Journal of Pathology and Translational Medicine

Review

A stepwise approach to fine needle aspiration cytology of lymph nodes: Yosep Chong, Gyeongsin Park, Hee Jeong Cha, Hyun-Jung Kim, Chang Suk Kang, Jamshid Abdul-Ghafar, Seung-Sook Lee; J Pathol Transl Med. 2023;57(4):196-207. Published online July 11, 2023; DOI: https://doi.org/10.4132/jptm.2023.06.12

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The cytological diagnosis of lymph node lesions is extremely challenging because of the diverse diseases that cause lymph node enlargement, including both benign and malignant or metastatic lymphoid lesions. Furthermore, the cytological findings of different lesions often resemble one another. A stepwise diagnostic approach is essential for a comprehensive diagnosis that combines: clinical findings, including age, sex, site, multiplicity, and ultrasonography findings; low-power reactive, metastatic, and lymphoma patterns; high-power population patterns, including two populations of continuous range, small monotonous pattern and large monotonous pattern; and disease-specific diagnostic clues including granulomas and lymphoglandular granules. It is also important to remember the histological features of each diagnostic category that are common in lymph node cytology and to compare them with cytological findings. It is also essential to identify a few categories of diagnostic pitfalls that often resemble lymphomas and easily lead to misdiagnosis, particularly in malignant small round cell tumors, poorly differentiated squamous cell carcinomas, and nasopharyngeal undifferentiated carcinoma. Herein, we review a stepwise approach for fine needle aspiration cytology of lymphoid diseases and suggest a diagnostic algorithm that uses this approach and the Sydney classification system.

Citations

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Immunocytochemical markers, molecular testing and digital cytopathology for aspiration cytology of metastatic breast carcinoma
Joshua J. X. Li, Gary M. Tse
Cytopathology.2024; 35(2): 218. CrossRef
Response to comment on “A stepwise approach to fine needle aspiration cytology of lymph nodes”
Yosep Chong, Gyeongsin Park, Hee Jeong Cha, Hyun-Jung Kim, Chang Suk Kang, Jamshid Abdul-Ghafar, Seung-Sook Lee
Journal of Pathology and Translational Medicine.2024; 58(1): 43. CrossRef
Comment on “A stepwise approach to fine needle aspiration cytology of lymph nodes”
Elisabetta Maffei, Valeria Ciliberti, Pio Zeppa, Alessandro Caputo
Journal of Pathology and Translational Medicine.2024; 58(1): 40. CrossRef

Original Article

Extremely well-differentiated adenocarcinoma of the stomach: diagnostic pitfalls in endoscopic biopsy: Jongwon Lee, In-Seob Lee, Ji Yong Ahn, Young Soo Park, Jihun Kim; J Pathol Transl Med. 2022;56(2):63-72. Published online November 16, 2021; DOI: https://doi.org/10.4132/jptm.2021.10.12

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Abstract PDF Supplementary Material

Background
Extremely well-differentiated adenocarcinoma (EWDA) is a deceptively bland-looking adenocarcinoma of the stomach. It often causes diagnostic problems, especially in endoscopic biopsy samples. To better recognize this deceptively bland lesion, we carefully reviewed a series of EWDAs treated at our institution.
Methods
A total of 55 specimens from 19 patients were obtained. Endoscopic, gross and microscopic features defining EWDA were described and documented. For comparison, hyperplastic polyp specimens were randomly selected and analyzed.
Results
Most cases (18 of 19, 94.7%) were advanced gastric cancer (AGC) and primarily located in the body of the stomach (15 of 19, 79.0%). The majority of AGCs were non-ulcerated (11 of 18, 61.1%) with an undermining growth pattern and a relatively small mucosal involvement. Specific histologic features included an irregular glandular shape, an undulating apical cytoplasmic border, disproportionately large glands, a variably distended mucinous cytoplasm. Classical features, such as small infiltrating glands or desmoplastic reactions, were barely observed. Identification of irregularly spaced nuclei and disruption of the foveolar epithelial structure, along with atypical features described above were helpful in making a diagnosis especially in gastric forceps biopsies.
Conclusions
Awareness of the histomorphologic characteristics described in this report would lead to timely diagnosis and prevent repeated endoscopic procedures.

