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Original Articles
Endobronchial Smooth Muscle Tumors: A Series of Five Cases Highlighting Pitfalls in Diagnosis
Tripti Nakra, Aanchal Kakkar, Shipra Agarwal, Karan Madan, Suresh C Sharma, Deepali Jain
J Pathol Transl Med. 2018;52(4):219-225.   Published online July 11, 2018
DOI: https://doi.org/10.4132/jptm.2018.05.16
  • 5,213 View
  • 95 Download
  • 5 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Primary endobronchial smooth muscle tumors (SMTs), which are extremely rare, include endobronchial leiomyomas and leiomyosarcomas. Clinically, SMTs present with signs and symptoms of bronchial obstruction, and lack specific radiological findings. Thus, histopathological examination is required for accurate diagnosis as well as for tumor grading. We examined the histomorphological and immunohistochemical features of endobronchial SMTs and highlighted pitfalls in diagnosis, particularly when using small biopsies.
Methods
Cases of primary endobronchial SMTs diagnosed at our Institute over the last 6 years (2012–2017) were retrieved from the departmental archives. Histopathological features and immunohistochemistry performed for establishing the diagnosis were reviewed.
Results
Five cases of SMTs occurring in endobronchial locations were identified. These included three cases of leiomyoma, and two cases of leiomyosarcoma. The age distribution of patients ranged from 13 to 65 years. Leiomyomas showed more consistent staining with smooth muscle markers (smooth muscle actin, desmin, and smooth muscle myosin heavy chain), while tumors of higher grade showed variable, focal staining, leading to erroneous diagnosis, especially on small biopsies.
Conclusions
The diagnosis of endobronchial SMTs relies on histopathological examination, for both confirmation of smooth muscle lineage and determination of the malignant potential of the lesion. Appropriate immunohistochemical panels including more than one marker of smooth muscle differentiation are extremely valuable for differential diagnosis from morphological mimics, which is necessary for instituting appropriate management.

Citations

Citations to this article as recorded by  
  • Smooth Muscle Conditions of the Chest
    Matthew R. McCann, Lucas R. Massoth, Carlos A. Rojas, Yin P. Hung, John P. Lichtenberger, Gerald F. Abbott, Justin T. Stowell
    Journal of Thoracic Imaging.2021; 36(5): 263.     CrossRef
  • A Well-Defined Endobronchial Tumor in a 26-Year-Old Man
    Christina Triantafyllidou, Petros Effraimidis, Mirjam Schimanke, Simone Ignatova, Anders Ringman, Susann Skoog, Farkas Vánky, Miklós Boros, Karin Cederquist
    Chest.2021; 159(5): e313.     CrossRef
  • Primary Pulmonary Leiomyoma
    Mohammad Abu-Hishmeh, Gowthami Kobbari, Fouzia Shakil, Oleg Epelbaum
    Journal of Bronchology & Interventional Pulmonology.2020; 27(4): e54.     CrossRef
Morphologic Analysis of Cytomegalovirus Infected Cells in Bronchial Washing Cytology: Comparison of Liquid-Based Preparation and Conventional Smear
Jae Yeon Seok, Jungsuk An, Seung Yeon Ha, Dong Hae Chung, Sangho Lee, Hyunchul Kim
J Pathol Transl Med. 2016;50(2):147-154.   Published online February 15, 2016
DOI: https://doi.org/10.4132/jptm.2015.12.25
  • 9,179 View
  • 72 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
The cytopathic effects of cytomegalovirus (CMV) infection have been well described since the virus was first reported; however, the morphology of CMV infection has not been clearly studied. We examined the difference in detailed cytologic findings in bronchial washing cytology between liquid-based and conventionally prepared smears. Methods: Bronchial washing cytology was processed using either the conventional preparation (CP) or liquid-based preparation (LBP). Sixty-nine cells with typical cytopathic effects of CMV infection were detected on CP slides and 18 cells on LBP slides. Using the image analyzer, area, circumference, major axis, and minor axis of the cytoplasm, nucleus, and intranuclear inclusion were measured in singly scattered CMV-infected cells, and histiocytes were used as a control. Results: The mean cytoplasmic area of CMV-infected cells was 1.47 times larger than that of histiocytes in CP and 2.92 times larger in LBP (p<.05). The mean nuclear area of CMV-infected cells was 2.61 times larger than that of histiocytes in CP and 4.25 times larger in LBP (p<.05). The nucleus to cytoplasm ratio and intranuclear inclusion to cytoplasm ratio of the mean area, circumference, major axis, and minor axis in CP were larger than those in LBP (p<.05). Conclusions: The sizes of cytoplasm, nucleus, and intranuclear inclusion were larger in LBP than in CP, indicating that CMV-infected cells are easily detectable in LBP. However, the nucleus-to-cytoplasm ratio was larger in CP, suggesting that differentiation from malignancy or regenerative atypia requires caution in CP.

