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Original Article
Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma
Jisup Kim, Beom Jin Lim, Soon Won Hong, Ju Yeon Pyo
J Pathol Transl Med. 2018;52(2):105-109.   Published online February 12, 2018
DOI: https://doi.org/10.4132/jptm.2017.12.26
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  • 2 Citations
AbstractAbstract PDF
Background
Warthin-like variant of papillary thyroid carcinoma (WLV-PTC) is a relatively rare variant of papillary thyroid carcinoma with favorable prognosis. However, preoperative diagnosis using fine-needle aspiration (FNA) specimens is challenging especially with lymphocytic thyroiditis characterized by Hürthle cells and lymphocytic background. To determine a helpful cytological differential point, we compared WLV-PTC FNA findings with conventional papillary thyroid carcinoma with lymphocytic thyroiditis (PTC-LT) and conventional papillary thyroid carcinoma without lymphocytic thyroiditis (PTC) regarding infiltrating inflammatory cells and their distribution. Preoperative diagnosis or potential for WLV-PTC will be helpful for surgeons to decide the scope of operation.
Methods
Of the 8,179 patients treated for papillary thyroid carcinoma between January 2007 and December 2012, 16 patients (0.2%) were pathologically confirmed as WLV-PTC and four cases were available for cytologic review. For comparison, we randomly selected six PTC-LT cases and five PTC cases during the same period. The number of intratumoral and background lymphocytes, histiocytes, neutrophils, and the presence of giant cells were evaluated and compared using conventional smear and ThinPrep preparations.
Results
WLV-PTC showed extensive lymphocytic smear with incorporation of thyroid follicular tumor cell clusters and frequent histiocytes. WLV-PTC was associated with higher intratumoral and background lymphocytes and histiocytes compared with PTC-LT or PTC. The difference was more distinct in liquid-based cytology.
Conclusions
The lymphocytic smear pattern and the number of inflammatory cells of WLV-PTC are different from those of PTC-LT or PTC and will be helpful for the differential diagnosis of WLV-PTC in preoperative FNA.

Citations

Citations to this article as recorded by  
  • Challenges in Cytology Specimens With Hürthle Cells
    Eleni Thodou, Sule Canberk, Fernando Schmitt
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Warthin-like variant of Papillary thyroid carcinoma—Case report of an uncommon tumour with review of literature
    Pradyumna Kumar Sahoo, Rashmi Patnayak, Perwez Alam Khan, Amitabh Jena
    International Journal of Surgery Case Reports.2020; 77: 9.     CrossRef
Review
Pathogenesis of Focal Segmental Glomerulosclerosis
Beom Jin Lim, Jae Won Yang, Woo Sung Do, Agnes B. Fogo
J Pathol Transl Med. 2016;50(6):405-410.   Published online October 16, 2016
DOI: https://doi.org/10.4132/jptm.2016.09.21
  • 11,196 View
  • 831 Download
  • 36 Citations
AbstractAbstract PDF
Focal segmental glomerulosclerosis (FSGS) is characterized by focal and segmental obliteration of glomerular capillary tufts with increased matrix. FSGS is classified as collapsing, tip, cellular, perihilar and not otherwise specified variants according to the location and character of the sclerotic lesion. Primary or idiopathic FSGS is considered to be related to podocyte injury, and the pathogenesis of podocyte injury has been actively investigated. Several circulating factors affecting podocyte permeability barrier have been proposed, but not proven to cause FSGS. FSGS may also be caused by genetic alterations. These genes are mainly those regulating slit diaphragm structure, actin cytoskeleton of podocytes, and foot process structure. The mode of inheritance and age of onset are different according to the gene involved. Recently, the role of parietal epithelial cells (PECs) has been highlighted. Podocytes and PECs have common mesenchymal progenitors, therefore, PECs could be a source of podocyte repopulation after podocyte injury. Activated PECs migrate along adhesion to the glomerular tuft and may also contribute to the progression of sclerosis. Markers of activated PECs, including CD44, could be used to distinguish FSGS from minimal change disease. The pathogenesis of FSGS is very complex; however, understanding basic mechanisms of podocyte injury is important not only for basic research, but also for daily diagnostic pathology practice.