Citations

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Unusual or Uncommon Histology of Gastric Cancer
Jinho Shin, Young Soo Park
Journal of Gastric Cancer.2024; 24(1): 69. CrossRef
A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
Kaiho Hirata, Shusuke Yagi, Hideki Miyazaki, Kazuhiko Yamada, Naoki Akazawa, Naoki Enomoto, Kyoko Nohara, Chizu Yokoi, Toru Igari, Norihiro Kokudo
Surgical Case Reports.2024;[Epub] CrossRef

Review

Standardization of the pathologic diagnosis of appendiceal mucinous neoplasms: Dong-Wook Kang, Baek-hui Kim, Joon Mee Kim, Jihun Kim, Hee Jin Chang, Mee Soo Chang, Jin-Hee Sohn, Mee-Yon Cho, So-Young Jin, Hee Kyung Chang, Hye Seung Han, Jung Yeon Kim, Hee Sung Kim, Do Youn Park, Ha Young Park, So Jeong Lee, Wonae Lee, Hye Seung Lee, Yoo Na Kang, Younghee Choi; J Pathol Transl Med. 2021;55(4):247-264. Published online July 8, 2021; DOI: https://doi.org/10.4132/jptm.2021.05.28

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Abstract PDF Supplementary Material

Although the understanding of appendiceal mucinous neoplasms (AMNs) and their relationship with disseminated peritoneal mucinous disease have advanced, the diagnosis, classification, and treatment of AMNs are still confusing for pathologists and clinicians. The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists (GPSG-KSP) proposed a multicenter study and held a workshop for the “Standardization of the Pathologic Diagnosis of the Appendiceal Mucinous Neoplasm” to overcome the controversy and potential conflicts. The present article is focused on the diagnostic criteria, terminologies, tumor grading, pathologic staging, biologic behavior, treatment, and prognosis of AMNs and disseminated peritoneal mucinous disease. In addition, GPSG-KSP proposes a checklist of standard data elements of appendiceal epithelial neoplasms to standardize pathologic diagnosis. We hope the present article will provide pathologists with updated knowledge on how to handle and diagnose AMNs and disseminated peritoneal mucinous disease.

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Lower Gastrointestinal Bleeding Secondary to Appendiceal Mucinous Neoplasm: A Report of Two Cases and a Review of the Literature
Jesús Omar Soto Llanes, Samanta Kin Dosal Limón, Ana Jimena Iberri Jaime, Mario Zambrano Lara, Billy Jiménez Bobadilla
Cureus.2024;[Epub] CrossRef
Appendiceal perforation secondary to endometriosis with intestinal metaplasia: A case report
Minghua Wang, Jing Liu, Boxin Hu, Simin Wang, Ping Xie, Ping Li
Experimental and Therapeutic Medicine.2023;[Epub] CrossRef
Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation
Javier Miguez González, Francesc Calaf Forn, Laura Pelegrí Martínez, Pilar Lozano Arranz, Rafael Oliveira Caiafa, Jordi Català Forteza, Lina Maria Palacio Arteaga, Ferrán Losa Gaspà, Isabel Ramos Bernadó, Pedro Barrios Sánchez, Juan Ramón Ayuso Colella
Insights into Imaging.2023;[Epub] CrossRef
Muzinöse Tumoren des Peritoneums
Anne Kristin Fischer, Andrea Tannapfel, Alexander Quaas
Die Chirurgie.2023; 94(10): 823. CrossRef
Landscape of Genetic Mutations in Appendiceal Cancers
Marian Constantin, Cristina Mătanie, Livia Petrescu, Alexandra Bolocan, Octavian Andronic, Coralia Bleotu, Mihaela Magdalena Mitache, Sorin Tudorache, Corneliu Ovidiu Vrancianu
Cancers.2023; 15(14): 3591. CrossRef
Delivery of an Incidental Appendiceal Mucinous Neoplasm
Madison Bowles, Jessica Y Ng, Hajir Nabi
Cureus.2022;[Epub] CrossRef
Unearthing novel fusions as therapeutic targets in solid tumors using targeted RNA sequencing
Sungbin An, Hyun Hee Koh, Eun Sol Chang, Juyoung Choi, Ji-Young Song, Mi-Sook Lee, Yoon-La Choi
Frontiers in Oncology.2022;[Epub] CrossRef

Original Article

Deep learning for computer-assisted diagnosis of hereditary diffuse gastric cancer: Sean A. Rasmussen, Thomas Arnason, Weei-Yuarn Huang; J Pathol Transl Med. 2021;55(2):118-124. Published online January 22, 2021; DOI: https://doi.org/10.4132/jptm.2020.12.22