Citations

Citations to this article as recorded by  
  • Tissue Pathogens and Cancers: A Review of Commonly Seen Manifestations in Histo- and Cytopathology
    Tzy Harn Chua, Lavisha S Punjabi, Li Yan Khor
    Pathogens.2021; 10(11): 1410.     CrossRef
  • Diagnosis of Infectious Diseases in the Lower Respiratory Tract: A Cytopathologist's Perspective
    Rebecca J. Baldassarri, Deepika Kumar, Stephen Baldassarri, Guoping Cai
    Archives of Pathology & Laboratory Medicine.2019; 143(6): 683.     CrossRef
Brief Case Report
Lymphoepithelioma-like Carcinoma of the Renal Pelvis: A Case Report and Review of the Literature
Hyein Ahn, Jongmin Sim, Hyunsung Kim, Kijong Yi, Hulin Han, Yumin Chung, Abdul Rehman, Seung Sam Paik
Korean J Pathol. 2014;48(6):458-461.   Published online December 31, 2014
DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.458
  • 8,018 View
  • 50 Download
  • 5 Crossref
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Citations

Citations to this article as recorded by  
  • Analysis of genetic profiling, pathomics signature, and prognostic features of primary lymphoepithelioma‐like carcinoma of the renal pelvis
    Bo Fan, Yuanbin Huang, Hongshuo Zhang, Tingyu Chen, Shenghua Tao, Xiaogang Wang, Shuang Wen, Honglong Wang, Zhe Lin, Tianqing Liu, Hongxian Zhang, Tao He, Xiancheng Li
    Molecular Oncology.2022; 16(20): 3666.     CrossRef
  • Lymphoepithelioma-like carcinoma of the upper urinary tract: A systematic review of case reports
    Shi-Cong Lai, Samuel Seery, Wei Zhang, Ming Liu, Guan Zhang, Jian-Ye Wang
    World Journal of Clinical Cases.2020; 8(4): 771.     CrossRef
  • Rare primary lymphoepithelioma-like carcinoma of the renal pelvis
    Shi-Cong Lai, Samuel Seery, Tong-Xiang Diao, Jian-Ye Wang, Ming Liu
    World Journal of Clinical Cases.2020; 8(9): 1752.     CrossRef
  • Eight-year follow-up of locally advanced lymphoepithelioma-like carcinoma at upper urinary tract: A case report
    Che H Yang, Wei C Weng, Yi S Lin, Li H Huang, Chin H Lu, Chao Y Hsu, Yen C Ou, Min C Tung
    World Journal of Clinical Cases.2020; 8(19): 4505.     CrossRef
  • Lymphoepithelioma-like, a variant of urothelial carcinoma of the urinary bladder: a case report and systematic review for optimal treatment modality for disease-free survival
    Andy W. Yang, Aydin Pooli, Subodh M. Lele, Ina W. Kim, Judson D. Davies, Chad A. LaGrange
    BMC Urology.2017;[Epub]     CrossRef
Original Article
Bronchial Schwannomas: Clinicopathologic Analysis of 7 Cases
Yoon Yang Jung, Min Eui Hong, Joungho Han, Tae Sung Kim, Jhingook Kim, Young-Mog Shim, Hojoong Kim
Korean J Pathol. 2013;47(4):326-331.   Published online August 26, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.326
  • 7,148 View
  • 60 Download
  • 17 Crossref
AbstractAbstract PDF
Background

It has long been recognized that bronchial schwannomas are extremely rare. As such, diagnosing tumors in this extraordinary location can sometimes be problematic.

Methods

We reviewed seven cases of bronchoscopically or surgically resected endobronchial schwannomas and evaluated their clinical and pathologic features.

Results

The present study included five female and two male patients, with ages ranging from 16 to 81 years (mean age, 44.9 years). The clinical presentation varied according to tumor size and location. Patients with more centrally (trachea or main bronchus) located tumors experienced respiratory symptoms (80%) more often than patients with more peripherally (lobar or segmental bronchus) located tumors (0%). Histologically, the tumors were composed of spindle cells that stained with S100 protein. Some of the tumors showed typical Antoni A areas with Verocay body formation. Five of six patients (83.3%) underwent complete tumor removal by rigid bronchoscopy.

Conclusions

Pathologists should consider endobronchial schwannoma in the differential diagnosis of a spindle cell tumor involving the bronchus. Additionally, our results showed that rigid bronchoscopy is an effective tool for tumor removal in endobronchial schwannoma patients.

