ABSTRACT
Malignant tumor is found in 1-2% of ovarian benign cystic teratomas. Among these malignant neoplasms, squamous cell carcinoma is by far the most common malignancy, whereas the incidence of struma ovarii is less than 5% in mature teratoma. As far as concerned the struma ovarii, a very small percentage is associated with carcinoid, mucinous or serous cystadenoma, or Brenner tumor. However, any reports of struma ovarii associated with squamous cell carcinoma in the same ovary could not be found in English literature. Recently we have experienced a case of squamous cell carcinoma and struma ovarii arising in an ovarian benign cystic teratoma in 72 year old female patient.
Subject(s)
Female , Humans , IncidenceABSTRACT
Lymphangioleiomyomatosis(LAM) is a rare disease of women of child-bearing age in which there is progressive hyperplasia of atypical smooth mucle along lymphatics in the lung, and/or axial lymphatics in the thorax and abdomen, resulting in honeycombing of lung. Interestingly there has been a speculation that it represents a forme furste or incomplete expression of tuberous sclerosis complex. This is based on the observation that patients with tuberous sclerosis can manifest pulmonary lesions indistinguishable from LAM. We report a case of LAM occuring in a 39-year-old female, who complained of recurrent pneumothorax, chest pain and shortness of breath. Three years ago, the patient had right nephrectomy under the diagnosis of ruptured angiomyolipoma. A X-ray film of the chest showed honeycombing with a diffusely reticulonodular pattern and cyst-like spaces. She had a characteristic facial appearance of adenoma sebaceum, which her father and uncle had. Microscopically, the lung showed a marked smooth muscle proliferation around the slit-like lymphatic spaces and also some respiratory bronchioles.
Subject(s)
Female , Humans , AdenomaABSTRACT
The alterations in the localization of keratinocyte membrane glycoconjugates in allergic contact dermatitis were investigated in guinea pig skin treated with topical application of 2.4-dinitro-chlorobenzene. We employed the avidin-biotin complex(ABC) method for the detection of localization of 10 commercially available lectins labelled with biotin: Con-A, SBA, WGA, DBA, UEA-1, RCA-1, PNA, HP, MPA, and ECA. Staining with WGA showed a remarkably decreased intensity in basal and spinous layers of the allergic skin in comparison to those of the control skin, suggesting loss of terminal sialic acids in cell membrane glycoconjugates. The other lectins showed no remarkable difference in the staining patterns between the normal and the allergic ski. The results suggest that epidermal cell membrane glycoconjugates undergoes selective perturbations in acute allergic contact dermatitis, and that the keratinocytes might be an active part of the cutaneous immune system.
ABSTRACT
Forty-four ovairan tumors were immunohistochemically studied for the presence of broad-spectrum keratin, vimentin, desin, carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), and alpha 1-antitrypsin (AAT) in formalin-fixed, paraffin-embedded tissues. 1) Among the common epithelial tumors, all the serous carcinomas (4) expressed keratin and AAT, and one additionally CEA. Six mucinous carcinomas exhibited keratin-positivity in two. One endometrioid carcinoma coexpressed keratin and vimentin as well as AAT, but one clear cell carcinoma expressed only keratin. Keratin-and CEA-positivity in epithelial cell nests and vimentin-positivity in stromal cells were observed in two Brenner tumors. Two undifferentiated carcinomas showed keratin-positivity in one and focal CEA positivity in the other. 2) In sex cord-stromal tumors, four out of six granulsa cell tumors, all four thecomas and three fibromas expressed vimentin, and two granulosa cell tumors and two thecomas showed AAT-positivity. The others were negative. 3) Among germ cell tumors, four dysgerminomas showed focal vimentin-positive cells in two and diffuse staining for AAT. Seven endodermal sinus tumors expressed AAT in all. Additionally, AFP were positive in two and CEA in three out of them. One embryonal carcinoma expressed CEA, AAT and AFP. 4) In four metastatic carcinomas, three exhibited keratin-and CEA-positivity, whereas one exhibited keartin-and vimentin-positivity. All showed AAT-positivity. 5) There was no positive case for desmin among ovarian tumors.