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Abstract PDF

Background
Patients with hereditary diffuse gastric cancer often undergo prophylactic gastrectomy to minimize cancer risk. Because intramucosal poorly cohesive carcinomas in this setting are typically not grossly visible, many pathologists assess the entire gastrectomy specimen microscopically. With 150 or more slides per case, this is a major time burden for pathologists. This study utilizes deep learning methods to analyze digitized slides and detect regions of carcinoma.
Methods
Prophylactic gastrectomy specimens from seven patients with germline CDH1 mutations were analyzed (five for training/validation and two for testing, with a total of 133 tumor foci). All hematoxylin and eosin slides containing cancer foci were digitally scanned, and patches of size 256×256 pixels were randomly extracted from regions of cancer as well as from regions of normal background tissue, resulting in 15,851 images for training/validation and 970 images for testing. A model with DenseNet-169 architecture was trained for 150 epochs, then evaluated on images from the test set. External validation was conducted on 814 images scanned at an outside institution.
Results
On individual patches, the trained model achieved a receiver operating characteristic (ROC) area under the curve (AUC) of 0.9986. This enabled it to maintain a sensitivity of 90% with a false-positive rate of less than 0.1%. On the external validation dataset, the model achieved a similar ROC AUC of 0.9984. On whole slide images, the network detected 100% of tumor foci and correctly eliminated an average of 99.9% of the non-cancer slide area from consideration.
Conclusions
Overall, our model shows encouraging progress towards computer-assisted diagnosis of hereditary diffuse gastric cancer.

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Artificial intelligence applicated in gastric cancer: A bibliometric and visual analysis via CiteSpace
Guoyang Zhang, Jingjing Song, Zongfeng Feng, Wentao Zhao, Pan Huang, Li Liu, Yang Zhang, Xufeng Su, Yukang Wu, Yi Cao, Zhengrong Li, Zhigang Jie
Frontiers in Oncology.2023;[Epub] CrossRef
Deep learning of endoscopic features for the assessment of neoadjuvant therapy response in locally advanced rectal cancer
Anqi Wang, Jieli Zhou, Gang Wang, Beibei Zhang, Hongyi Xin, Haiyang Zhou
Asian Journal of Surgery.2023; 46(9): 3568. CrossRef
Non-endoscopic Applications of Machine Learning in Gastric Cancer: A Systematic Review
Marianne Linley L. Sy-Janairo, Jose Isagani B. Janairo
Journal of Gastrointestinal Cancer.2023;[Epub] CrossRef
Preparing Data for Artificial Intelligence in Pathology with Clinical-Grade Performance
Yuanqing Yang, Kai Sun, Yanhua Gao, Kuansong Wang, Gang Yu
Diagnostics.2023; 13(19): 3115. CrossRef
Using Deep Learning to Predict Final HER2 Status in Invasive Breast Cancers That are Equivocal (2+) by Immunohistochemistry
Sean A. Rasmussen, Valerie J. Taylor, Alexi P. Surette, Penny J. Barnes, Gillian C. Bethune
Applied Immunohistochemistry & Molecular Morphology.2022; 30(10): 668. CrossRef

Reviews

Standardized pathology report for breast cancer: Soo Youn Cho, So Yeon Park, Young Kyung Bae, Jee Yeon Kim, Eun Kyung Kim, Woo Gyeong Kim, Youngmee Kwon, Ahwon Lee, Hee Jin Lee, Ji Shin Lee, Jee Young Park, Gyungyub Gong, Hye Kyoung Yoon; J Pathol Transl Med. 2021;55(1):1-15. Published online January 11, 2021; DOI: https://doi.org/10.4132/jptm.2020.11.20

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Abstract PDF Supplementary Material

Given the recent advances in management and understanding of breast cancer, a standardized pathology report reflecting these changes is critical. To meet this need, the Breast Pathology Study Group of the Korean Society of Pathologists has developed a standardized pathology reporting format for breast cancer, consisting of ‘standard data elements,’ ‘conditional data elements,’ and a biomarker report form. The ‘standard data elements’ consist of the basic pathologic features used for prognostication, while other factors related to prognosis or diagnosis are described in the ‘conditional data elements.’ In addition to standard data elements, all recommended issues are also presented. We expect that this standardized pathology report for breast cancer will improve diagnostic concordance and communication between pathologists and clinicians, as well as between pathologists inter-institutionally.

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Residual pure intralymphatic carcinoma component only (lymphovascular tumor emboli without invasive carcinoma) after neoadjuvant chemotherapy is associated with poor outcome: Not pathologic complete response
Hyunwoo Lee, Yunjeong Jang, Yoon Ah Cho, Eun Yoon Cho
Human Pathology.2024; 145: 1. CrossRef
Sentinel lymph node biopsy in patients with ductal carcinomain situ: systematic review and meta-analysis
Matthew G. Davey, Colm O’Flaherty, Eoin F. Cleere, Aoife Nohilly, James Phelan, Evan Ronane, Aoife J. Lowery, Michael J. Kerin
BJS Open.2022;[Epub] CrossRef

Molecular characteristics of meningiomas: Young Suk Lee, Youn Soo Lee; J Pathol Transl Med. 2020;54(1):45-63. Published online January 15, 2020; DOI: https://doi.org/10.4132/jptm.2019.11.05

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Abstract PDF

Meningioma is the most common primary intracranial tumor in adults. The grading of meningioma is based on World Health Organization criteria, which rely on histopathological features alone. This grading system is unable to conclusively predict the clinical behavior of these tumors (i.e., recurrence or prognosis in benign or atypical grades). Advances in molecular techniques over the last decade that include genomic and epigenomic data associated with meningiomas have been used to identify genetic biomarkers that can predict tumor behavior. This review summarizes the molecular characteristics of meningioma using genetic and epigenetic biomarkers. Molecular alterations that can predict meningioma behavior may be integrated into the upcoming World Health Organization grading system.