Citations

Citations to this article as recorded by  
  • Two cases of large tracheobronchial schwannomas completely resected by rigid bronchoscopy with multiple instruments
    Changhwan Kim, Hae‐Seong Nam, Yousang Ko
    Respirology Case Reports.2023;[Epub]     CrossRef
  • Tracheobronchial schwannoma: a case report and literature review
    Guo Lina, Hou Pengguo, Xiao Zhihua, Wang Jianxin, Bai Baoqin, Zhang Mingyue, Sun Junping
    Journal of International Medical Research.2023; 51(1): 030006052211498.     CrossRef
  • Malignant and Benign Tracheobronchial Neoplasms: Comprehensive Review with Radiologic, Bronchoscopic, and Pathologic Correlation
    Francis Girvin, Alexander Phan, Sharon Steinberger, Eugene Shostak, Jamie Bessich, Fang Zhou, Alain Borczuk, Geraldine Brusca-Augello, Margaret Goldberg, Joanna Escalon
    RadioGraphics.2023;[Epub]     CrossRef
  • Clinicopathological Characteristics and Pathogenesis of Granular Cell Tumours of the Airways
    Jesús Machuca-Aguado, Fernando Cózar-Bernal, Enrique Rodríguez-Zarco, Juan José Ríos-Martin, Miguel Ángel Idoate Gastearena
    Journal of Bronchology & Interventional Pulmonology.2023; 30(4): 390.     CrossRef
  • Treatment of primary tracheal schwannoma with endoscopic resection: A case report
    Yong-Shuai Shen, Xiang-Dong Tian, Yi Pan, Hua Li
    World Journal of Clinical Cases.2022; 10(28): 10279.     CrossRef
  • Primary bronchial schwannoma: A case report
    Yosuke Aoyama, Atsushi Miyamoto, Takeshi Fujii, Sakashi Fujimori, Meiyo Tamaoka, Daiya Takai
    Medicine.2022; 101(40): e31062.     CrossRef
  • Endobronchial schwannoma in adult: A case report
    Touil Imen, Boudaya Mohamed Sadok, Aloui Raoudha, Souhir Ksissa, Brahem Yosra, Ben Attig Yosr, Ksontini Meriem, Bouchareb Soumaya, Keskes Boudawara Nadia, Boussoffara Leila, Knani Jalel
    Respiratory Medicine Case Reports.2021; 33: 101396.     CrossRef
  • Primary intratracheal schwannoma misdiagnosed as severe asthma in an adolescent: A case report
    Hui-Rong Huang, Pei-Qiang Li, Yi-Xin Wan
    World Journal of Clinical Cases.2021; 9(17): 4388.     CrossRef
  • PD‐1/PD‐L1 negative schwannoma mimicking obstructive bronchial malignancy: A case report
    Daibing Zhou, Xiaoyan Xing, Jie Fan, Youzhi Zhang, Jie Liu, Yi Gong
    Thoracic Cancer.2020; 11(8): 2335.     CrossRef
  • Case report: A tracheobronchial schwannoma in a child
    Li Zhang, Wen Tang, Qing-Shan Hong, Pei-feng Lv, Kui-Ming Jiang, Rui Du
    Respiratory Medicine Case Reports.2020; 30: 101047.     CrossRef
  • Recurrent transmural tracheal schwannoma resected by video-assisted thoracoscopic window resection
    Huiguo Chen, Kai Zhang, Mingjun Bai, Haifeng Li, Jian Zhang, Lijia Gu, Weibin Wu
    Medicine.2019; 98(51): e18180.     CrossRef
  • Primary intratracheal schwannoma resected during bronchoscopy using argon plasma coagulation
    Purva V Sharma, Yash B Jobanputra, Tatiana Perdomo Miquel, J Ryan Schroeder, Adam Wellikoff
    BMJ Case Reports.2018; : bcr-2018-225140.     CrossRef
  • Dumbbell posterior mediastinal schwannoma invading trachea: Multidisciplinary management – weight off the chest
    Abhijeet Singh, VallandramamR Pattabhiraman, Arjun Srinivasan, Sivaramakrishnan Mahadevan
    Lung India.2018; 35(3): 269.     CrossRef
  • Primary tracheal schwannoma a review of a rare entity: current understanding of management and followup
    Shadi Hamouri, Nathan M. Novotny
    Journal of Cardiothoracic Surgery.2017;[Epub]     CrossRef
  • A Case of Primary Tracheal Schwannoma
    Sung Min Choi, Ji Hong You, Sang Bae Lee, Seong Han Kim, Yon Soo Kim
    Kosin Medical Journal.2017; 32(2): 258.     CrossRef
  • Endobronchial Neurilemmoma Mimicking a Bronchial Polyp
    Ryoung Eun Ko, Seung Yong Park, Yeong Hun Choe, So Ri Kim, Heung Bum Lee, Yong Chul Lee, Seoung Ju Park
    Soonchunhyang Medical Science.2015; 21(2): 176.     CrossRef
  • Optimal treatment for primary benign intratracheal schwannoma: A case report and review of the literature
    XIAHUI GE, FENGFENG HAN, WENBIN GUAN, JINYUAN SUN, XUEJUN GUO
    Oncology Letters.2015; 10(4): 2273.     CrossRef
Case Study
Congenital Peribronchial Myofibroblastic Tumor: A Case Study and Literature Review
Yuil Kim, Ha Young Park, Junhun Cho, Joungho Han, Eun Yoon Cho
Korean J Pathol. 2013;47(2):172-176.   Published online April 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.172
  • 6,961 View
  • 44 Download
  • 7 Crossref
AbstractAbstract PDF