Citations

Citations to this article as recorded by  
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    Molecular Genetics & Genomic Medicine.2020;[Epub]     CrossRef
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    Sonja Djudjaj, Peter Boor
    Molecular Aspects of Medicine.2019; 65: 16.     CrossRef
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    Xueying Zhao, Xiaoming Chen, Ashmeer Chima, Yuanyuan Zhang, Jasmine George, Alyssa Cobbs, Nerimiah Emmett
    Journal of Cellular Physiology.2019; 234(5): 7224.     CrossRef
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    Kidney International.2019; 96(4): 927.     CrossRef
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    Journal of Histochemistry & Cytochemistry.2019; 67(9): 623.     CrossRef
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    Andrew S. Potter, Keri Drake, Eric W. Brunskill, S. Steven Potter, Peter Hohenstein
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    Proteome Science.2019;[Epub]     CrossRef
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    Matrix Biology.2018; 68-69: 230.     CrossRef
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Original Article
Aberrant Blood Vessel Formation Connecting the Glomerular Capillary Tuft and the Interstitium Is a Characteristic Feature of Focal Segmental Glomerulosclerosis-like IgA Nephropathy
Beom Jin Lim, Min Ju Kim, Soon Won Hong, Hyeon Joo Jeong
J Pathol Transl Med. 2016;50(3):211-216.   Published online April 11, 2016
DOI: https://doi.org/10.4132/jptm.2016.02.01
  • 6,326 View
  • 63 Download
  • 1 Citations
AbstractAbstract PDF
Background
Segmental glomerulosclerosis without significant mesangial or endocapillary proliferation is rarely seen in IgA nephropathy (IgAN), which simulates idiopathic focal segmental glomerulosclerosis (FSGS). We recently recognized aberrant blood vessels running through the adhesion sites of sclerosed tufts and Bowman’s capsule in IgAN cases with mild glomerular histologic change.
Methods
To characterize aberrant blood vessels in relation to segmental sclerosis, we retrospectively reviewed the clinical and histologic features of 51 cases of FSGS-like IgAN and compared them with 51 age and gender-matched idiopathic FSGS cases.
Results
In FSGS-like IgAN, aberrant blood vessel formation was observed in 15.7% of cases, 1.0% of the total glomeruli, and 7.3% of the segmentally sclerosed glomeruli, significantly more frequently than in the idiopathic FSGS cases (p = .009). Aberrant blood vessels occasionally accompanied mild cellular proliferation surrounding penetrating neovessels. Clinically, all FSGS-like IgAN cases had hematuria; however, nephrotic range proteinuria was significantly less frequent than idiopathic FSGS.
Conclusions
Aberrant blood vessels in IgAN are related to glomerular capillary injury and may indicate abnormal repair processes in IgAN.

Citations

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  • IgA nephropathy
    Maria F. Soares, Ian S.D. Roberts
    Current Opinion in Nephrology and Hypertension.2017; 26(3): 165.     CrossRef
Review
Overview of IgG4-Related Tubulointerstitial Nephritis and Its Mimickers
Hyeon Joo Jeong, Su-Jin Shin, Beom Jin Lim
J Pathol Transl Med. 2016;50(1):26-36.   Published online December 14, 2015
DOI: https://doi.org/10.4132/jptm.2015.11.09
  • 9,356 View
  • 201 Download
  • 7 Citations
AbstractAbstract PDF
Tubulointerstitial nephritis (TIN) is the most common form of renal involvement in IgG4-related disease. It is characterized by a dominant infiltrate of IgG4-positive plasma cells in the interstitium and storiform fibrosis. Demonstration of IgG4-positive plasma cells is essential for diagnosis, but the number of IgG4-positive cells and the ratio of IgG4-positive/IgG-positive plasma cells may vary from case to case and depending on the methods of tissue sampling even in the same case. IgG4-positive plasma cells can be seen in TIN associated with systemic lupus erythematosus, Sjögren syndrome, or anti-neutrophil cytoplasmic antibody–associated vasculitis, which further add diagnostic confusion and difficulties. To have a more clear view of IgG4-TIN and to delineate differential points from other TIN with IgG4-positive plasma cell infiltrates, clinical and histological features of IgG4-TIN and its mimickers were reviewed. In the rear part, cases suggesting overlap of IgG4-TIN and its mimickers and glomerulonephritis associated with IgG4-TIN were briefly described.