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Original Articles

Cytological Features That Differentiate Follicular Neoplasm from Mimicking Lesions: Kanghee Han, Hwa-Jeong Ha, Joon Seog Kong, Jung-Soon Kim, Jae Kyung Myung, Jae Soo Koh, Sunhoo Park, Myung-Soon Shin, Woo-Tack Song, Hye Sil Seol, Seung-Sook Lee; J Pathol Transl Med. 2018;52(2):110-120. Published online January 29, 2018; DOI: https://doi.org/10.4132/jptm.2018.01.17

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Abstract PDF

Background
It is difficult to correctly diagnose follicular neoplasms (FNs) on fine-needle aspiration cytology (FNAC) because it shares many cytological features with other mimicking lesions. The aim of this study was to identify the cytological features that differentiate FNs from mimicking lesions.
Methods
We included the cytological slides from 116 cases of thyroid FN diagnosed on FNAC, and included their subsequent histological diagnoses. We evaluated the cytological architectural pattern and nuclear features of the lesions according to their histological groups.
Results
The final histological diagnoses of the 116 cases varied, and included 51 FNs (44%), 47 papillary thyroid carcinomas (40%) including follicular variant, and seventeen cellular nodular hyperplasias (15%). Regardless of the final histological diagnosis, microfollicular pattern was observed in most cases. On the other hand, trabecular pattern was identified in 34% of FNs, but not in any other lesions. Additionally, elongated nuclei and ground glass chromatin were found in only some papillary thyroid carcinomas.
Conclusions
This study shows that the trabecular pattern is a representative cytological feature of FNs that can be used to distinguish FNs from mimicking lesions. In addition, nuclear shape and chromatin pattern can be used to further confirm the diagnosis of FNs from mimicking lesions through FNAC.

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Diagnostic implication of thyroid spherules for cytological diagnosis of thyroid nodules
Heeseung Sohn, Kennichi Kakudo, Chan Kwon Jung
Cytopathology.2024; 35(3): 383. CrossRef
Using Deep Convolutional Neural Networks for Enhanced Ultrasonographic Image Diagnosis of Differentiated Thyroid Cancer
Wai-Kin Chan, Jui-Hung Sun, Miaw-Jene Liou, Yan-Rong Li, Wei-Yu Chou, Feng-Hsuan Liu, Szu-Tah Chen, Syu-Jyun Peng
Biomedicines.2021; 9(12): 1771. CrossRef
The Role of Fine Needle Aspiration Biopsy with Bethesda System in the Evaluation of Thyroid Nodules
Gizem AKKAŞ AKGÜN, Figen ASLAN
Anadolu Kliniği Tıp Bilimleri Dergisi.2021; 26(1): 23. CrossRef
Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
Thyroid.2020; 30(2): 192. CrossRef
Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
PLOS ONE.2020; 15(11): e0241597. CrossRef

Reclassification of Mixed Oligoastrocytic Tumors Using a Genetically Integrated Diagnostic Approach: Seong-Ik Kim, Yujin Lee, Jae-Kyung Won, Chul-Kee Park, Seung Hong Choi, Sung-Hye Park; J Pathol Transl Med. 2018;52(1):28-36. Published online September 29, 2017; DOI: https://doi.org/10.4132/jptm.2017.09.25

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Abstract PDF

Background
Mixed gliomas, such as oligoastrocytomas (OA), anaplastic oligoastrocytomas, and glioblastomas (GBMs) with an oligodendroglial component (GBMO) are defined as tumors composed of a mixture of two distinct neoplastic cell types, astrocytic and oligodendroglial. Recently, mutations ATRX and TP53, and codeletion of 1p/19q are shown to be genetic hallmarks of astrocytic and oligodendroglial tumors, respectively. Subsequent molecular analyses of mixed gliomas preferred the reclassification to either oligodendroglioma or astrocytoma. This study was designed to apply genetically integrated diagnostic criteria to mixed gliomas and determine usefulness and prognostic value of new classification in Korean patients.
Methods
Fifty-eight cases of mixed OAs and GBMOs were retrieved from the pathology archives of Seoul National University Hospital from 2004 to 2015. Reclassification was performed according to genetic and immunohistochemical properties. Clinicopathological characteristics of each subgroup were evaluated. Overall survival was assessed and compared between subgroups.
Results
We could reclassify all mixed OAs and GBMOs into either astrocytic or oligodendroglial tumors. Notably, 29 GBMOs could be reclassified into 11 cases of GBM, IDH-mutant, 16 cases of GBM, IDH-wildtype, and two cases of anaplastic oligodendroglioma, IDH mutant. Overall survival was significantly different among these new groups (p<.001). Overall survival and progression-free survival were statistically better in gliomas with IDH mutation, ATRX mutation, no microscopic necrosis, and young patient age (cut off, 45 years old).
Conclusions
Our results strongly suggest that a genetically integrated diagnosis of glioma better reflects prognosis than former morphology-based methods.