Congenital peribronchial myofibroblastic tumor (CPMT) is a benign pulmonary spindle cell neoplasm of intrauterine and perinatal period, which is thought to arise from primitive peribronchial mesenchyme. We present a case detected incidentally in a one-month-old infant. The solid and partially necrotic tumor involved the right middle and lower lobes of the lung with extension to the diaphragm. Histologically, the tumor was composed of fasciculated monotonous spindle cells, proliferating peribronchiolar cartilage and round cells with rich vasculature, and high mitotic activity was identified in the round cell area. Immunohistochemical and electron microscopic studies showed that the spindle cells were myofibroblastic in phenotype. Although the tumor showed several malignant pathological features, recurrence was not observed in the two-year follow-up period, consistent with the benign clinical behavior of CPMT.

Citations

Citations to this article as recorded by  
  • Congenital peribronchial myofibroblastic tumor (CPMT): a case report with long term follow-up and next-generation sequencing (NGS)
    Ping Zhou, Shuang Li, Weiya Wang, Yuan Tang, Lili Jiang
    BMC Pediatrics.2023;[Epub]     CrossRef
  • Neonatal congenital lung tumors — the importance of mid-second-trimester ultrasound as a diagnostic clue
    Stephan L. Waelti, Laurent Garel, Dorothée Dal Soglio, Françoise Rypens, Michael Messerli, Josée Dubois
    Pediatric Radiology.2017; 47(13): 1766.     CrossRef
  • Congenital peribronchial myofibroblastic tumor: Case report and review of literature
    Jolanta Jedrzkiewicz, Eric Scaife, Bo Hong, Sarah South, Mouied Alashari
    Journal of Pediatric Surgery Case Reports.2015; 3(4): 154.     CrossRef
  • Perinatal Thoracic Mass Lesions: Pre- and Postnatal Imaging
    Evan J. Zucker, Monica Epelman, Beverley Newman
    Seminars in Ultrasound, CT and MRI.2015; 36(6): 501.     CrossRef
  • Prenatal imaging and immunohistochemical analysis of congenital peribronchial myofibroblastic tumor
    Y.‐A. Tu, W.‐C. Lin, H.‐J. Chen, J.‐C. Shih
    Ultrasound in Obstetrics & Gynecology.2015; 46(2): 247.     CrossRef
  • A Congenital Peribronchial Myofibroblastic Tumor Detected in a Premature Infant at 28 Weeks but That Resolved in the Late Stage of Pregnancy
    Bo Xia, Gang Yu, Chun Hong, Lei Zhang, Jing Tang, Cuifen Liu
    Medicine.2015; 94(42): e1842.     CrossRef
  • Congenital peribronchial myofibroblastic tumor
    Yuka Hotokebuchi, Kenichi Kohashi, Satoshi Toyoshima, Naoko Matsumoto, Toshinori Nakashima, Yoshinao Oda
    Pathology International.2014; 64(4): 189.     CrossRef
Original Articles
Evaluation of Bronchiolar and Alveolar Cell Injuries Induced by Short- and Long-term Exposure to Sidestream Smoke
Kun-Young Kwon, Hye-Ra Jung, Ilseon Hwang, Won-Il Choi
Korean J Pathol. 2012;46(2):151-161.   Published online April 25, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.151
  • 7,182 View
  • 36 Download
  • 2 Crossref
AbstractAbstract PDF
Background

We investigated effects of short- and long-term exposure to sidestream smoke on the bronchiolar and alveolar cells in Sprague-Dawley rats.

