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Case Studies
A Rare Case of Adenosquamous Carcinoma Arising in the Background of IgG4-Related Lung Disease
Sangjoon Choi, Sujin Park, Man Pyo Chung, Tae Sung Kim, Jong Ho Cho, Joungho Han
J Pathol Transl Med. 2019;53(3):188-191.   Published online March 11, 2019
DOI: https://doi.org/10.4132/jptm.2019.02.21
  • 4,512 View
  • 147 Download
  • 9 Citations
AbstractAbstract PDF
IgG4-related disease is a systemic inflammatory disease and is known as IgG4-related lung disease (IgG4-RLD) when it involves the respiratory system. Primary lung cancer arising from a background of IgG4-RLD is very rare. Herein, we report a case of adenosquamous carcinoma arising from the background of IgG4-RLD and presenting as an interstitial lung disease pattern. A 66-year-old man underwent lobectomy under the impression of primary lung cancer. Grossly, the mass was ill-defined and gray-tan colored, and the background lung was fibrotic. Microscopically, tumor cells showed both squamous and glandular differentiation. Dense lymphoplasmacytic infiltration with fibrosis and obliterative phlebitis were seen in the background lung. IgG4 immunohistochemical stain showed diffuse positivity in infiltrating plasma cells. Primary lung adenosquamous carcinoma has not been reported in a background of IgG4-RLD. Due to the rarity of IgG4-RLD, physicians must follow patients with IgG4-RLD over long periods of time to accurately predict the risk of lung cancer.

Citations

Citations to this article as recorded by  
  • Endometrioid Carcinomas of the Ovaries and Endometrium Involving Endocervical Polyps: Comprehensive Clinicopathological Analyses
    Jihee Sohn, Yurimi Lee, Hyun-Soo Kim
    Diagnostics.2022; 12(10): 2339.     CrossRef
  • A Case of IgG4-related Disease Composed of a Paravertebral Tumor Alone with Multiple Lung Cancers
    Mutsumi Ozasa, Toyomitsu Sawai, Yosuke Harada, Sumako Yoshioka, Nobuko Matsuo, Hiroshi Mukae
    Haigan.2021; 61(3): 213.     CrossRef
  • Serous Carcinoma of the Endometrium with Mesonephric-Like Differentiation Initially Misdiagnosed as Uterine Mesonephric-Like Adenocarcinoma: A Case Report with Emphasis on the Immunostaining and the Identification of Splice Site TP53 Mutation
    Sangjoon Choi, Yoon Yang Jung, Hyun-Soo Kim
    Diagnostics.2021; 11(4): 717.     CrossRef
  • A Case of IgG4-related Thyroiditis Diagnosed by Total Thyroidectomy
    Daiki Sakamoto, Masao Yagi, Hiroshi Iwai
    Practica Oto-Rhino-Laryngologica.2021; 114(7): 547.     CrossRef
  • Mesonephric-like Differentiation of Endometrial Endometrioid Carcinoma: Clinicopathological and Molecular Characteristics Distinct from Those of Uterine Mesonephric-like Adenocarcinoma
    Sujin Park, Go Eun Bae, Jiyoung Kim, Hyun-Soo Kim
    Diagnostics.2021; 11(8): 1450.     CrossRef
  • Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
    Hyunjin Kim, Kiyong Na, Go Eun Bae, Hyun-Soo Kim
    Diagnostics.2021; 11(11): 2042.     CrossRef
  • Not Cancer After All: Two Rare Cases of IgG4-Related Lung Disease
    Josué Pinto, Carla Damas, António Morais
    Archivos de Bronconeumología.2020; 56(1): 53.     CrossRef
  • Not Cancer After All: Two Rare Cases of IgG4-Related Lung Disease
    Josuèc) Pinto, Carla Damas, António Morais
    Archivos de Bronconeumología (English Edition).2020; 56(1): 52.     CrossRef
  • Axillary lymphadenopathy with IgG4 positive plasma cell infiltration as differential diagnosis of metastatic lung adenocarcinoma
    Yutaro Ito, Masanori Harada, Namio Kagoo, Tsutomu Kubota, Koshiro Ichijyo, Eisuke Mochizuki, Masahiro Uehara, Shun Matsuura, Masaru Tsukui, Naoki Koshimizu
    Respiratory Medicine Case Reports.2020; 31: 101196.     CrossRef
Abrupt Dyskeratotic and Squamoid Cells in Poorly Differentiated Carcinoma: Case Study of Two Thoracic NUT Midline Carcinomas with Cytohistologic Correlation
Taebum Lee, Sangjoon Choi, Joungho Han, Yoon-La Choi, Kyungjong Lee
J Pathol Transl Med. 2018;52(5):349-353.   Published online July 27, 2018
DOI: https://doi.org/10.4132/jptm.2018.07.16
  • 5,426 View
  • 125 Download
  • 11 Citations
AbstractAbstract PDF
Cytologic diagnosis of nuclear protein in testis (NUT) midline carcinoma (NMC) is important due to its aggressive behavior and miserable prognosis. Early diagnosis of NMC can facilitate proper management, and here we report two rare cases of thoracic NMC with cytohistologic correlation. In aspiration cytology, the tumor presented with mixed cohesive clusters and dispersed single cells, diffuse background necrosis and many neutrophils. Most of the tumor cells had scanty cytoplasm and medium-sized irregular nuclei, which had fine to granular nuclear chromatin. Interestingly, a few dyskeratotic cells or squamoid cell clusters were present in each case. Biopsy specimen histology revealed more frequent squamous differentiation, and additional immunohistochemistry tests showed nuclear expression of NUT. Because this tumor has a notorious progression and has been previously underestimated in terms of its prevalence, awareness of characteristic findings and proper ancillary tests should be considered in all suspicious cases.