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Dynamic susceptibility contrast and diffusion MR imaging identify oligodendroglioma as defined by the 2016 WHO classification for brain tumors: histogram analysis approach
Anna Latysheva, Kyrre Eeg Emblem, Petter Brandal, Einar Osland Vik-Mo, Jens Pahnke, Kjetil Røysland, John K. Hald, Andrés Server
Neuroradiology.2019; 61(5): 545. CrossRef

Reviews

Molecular Testing of Brain Tumor: Sung-Hye Park, Jaekyung Won, Seong-Ik Kim, Yujin Lee, Chul-Kee Park, Seung-Ki Kim, Seung-Hong Choi; J Pathol Transl Med. 2017;51(3):205-223. Published online May 12, 2017; DOI: https://doi.org/10.4132/jptm.2017.03.08

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Abstract PDF

The World Health Organization (WHO) classification of central nervous system (CNS) tumors was revised in 2016 with a basis on the integrated diagnosis of molecular genetics. We herein provide the guidelines for using molecular genetic tests in routine pathological practice for an accurate diagnosis and appropriate management. While astrocytomas and IDH-mutant (secondary) glioblastomas are characterized by the mutational status of IDH, TP53, and ATRX, oligodendrogliomas have a 1p/19q codeletion and mutations in IDH, CIC, FUBP1, and the promoter region of telomerase reverse transcriptase (TERTp). IDH-wildtype (primary) glioblastomas typically lack mutations in IDH, but are characterized by copy number variations of EGFR, PTEN, CDKN2A/B, PDGFRA, and NF1 as well as mutations of TERTp. High-grade pediatric gliomas differ from those of adult gliomas, consisting of mutations in H3F3A, ATRX, and DAXX, but not in IDH genes. In contrast, well-circumscribed low-grade neuroepithelial tumors in children, such as pilocytic astrocytoma, pleomorphic xanthoastrocytoma, and ganglioglioma, often have mutations or activating rearrangements in the BRAF, FGFR1, and MYB genes. Other CNS tumors, such as ependymomas, neuronal and glioneuronal tumors, embryonal tumors, meningothelial, and other mesenchymal tumors have important genetic alterations, many of which are diagnostic, prognostic, and predictive markers and therapeutic targets. Therefore, the neuropathological evaluation of brain tumors is increasingly dependent on molecular genetic tests for proper classification, prediction of biological behavior and patient management. Identifying these gene abnormalities requires cost-effective and high-throughput testing, such as next-generation sequencing. Overall, this paper reviews the global guidelines and diagnostic algorithms for molecular genetic testing of brain tumors.

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Molecular Testing for Gastrointestinal Cancer: Hye Seung Lee, Woo Ho Kim, Yoonjin Kwak, Jiwon Koh, Jeong Mo Bae, Kyoung-Mee Kim, Mee Soo Chang, Hye Seung Han, Joon Mee Kim, Hwal Woong Kim, Hee Kyung Chang, Young Hee Choi, Ji Y. Park, Mi Jin Gu, Min Jin Lhee, Jung Yeon Kim, Hee Sung Kim, Mee-Yon Cho; J Pathol Transl Med. 2017;51(2):103-121. Published online February 19, 2017; DOI: https://doi.org/10.4132/jptm.2017.01.24

