Journal of Pathology and Translational Medicine

Original Article

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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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.

Citations

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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

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.

Citations

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Cytological Features of a Metastatic Angiosarcoma in the Lymph Node Diagnosed via Liquid-Based Cytology
Jie-Yang Jhuang, Chih-Yi Liu, Min-Hui Tseng, Shih-Sung Chuang
Diagnostics.2023; 13(12): 2124. CrossRef
Radiation-associated Angiosarcoma Presenting as Massive Pleural Effusion
Hirokazu Ogino, Makoto Tobiume, Kozo Kagawa, Hiroshi Kawano, Satoshi Sakaguchi, Atsuro Saijo, Daisuke Matsumoto, Hiromitsu Takizawa, Yuriko Morikawa, Yoshimi Bando, Hisatsugu Goto, Hiroshi Nokihara, Yasuhiko Nishioka
Internal Medicine.2022; 61(9): 1393. CrossRef
Delayed diagnosis of angiosarcoma of the spleen: clinically presenting as recurrent haemoperitoneum following embolisation
V. Kornmann, P. van Rijn, D. Mulder, K. Reijnders
Case Reports.2015; 2015(apr09 1): bcr2014208956. CrossRef
A Case of Angiosarcoma of the Scalp with Invasion to the Pleural Effusion
Yusuke Amano, Yukari Obana, Yoko Nakanishi, Ryusuke Tsujimura, Kayomi Wakamatsu, Fumiko Uemura, Yoshihisa Katsura, Masahiko Sugitani, Norimichi Nemoto
Journal of Nihon University Medical Association.2015; 74(3): 113. CrossRef

Original Articles

Use of Calretinin, CD56, and CD34 for Differential Diagnosis of Schwannoma and Neurofibroma.: Ji Young Park, Hoon Park, Nam Jo Park, June Sik Park, Hyun Jung Sung, Sang Sook Lee; Korean J Pathol. 2011;45(1):30-35.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.30

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Abstract PDF

BACKGROUND
It is important to differentiate between schwannomas and neurofibromas for the cases in which the histopathologic features overlap. Depending on the tumor type, surgeons can decide on a treatment method and whether to preserve or sacrifice the nerve; the possibility of malignant transformation in the case of neurofibromas also needs to be considered.
METHODS
We studied 101 cases of schwannoma and 103 cases of neurofibroma. All the hematoxylin and eosin slides for these cases were reviewed, and tissue microarrays were prepared from the representative areas. Immunohistochemical analysis was performed using antibodies for S-100 protein, calretinin, CD56 and CD34.
RESULTS
All the tumors except 3 neurofibromas were positive for the S-100 protein. Calretinin was found in 26.7% of the schwannomas (27/101), but it was not found in any of the neurofibromas. CD56 was positive in 77.2% of the schwannomas (78/101) and in 9.8% of the neurofibromas (10/102). CD34 was positive in 42.5% of the schwannomas (43/101) and in 80.2% of the neurofibromas (81/101). Statistically, calretinin was significantly specific for schwannomas (p<0.001) and CD56 was also sensitive for these tumors (p<0.001). On the other hand, a CD34 expression seemed highly sensitive (p<0.001) for neurofibromas.
CONCLUSIONS
We concluded that combined immunohistochemical analysis for calretinin, CD56, and CD34 may be very useful for differentiating schwannomas from neurofibromas.

