sequencing was performed on DNA extracted from formalin-fixed paraffin-embedded samples of the tumors. Results showed unusual epidermal growth factor receptor (EGFR) mutations, which are associated with drug resistance to EGFR tyrosine kinase inhibitors, revealing the importance of identifying morule-like features in pulmonary adenocarcinoma and the need for additional study, since there are few reported cases.

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  • Pulmonary adenocarcinoma in situ with morule - like components: A surgical case report
    Mitsuteru Yosida, Mitsuru Tomita, Naoya Kawakita, Teruki Shimizu, Ryou Yamada, Hiromitsu Takizawa, Hisanori Uehara
    Respiratory Medicine Case Reports.2024; 48: 102008.     CrossRef
  • Clinicopathological, Radiological, and Molecular Features of Primary Lung Adenocarcinoma with Morule-Like Components
    Li-Li Wang, Li Ding, Peng Zhao, Jing-Jing Guan, Xiao-Bin Ji, Xiao-Li Zhou, Shi-Hong Shao, Yu-Wei Zou, Wei-Wei Fu, Dong-Liang Lin, Dong Pan
    Disease Markers.2021; 2021: 1.     CrossRef
Brief Case Reports
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Adenocarcinoma Arising in an Ectopic Hamartomatous Thymoma with HER2 Overexpression
Harim Oh, Eojin Kim, Bokyung Ahn, Jeong Hyeon Lee, Youngseok Lee, Yang Seok Chae, Chul Hwan Kim, Yoo Jin Lee
J Pathol Transl Med. 2019;53(6):403-406.   Published online August 19, 2019
DOI: https://doi.org/10.4132/jptm.2019.06.23
  • 4,043 View
  • 115 Download
  • 2 Web of Science
  • 3 Crossref
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Citations to this article as recorded by  
  • Branchioma: immunohistochemical and molecular genetic study of 23 cases highlighting frequent loss of retinoblastoma 1 immunoexpression
    Martina Bradová, Lester D. R. Thompson, Martin Hyrcza, Tomáš Vaněček, Petr Grossman, Michael Michal, Veronika Hájková, Touraj Taheri, Niels Rupp, David Suster, Sunil Lakhani, Dimitar Hadži Nikolov, Radim Žalud, Alena Skálová, Michal Michal, Abbas Agaimy
    Virchows Archiv.2024; 484(1): 103.     CrossRef
  • Adenocarcinoma arising in branchioma with a KRAS and TP53 mutation
    Natsuki Taniguchi, Akira Satou, Takanori Ito, Masato Nakaguro, Toyonori Tsuzuki
    Pathology International.2023; 73(7): 317.     CrossRef
  • Two Ectopic Hamartomatous Thymomas of Suprasternal Region of the Neck in A Single Patient: A Case Report
    Wei WANG, Manmei LONG, Zhichao WANG
    Chinese Journal of Plastic and Reconstructive Surgery.2021; 3(1): 51.     CrossRef
Human Papillomavirus–Related Multiphenotypic Sinonasal Carcinoma with Late Recurrence
Bokyung Ahn, Eojin Kim, Harim Oh, Yang-Seok Chae, Chul Hwan Kim, Youngseok Lee, Jeong Hyeon Lee, Yoo Jin Lee
J Pathol Transl Med. 2019;53(5):337-340.   Published online April 25, 2019
DOI: https://doi.org/10.4132/jptm.2019.04.02
  • 5,048 View
  • 106 Download
  • 8 Web of Science
  • 8 Crossref
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Citations