Citations

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  • BRD3‐NUTM1 ‐expressing NUT carcinoma of lung on endobronchial ultrasound‐guided transbronchial needle aspiration cytology, a diagnostic pitfall
    Sameer Chhetri Aryal, Shereen Zia, Shannon Rodgers, Yulei Shen, Kyle Perry, Lisi Yuan
    Diagnostic Cytopathology.2022;[Epub]     CrossRef
  • Nuclear protein of the testis midline carcinoma of the thorax
    Ayae Saiki, Keita Sakamoto, Yuan Bee, Takehiro Izumo
    Japanese Journal of Clinical Oncology.2022; 52(6): 531.     CrossRef
  • Approach to Mediastinal Fine Needle Aspiration Cytology
    Zaibo Li, Huihong Xu, Fang Fan
    Advances in Anatomic Pathology.2022; 29(6): 337.     CrossRef
  • Diagnosis, Treatment and Prognosis of Primary Pulmonary NUT Carcinoma: A Literature Review
    Jiaqian Yuan, Zhili Xu, Yong Guo
    Current Oncology.2022; 29(10): 6807.     CrossRef
  • Case report: Immunovirotherapy as a novel add-on treatment in a patient with thoracic NUT carcinoma
    Linus D. Kloker, Branko Calukovic, Katrin Benzler, Alexander Golf, Sebastian Böhm, Sven Günther, Marius Horger, Simone Haas, Susanne Berchtold, Julia Beil, Mary E. Carter, Tina Ganzenmueller, Stephan Singer, Abbas Agaimy, Robert Stöhr, Arndt Hartmann, Tho
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Cytomorphology of primary pulmonary NUT carcinoma in different cytology preparations
    Rimlee Dutta, Aruna Nambirajan, Saurabh Mittal, Sinchita Roy‐Chowdhuri, Deepali Jain
    Cancer Cytopathology.2021; 129(1): 53.     CrossRef
  • Update on genetically defined lung neoplasms: NUT carcinoma and thoracic SMARCA4-deficient undifferentiated tumors
    Kyriakos Chatzopoulos, Jennifer M. Boland
    Virchows Archiv.2021; 478(1): 21.     CrossRef
  • Immunotherapy and Targeting the Tumor Microenvironment: Current Place and New Insights in Primary Pulmonary NUT Carcinoma
    Xiang Li, Hui Shi, Wei Zhang, Chong Bai, Miaoxia He, Na Ta, Haidong Huang, Yunye Ning, Chen Fang, Hao Qin, Yuchao Dong
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Prevalence of NUT carcinoma in head and neck: Analysis of 362 cases with literature review
    Taebum Lee, Junhun Cho, Chung‐Hwan Baek, Young‐Ik Son, Han‐Sin Jeong, Man Ki Chung, Sang Duk Hong, Yong Chan Ahn, Dong Ryul Oh, Jae Myoung Noh, Keunchil Park, Myung‐Ju Ahn, Hyung‐Jin Kim, Yi Kyung Kim, Young Hyeh Ko
    Head & Neck.2020; 42(5): 924.     CrossRef
  • Lung nuclear protein in testis carcinoma in an elderly Korean woman: A case report with cytohistological analysis
    Hwa Jin Cho, Hyun‐Kyung Lee
    Thoracic Cancer.2020; 11(6): 1724.     CrossRef
  • Clinicopathological characteristics of primary lung nuclear protein in testis carcinoma: A single‐institute experience of 10 cases
    Yoon Ah Cho, Yoon‐La Choi, Inwoo Hwang, Kyungjong Lee, Jong Ho Cho, Joungho Han
    Thoracic Cancer.2020; 11(11): 3205.     CrossRef
Original Article
Pulmonary Nodular Lymphoid Hyperplasia with Mass-Formation: Clinicopathologic Characteristics of Nine Cases and Review of the Literature
Jongmin Sim, Hyun Hee Koh, Sangjoon Choi, Jinah Chu, Tae Sung Kim, Hojoong Kim, Joungho Han
J Pathol Transl Med. 2018;52(4):211-218.   Published online June 15, 2018
DOI: https://doi.org/10.4132/jptm.2018.04.27
  • 7,227 View
  • 241 Download
  • 5 Citations
AbstractAbstract PDF
Background
Pulmonary nodular lymphoid hyperplasia (PNLH) is a non-neoplastic pulmonary lymphoid disorder that can be mistaken for malignancy on radiography. Herein, we present nine cases of PNLH, emphasizing clinicoradiological findings and histological features.
Methods
We analyzed radiological and clinicopathological features from the electronic medical records of nine patients (eight females and one male) diagnosed with PNLH. IgG and IgG4 immunohistochemical staining was performed in three patients.
Results
Two of the nine patients had experienced tuberculosis 40 and 30 years prior, respectively. Interestingly, none were current smokers, although two were ex-smokers. Three patients complaining of persistent cough underwent computed tomography of the chest. PNLH was incidentally discovered in five patients during examination for other reasons. The remaining patient was diagnosed with the disease following treatment for pneumonia. Imaging studies revealed consolidation or a mass-like lesion in eight patients. First impressions included invasive adenocarcinoma and mucosal-associated lymphoid tissue‒type lymphoma. Aspergillosis was suspected in the remaining patient based on radiological images. Resection was performed in all patients. Microscopically, the lesions consisted of nodular proliferation of reactive germinal centers accompanied by infiltration of neutrophils and macrophages in various degrees and surrounding fibrosis. Ultimately, all nine patients were diagnosed with PNLH and showed no evidence of recurrence on follow-up.
Conclusions
PNLH is an uncommon but distinct entity with a benign nature, and understanding the radiological and clinicopathological characteristics of PNLH is important.