Citations

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    World Journal of Nephrology.2018; 7(1): 29.     CrossRef
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    E. V. Lebedeva, M. V. Novoseltsev, A. N. Lvov, I. V. Khamaganova
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Brief Case Reports
The Limitations of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of Pancreatic Serous Cystadenoma: A Brief Case Report
Heae Surng Park, Sun Och Yoon, Beom Jin Lim, Joo Hee Kim, Soon Won Hong
Korean J Pathol. 2014;48(5):405-408.   Published online October 27, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.5.405
  • 6,041 View
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Usefulness of Nuclear Protein in Testis (NUT) Immunohistochemistry in the Cytodiagnosis of NUT Midline Carcinoma: A Brief Case Report
Heae Surng Park, Yoon Sung Bae, Sun Och Yoon, Beom Jin Lim, Hyun Jun Hong, Jae Y Ro, Soon Won Hong
Korean J Pathol. 2014;48(4):335-338.   Published online August 26, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.4.335
  • 8,630 View
  • 81 Download
  • 15 Citations
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Original Articles
Renal Histologic Parameters Influencing Postoperative Renal Function in Renal Cell Carcinoma Patients
Myoung Ju Koh, Beom Jin Lim, Kyu Hun Choi, Yon Hee Kim, Hyeon Joo Jeong
Korean J Pathol. 2013;47(6):557-562.   Published online December 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.557
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AbstractAbstract PDF
Background

Pre-existing non-neoplastic renal diseases or lesions may influence patient renal function after tumor removal. However, its description is often neglected or omitted in pathologic reports. To determine the incidence and clinical significance of non-neoplastic lesions, we retrospectively examined renal tissues obtained during 85 radical nephrectomies for renal cell carcinoma.

Methods

One paraffin-embedded tissue block from each case containing a sufficient amount of non-tumorous renal parenchyma was cut and processed with hematoxylin and eosin and periodic acid-Schiff methods. Non-neoplastic lesions of each histological compartment were semi-quantitatively and quantitatively evaluated.

Results

Among the various histologic lesions found, tubular atrophy, arterial intimal thickening, and glomerulosclerosis were the most common (94.1%, 91.8%, and 88.2%, respectively). Glomerulosclerosis correlated with estimated glomerular filtration rate at the time of surgery, as well as at 1- and 5-years post-surgery (p=.0071), but tubulointerstitial fibrosis or arterial fibrous intimal thickening did not. Post-hoc analysis revealed that glomerulosclerosis of more than 20% predicted post-operative renal function. However, its significance disappeared when gender and age were considered.

Conclusions

In conclusion, non-neoplastic lesions, especially with regard to glomerulosclerosis percentage, should be described in pathology reports to provide additional information on renal function decline.

Citations

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    Human Pathology.2022; 124: 76.     CrossRef
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    Qingqiang Zhu, Wenrong Zhu, Jing Ye, Jingtao Wu, Wenxin Chen, Zhihua Hao
    Acta Radiologica.2019; 60(3): 382.     CrossRef
  • Conventional and Papillary Renal Cell Carcinomas and Focal Segmental Glomerulosclerosis in a Nephrectomy
    Firas Al-Delfi, Guillermo A. Herrera
    Pathology Case Reviews.2015; 20(6): 263.     CrossRef
The Definition of Minimal Extrathyroid Extension in Thyroid Pathology by Analyzing Sizable Intra- and Extrathyroid Blood Vessels
Hyae Min Jeon, Beom Jin Lim, Hang-Seok Chang, SoonWon Hong
Korean J Pathol. 2012;46(6):548-553.   Published online December 26, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.548
  • 7,821 View
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  • 7 Citations
AbstractAbstract PDF
Background

To define the exact boundary of the intrathyroid and extrathyroid aspects of a gland when determining the extent of cancer invasion, we plan to clarify the definition of sizable vascular structures, which is one of the helpful histologic clues in determining a minimal extrathyroid extension. We hypothesized that arterial wall thicknesses in extrathyroid soft tissue would be significantly different from the arteries in the thyroid parenchyma.

Methods

Twenty cases of papillary carcinoma were selected. The numbers and wall thicknesses of the arteries and arterioles in intrathyroid and extrathyroid tissue were evaluated. The absence of nerve tissue in the thyroid gland was confirmed using the S-100 protein immunohistochemical stain.

Results

The comparison of the mean thicknesses of the total arteries between the extrathyroid and intrathyroid tissues in the retrospective study (26.88 µm vs. 15.07 µm, respectively) and the prospective study (35.24 µm vs. 16.52 µm, respectively) revealed significant differences (p=0.000). The greatest thickness of the intrathyroid arteries was 67.93 µm.