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  • HPV-Related Multiphenotypic Sinonasal Carcinoma: A Clinicoradiological Series of 3 Cases With Full Endoscopic Surgical Outcome
    Catherine Beaumont, Sylvie Nadeau, Pierre-Olivier Champagne, Michel Beauchemin, Noémie Villemure-Poliquin
    Ear, Nose & Throat Journal.2024;[Epub]     CrossRef
  • A Case of Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma Resected by Endoscopic Surgery
    Keigo Nakamura, Ichiro Tojima, Yoshihito Kubo, Kento Kawakita, Takuya Murao, Yuichiro Oe, Hiroyuki Arai, Koji Matsumoto, Hideaki Kouzaki, Takeshi Shimizu
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  • Human papillomavirus-related multiphenotypic sinonasal carcinoma: A report of two patients and review of the literature
    Satoru Miyamaru, Tetsuji Sanuki, Yusuke Miyamoto, Kohei Nishimoto, Masako Masuda, Yumi Honda, Yoshiki Mikami, Yorihisa Orita
    Auris Nasus Larynx.2023; 50(3): 473.     CrossRef
  • Malignant Sinonasal Tumors: Update on Histological and Clinical Management
    Alessandra Bracigliano, Fabiana Tatangelo, Francesco Perri, Giuseppe Di Lorenzo, Roberto Tafuto, Alessandro Ottaiano, Ottavia Clemente, Maria Luisa Barretta, Nunzia Simona Losito, Mariachiara Santorsola, Salvatore Tafuto
    Current Oncology.2021; 28(4): 2420.     CrossRef
  • Human Papillomavirus-Related Multiphenotypic Sinonasal Carcinoma—An Even Broader Tumor Entity?
    Mark Zupancic, Anders Näsman
    Viruses.2021; 13(9): 1861.     CrossRef
  • A Case of Human Papillomavirus-related Multiphenotypic Sinonasal Carcinoma Resected by Endonasal Endoscopic En Bloc Resection
    Satoru Miyamaru, Yu Shimoda, Kohei Nishimoto, Hiroyuki Ueda, Masako Masuda, Taro Okazaki, Tetsuji Sanuki, Yumi Honda, Yoshiki Mikami, Yorihisa Orita
    Nihon Bika Gakkai Kaishi (Japanese Journal of Rhinology).2021; 60(4): 531.     CrossRef
  • Don't stop the champions of research now: a brief history of head and neck pathology developments
    Lester D.R. Thompson, James S. Lewis, Alena Skálová, Justin A. Bishop
    Human Pathology.2020; 95: 1.     CrossRef
  • HPV-Related Multiphenotypic Sinonasal Carcinoma: Four Cases that Expand the Morpho-Molecular Spectrum and Include Occupational Data
    Niels J. Rupp, Ulrike Camenisch, Kati Seidl, Elisabeth J. Rushing, Nanina Anderegg, Martina A. Broglie, David Holzmann, Grégoire B. Morand
    Head and Neck Pathology.2020; 14(3): 623.     CrossRef
Case Study
Combined Adenosquamous and Large Cell Neuroendocrine Carcinoma of the Gallbladder
Jiyoon Jung, Yang-Seok Chae, Chul Hwan Kim, Youngseok Lee, Jeong Hyeon Lee, Dong-Sik Kim, Young-Dong Yu, Joo Young Kim
J Pathol Transl Med. 2018;52(2):121-125.   Published online October 5, 2017
DOI: https://doi.org/10.4132/jptm.2017.08.20
  • 6,899 View
  • 153 Download
  • 10 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Large cell neuroendocrine carcinoma (LCNEC) of the gallbladder is extremely rare and usually combined with other type of malignancy, mostly adenocarcinoma. We report an unusual case of combined adenosquamous carcinoma and LCNEC of the gallbladder in a 54-year-old woman. A radical cholecystectomy specimen revealed a 4.3×4.0 cm polypoid mass in the fundus with infiltration of adjacent liver parenchyma. Microscopically, the tumor consisted of two distinct components. Adenosquamous carcinoma was predominant and abrupt transition from adenocarcinoma to squamous cell carcinoma was observed. LCNEC showed round cells with large, vesicular nuclei, abundant mitotic figures, and occasional pseudorosette formation. The patient received adjuvant chemotherapy. However, multiple liver metastases were identified at 3-month follow-up. Metastatic nodules were composed of LCNEC and squamous cell carcinoma components. Detecting LCNEC component is important in gallbladder cancer, because the tumor may require a different chemotherapy regimen and show early metastasis and poor prognosis.