Citations

Citations to this article as recorded by  
  • Pulmonary Nodular Lymphoid Hyperplasia Evaluated with Bronchoalveolar Lavage Fluid Findings: A Case Report and Review of the Literature on Japanese Patients
    Sakiko Moriyama, Takashi Kido, Noriho Sakamoto, Mai Fuchigami, Takatomo Tokito, Daisuke Okuno, Takuto Miyamura, Shota Nakashima, Atsuko Hara, Hiroshi Ishimoto, Yoshitaka Imaizumi, Kazuto Tsuruda, Katsunori Yanagihara, Junya Fukuoka, Hiroshi Mukae
    Internal Medicine.2023; 62(1): 95.     CrossRef
  • Clinicopathological Characteristics and Curative Effect of Lymphoma Based on Sampling Theory
    Shuxiang Ding, Leipo Liu
    Mathematical Problems in Engineering.2022; 2022: 1.     CrossRef
  • Pulmonary nodular lymphoid hyperplasia presenting as multifocal subsolid nodules: A case report and literature review
    Yoon Jin Cha, Duk Hwan Moon, Ji Hyun Park, Sungsoo Lee, Ji Ae Choi, Tae Hoon Kim, Chul Hwan Park
    Respiratory Medicine Case Reports.2022; 36: 101581.     CrossRef
  • Pulmonary nodular lymphoid hyperplasia in a 53-year-old man with malignant sign: a case report
    Zhen Yang, Lianshuang Wei, Xu Li, Xin Liu
    Journal of Cardiothoracic Surgery.2021;[Epub]     CrossRef
  • The diagnostic challenge of adenocarcinoma in pulmonary nodular lymphoid hyperplasia
    Anita Savić Vuković, Melita Kukuljan, Morana Dinter, Ksenija Jurinović, Nives Jonjić
    SAGE Open Medical Case Reports.2021; 9: 2050313X2110393.     CrossRef
Case Study
Cytologic Characteristics of Thymic Adenocarcinoma with Enteric Differentiation: A Study of Four Fine-Needle Aspiration Specimens
Ah-Young Kwon, Joungho Han, Hae-yon Cho, Seokhwi Kim, Heejin Bang, Jiyeon Hyeon
J Pathol Transl Med. 2017;51(5):509-512.   Published online August 4, 2017
DOI: https://doi.org/10.4132/jptm.2017.03.22
  • 5,681 View
  • 99 Download
  • 6 Citations
AbstractAbstract PDF
Thymic adenocarcinoma is extremely rare. Although its histologic features have been occasionally reported, a lack of description of the cytologic features has hampered the prompt and accurate diagnosis of this condition. Herein, we describe the cytologic findings and histology of four aspiration cytology specimens of thymic adenocarcinoma. The specimens were obtained from primary tumors, metastatic lymph nodes, and pericardial effusions. All four specimens showed three-dimensional glandular clusters with a loss of polarity and nuclear overlapping. One specimen had extensive extracellular mucinous material. Three specimens contained tumor cells with intracytoplasmic vacuoles. While the specimen with extracellular mucin showed relatively mild cytologic atypia, other specimens exhibited more atypical cytologic changes: irregular nuclear membranes, a coarse chromatin pattern, and prominent nucleoli. The cytologic features were correlated with the histologic features in each case of enteric type thymic adenocarcinoma. The differential diagnosis included other thymic carcinomas, yolk sac tumors, and metastatic adenocarcinoma from the lung or colorectum.

Citations

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  • Systemic chemotherapy for unresectable or recurrent primary thymic adenocarcinoma of enteric type
    Xiaofang Gao
    International Cancer Conference Journal.2022; 12(1): 46.     CrossRef
  • Thymic adenocarcinoma accompanied by type A thymoma and pulmonary minimally invasive adenocarcinoma and harboring distinct gene alterations
    Yi-Wen Zheng, Lin-Lin Bai, Gui-Yang Jiang, Xu-Yong Lin, Yang Liu, Hong-Tao Xu
    Medicine.2021; 100(15): e25254.     CrossRef
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    Yuuki Kou, Hirokazu Tanaka, Nobuhisa Yamazaki, Hiroyoshi Watanabe, Makoto Sonobe
    The Journal of the Japanese Association for Chest Surgery.2020; 34(2): 107.     CrossRef
  • Primary thymic adenocarcinoma with an aggressive clinical course: An autopsy case showing signet ring cell‐like features
    Ayako Shiono, Takashi Fujino, Kyoichi Kaira, Tomomi Kato, Masanori Yasuda, Kunihiko Kobayashi, Hiroshi Kagamu
    Thoracic Cancer.2020; 11(12): 3609.     CrossRef
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    Richard Benedict Supan Roxas, Marie Christine Fajatin Bernardo, Araceli Pacis Jacoba, Janet Lim-Dy, Anarose Cariaga Alvarado, Jasna Metovic, Laura Annaratone, Mauro Papotti
    International Journal of Surgical Pathology.2019; 27(3): 315.     CrossRef
  • Disseminated and massive tumor burden in a case of primary thymic mucinous adenocarcinoma
    Hui-Wen Liu, Chih-Yi Liu, Yi-Chen Yeh
    Journal of Cancer Research and Practice.2019; 6(3): 151.     CrossRef
Brief Case Report
Metastatic Squamous Cell Carcinoma from Lung Adenocarcinoma after Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy
Hyung Kyu Park, Youjeong Seo, Yoon-La Choi, Myung-Ju Ahn, Joungho Han
J Pathol Transl Med. 2017;51(4):441-443.   Published online April 4, 2017
DOI: https://doi.org/10.4132/jptm.2016.10.18
  • 5,618 View
  • 125 Download
  • 8 Citations
PDF