Conclusions

According to our results, the study showed that the extrathyroidal arteries were significantly thicker than the intrathyroidal arteries. We suggest that the sizable blood vessels of extrathyroidal arteries should be greater than 67.93 µm in thickness.

Citations

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  • Invasion in thyroid cancer: Controversies and best practices
    Michiya Nishino, Jack Jacob
    Seminars in Diagnostic Pathology.2020; 37(5): 219.     CrossRef
  • MiR-221/222 promote migration and invasion, and inhibit autophagy and apoptosis by modulating ATG10 in aggressive papillary thyroid carcinoma
    Hao Shen, Zaikai Lin, Haiyan Shi, Lingling Wu, Baojin Ma, Hong Li, Baobing Yin, Jun Tang, Hongjin Yu, Xiaoxing Yin
    3 Biotech.2020;[Epub]     CrossRef
  • Minimal extrathyroidal extension affects the prognosis of differentiated thyroid cancer: Is there a need for change in the AJCC classification system?
    Zeming Liu, Yihui Huang, Sichao Chen, Di Hu, Min Wang, Ling Zhou, Wei Zhou, Danyang Chen, Haifeng Feng, Wei Wei, Chao Zhang, Wen Zeng, Liang Guo, Scott M. Langevin
    PLOS ONE.2019; 14(6): e0218171.     CrossRef
  • miR-199a-3p downregulation in thyroid tissues is associated with invasion and metastasis of papillary thyroid carcinoma
    Chengbiao Liu, Meiling Xing, Liping Wang, Kejun Zhang
    British Journal of Biomedical Science.2017; 74(2): 90.     CrossRef
  • Clinicopathological Significance of Minimal Extrathyroid Extension in Solitary Papillary Thyroid Carcinomas
    Chang Gok Woo, Chang Ohk Sung, Yun Mi Choi, Won Gu Kim, Tae Yong Kim, Young Kee Shong, Won Bae Kim, Suck Joon Hong, Dong Eun Song
    Annals of Surgical Oncology.2015; 22(S3): 728.     CrossRef
  • Intraoperative Frozen Section for the Evaluation of Extrathyroidal Extension in Papillary Thyroid Cancer
    Om Prakash Prajapati, A. K. Verma, M. Sabaretnam
    World Journal of Surgery.2015; 39(7): 1855.     CrossRef
  • Tumor Sprouting in Papillary Thyroid Carcinoma Is Correlated with Lymph Node Metastasis and Recurrence
    Eunjung Lee, Wonkyung Jung, Jeong-Soo Woo, Jae Bok Lee, Bong Kyung Shin, Han Kyeom Kim, Aeree Kim, Baek-hui Kim
    Korean Journal of Pathology.2014; 48(2): 117.     CrossRef
Urinary Decoy Cell Grading and Its Clinical Implications
Myoung Ju Koh, Beom Jin Lim, Songmi Noh, Yon Hee Kim, Hyeon Joo Jeong
Korean J Pathol. 2012;46(3):233-236.   Published online June 22, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.233
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  • 4 Citations
AbstractAbstract PDF
Background

Examination of urine for decoy cells (DCs) is a useful screening test for polyomavirus (PV) activation. We explored the significance of the amount of DCs in persistent shedding, PV nephropathy and acute rejection.

Methods

A case-controlled study was performed in 88 renal allograft patients who had DCs detected at least once in four or more urine samples.

Results

Fifty one patients were classified into the high-grade shedding group (HG) and 37 patients into the low-grade shedding group (LG) according to DC shedding (≥10 or <10 DCs/10 high power field [HPF]). DC shedding of more than three consecutive months was significantly more prevalent in the HG as compared with their LG counterparts (p<0.0001). Urinary DCs were present for more than one year in 29.4% of the HG and 8.1% of the LG. Real-time polymerase chain reaction for PV was higher in both urine (51.4% vs. 11.1%) and plasma (9.1% vs. 0%) of the HG than the LG. The prevalence of PV nephropathy was higher in the HG than the LG (p=0.019). However, there was no significant difference in the prevalence of acute rejection.

Conclusions

Shedding of ≥10 DCs/10 HPF is associated with sustained shedding, polymerase chain reaction positivity and PV nephropathy, but not a predictor of acute rejection.