Citations

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  • Does the size of the neuroendocrine-carcinoma component determine the prognosis of gallbladder cancer?
    Ya-Fei Hu, Jun-Ke Wang, Wen-Jie Ma, Hai-Jie Hu, Han-Fei Gu, Fei Liu, Tian-Run Lv, Si-Qi Yang, Yu-Shi Dai, Rui-Qi Zou, Yan-Wen Jin, Fu-Yu Li
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
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    Hyung Kyu Park, Ghee Young Kwon
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Man Jiang, Yijing Zhang
    Journal of Cancer Research and Therapeutics.2023; 19(4): 910.     CrossRef
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    Tingting Yu, Shike Li, Zhuo Zhang
    Asian Journal of Surgery.2022; 45(11): 2336.     CrossRef
  • Mixed neuroendocrine-non-neuroendocrine neoplasm of the gallbladder: case report and literature review
    Xu Ren, Hong Jiang, Kan Sun, Xufu Qin, Yongping Qu, Tian Xia, Yan Chen
    Diagnostic Pathology.2022;[Epub]     CrossRef
  • Neuroendocrine Neoplasms of the Gallbladder: A Clinicopathological Analysis of 13 Patients and a Review of the Literature
    Pengyan Wang, Jingci Chen, Ying Jiang, Congwei Jia, Junyi Pang, Shan Wang, Xiaoyan Chang, Oronzo Brunetti
    Gastroenterology Research and Practice.2021; 2021: 1.     CrossRef
  • Gallbladder Mixed Neuroendocrine-Non-neuroendocrine Neoplasm (MiNEN) Arising in Intracholecystic Papillary Neoplasm: Clinicopathologic and Molecular Analysis of a Case and Review of the Literature
    Amedeo Sciarra, Edoardo Missiaglia, Mounir Trimech, Emmanuel Melloul, Jean-Philippe Brouland, Christine Sempoux, Stefano La Rosa
    Endocrine Pathology.2020; 31(1): 84.     CrossRef
  • Mixed neuroendocrine-non-neuroendocrine carcinoma of gallbladder: case report
    Adam Skalický, Lucie Vištejnová, Magdaléna Dubová, Tomáš Malkus, Tomáš Skalický, Ondřej Troup
    World Journal of Surgical Oncology.2019;[Epub]     CrossRef
Brief Case Report
Hyalinizing Cholecystitis and Associated Carcinoma: A Case Report
Youngjin Kang, Yang-Seok Chae, Chul Hwan Kim, Youngseok Lee, Dong-Sik Kim, Young-Dong Yu, Joo Young Kim
J Pathol Transl Med. 2018;52(1):64-66.   Published online April 4, 2017
DOI: https://doi.org/10.4132/jptm.2016.11.04
  • 9,148 View
  • 211 Download
  • 4 Web of Science
  • 4 Crossref
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  • 18F-FDG PET/CT in Hyalinized Cholecystitis
    Esra Arslan, Aytül Hande Yardimci, Enver Yarikkaya, Göksel Alçin, Tevfik Fikret Çermik
    Clinical Nuclear Medicine.2021; 46(4): e228.     CrossRef
  • Gallbladder Carcinoma and Its Differential Diagnosis at MRI: What Radiologists Should Know
    Camila Lopes Vendrami, Michael J. Magnetta, Pardeep K. Mittal, Courtney C. Moreno, Frank H. Miller
    RadioGraphics.2021; 41(1): 78.     CrossRef
  • A simple method for diagnosing gallbladder malignant tumors with subserosa invasion by endoscopic ultrasonography
    Mitsuru Sugimoto, Hiroki Irie, Mika Takasumi, Minami Hashimoto, Yuka Oka, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Jun Nakamura, Tsunetaka Kato, Ryoichiro Kobashi, Yuko Hashimoto, Shigeru Marubashi, Takuto Hikichi, Hiromasa Ohi
    BMC Cancer.2021;[Epub]     CrossRef
  • KRONİK KOLESİSTİTİN NADİR VE MALİGNİTE POTANSİYELİ YÜKSEK OLAN ALT TİPİ; HYALİNİZE KOLESİSTİT: OLGU SUNUMU
    Leymune PARLAK, Bahar MEMİŞ
    Balıkesir Medical Journal.2019; 3(3): 129.     CrossRef
Original Articles
Comparison of the Mismatch Repair System between Primary and Metastatic Colorectal Cancers Using Immunohistochemistry
Jiyoon Jung, Youngjin Kang, Yoo Jin Lee, Eojin Kim, Bokyung Ahn, Eunjung Lee, Joo Young Kim, Jeong Hyeon Lee, Youngseok Lee, Chul Hwan Kim, Yang-Seok Chae
J Pathol Transl Med. 2017;51(2):129-136.   Published online February 14, 2017
DOI: https://doi.org/10.4132/jptm.2016.12.09
  • 9,632 View
  • 321 Download
  • 27 Web of Science
  • 24 Crossref
AbstractAbstract PDF
Background
Colorectal cancer (CRC) is one of the most common malignancies worldwide. Approximately 10%–15% of the CRC cases have defective DNA mismatch repair (MMR) genes. Although the high level of microsatellite instability status is a predictor of favorable outcome in primary CRC, little is known about its frequency and importance in secondary CRC. Immunohistochemical staining (IHC) for MMR proteins (e.g., MLH1, MSH2, MSH6, and PMS2) has emerged as a useful technique to complement polymerase chain reaction (PCR) analyses. Methods: In this study, comparison between the MMR system of primary CRCs and paired liver and lung metastatic lesions was done using IHC and the correlation with clinical outcomes was also examined. Results: Based on IHC, 7/61 primary tumors (11.4%) showed deficient MMR systems, while 13/61 secondary tumors (21.3%) showed deficiencies. In total, 44 cases showed proficient expression in both the primary and metastatic lesions. Three cases showed deficiencies in both the primary and paired metastatic lesions. In 10 cases, proficient expression was found only in the primary lesions, and not in the corresponding metastatic lesions. In four cases, proficient expression was detected in the secondary tumor, but not in the primary tumor. Conclusions: Although each IHC result and the likely defective genes were not exactly matched between the primary and the metastatic tumors, identical results for primary and metastatic lesions were obtained in 77% of the cases (47/61). These data are in agreement with the previous microsatellite detection studies that used PCR and IHC.