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Abstract PDF

With recent advances in molecular diagnostic methods and targeted cancer therapies, several molecular tests have been recommended for gastric cancer (GC) and colorectal cancer (CRC). Microsatellite instability analysis of gastrointestinal cancers is performed to screen for Lynch syndrome, predict favorable prognosis, and screen patients for immunotherapy. The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor has been approved in metastatic CRCs with wildtype RAS (KRAS and NRAS exon 2–4). A BRAF mutation is required for predicting poor prognosis. Additionally, amplification of human epidermal growth factor receptor 2 (HER2) and MET is also associated with resistance to EGFR inhibitor in metastatic CRC patients. The BRAF V600E mutation is found in sporadic microsatellite unstable CRCs, and thus is helpful for ruling out Lynch syndrome. In addition, the KRAS mutation is a prognostic biomarker and the PIK3CA mutation is a molecular biomarker predicting response to phosphoinositide 3-kinase/AKT/mammalian target of rapamycin inhibitors and response to aspirin therapy in CRC patients. Additionally, HER2 testing should be performed in all recurrent or metastatic GCs. If the results of HER2 immunohistochemistry are equivocal, HER2 silver or fluorescence in situ hybridization testing are essential for confirmative determination of HER2 status. Epstein-Barr virus–positive GCs have distinct characteristics, including heavy lymphoid stroma, hypermethylation phenotype, and high expression of immune modulators. Recent advances in next-generation sequencing technologies enable us to examine various genetic alterations using a single test. Pathologists play a crucial role in ensuring reliable molecular testing and they should also take an integral role between molecular laboratories and clinicians.

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Original Article

Differential Immunohistochemical Profiles for Distinguishing Prostate Carcinoma and Urothelial Carcinoma: Woo Jin Oh, Arthur Minwoo Chung, Jee Soon Kim, Ji Heun Han, Sung Hoo Hong, Ji Yeol Lee, Yeong Jin Choi; J Pathol Transl Med. 2016;50(5):345-354. Published online August 7, 2016; DOI: https://doi.org/10.4132/jptm.2016.06.14

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Abstract PDF

Background
The pathologic distinction between high-grade prostate adenocarcinoma (PAC) involving the urinary bladder and high-grade urothelial carcinoma (UC) infiltrating the prostate can be difficult. However, making this distinction is clinically important because of the different treatment modalities for these two entities.
Methods
A total of 249 patient cases (PAC, 111 cases; UC, 138 cases) collected between June 1995 and July 2009 at Seoul St. Mary’s Hospital were studied. An immunohistochemical evaluation of prostatic markers (prostate-specific antigen [PSA], prostate-specific membrane antigen [PSMA], prostate acid phosphatase [PAP], P501s, NKX3.1, and α-methylacyl coenzyme A racemase [AMACR]) and urothelial markers (CK34βE12, p63, thrombomodulin, S100P, and GATA binding protein 3 [GATA3]) was performed using tissue microarrays from each tumor.
Results
The sensitivities of prostatic markers in PAC were 100% for PSA, 83.8% for PSMA, 91.9% for PAP, 93.7% for P501s, 88.3% for NKX 3.1, and 66.7% for AMACR. However, the urothelial markers CK34βE12, p63, thrombomodulin, S100P, and GATA3 were also positive in 1.8%, 0%, 0%, 3.6%, and 0% of PAC, respectively. The sensitivities of urothelial markers in UC were 75.4% for CK34βE12, 73.9% for p63, 45.7% for thrombomodulin, 22.5% for S100P, and 84.8% for GATA3. Conversely, the prostatic markers PSA, PSMA, PAP, P501s, NKX3.1, and AMACR were also positive in 9.4%, 0.7%, 18.8%, 0.7%, 0%, and 8.7% of UCs, respectively.
Conclusions
Prostatic and urothelial markers, including PSA, NKX3.1, p63, thrombomodulin, and GATA3 are very useful for differentiating PAC from UC. The optimal combination of prostatic and urothelial markers could improve the ability to differentiate PAC from UC pathologically.

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Review

Pathology Reporting of Thyroid Core Needle Biopsy: A Proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group: Chan Kwon Jung, Hye Sook Min, Hyo Jin Park, Dong Eun Song, Jang Hee Kim, So Yeon Park, Hyunju Yoo, Mi Kyung Shin, Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group; J Pathol Transl Med. 2015;49(4):288-299. Published online June 17, 2015; DOI: https://doi.org/10.4132/jptm.2015.06.04

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Abstract PDF

In recent years throughout Korea, the use of ultrasound-guided core needle biopsy (CNB) has become common for the preoperative diagnosis of thyroid nodules. However, there is no consensus on the pathology reporting system for thyroid CNB. The Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group held a conference on thyroid CNB pathology and developed guidelines through contributions from the participants. This article discusses the outcome of the discussions that led to a consensus on the pathology reporting of thyroid CNB.