Citations

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  • Morphologic-Molecular Transformation of Oncogene Addicted Non-Small Cell Lung Cancer
    Fiorella Calabrese, Federica Pezzuto, Francesca Lunardi, Francesco Fortarezza, Sofia-Eleni Tzorakoleftheraki, Maria Vittoria Resi, Mariaenrica Tiné, Giulia Pasello, Paul Hofman
    International Journal of Molecular Sciences.2022; 23(8): 4164.     CrossRef
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    Frontiers in Oncology.2021;[Epub]     CrossRef
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    Cytopathology.2020; 31(3): 232.     CrossRef
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Original Articles
Size of Non-lepidic Invasive Pattern Predicts Recurrence in Pulmonary Mucinous Adenocarcinoma: Morphologic Analysis of 188 Resected Cases with Reappraisal of Invasion Criteria
Soohyun Hwang, Joungho Han, Misun Choi, Myung-Ju Ahn, Yong Soo Choi
J Pathol Transl Med. 2017;51(1):56-68.   Published online October 16, 2016
DOI: https://doi.org/10.4132/jptm.2016.09.17
  • 8,174 View
  • 204 Download
  • 3 Citations
AbstractAbstract PDF
Background
We reviewed a series of 188 resected pulmonary mucinous adenocarcinomas (MAs) to clarify the prognostic significance of lepidic and non-lepidic patterns.
Methods
Non-lepidic patterns were divided into bland, non-distorted acini with uncertain invasiveness (pattern 1), unequivocal invasion into stroma (pattern 2), or invasion into alveolar spaces (pattern 3).
Results
The mean proportion of invasive patterns (patterns 2 and 3) was lowest in small (≤ 3 cm) tumors, and gradually increased in intermediate (> 3 cm and ≤ 7 cm) and large (> 7 cm) tumors (8.4%, 34.3%, and 50.1%, respectively). Adjusted T (aT) stage, as determined by the size of invasive patterns, was positively correlated with adverse histologic and clinical features including older age, male sex, and ever smokers. aTis tumors, which were exclusively composed of lepidic pattern (n = 9), or a mixture of lepidic and pattern 1 (n = 40) without any invasive patterns, showed 100% disease- free survival (DFS). The aT1mi tumors, with minimal (≤ 5 mm) invasive patterns (n = 63), showed a 95.2% 5-year DFS, with recurrences (n = 2) limited to tumors greater than 3 cm in total size (n = 23). Both T and aT stage were significantly associated with DFS; however, survival within the separate T-stage subgroups was stratified according to the aT stage, most notably in the intermediatestage subgroups. In multivariate analysis, the size of invasive patterns (p = .020), pleural invasion (p < .001), and vascular invasion (p = .048) were independent predictors of recurrence, whereas total size failed to achieve statistical significance (p = .121).
Conclusions
This study provides a rationale for histologic risk stratification in pulmonary MA based on the extent of invasive growth patterns with refined criteria for invasion.