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Does Polymerase Chain Reaction of Tissue Specimens Aid in the Diagnosis of Tuberculosis?
Yoo Jin Lee, Seojin Kim, Youngjin Kang, Jiyoon Jung, Eunjung Lee, Joo-Young Kim, Jeong Hyeon Lee, Youngseok Lee, Yang-seok Chae, Chul Hwan Kim
J Pathol Transl Med. 2016;50(6):451-458.   Published online October 10, 2016
DOI: https://doi.org/10.4132/jptm.2016.08.04
  • 9,915 View
  • 240 Download
  • 6 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Background
Mycobacterial culture is the gold standard test for diagnosing tuberculosis (TB), but it is time-consuming. Polymerase chain reaction (PCR) is a highly sensitive and specific method that can reduce the time required for diagnosis. The diagnostic efficacy of PCR differs, so this study determined the actual sensitivity of TB-PCR in tissue specimens.
Methods
We retrospectively reviewed 574 cases. The results of the nested PCR of the IS6110 gene, mycobacterial culture, TB-specific antigen-induced interferon-γ release assay (IGRA), acid-fast bacilli (AFB) staining, and histological findings were evaluated.
Results
The positivity rates were 17.6% for PCR, 3.3% for the AFB stain, 22.2% for mycobacterial culture, and 55.4% for IGRA. PCR had a low sensitivity (51.1%) and a high specificity (86.3%) based on the culture results of other studies. The sensitivity was higher (65.5%) in cases with necrotizing granuloma but showed the highest sensitivity (66.7%) in those with necrosis only. The concordance rate between the methods indicated that PCR was the best method compared to mycobacterial culture, and the concordance rate increased for the methods using positive result for PCR or histologic features.
Conclusions
PCR of tissue specimens is a good alternative to detect tuberculosis, but it may not be as sensitive as previously suggested. Its reliability may also be influenced by some histological features. Our data showed a higher sensitivity when specimens contained necrosis, which indicated that only specimens with necrosis should be used for PCR to detect tuberculosis.

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Morphometric Analysis of Thyroid Follicular Cells with Atypia of Undetermined Significance
Youngjin Kang, Yoo Jin Lee, Jiyoon Jung, Youngseok Lee, Nam Hee Won, Yang Seok Chae
J Pathol Transl Med. 2016;50(4):287-293.   Published online June 13, 2016
DOI: https://doi.org/10.4132/jptm.2016.04.04
  • 9,308 View
  • 95 Download
  • 4 Web of Science
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AbstractAbstract PDF
Background
Atypia of undetermined significance (AUS) is a category that encompasses a heterogeneous group of thyroid aspiration cytology. It has been reclassified into two subgroups based on the cytomorphologic features: AUS with cytologic atypia and AUS with architectural atypia. The nuclear characteristics of AUS with cytologic atypia need to be clarified by comparing to those observed in Hashimoto thyroiditis and benign follicular lesions.
Methods
We selected 84 cases of AUS with histologic follow-up, 24 cases of Hashimoto thyroiditis, and 26 cases of benign follicular lesions. We also subcategorized the AUS group according to the follow-up biopsy results into a papillary carcinoma group and a nodular hyperplasia group. The differences in morphometric parameters, including the nuclear areas and perimeters, were compared between these groups.
Results
The AUS group had significantly smaller nuclear areas than the Hashimoto thyroiditis group, but the nuclear perimeters were not statistically different. The AUS group also had significantly smaller nuclear areas than the benign follicular lesion group; however, the AUS group had significantly longer nuclear perimeters. The nuclear areas in the papillary carcinoma group were significantly smaller than those in the nodular hyperplasia group; however, the nuclear perimeters were not statistically different.
Conclusions
We found the AUS group to be a heterogeneous entity, including histologic follow-up diagnoses of papillary carcinoma and nodular hyperplasia. The AUS group showed significantly greater nuclear irregularities than the other two groups. Utilizing these features, nuclear morphometry could lead to improvements in the accuracy of the subjective diagnoses made with thyroid aspiration cytology.