Citations

Citations to this article as recorded by

Lung schwannomas, an unusual entity: A series of five cases
NaziaM Walvir, RumanaH Makhdoomi, Meesa Zargar, Aiffa Aiman, Shadab Maqsood
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A Spectrum of Histomorphological and Immunohistochemical Expression Profiles of S-100, CD56 and Calretinin in Benign Peripheral Nerve Sheath Tumours
Poornima Jaiswal, Anand CD, Jaison Jacob John
Cureus.2023;[Epub] CrossRef
An unusual diffuse CD34 staining in an olfactory groove cellular schwannoma: Case report
Marios Theologou, Jorge D. Perez Ruiz, Panagiotis Varoutis, Nicolaos Flaris, Nikolaos `Skoulios
Archivos de Neurociencias.2023;[Epub] CrossRef
An unusual diffuse CD34 staining in an olfactory groove cellular schwannoma: Case report
Marios Theologou, Jorge D. Perez Ruiz, Panagiotis Varoutis, Nicolaos Flaris, Nikolaos `Skoulios
Archivos de Neurociencias.2023;[Epub] CrossRef
Intranodal Neurofibroma: A Case Report and Literature Review
Steven H. Adams, Tara L. Huston, Daniel Lozeau
The American Journal of Dermatopathology.2022; 44(4): 306. CrossRef
A rare case of pseudoglandular schwannoma
Fadime Eda GÖKALP SATICI, Hamide SAYAR
Journal of Surgery and Medicine.2022; 6(4): 1. CrossRef
Gastric Schwannoma as an Important and Infrequent Differential Diagnosis of Gastric Mesenchymal Tumours: A Case Report and Review of Literature
Abdalla Saad Abdalla Al-Zawi, Salma Lahmadi, Saman Jalilzadeh Afshari, Ipshita Kak, Salem Alowami
Cureus.2022;[Epub] CrossRef
Spindle cell proliferations of the sigmoid colon, rectum and anus: a review with emphasis on perineurioma
Patrice Grech, John B Schofield
Histopathology.2020; 76(3): 342. CrossRef
Large retroperitoneal schwannoma: a rare cause of chronic back pain
Milan Radojkovic, Dragan Mihailovic, Miroslav Stojanovic, Danijela Radojković
Journal of International Medical Research.2018; 46(8): 3404. CrossRef
Nasal Septal Schwannoma
Hyun Jin Min, Seok Chan Hong, Kyung Soo Kim
Journal of Craniofacial Surgery.2017; 28(1): e97. CrossRef
Neurofibroma of the Colon: A Diagnostic Mimicker of Gastrointestinal Stromal Tumor
Soomin Ahn, Choon Sik Chung, Kyoung-Mee Kim
Case Reports in Gastroenterology.2016; 10(3): 674. CrossRef
Solitary Epibulbar Neurofibroma in Older Adult Patients
Thais Shiota Tanaka, Victor M. Elner, Hakan Demirci
Cornea.2015; 34(4): 475. CrossRef
Syncytial nuclear aggregates in normal placenta show increased nuclear condensation, but apoptosis and cytoskeletal redistribution are uncommon
S.J. Coleman, L. Gerza, C.J.P. Jones, C.P. Sibley, J.D. Aplin, A.E.P. Heazell
Placenta.2013; 34(5): 449. CrossRef
Analysis of syncytial nuclear aggregates in preeclampsia shows increased sectioning artefacts and decreased inter-villous bridges compared to healthy placentas
S.J. Calvert, C.J.P. Jones, C.P. Sibley, J.D. Aplin, A.E.P. Heazell
Placenta.2013; 34(12): 1251. CrossRef

Malignant Mesothelioma in Body Fluids: with Special Reference to Differential Diagnosis from Metastatic Adenocarcinoma.: Jin Ho Paik, Jin Haeng Chung, Baek Hui Kim, Gheeyoung Choe; Korean J Pathol. 2009;43(5):458-466.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.458

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Abstract PDF: BACKGROUND
Malignant mesothelioma (MM) is a rare malignant neoplasm occurring in pleura, pericardium, and peritoneum. The differential diagnosis between MM and metastatic adenocarcinoma (MA) causes diagnostic, staging, and therapeutic dilemmas. Herein, we investigated characteristic cytologic features of MM.
METHODS
Cytologic specimens of MM (n=10), MA (n=25), and reactive mesothelial hyperplasia (n=10) were retrieved and reviewed from archival materials in the Department of Pathology, Seoul National University Bundang Hospital from May 2003 to July 2008.
RESULTS
MM showed tumor cell clusters and singly scattered malignant tumor cells forming single cell populations with sparse reactive benign mesothelial cells. In contrast, MA showed distinct two cell populations of tumor cell clusters and scattered reactive mesothelial cells. Furthermore, MM frequently exhibited a characteristic long chain-like arrangement (hand-in-hand appearance) and intercellular windows, which were rarely evident in MA. Variable nuclear size, relatively consistent nuclear-cytoplasmic ratio, bior multi-nucleation, and lacy cytoplasmic borders were also frequently observed in MM.
CONCLUSIONS
Differential diagnosis of MM from MA in body fluids is possible based on meticulous examination of certain cytologic parameters, which could have significant implications in staging and treatment.

Case Report

Granulomatous Mycosis Fungoides: A case report.: Kyung Sin Lee, Young Oak Kim, Kee Suck Suh, Sang Tae Kim, Man Ha Huh; Korean J Pathol. 1995;29(5):694-697.

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Abstract: Granulomatous mycosis fungoides is an extremely rare and unusual histologic variant of mycosis fungoides. This form is clinically characterized by spontaneous resolution of ulcerated nodular lesions into poikiloderma. Histologically, a strong granulomatous component can obscure the underlying cutaneous lymphoma, which is frequently mistaken for non-neoplastic dermatitides or cutaneous sarcoidosis. We report a case of granulomatous mycosis fungoides occurring on the left cheek of 34-year-old man confirmed histologically with an aid of immunohistochemistry and clinical course (immediate response to PROMACE-CYTOBAM chemotherapy), with emphasis on differential diagnosis, along with a review of literature. This is the first documented report in the Korean literature.

Original Articles

Detection of the c-m c Oncogene Amplification in Ovarian Carcinomas by Differential Polymerase Chain Reaction.: Geun Shin Lyu, Chan Kum Park, Chun Geun Lee, Youl Hee Cho, Youn Yeoung Hwang, Jung Dal Lee; Korean J Pathol. 1997;31(7):644-654.