Citations

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  • BK Virus-Associated Nephropathy after Renal Transplantation
    Yasuhito Funahashi
    Pathogens.2021; 10(2): 150.     CrossRef
  • Diagnostic utility of urine cytology in detection of decoy cells in renal transplant patients: Report of five cases and review of literature
    Santosh Tummidi, Kanchan Kothari, Mona Agnihotri, Leena Naik, Amey Rojekar
    Diagnostic Cytopathology.2020; 48(3): 222.     CrossRef
  • Association of Pretransplant BK Polyomavirus Antibody Status with BK Polyomavirus Infection After Kidney Transplantation: A Prospective Cohort Pilot Study of 47 Transplant Recipients
    Yu Hisadome, Hiroshi Noguchi, Yuki Nakafusa, Kukiko Sakihama, Takanori Mei, Keizo Kaku, Yasuhiro Okabe, Kosuke Masutani, Yuki Ohara, Kazuyuki Ikeda, Yoshinao Oda, Masafumi Nakamura
    Transplantation Proceedings.2020; 52(6): 1762.     CrossRef
  • Association Between the Polyomaviruses Titers and Decoy Cell Positivity Rates After Renal Transplantation
    Y. Funahashi, M. Kato, T. Fujita, S. Ishida, A. Mori, M. Gotoh
    Transplantation Proceedings.2016; 48(3): 921.     CrossRef
Practical Standardization in Renal Biopsy Reporting.
So Young Jin, Hyeon Joo Jeong, Sun Hee Sung, Beom Jin Lim, Jee Young Han, Soon Won Hong, Hyun Ee Yim, Yeong Jin Choi, Yong Mee Cho, Myoung Jae Kang, Kyung Chul Moon, Hee Jeong Cha, Seung Yeon Ha, Mi Seon Kang, Mee Young So, Kwang Sun Suh, Jong Eun Joo, Yong Jin Kim, Nam Hee Won, Moon Hyang Park
Korean J Pathol. 2010;44(6):613-622.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.613
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  • 2 Citations
AbstractAbstract PDF
BACKGROUND
To standardize renal biopsy reporting and diagnosis, The Renal Pathology Study Group of the Korean Society of Pathologists (RPSKSP) has developed a renal pathology reporting format for the native and allograft kidney.
METHODS
A consensus checklist of a provisional renal biopsy format was sent to all members of the RPSKSP. Feed back opinions regarding the practical application of the checklist to the diagnostic work were received.
RESULTS
Kidney biopsies require three essential examinations: by light microscopy, immunofluorescence (IF), and electron microscopy (EM). A final report of a renal biopsy should include information on specimen adequacy and a description of the morphologic change using a systematic semiquantitative method for each of the compartments, with optional separate IF and EM reports.
CONCLUSIONS
A standard renal biopsy report format is important in establishing clinicopathologic correlations, making reliable prognostic considerations, comparing the findings in sequential biopsies and evaluating the effects of therapy.

Citations

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  • Additional antihypertensive effect of magnesium supplementation with an angiotensin II receptor blocker in hypomagnesemic rats
    Kyubok Jin, Tae Hee Kim, Yeong Hoon Kim, Yang Wook Kim
    The Korean Journal of Internal Medicine.2013; 28(2): 197.     CrossRef
  • Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis
    Tai Yeon Koo, Gheun-Ho Kim, Hyang Park
    Korean Journal of Pathology.2012; 46(2): 105.     CrossRef
An Analysis of Focal Segmental Glomerulosclerosis according to Morphologic Subtypes.
Min Ju Kim, Dokyung Kim, Beom Jin Lim, Hyeon Joo Jeong
Korean J Pathol. 2010;44(6):589-596.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.589
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  • 2 Citations
AbstractAbstract PDF
BACKGROUND
The histological subtypes of focal segmental glomerulosclerosis (FSGS) have different significance and influence clinical presentations and outcomes in patients with FSGS. However, no such data has been reported in Korea.
METHODS
We reviewed renal biopsy specimens of 69 adult patients who were diagnosed with idiopathic FSGS between 2000 and 2008, subclassified them according to the Columbia classification and correlated the results with clinical findings.
RESULTS
The frequencies of the FSGS subtypes were not otherwise specified (NOS) (n = 28), tip (n = 21), perihilar (n = 11), collapsing (n = 5) and cellular types (n = 4) in descending order. Nephrotic syndrome was more common in patients with the tip and collapsing types than the perihilar type. The prevalence of chronic kidney disease stage 4/5 at the time of renal biopsy was significantly higher in patients with the cellular type than the NOS or the tip type. The remission rate after treatment tended to be higher in patients with the NOS type (22.0%) and the tip type (15.2%) than the perihilar (6.8%) and collapsing types (3.4%).
CONCLUSIONS
Classifying FSGS subtypes may be helpful to predict of clinical features and renal outcomes.