Citations

Citations to this article as recorded by  
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  • The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
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Case Reports
Fine Needle Aspiration Cytology of Extranodal Marginal Zone B cell Lymphoma with Abundant Plasma Cells and Eosinophilic Histiocytes in Parotid Gland.
Youngseok Lee, Jungsuk An, Yang Seok Chae, Bom Woo Yeom, Jong Sang Choi, Chul Hwan Kim
Korean J Cytopathol. 2007;18(2):165-169.
  • 1,697 View
  • 21 Download
AbstractAbstract PDF
The authors present the fine needle aspiration cytology (FNAC) cytologic findings of a case of extranodal marginal zone B cell lymphoma (MZBCL), which featured abundant plasma cells and eosinophilic histiocytes arising in both parotid glands. A 49-year-old female presented with palpable masses in both parotid glands. She had been suffering from systemic lupus erythematosus and rheumatoid arthritis. The lesions were evaluated by FNAC and smears showed a small number of clusters of oncocytic cells with abundant eosinophilic granular cytoplasm and small nuclei, intermixed with small to medium-sized lymphoid cells containing round to lobulated nuclei, which suggested Warthin's tumor. Some of lymphoid cells had a plasmacytoid appearance, and some scattered large cells contained a large amount of eosinophilic cytoplasm. Bilateral superficial parotidectomy was performed and a histopathologic study indicated MZBCL with abundant plasma cells, intermixed with eosinophilic histiocytes. The presence of oncocytic cells and a mixture of lymphoid and plasma cells indicates Warthin's tumor, but the cytologic features of a relatively monotonous small to medium-sized lymphoid infiltrate suggest the possibility of MZBCL in the clinical setting of an FNAC study performed on a patient suffering from a connective tissue disease.
Gliosarcoma with Components of Anaplastic Oligodendroglioma and Unclassifiable Spindle Cells: A Case Report.
Jung Woo Choi, Youngseok Lee, Jung Suk An, Nam Hee Won, Yong Gu Chung, Yang Seok Chae
Korean J Pathol. 2008;42(1):45-49.
  • 1,751 View
  • 18 Download
AbstractAbstract PDF
Gliosarcoma is a distinct disease entity that is characterized by a biphasic tissue pattern with alternating areas displaying glial and mesenchymal differentiation. The tumor in our case was a rare morphologic variant of gliosarcoma with components of anaplastic oligodendroglioma and unclassifiable spindle cells. Spindle cells showed CD34 and S-100 protein immunoreactivity, which was possibly related to peripheral nerve sheath differentiation. This unique feature has not been described previously and so this case expands the spectrum of possible divergent mesenchymal differentiation, and it lends support to pluripotential stem cells being the origin of this tumor.
Metastatic Medullary Carcinoma of Thyroid to Breast; A Case Initially Diagnosed as Primary Invasive Lobular Carcinoma: A Case Report.
Youngseok Lee, Jungsuk An, Chul Hwan Kim, Bom Woo Yeom, Jong Sang Choi, Yang Seok Chae
Korean J Pathol. 2007;41(6):412-415.
  • 1,861 View
  • 25 Download
AbstractAbstract PDF
Metastasis to the breast from medullary carcinoma of the thyroid is extremely rare. We report a case of metastatic medullary carcinoma of the thyroid which presented as multiple breast masses with ipsilateral axillary lymphadenopathy in a 48-year-old woman. Six years ago, she underwent total thyroidectomy and neck dissection because of palpable neck masses, with a diagnosis of medullary thyroid carcinoma. Histological features of breast masses showed single- file or linear-cord arrangements, with plasmacytoid appearance, and the initial diagnosis was invasive lobular carcinoma. She underwent modified radical mastectomy. The tumor cells were diffusely positive for E-cadherin, calcitonin and thyroid transcription factor-1 (TTF-1) and were metastatic medullary carcinoma of thyroid. In the patients with a history of medullary carcinoma of the thyroid, a careful examination is necessary for a breast mass composed of solid and cord-like clusters of small round to ovoid cells with plasmacytoid appearance. Immunohistochemical staining for E-cadherin, calcitonin and TTF-1 could be helpful for differential diagnosis.

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