Subject(s)
Neoplasm MetastasisABSTRACT
A 49-year old man was admitted to the Korea university hospital, department of surgery, for evaluation of anterior neck mass which was slowly growing for five years. His past history was unremarkable except for known hypertension for several years. Physical examination revealed high blood pressure, measuring 180 mmHg in systolic phase and 120 mmHg in diastolic phase. A soft nontender mass was palpated at anterior neck just above the sternal notch with smooth surface and its size was about 4 x 5 cm in cross. On laboratory examination, diabetic evidence such as high blood sugar (FBS 170 mg/dl, PP2hr. 234 mg/dl) and glucosuria. The CBC finding suggested polycythemia with high hemoglobin (18.0 g/dl) and hematocrit (54%) levels. The differential count and platelet count were within normal limits.
Subject(s)
Male , HumansABSTRACT
This report describes a very rare case of primary undifferentiated carcinoma of the endometrium with small cell and trophoblastic differentiation. The patient was 54-year-old woman with complaints of vaginal bleeding and palpable lower abdominal mass. The light microscopic findings revealed predominantly small cells with round nuclei, spindle cells, and large cells with hyperchromatic bizarre nuclei. Foci of syncytiotrophoblastic giant cells are scattered, especially in the hemorrhagic areas. Immunohistochemical stainging for neuron specific enolase and beta-hCG showed positive reactions to small cells and syncytiotrophoblastic giant cells, respectively. Argentaffin and argyrophil stains, however, showed negative reactions to small cells. The histogenesis of small cell undifferentiated carcinoma of the endometrium remains unclear; however, it may arise from epithelial precursors instead of neuroendocrine cells, and syncytiotrophoblastic cells may be differentiated or dedifferentiated from the undifferentiated carcinoma cells.
Subject(s)
Female , HumansABSTRACT
For the identification of proliferating cells in tissue, the argyrophilic method for the demonstration of nucleolar organizer regions (Ag-NORs) have been described. To evaluate the applicability of Ag-NORs in surgical pathology, the authors have done Ag-NORs staining on 144 cases of routinely processed, formalin-fixed paraffin sections of various tissues; 15 normal tissues, 12 reactive and hyperplastic lesions, 30 benign neoplasms, 4 borderline lesions, and 83 malignant tumors. The results were summerized as follows; 1) In normal tissues, the mean numbers of Ag-NORs were highter in labile cells, especially in actively proliferating cells such as germ cells of testis, crypt epithelial cells in gastrointestinal mucosa, and lymphocytes from germinal center of tonsil and lymph node, than those of stable cells. 2) The mean numbers of Ag-NORs in reactive and hyperplastic lesions, benign neoplasms, and borderline lesions were similar to those of normal labile cells. 3) The mean numbers of Ag-NORs in carcinomas and sarcomas, (usually more than 2) significantly exceeded those of normal and non-malignant conditions. However, certain cases of carcinomas such as papillary carcinomas of thyroid, mucinous carcinoma of stomach, bronchioloalveolar carcinoma of lung, and adenoid cystic carcinoma of lung, and some of the leiomyosarcoma, malignant fibrous histiocytoma, and malignant schwannoma showed relatively lower numbers of Ag-NORs. 4) In non-Hodgkin's lymphomas, the high grade lymphomas showed more Ag-NORs than the low grade ones. From above results, it is suggested that the Ag-NORs technique is helpful in differentiation between malignant and non-malignant lesions. However, further evaluation on the significance of Ag-NORs upon the behavior of the cancer is to be made.
ABSTRACT
The cyto-histologic correlation and cytologic accuracy are reported in thirty cases of consecutive aspirated cells and their biopsied tissues of patients with clinical and neuroradiologic evidences of central nervous system tumors and other lesions investigated at the Pathology and Neurosurgery Department, Korea University Hospital, from Apr. 1987 to Apr. 1988. The series comprised of 17 benign and 12 malignant histopathologically verified brain neoplasms and 1 infectious lesion. In 78% of the cases, the cytologic diagnosis was concordant with the histologic diagnosis provided adequate sample was obtained. In 17 benign tumors, the diagnostic rate was 87% ; the diagnostic accuracy for 12 malignant CNS tumors was 63% cytologically. In almost all cases, differentiation of non-neoplastic lesion from neoplastic one and that of benign tumors from malignant ones were possible. Most discordance stemmed from failure to distinguish different types of malignant tumors. In meningioma, neurilemmoma, pituitary adenoma, and medulloblastoma, cytologic diagnostic accuracy was high, but germinoma, malignant ependymoma, and hemangioblastoma were difficult to diagnose by cytology alone.