Methods

Rats were divided into five experimental groups: groups 1, 2, and 3 (1-month exposure to 3, 5, and 7 cigarettes a day, respectively), groups 4 and 5 (3- and 6 month exposure to five cigarettes a day, respectively). We examined the morphologic changes, the expressions of tumor necrosis factor α (TNF-α), tumor growth factor β1 (TGF-β1), interlekin (IL)-1α, IL-1β, Ki-67, and cytokeratin 14 and in situ apoptosis in the bronchiolar and alveolar cells on light microscopy (LM) and electron microscopic (EM) terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining.

Results

LM showed the respiratory bronchiolar dilatation and alveolar wall collapse. In groups 3, 4, and 5, EM showed loss of the cilia and Clara cells with irregular size, more prominent alveolar wall collapse and dilation of alveolar duct than those of groups 1 and 2. Bronchiolar and alveolar cells showed increased expressions of TNF-α and TGF-β in groups 4 and 5. LM and EM TUNEL stains showed increased apoptosis in groups 3, 4, and 5.

Conclusions

Sidestream smoke causes a bronchiolar and alveolar cell injury and the severity correlates strongly the volume and duration of exposure to sidestream smoke.

Citations

Citations to this article as recorded by  
  • Cigarette smoke extract alters the cell cycle via the phospholipid transfer protein/transforming growth factor-β1/CyclinD1/CDK4 pathway
    Xue-Min Chai, You-Lun Li, Hong Chen, Shu-Liang Guo, Li-Li Shui, Ya-Juan Chen
    European Journal of Pharmacology.2016; 786: 85.     CrossRef
  • Keratin-14 Expression in Pneumocytes as a Marker of Lung Regeneration/Repair during Diffuse Alveolar Damage
    Miriam Ficial, Caterina Antonaglia, Marco Chilosi, Mario Santagiuliana, Al-Omoush Tahseen, Davide Confalonieri, Lorenzo Zandonà, Rossana Bussani, Marco Confalonieri
    American Journal of Respiratory and Critical Care Medicine.2014; 189(9): 1142.     CrossRef
Evaluation of cytopathologic diagnosis of lung carcinoma.
In Ae Park, Eui Keun Ham
Korean J Cytopathol. 1991;2(1):20-27.
  • 1,639 View
  • 14 Download
AbstractAbstract PDF
In order to evaluate the role of cytopathologic diagnosis of sputum, bronchial washing and bronchial brushing in the diagnosis of lung cancer, we performed this study. The patients included in this study had undergone sputum, bronchial washing and brushing cytology over the 20-month period of 1985 through 1987. The total number of specimens was 5,495 of 2,242 patients, including 4,830 sputa and 665 bronchial washing and brushings. The average number of sputa and bronchial washings and brushings per case was 2.4 and 1.2 respectively. Among them, about 10% were unsatisfactory specimen, and three-fourths were negative specimens. In sputum cytology, the diagnosis of "atypical cells" was given to 3%, "suspicious for malignancy" was given to 1 %, and "malignancy" was given to 13%. In bronchial washing and brushing cytology, the diagnosis of "atypical cells", "suspicious for malignancy" and malignancy" was given to 6%, 3%, and 20% respectively. The cases diagnosed as "atypical cells" in cytology were actually malignancy in 95% and 84.8% of sputum and bronchial washing and brushings respectively, and the "suspicious for malignancy" were actually malignancy in 100% in both methods. The detection rates of malignancy were 50.4% and 55.2% in sputum and bronchial washing and brushing respectively, and the specificity was 100% in both methods. The accuracy of cell typing was 92% in sputum and 89.7% in bronchial washing and brushing.
Case Report
Bronchial Brushing Cytologic Finding of Primary Pulmonary Adenoid Cystic Carcinoma Misinterpretated as Small Cell Carcinoma: A Case Report with Literature Review.
Hyun Jung Kim, Sangbong Choi, Jieun Kwon, Jeong Yeon Kim, Kyeongmee Park
Korean J Pathol. 2011;45(4):441-444.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.441
  • 3,408 View
  • 17 Download
  • 2 Crossref
AbstractAbstract PDF
An adenoid cystic carcinoma is a very rare primary pulmonary neoplasm. Bronchial washing and brushing cytological findings of pulmonary adenoid cystic carcinoma have rarely been described. Here, we report the bronchial brushing cytological findings of an adenoid cystic carcinoma, finally diagnosed in a 71-year-old female patient. The low-power view showed moderate cellularity and cohesive clusters of small to medium-sized cells. The high-power view revealed distinct nuclear moldings, a coarse chromatin pattern, and inconspicuous nucleoli, which was favorable to a diagnosis of small cell carcinoma. However, apoptotic bodies, nuclear debris, and mitoses were not seen frequently. The bronchial biopsy showed solid, trabecular, and cribriform patterns in small cells. Periodic acid Schiff staining disclosed globular basement membrane-like materials, and the immunohistochemical staining revealed the presence of myoepithelial cell components, strongly suggestive of a salivary gland type tumor, compatible with an adenoid cystic carcinoma. In this report, we describe the exfoliative cytological features of a pulmonary adenoid cystic carcinoma with emphasis on some diagnostic pitfalls.