Citations

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  • Radiological and clinical features of screening-detected pulmonary invasive mucinous adenocarcinoma
    Dae Hyeon Kim, So Young Bae, Kwon Joong Na, Samina Park, In Kyu Park, Chang Hyun Kang, Young Tae Kim
    Interactive CardioVascular and Thoracic Surgery.2022; 34(2): 229.     CrossRef
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    Tomonari Oki, Keiju Aokage, Shogo Nomura, Kenta Tane, Tomohiro Miyoshi, Norihiko Shiiya, Kazuhito Funai, Masahiro Tsuboi, Genichiro Ishii
    Journal of Cancer Research and Clinical Oncology.2020; 146(5): 1291.     CrossRef
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    Wei-Chin Chang, Yu Zhi Zhang, Eric Lim, Andrew G Nicholson
    American Journal of Clinical Pathology.2020; 154(1): 88.     CrossRef
Transformation to Small Cell Lung Cancer of Pulmonary Adenocarcinoma: Clinicopathologic Analysis of Six Cases
Soomin Ahn, Soo Hyun Hwang, Joungho Han, Yoon-La Choi, Se-Hoon Lee, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn, Woong-Yang Park
J Pathol Transl Med. 2016;50(4):258-263.   Published online May 10, 2016
DOI: https://doi.org/10.4132/jptm.2016.04.19
  • 9,820 View
  • 223 Download
  • 34 Citations
AbstractAbstract PDF
Background
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are considered the first line treatment for a subset of EGFR-mutated non-small cell lung cancer (NSCLC) patients. Although transformation to small cell lung cancer (SCLC) is one of the known mechanisms of resistance to EGFR TKIs, it is not certain whether transformation to SCLC is exclusively found as a mechanism of TKI resistance in EGFR-mutant tumors.
Methods
We identified six patients with primary lung adenocarcinoma that showed transformation to SCLC on second biopsy (n = 401) during a 6-year period. Clinicopathologic information was analyzed and EGFR mutation results were compared between initial and second biopsy samples.
Results
Six patients showed transformation from adenocarcinoma to SCLC, of which four were pure SCLCs and two were combined adenocarcinoma and SCLCs. Clinically, four cases were EGFR-mutant tumors from non-smoking females who underwent TKI treatment, and the EGFR mutation was retained in the transformed SCLC tumors. The remaining two adenocarcinomas were EGFR wild-type, and one of these patients received EGFR TKI treatment.
Conclusions
NSCLC can acquire a neuroendocrine phenotype with or without EGFR TKI treatment.

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Case Study
Pulmonary Arteriovenous Fistula: Clinical and Histologic Spectrum of Four Cases
Soomin Ahn, Joungho Han, Hong Kwan Kim, Tae Sung Kim
J Pathol Transl Med. 2016;50(5):390-393.   Published online May 9, 2016
DOI: https://doi.org/10.4132/jptm.2016.04.18
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AbstractAbstract PDF