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Abstract PDF: The amplification of c-myc oncogene was evaluated in 42 cases of ovarian carcinomas to correlate with clinical parameters. Using oligonucleotide primers, sequences from the c-myc exon-3 gene and from a control gene, tissue plasminogen activator (tPA), were amplified simultaneously by polymerase chain reaction (PCR). After the products of differential PCR (d-PCR) were electrophoresed, slot blot hybridization was performed, and hybridized with P32 dATP-labeled myc and tPA oligonucleotide probes and then autoradiographed. The signal intensities of the two products were quantitated by densitometry and the ratios of two products (c-myc/tPA) were measured. The ovarian carcinomas showed significantly increased amplification of c-myc oncogene Oligonucleoti compared to normal control group (p<0.05). 15 of 42 cases (35.7%) showed various degrees of the MYC gene amplification up to 27 folds in various histologic types of ovarian carcinomas. No significant differences of the MYC gene amplification according to histologic subtypes, tumor action) grades and clinical stages of ovarian carcinomas were present.

Identification of Differentially Expressed Genes from Serum Deprived p388D1 Cells.: Su Young Kim, Sang Ho Kim, Sug Hyung Lee, Nam Jin Yoo, Jung Young Lee, Choo Soung Kim; Korean J Pathol. 1998;32(7):488-493.

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Abstract: This experiment is designed to find differentially expressed genes in p388D1 cells that are specific for the serum deprived state. Serum starvation induces cells to enter the quiscent state in the cell cycle and is used to arrest cell growth or synchronize the cell cycle. Differential display and ribonuclease protection assay were used to identify quantitative change in gene expression. Nineteen genes that showed a differential expression in the differential display were cloned and 7 clones were verified by a ribonuclease protection assay. Among the 7 clones clone-16 showed same expression pattern in comparison with the differential display. Deduced amino acid sequences of clone-16 had N-glycosylation motif and seems to be a secretory protein. Getting a full sequence of clone-16 is critical for the characterization of it.

Case Reports

Intraductal Cystic Hypersecretory Carcinoma of the Breast: A case report.: Jin Haeng Chung, Seung Sook Lee, Jae Soo Koh, Kyung Ja Cho, Jong Inn Lee; Korean J Pathol. 1999;33(2):137-140.

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Abstract: The cystic hypersecretory duct carcinoma of the breast was first described in 1984 by Rosen and Scott and warrants separate discussion because of its unusual pathological features. It is morphologically distinguishable from juvenile (secretory) carcinoma and from mucinous (colloid) carcinoma or mucocele-like tumor. We present a case report of intraductal cystic hypersecretory carcinoma of the breast with hormone receptor and oncogene study. The histologic differential diagnosis, with an emphasis on benign lesions that may have a predominant cystic component, is also discussed.

Choroid Plexus Carcinoma: A Report of Two Cases.: Young Ran Shim, Mi Jin Gu, Dong Sug Kim, Oh Lyong Kim, Woo Mok Byun, Yong Jin Kim; Korean J Pathol. 2001;35(2):176-179.

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Abstract PDF: Choroid plexus carcinoma (CPC), a frankly malignant epithelial neoplasm derived from choroid plexus epithelium, is a rare tumor with a predilection for infants and children. It may be difficult to histologically differentiate it from choroid plexus papilloma, anaplastic ependymoma, medulloblastoma, germ cell tumors, and metastatic carcinoma. We examined two cases of CPC. One is a 12-month-old boy, and the other is a 13-month-old boy. Both patients present lateral ventricular masses with extensive hydrocephalus. Histologically, both tumors show papillary growth in most area, and focal solid growth. The tumor cells show marked nuclear pleomorphism and frequent mitoses on squash and hematoxylin-eosin slides. Immunohistochemically, both tumors are positive for cytokeratin, vimentin, and S-100 protein; but they are negative for glial fibrillary acidic protein, -fetoprotein, and placental alkaline phosphatase. Both tumors show diffuse and strong positivity for p53. The MIB-1 labelling index is 23.6% and 15.82%, respectively. We report two cases of typical CPC, and we briefly discuss differential diagnosis with review of literatures.

Original Article

Solid and Papillary Epithelial Neoplasm of the Pancreas Diagnosed by Percutaneous Fine Needle Aspiration Biopsy.: Chan Kum Park, Jung Dal Lee; Korean J Pathol. 1990;24(3):304-309.

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Abstract PDF: Solid and papillary epithelial neoplasm of the pancreas is a rare, low grade malignant tumor of adolescence. The tumor we described was diagnosed by following preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination. Characteristic cytologic findings were monotonous cells arranged in papillary fronds, acinus, and cords in necrotic and hemorrhagic backgrounds. Occasional foamy histiocytes and hyaline globules were present. The cytoplasm of the tumor cells were moderate in amount, pale eosinophilic or vacuolated with distinct borders. The nuclei were centrally located and round. There were one or two small nucleoli and finely granular chromatin throughout the nucleus.

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