Citations

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  • Bronchial cytology of pulmonary adenoid cystic carcinoma – A multi-institute series with emphasis on immunocytochemistry
    Joanna K.M. Ng, Ka Pang Chan, Gary M. Tse, Joshua J.X. Li
    Annals of Diagnostic Pathology.2023; 64: 152132.     CrossRef
  • 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
    Journal of Pathology and Translational Medicine.2015; 49(6): 511.     CrossRef
Original Articles
Comparison of Conventional Smear, Cell Block and Liquid-based Preparation in the Evaluation of Bronchial Washing Specimen in Lung Cancer Patients.
Hyunee Yim, Hee Jae Joo, Young Bae Kim, Soon Won Hong
Korean J Pathol. 2011;45(3):296-302.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.296
  • 4,155 View
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AbstractAbstract PDF
BACKGROUND
The preparation of conventional smears (CS) from mucoid samples, despite mucolysis, can pose difficulties for cytotechnologists or cytopathologists. In recent years, liquid-based cytology (LBC) devices have been developed in attempts to improve the cytopreparation process. LBC improves both sample collection and sample preparation. Cell block preparations (CB) can be made from residual tissue fluids, and are a useful adjunct to smears.
METHODS
We retrospectively reviewed 3 preparations from 209 patients whose diagnosis was later confirmed via bronchoscopic biopsy, fine needle aspiration, gun biopsy or operation. Each case was categorized into one of three groups: "negative," "atypical or suspicious" and "malignant." RESULTS: When conflating the "atypical" and "malignant" categories into a "positive" category, the sensitivity of each preparation was 74.4% in LBC, 72.9% in CS, and 76.5% in CB preparations. Specificity was 98.7%, 94.7% and 98.7%, respectively. By combining LBC and CB, the sensitivity is 78.2%.
CONCLUSIONS
Among three different preparation methods, sensitivity is highest in the CB method. LBC has many advantages in evaluating cell morphology and by combining CB method, the sensitivity can be improved slightly. The application of all three methods may prove helpful when one or another method proves diagnostically inconclusive.

Citations

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  • Comparison of diagnostic accuracy between CellprepPlus® and ThinPrep® liquid‐based preparations in effusion cytology
    Yong‐Moon Lee, Ji‐Yong Hwang, Seung‐Myoung Son, Song‐Yi Choi, Ho‐Chang Lee, Eun‐Joong Kim, Hye‐Suk Han, Jin young An, Joung‐Ho Han, Ok‐Jun Lee
    Diagnostic Cytopathology.2014; 42(5): 384.     CrossRef
  • Evaluation of Urine Cytology in Urothelial Carcinoma Patients: A Comparison of CellprepPlus® Liquid-Based Cytology and Conventional Smear
    Seung-Myoung Son, Ji Hae Koo, Song-Yi Choi, Ho-Chang Lee, Yong-Moon Lee, Hyung Geun Song, Hae-Kyung Hwang, Hye-Suk Han, Seok-Joong Yun, Wun-Jae Kim, Eun-Joong Kim, Ok-Jun Lee
    Korean Journal of Pathology.2012; 46(1): 68.     CrossRef
Mucoepidermoid Carcinoma of Tracheobronchial Tree: Clinicopathological Study of 31 Cases.
Sang Yun Ha, Joungho Han, Jae Jun Lee, Young Eun Kim, Yoon La Choi, Hong Kwan Kim
Korean J Pathol. 2011;45(2):175-181.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.175
  • 3,919 View
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  • 8 Crossref
AbstractAbstract PDF
BACKGROUND
All aspects of mucoepidermoid carcinoma (MEC) of the lung including histologic grading, clinical behavior and its differentiation from adenosquamous cell carcinoma are still not fully understood.
METHODS
We reviewed the hematoxylin-eosin stained slides and medical records of 31 cases of MEC of the lungs. The cases were classified as low and high grade according to the quantitative grading system formulated for MEC. High grade tumors were tested for an epidermal growth factor receptor (EGFR) mutation.
RESULTS
Twenty eight cases were classified as low grade and 3 cases as high grade. Histologically, lower glandular component, cellular atypia, necrosis, mitoses >4/10 high power fields, and endolymphatic tumor emboli were typical characteristics of a high grade tumor. Although some tumors showed histologic features mimicking high grade tumors, they were classified as low grade tumors according to this quantitative grading system. Low grade tumors showed no recurrence or metastasis. However, among three patients with a high grade tumor, two had distant metastases and one died of disease. Additionally, an EGFR mutation was not detected.
CONCLUSIONS
A high grade MEC was consistently different from a low grade tumor with regard to malignant histologic features and poor prognosis. Therefore, correct histologic grading is important in predicting the prognosis to avoid unnecessary treatment.