Pulmonary arteriovenous fistula (PAVF) is abnormally dilated vessels that provide a right-to-left shunt between pulmonary artery and pulmonary vein and is clinically divided into simple and complex type. Here, we report four cases of surgically resected sporadic PAVFs presenting various clinical and histologic spectrums. Cases 1 (a 57-old-female) and 2 (a 54-old-female) presented as incidentally identified single aneurysmal fistulas and the lesions were surgically removed without complication. On the other hand, case 3 (an 11-old-male) showed diffuse dilated vascular sacs involving both lungs and caused severe hemodynamic and pulmonary dysfunction. Embolization and surgical resection of the main lesion failed to relieve the symptoms. Case 4 (a 36-old-male) had a localized multiloculated cyst clinically mimicking congenital cystic adenomatoid malformation. Microscopically, the lesion consisted of dilated thick vessels, consistent with the diagnosis of fistulous arteriovenous malformation/hemangioma.

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Original Article
Non-small Cell Lung Cancer with Concomitant EGFR, KRAS, and ALK Mutation: Clinicopathologic Features of 12 Cases
Taebum Lee, Boram Lee, Yoon-La Choi, Joungho Han, Myung-Ju Ahn, Sang-Won Um
J Pathol Transl Med. 2016;50(3):197-203.   Published online April 18, 2016
DOI: https://doi.org/10.4132/jptm.2016.03.09
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  • 54 Citations
AbstractAbstract PDF
Background
Although epidermal growth factor receptor (EGFR), v-Ki-ras2 Kirsten rat sarcoma viral oncogene (KRAS), and anaplastic lymphoma kinase (ALK) mutations in non-small cell lung cancer (NSCLC) were thought to be mutually exclusive, some tumors harbor concomitant mutations. Discovering a driver mutation on the basis of morphologic features and therapeutic responses with mutation analysis can be used to understand pathogenesis and predict resistance in targeted therapy.
Methods
In 6,637 patients with NSCLC, 12 patients who had concomitant mutations were selected and clinicopathologic features were reviewed. Clinical characteristics included sex, age, smoking history, previous treatment, and targeted therapy with response and disease-free survival. Histologic features included dominant patterns, nuclear and cytoplasmic features.
Results
All patients were diagnosed with adenocarcinoma and had an EGFR mutation. Six patients had concomitant KRAS mutations and the other six had ALK mutations. Five of six EGFR-KRAS mutation patients showed papillary and acinar histologic patterns with hobnail cells. Three of six received EGFR tyrosine kinase inhibitor (TKI) and showed partial response for 7–29 months. All six EGFR-ALK mutation patients showed solid or cribriform patterns and three had signet ring cells. Five of six EGFR-ALK mutation patients received EGFR TKI and/or ALK inhibitor and four showed partial response or stable disease, except for one patient who had acquired an EGFR mutation.
Conclusions
EGFR and ALK mutations play an important role as driver mutations in double mutated NSCLC, and morphologic analysis can be used to predict treatment response.