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Korean Journal of Radiology.2018; 19(3): 534. CrossRef
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International Journal of Thyroidology.2018; 11(1): 15. CrossRef
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Korean Journal of Radiology.2018; 19(4): 673. CrossRef
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Korean Journal of Radiology.2018; 19(4): 656. CrossRef
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Min Ji Hong, Dong Gyu Na, Soo Jin Kim, Dae Sik Kim
Ultrasonography.2018; 37(3): 244. CrossRef
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Thyroid.2018; 28(12): 1587. CrossRef
Risk of malignancy according to sub‐classification of the atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) category in the Bethesda system for reporting thyroid cytopathology
S. J. Kim, J. Roh, J. H. Baek, S. J. Hong, Y. K. Shong, W. B. Kim, D. E. Song
Cytopathology.2017; 28(1): 65. CrossRef
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Soo-Yeon Kim, Hye Sun Lee, Jieun Moon, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Jin Young Kwak
European Radiology.2017; 27(2): 801. CrossRef
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Soo Yeon Hahn, Jung Hee Shin, Hyun Kyung Lim, So Lyung Jung
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H.C. Kim, Y.J. Kim, H.Y. Han, J.M. Yi, J.H. Baek, S.Y. Park, J.Y. Seo, K.W. Kim
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Thyroid.2017; 27(7): 953. CrossRef
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Hyemi Kwon, Min Ji Jeon, Jong Ho Yoon, Suck Joon Hong, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Won Bae Kim, Won Gu Kim, Dong Eun Song
Journal of Surgical Oncology.2017; 116(6): 746. CrossRef
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Hyemi Kwon, Hye-Seon Oh, Mijin Kim, Suyeon Park, Min Ji Jeon, Won Gu Kim, Won Bae Kim, Young Kee Shong, Dong Eun Song, Jung Hwan Baek, Ki-Wook Chung, Tae Yong Kim
The Journal of Clinical Endocrinology & Metabolism.2017; 102(6): 1917. CrossRef
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Soon-Hyun Ahn, So-Yeon Park, Sang Il Choi
Endocrine Pathology.2017; 28(4): 332. CrossRef
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Chong Hyun Suh, Jung Hwan Baek, Young Jun Choi, Tae Yong Kim, Tae Yon Sung, Dong Eun Song, Jeong Hyun Lee
Scientific Reports.2017;[Epub] CrossRef
Comparison of Core-Needle Biopsy and Fine-Needle Aspiration for Evaluating Thyroid Incidentalomas Detected by 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Propensity Score Analysis
Chong Hyun Suh, Young Jun Choi, Jong Jin Lee, Woo Hyun Shim, Jung Hwan Baek, Han Cheol Chung, Young Kee Shong, Dong Eun Song, Tae Yon Sung, Jeong Hyun Lee
Thyroid.2017; 27(10): 1258. CrossRef
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Journal of Pathology and Translational Medicine.2017; 51(6): 521. CrossRef
Recent Advances in Core Needle Biopsy for Thyroid Nodules
Chan Kwon Jung, Jung Hwan Baek
Endocrinology and Metabolism.2017; 32(4): 407. CrossRef
Core-needle biopsy for the preoperative diagnosis of follicular neoplasm in thyroid nodule screening: A validation study
Sung Hak Lee, Gyeong Sin Park, So Lyung Jung, Min-Hee Kim, Ja Seong Bae, Dong Jun Lim, Chan Kwon Jung
Pathology - Research and Practice.2016; 212(1): 44. CrossRef
The Role of Core-Needle Biopsy as a First-Line Diagnostic Tool for Initially Detected Thyroid Nodules
Chong Hyun Suh, Jung Hwan Baek, Jeong Hyun Lee, Young Jun Choi, Jae Kyun Kim, Tae-Yon Sung, Jong Ho Yoon, Young Kee Shong
Thyroid.2016; 26(3): 395. CrossRef
Thyroid nodules with minimal cystic changes have a low risk of malignancy
Dong Gyu Na, Ji-hoon Kim, Dea Sik Kim, Soo Jin Kim
Ultrasonography.2016; 35(2): 153. CrossRef
Thyroid nodules with isolated macrocalcification: malignancy risk and diagnostic efficacy of fine-needle aspiration and core needle biopsy
Dong Gyu Na, Dae Sik Kim, Soo Jin Kim, Jae Wook Ryoo, So Lyung Jung
Ultrasonography.2016; 35(3): 212. CrossRef
Thyroid Imaging Reporting and Data System Risk Stratification of Thyroid Nodules: Categorization Based on Solidity and Echogenicity
Dong Gyu Na, Jung Hwan Baek, Jin Yong Sung, Ji-Hoon Kim, Jae Kyun Kim, Young Jun Choi, Hyobin Seo
Thyroid.2016; 26(4): 562. CrossRef
Fine‐needle aspiration and core needle biopsy: An update on 2 common minimally invasive tissue sampling modalities
Paul A. VanderLaan
Cancer Cytopathology.2016; 124(12): 862. CrossRef
The role of core-needle biopsy in the diagnosis of thyroid malignancy in 4580 patients with 4746 thyroid nodules: a systematic review and meta-analysis
Chong Hyun Suh, Jung Hwan Baek, Jeong Hyun Lee, Young Jun Choi, Kyung Won Kim, Jayoun Lee, Ki-Wook Chung, Young Kee Shong
Endocrine.2016; 54(2): 315. CrossRef
The Role of Core-Needle Biopsy for Thyroid Nodules with Initially Nondiagnostic Fine-Needle Aspiration Results: A Systematic Review and Meta-Analysis
Chong Hyun Suh, Jung Hwan Baek, Kyung Won Kim, Tae Yon Sung, Tae Yong Kim, Dong Eun Song, Young Jun Choi, Jeong Hyun Lee
Endocrine Practice.2016; 22(6): 679. CrossRef
Should Core Needle Biopsy be Used in the Evaluation of Thyroid Nodules?
Beril Guler, Tugce Kiran, Dilek Sema Arici, Erhan Aysan, Fatma Cavide Sonmez
Endocrine Pathology.2016; 27(4): 352. CrossRef
A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules
Eun Ju Ha, Won-Jin Moon, Dong Gyu Na, Young Hen Lee, Nami Choi, Soo Jin Kim, Jae Kyun Kim
Korean Journal of Radiology.2016; 17(5): 811. CrossRef
Impact of Reclassification on Thyroid Nodules with Architectural Atypia: From Non-Invasive Encapsulated Follicular Variant Papillary Thyroid Carcinomas to Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features
Min Ji Jeon, Dong Eun Song, Chan Kwon Jung, Won Gu Kim, Hyemi Kwon, Yu-Mi Lee, Tae-Yon Sung, Jong Ho Yoon, Ki-Wook Chung, Suck Joon Hong, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Won Bae Kim, Rafael Rosell
PLOS ONE.2016; 11(12): e0167756. CrossRef