Citations

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  • A rare case of endobronchial mucoepidermoid carcinoma of the lung presenting as non-resolving pneumonia
    Toolsie Omesh, Ranjan Gupta, Anjali Saqi, Joshua Burack, Misbahuddin Khaja
    Respiratory Medicine Case Reports.2018; 25: 154.     CrossRef
  • Cutaneous Involvement by Nasal Mucoepidermoid Carcinoma: The Tip of the Iceberg Phenomenon
    Ge Zhao, Oliver Chang, John Streidl, Amit Bhrany, Kyle Garton, Timothy H. McCalmont, Paul E. Swanson, Zsolt Argenyi, Michi M. Shinohara
    Journal of Cutaneous Pathology.2017; 44(2): 113.     CrossRef
  • Surgical outcomes of pulmonary mucoepidermoid carcinoma: A review of 41 cases
    Chih-Cheng Hsieh, Yung-Han Sun, Shih-Wei Lin, Yi-Chen Yeh, Mei-Lin Chan, Pei-Yi Chu
    PLOS ONE.2017; 12(5): e0176918.     CrossRef
  • Clinicopathologic characteristics of EGFR, KRAS, and ALK alterations in 6,595 lung cancers
    Boram Lee, Taebum Lee, Se-Hoon Lee, Yoon-La Choi, Joungho Han
    Oncotarget.2016; 7(17): 23874.     CrossRef
  • Metastatic Pulmonary Mucoepidermoid Carcinoma with Fulminant Clinical Course
    Yong Won Park, Seon Bin Yoon, Mi Ju Cheon, Young Min Koh, Hyeon Sik Oh, Se Joong Kim, Seung Hyeun Lee
    The Ewha Medical Journal.2015; 38(2): 85.     CrossRef
  • Lung cancer in never-smoker Asian females is driven by oncogenic mutations, most often involving EGFR
    Sang Yun Ha, So-Jung Choi, Jong Ho Cho, Hye Joo Choi, Jinseon Lee, Kyungsoo Jung, Darry Irwin, Xiao Liu, Maruja E. Lira, Mao Mao, Hong Kwan Kim, Yong Soo Choi, Young Mog Shim, Woong Yang Park, Yoon-La Choi, Jhingook Kim
    Oncotarget.2015; 6(7): 5465.     CrossRef
  • Bronchoscopic Resection of an Exophytic Endoluminal Tracheal Mass
    Russell J. Miller, Septimiu D. Murgu
    Annals of the American Thoracic Society.2013; 10(6): 697.     CrossRef
  • EGFR mutations and mucoepidermoid carcinoma: Putative significance in differing populations
    Iain D. O’Neill
    Lung Cancer.2012; 78(1): 125.     CrossRef
Case Reports
Mucinous Bronchioloalveolar Carcinoma Associated with Bronchiectatic Cyst: A Brief Case Report.
Chang Ohk Sung, Joungho Han, Sang Won Um, Chin A Yi, Young Mog Shim
Korean J Pathol. 2010;44(5):540-542.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.540
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AbstractAbstract PDF
Herein we report a rare case of mucinous bronchioloalveolar carcinoma (BAC) associated with a solitary bronchiectatic cyst in a 29-year-old man. The patient presented with hemoptysis and had a history of pulmonary tuberculosis. Chest radiographs and computed tomography revealed a well-circumscribed, thin-walled cavitary lesion in the right upper pulmonary lobe. Gross examination of a lobectomy specimen showed a bronchiectatic cavity and a fungus ball within it. There were also several ill-defined small gray-white nodules around the cyst, nodules that were mucinous BAC. On microscopy, they were composed of columnar tumor cells along the intact alveolar walls in a single layer.
Mucous Gland Adenoma of the Bronchus; Light Microscopic and Ultrastructural Features.
Mi Seon Kwon, Kyo Young Lee, Young Shin Kim, Chang Suk Kang, Sang In Shim
Korean J Pathol. 1997;31(9):898-901.
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We present a case of mucous gland adenoma arising from the main bronchus of the lower lobe of the left lung in terms of clinicopathologic, immunohistochemical, and ultrastructural aspects as well as review of related literatures. The patient, a 31-year-old female, was admitted to Catholic University Medical College Hospital with complaints of coughing and purulent sputum for about seven years. The chest CT showed a severely calcified tumor in the left lower lobe of the lung. Grossly, the calcified tumor arising from the main bronchus protruded into the lumen and showed bronchiectasis of the lower lobe and atelectasis of the upper lobe of the lung. The tumor was pale brown-gray and sharply circumscribed and showed some small cystic spaces filled with mucoid material. Microscopically, most of the tumor showed dystrophic calcification. The growth pattern of the tumor is composed of cysts, tubules, and glands lined by cytologically bland columnar, cuboidal, or flattened mucus secreting cells. Electron micrograph of tumor cells showed some round or oval mucous granules measuring 0.5-1.8 micrometer.
Original Article
Morphologic Changes of Pulmonary Tissue Secondary to Sidestream Cigarette Smoke.