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Brief Case Report
A Rare Case of Pulmonary Arteriovenous Hemangioma Presenting as a Peribronchial Mass
Soomin Ahn, Sejin Jung, Jong Ho Cho, Tae Sung Kim, Joungho Han
J Pathol Transl Med. 2016;50(3):243-245.   Published online November 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.10.15
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  • Incidental discovery of a large complicated arteriovenous haemangioma
    Alberto Anthony Goizueta, Peter Libbey, Anthony Moulton, Rabih El-Bizri
    BMJ Case Reports.2017; : bcr-2016-218759.     CrossRef
  • Pulmonary Arteriovenous Fistula: Clinical and Histologic Spectrum of Four Cases
    Soomin Ahn, Joungho Han, Hong Kwan Kim, Tae Sung Kim
    Journal of Pathology and Translational Medicine.2016; 50(5): 390.     CrossRef
Original Article
Comprehensive Cytomorphologic Analysis of Pulmonary Adenoid Cystic Carcinoma: Comparison to Small Cell Carcinoma and Non-pulmonary Adenoid Cystic Carcinoma
Seokhwi Kim, Jinah Chu, Hojoong Kim, Joungho Han
J Pathol Transl Med. 2015;49(6):511-519.   Published online October 19, 2015
DOI: https://doi.org/10.4132/jptm.2015.09.07
  • 8,324 View
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  • 2 Citations
AbstractAbstract PDF
Background
Cytologic diagnosis of pulmonary adenoid cystic carcinoma (AdCC) is frequently challenging and differential diagnosis with small cell carcinoma is often difficult. Methods: Eleven cytologically diagnosed cases of pulmonary AdCC were collected and reviewed according to fifteen cytomorphologic characteristics: small cell size, cellular uniformity, coarse chromatin, hyperchromasia, distinct nucleolus, frequent nuclear molding, granular cytoplasm, organoid cluster, sheet formation, irregular border of cluster, hyaline globule, hyaline basement membrane material, individual cell necrosis or apoptotic body, and necrotic background. Twenty cases of small cell carcinoma and fifteen cases of non-pulmonary AdCC were also reviewed for the comparison. Results: Statistically significant differences were identified between pulmonary AdCC and small cell carcinoma in fourteen of the fifteen cytomorphologic criteria (differences in sheet formation were not statistically significant). Cellular uniformity, distinct nucleolus, granular cytoplasm, distinct cell border, organoid cluster, hyaline globule, and hyaline basement membrane material were characteristic features of AdCC. Frequent nuclear molding, individual cell necrosis, and necrotic background were almost exclusively identified in small cell carcinoma. Although coarse chromatin and irregular cluster border were observed in both, they favored the diagnosis of small cell carcinoma. Hyaline globules were more frequently seen in non-pulmonary AdCC cases. Conclusions: Using the fifteen cytomorphologic criteria described by this study, pulmonary AdCC could be successfully distinguished from small cell carcinoma. Such a comprehensive approach to an individual case is recommended for the cytologic diagnosis of pulmonary AdCC.