Original Article

Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions: Hae Woon Baek, Min Jee Park, Ye-Young Rhee, Kyoung Bun Lee, Min A Kim, In Ae Park; J Pathol Transl Med. 2015;49(1):52-60. Published online January 15, 2015; DOI: https://doi.org/10.4132/jptm.2014.10.26

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28 Crossref

Abstract PDF

Background
Endoscopic ultrasound–guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. Methods: We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. Results: In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. Conclusions: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.

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Case Study

A Case of Metastatic Angiosarcoma Diagnosed by Liquid-Based Preparation: Peculiar Cytoplasmic Changes: Min Jung Jung, Young Ok Kim; Korean J Pathol. 2014;48(3):241-247. Published online June 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.3.241

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Abstract PDF

Angiosarcoma with predominantly epithelioid features is a rare soft tissue neoplasm and the interpretation of its cytopathologic findings may be difficult. We report a case of metastatic angiosarcoma with predominantly epithelioid features diagnosed by liquid-based cytology. The cytopathologic findings in this case differed from those of the conventional preparation and we found a clean background, no hyperchromatic nuclei and several cytoplasmic changes, including intracytoplasmic vacuoles with peculiar shapes, juxtanuclear condensation and perinuclear clearing. Identification of these changes using liquid-based cytology supplemented with immunochemistry may be helpful in reaching a correct cytopathologic diagnosis.

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Journal of Nihon University Medical Association.2015; 74(3): 113. CrossRef

Original Article

Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis: Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon Mee Kim, Hye Seung Han, Won Ae Lee, Yoon Jung Choi, Dong Wook Kang, Sunhoo Park, Jae Hyuk Lee, Mee-Yon Cho; Korean J Pathol. 2013;47(3):245-251. Published online June 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.3.245

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Abstract PDF

Background

The incidence of early colorectal epithelial neoplasm (ECEN) is increasing, and its pathologic diagnosis is important for patient care. We investigated the incidence of ECEN and the current status of its pathologic diagnosis.

Methods

We collected datasheets from 25 institutes in Korea for the incidence of colorectal adenoma with high grade dysplasia (HGD) and low grade dysplasia in years 2005, 2007, and 2009; and early colorectal carcinoma in the year 2009. We also surveyed the diagnostic terminology of ECEN currently used by the participating pathologists.

Results

The average percentage of diagnoses of adenoma HGD was 7.0%, 5.0%, and 3.4% in years 2005, 2007, and 2009, respectively. The range of incidence rates of adenoma HGD across the participating institutes has gradually narrowed over the years 2005 to 2009. The incidence rate of early colorectal carcinoma in the year 2009 was 21.2%. The participants did not share a single criterion or terminology for the diagnosis of adenoma HGD. The majority accepted the diagnostic terms that distinguished noninvasive, mucosal confined, and submucosal invasive carcinoma.

Conclusions

Further research requirements suggested are a diagnostic consensus for the histopathologic diagnosis of ECEN; and standardization of diagnostic terminology critical for determining the disease code.

Citations

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Diminutive and Small Colorectal Polyps: The Pathologist's Perspective
Yun Kyung Kang
Clinical Endoscopy.2014; 47(5): 404. CrossRef

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