Kun Young Kwon, Ji Min Jeon, Sang Pyo Kim, Kwan Kyu Park, Dae Hyun Kim
Korean J Pathol. 1999;33(6):395-403.
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AbstractAbstract PDF
Chronic bronchiolitis is a condition associated with cigarette smoking, and later associated with pulmonary parenchymal alteration and progressive deterioration of lung function. Early respiratory bronchiolitis was produced in Sprague-Dawley rats by indirect inhalation of cigarette smoke daily in a smoke exposure chamber designed by authors for 1 month. Experimental group A (n=5) was sacrificed after having smoked 30 cigarettes, group B (n=5) after 80 cigarette, and group C (n=7) after 140 cigarettes, respectively. Examination of morphologic changes in the lungs was done on light microscope, transmission and scanning electron microscopes. Light microscopically, increase in number of goblet cells in the bronchial mucosa, brown-pigmented macrophages in the alveoli, multifocal alveolar collapse adjacent to the bronchioles, dilatation of alveolar ducts and alveolar spaces were observed. Transmission electron microscopically, irregularly shaped Clara cells, alveolar wall collapse, and focally type I epithelial cell injury were seen. Scanning electron microscopically, scattered alveolar collapse, irregular dilatation of alveolar ducts, alveolar spaces and interalveolar pores (pores of Kohn) were seen. The terminal and respiratory bronchioles showed morphological alteration of Clara cells, but no evidence of cellular bronchiolitis or bronchiolar obstruction. We conclude that sidestream smoke induces an early respiratory bronchiolitis including aggregates of brown pigmented macrophages and varying degrees of structural alteration of adjacent pulmonary parenchyma.
Case Reports
Tracheobronchial Aspergillosis An autopsy case report.
Tae jung Kwon, Dong Joo Lee, Il Hoon Kwon
Korean J Pathol. 1999;33(8):620-623.
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AbstractAbstract
Tracheobronchial aspergillosis is an unusual form of invasive aspergillosis characterized by noninvasive or only superficially invasive tracheobronchitis with a propensity for dissemination. We report a two-year-old male who suddenly died of respiratory failure. Postmortem examination revealed a pseudomembrane covering the mucosa of larynx, trachea and bronchial tree of both lungs. This pseudomembrane was composed predominantly of Aspergillus hyphae. There was transmural necrotizing bronchitis with fungal invasion to the narrow zone of peribronchial tissue, and dissemination to the stomach and kidney. This form of pulmonary aspergillosis had not been reported in this country.
Endobronchial Actinomycosis: A report of two cases.
Hye Seung Han, Kwang Ho Kim, In Seo Park, Jee Young Han, Young Bae Kim, Tae Sook Hwang, Young Chae Chu
Korean J Pathol. 2000;34(6):465-470.
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AbstractAbstract PDF
Actinomycosis causes a chronic suppurative infection most commonly involving the cervico-facial region, thorax, and the abdomen. Thoracic infection results from an aspiration of contaminated material from mouth or oropharynx. Actinomyces was known to have a predilection for the periphery of the lung and the endobronchial lesion is extremely rare. We report two cases of actinomycosis presenting as an endobronchial mass which arose in 53-year-old and 44-year-old women. The first case presented with cough, sputum, weight loss and had a history of pulmonary tuberculosis 24 years ago. Chest CT revealed a right lobe collapse simulating mass and suggested carcinoma. The second case presented with hemoptysis for 2 years. Chest CT revealed cystic bronchiectasis of both lungs and intracystic soft tissue mass in the anterior segment of the right upper lobe which suggested aspergilloma. The gross features of them were similar to those of aspergilloma. Characteristic sulphur granules consisting of a granular basophilic center surrounded by a radiating zone of eosinophilic, hyaline, club-shaped projection were histologically confirmed in both cases. Granulomas containing P. westermani eggs were present in the second case. Staphylococcus, true fungal organism, nocardia, and streptomyces shoud be distinguished by analysing their morphologic characteristics in the appropriate stains. Actinomycosis should be included in the differential diagnoses of an endobronchial mass.

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