Citations

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  • Podocytopathy and Morphologic Changes in Focal Segmental Glomerulosclerosis
    Hyeon Joo Jeong
    Journal of the Korean Society of Pediatric Nephrology.2013; 17(1): 13.     CrossRef
  • Pathology and Classification of Focal Segmental Glomerulosclerosis
    Yong-Jin Kim
    Journal of the Korean Society of Pediatric Nephrology.2012; 16(1): 21.     CrossRef
Galectin-3 Expression and BRAF Mutation in Cases of Cytologically Suspicious Papillary Thyroid Carcinoma.
Dokyung Kim, Hyunki Kim, Jinyoung Kwak, Minju Kim, Hyung Jae Jung, Ja Seung Koo, Beom Jin Lim, Chankwon Jung, SoonWon Hong
Korean J Pathol. 2010;44(2):191-198.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.191
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AbstractAbstract PDF
BACKGROUND
Fine needle aspiration, which is known as the most accurate and cost-effective method for diagnosis of thyroid nodule, still may result in indeterminate cases that are pauci-cellular and show minor nuclear atypia, but most cases are associated with suspicion of papillary thyroid carcinoma (PTC). A B-type Raf kinase (BRAF) mutation was found in about half of PTCs and galectin-3 was expressed by malignant tumors, helping us to differentiate malignancies from benign lesions.
METHODS
Cases studied included histologically 44 confirmed PTC cases and 18 benign cases previously diagnosed as suspicious of PTC using cytologic examination. Cases were analyzed for galectin-3 expression by immunohistochemical staining and BRAF mutation by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with a new restriction enzyme.
RESULTS
All 44 cases of PTC and 8 of 18 benign controls expressed galectin-3. BRAF mutations were found in only 9 of the 44 PTC cases. Assessment of galectin-3 expression demonstrated high sensitivity but low specificity. Evaluation of BRAF mutation revealed high specificity and low sensitivity.
CONCLUSIONS
This study suggests that the combined application of these two methods for PTC of suspicious cytology is complementary.
Case Reports
Calcitonin Producing Middle Ear Carcinoid with Amyloid Deposition: A Case Report.
Beom Jin Lim, Woo Ick Yang, Soon Won Hong, Chanil Park
Korean J Pathol. 2002;36(2):115-118.
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AbstractAbstract PDF
Carcinoid tumor of the middle ear cavity is a rare neoplasm of low malignant potential. It grows slowly and rarely metastasizes. We recently experienced a case of carcinoid tumor of the middle ear cavity occurring in a 51-year-old female who was presented with hearing loss and tinnitus of the right ear. A 1 cm sized pinkish soft mass was noted in the promontory of the middle ear. Histologically, the mass was composed of nests and cords of tumor cells with slightly pleomorphic nuclei and eosinophilic cytoplasm. The extracellular matrix was glassy pink, homogeneous and exhibited apple green birefringence under a polarized light microscope after Congo red staining. The tumor cells showed immunoreactivity for cytokeratin, chromogranin A, synaptophysin, neuron-specific enolase and calcitonin. Electron microscopic examination confirmed the presence of neurosecretory granules. The production of calcitonin and amyloid by the tumor cells suggests the possible relationship of this tumor to the thyroid C cells.
Malignant Mixed Mullerian Tumor of Fallopian Tube with Multiple Distinct Heterologous Components.
Beom Jin Lim, Jae Wook Kim, Woo Ick Yang, Nam Hoon Cho
Korean J Pathol. 2003;37(6):429-431.
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AbstractAbstract PDF
We experienced a case of primary malignant mixed mullerian tumors (MMMT) of the fallopian tube of FIGO stage I. In addition to endometrioid adenocarcinomas, multiple apparent heterologous elements encompassing myxoid chondrosarcoma, osteosarcoma, myxoid liposarcoma and well differentiated angiosarcoma were recognized as separate nodules. These findings have not been described previously in MMMTs of the female genital tract.

JPTM : Journal of Pathology and Translational Medicine