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  • Recent updates in salivary gland tumors of the lung
    Anja C. Roden
    Seminars in Diagnostic Pathology.2021; 38(5): 98.     CrossRef
  • Cytology of Primary Salivary Gland-Type Tumors of the Lower Respiratory Tract: Report of 15 Cases and Review of the Literature
    Chiara Saglietti, Marco Volante, Stefano La Rosa, Igor Letovanec, Marc Pusztaszeri, Gaia Gatti, Massimo Bongiovanni
    Frontiers in Medicine.2017;[Epub]     CrossRef
Brief Case Report
A Rare Case of Thymic Gangliocytic Paraganglioma
Jung Wook Yang, Joungho Han, Hyun Woo Lee, Soo Youn Cho, Hong Kwan Kim
J Pathol Transl Med. 2016;50(2):165-167.   Published online October 8, 2015
DOI: https://doi.org/10.4132/jptm.2015.07.15
  • 6,951 View
  • 47 Download
  • 5 Citations
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  • Overview of the 2022 WHO Classification of Paragangliomas and Pheochromocytomas
    Ozgur Mete, Sylvia L. Asa, Anthony J. Gill, Noriko Kimura, Ronald R. de Krijger, Arthur Tischler
    Endocrine Pathology.2022; 33(1): 90.     CrossRef
  • The Rarest of Rare Thymic Lesions: A 10-Year Surgical Pathology Experience
    Fiorella Calabrese, Francesco Fortarezza, Federica Pezzuto, Francesca Lunardi, Giovanni Comacchio, Marta Sbaraglia, Giulia Pasello, Giuseppe Marulli, Angelo Paolo Dei Tos, Federico Rea
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  • Gangliocytic Paraganglioma of the Minor Papilla of the Duodenum
    Hiroyuki Matsubayashi, Hirotoshi Ishiwatari, Toru Matsui, Shinya Fujie, Katsuhiko Uesaka, Teiichi Sugiura, Yukiyasu Okamura, Yusuke Yamamoto, Ryo Ashida, Takaaki Ito, Keiko Sasaki, Hiroyuki Ono
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    Christoph Paasch, Michael Hünerbein, Franz Theissig
    International Journal of Surgery Case Reports.2016; 29: 39.     CrossRef
  • Duodenal Rare Neuroendocrine Tumor: Clinicopathological Characteristics of Patients with Gangliocytic Paraganglioma
    Yoichiro Okubo, Tomoyuki Yokose, Osamu Motohashi, Yohei Miyagi, Emi Yoshioka, Masaki Suzuki, Kota Washimi, Kae Kawachi, Madoka Nito, Tetsuo Nemoto, Kazutoshi Shibuya, Yoichi Kameda
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Original Article
Analysis of Histologic Features Suspecting Anaplastic Lymphoma Kinase (ALK)-Expressing Pulmonary Adenocarcinoma
In Ho Choi, Dong Won Kim, Sang Yun Ha, Yoon-La Choi, Hee Jeong Lee, Joungho Han
J Pathol Transl Med. 2015;49(4):310-317.   Published online June 22, 2015
DOI: https://doi.org/10.4132/jptm.2015.05.13
  • 8,728 View
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  • 17 Citations
AbstractAbstract PDF
Background
Since 2007 when anaplastic lymphoma kinase (ALK) rearrangements were discovered in non-small cell lung cancer, the ALK gene has received attention due to ALK-targeted therapy, and a notable treatment advantage has been observed in patients harboring the EML4/ALK translocation. However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation. We analyzed the histologic findings which could complement the limitation of ALK-FISH test for pulmonary adenocarcinoma. Methods: Two hundred five cases of ALK-positive and 101 of ALK-negative pulmonary adenocarcinoma from January 2007 to May 2013 were enrolled in this study. The histologic findings and ALK immunohistochemistry results were reviewed and compared with the results of ALK-FISH and EGFR/KRAS mutation status. Results: Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer. In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group. Conclusions: The above histologic parameters can be helpful in predicting ALK rearranged pulmonary adenocarcinoma, leading to rapid FISH analysis and timely treatment.

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Brief Case Reports
A Rare Case of Tumor-to-Tumor Metastasis of Thyroid Papillary Carcinoma within a Pulmonary Adenocarcinoma
Taebum Lee, Yoon Jin Cha, Sangjeong Ahn, Joungho Han, Young Mog Shim
J Pathol Transl Med. 2015;49(1):78-80.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.12.15
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  • 8 Citations
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A Rare Case of Mixed Type A Thymoma and Micronodular Thymoma with Lymphoid Stroma
Yoon Jin Cha, Joungho Han, Jimin Kim, Kyung Soo Lee, Young Mog Shim
J Pathol Transl Med. 2015;49(1):75-77.   Published online January 15, 2015
DOI: https://doi.org/10.4132/jptm.2014.10.27
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JPTM : Journal of Pathology and Translational Medicine