ABSTRACT
Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.
ABSTRACT
Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.
ABSTRACT
Nowday, ionizing radiation is one of the methods eradicating the uterine cervical malignancy. However radiation alone or in combination with surgery have an effect on normal tissue as well as the malignant cells, and their changes have been well described in other countries. Unfortunately, the history of radiation modality for cancer treatment is relatively short and the reports about radiation induced changes are limited in our country. We evaluated the radiation-induced changes in cervico-vaginal smears of 107 uterine cervical cancer patients obtained from March, 1985 to October, 1987. Most patients had been received 5,400 Rads of external radiation and intracavitary radiation. Patient's age ranged from 30 to 67 years old. Of 107 cases, 24 cases were normal, 72 cases showed benign radiation changes, 7 cases revealed radiation dysplasia, and residual and recurrent carcinomas found in one and 3 cases, respectively. Cytoplasmic and nuclear enlargement were the most common and noted in 57 and 38 cases, respectively. Vacuolization and polychromasia of the cytoplasm were identified in 43 and 30 cases, respectively. The most common histiocytic change was multinucleation, which was found in about one third. The radiation changes of the cytoplasm and nuclear enlargement persisted for a long time after completion of radiation, however, nuclear degeneration and multinucleation gradually disappeared after 6 months. The inflammation in background prolonged for a long time but degeneration disappeared after 6 months. The biologic significance of post-radiation dysplasia could not evaluated because of short follow up period.
ABSTRACT
This is a report of the clinico-pathologic findings in six cases of histologically verified malignant meningiomas-three hemangiopericytic and three anaplastic types. They were three males and three females and two of them were reoperated for recurrence. The hemangiopericytic types had similar angiographic and macroscopic features and malignant characteristics such as increased mitoses. The anaplastic types lacked typical arrangement, but had a large number of mitoses, increased cellularity, focal necrosis, pleomorphism, anaplasia, and the adjacent normal parenchymal infiltration. However the metastasis was not yet proven in these cases.
Subject(s)
Female , Male , Humans , Neoplasm MetastasisABSTRACT
Nowday, ionizing radiation is one of the methods eradicating the uterine cervical malignancy. However radiation alone or in combination with surgery have an effect on normal tissue as well as the malignant cells, and their changes have been well described in other countries. Unfortunately, the history of radiation modality for cancer treatment is relatively short and the reports about radiation induced changes are limited in our country. We evaluated the radiation-induced changes in cervico-vaginal smears of 107 uterine cervical cancer patients obtained from March, 1985 to October, 1987. Most patients had been received 5,400 Rads of external radiation and intracavitary radiation. Patient's age ranged from 30 to 67 years old. Of 107 cases, 24 cases were normal, 72 cases showed benign radiation changes, 7 cases revealed radiation dysplasia, and residual and recurrent carcinomas found in one and 3 cases, respectively. Cytoplasmic and nuclear enlargement were the most common and noted in 57 and 38 cases, respectively. Vacuolization and polychromasia of the cytoplasm were identified in 43 and 30 cases, respectively. The most common histiocytic change was multinucleation, which was found in about one third. The radiation changes of the cytoplasm and nuclear enlargement persisted for a long time after completion of radiation, however, nuclear degeneration and multinucleation gradually disappeared after 6 months. The inflammation in background prolonged for a long time but degeneration disappeared after 6 months. The biologic significance of post-radiation dysplasia could not evaluated because of short follow up period.
ABSTRACT
This is a report of the clinico-pathologic findings in six cases of histologically verified malignant meningiomas-three hemangiopericytic and three anaplastic types. They were three males and three females and two of them were reoperated for recurrence. The hemangiopericytic types had similar angiographic and macroscopic features and malignant characteristics such as increased mitoses. The anaplastic types lacked typical arrangement, but had a large number of mitoses, increased cellularity, focal necrosis, pleomorphism, anaplasia, and the adjacent normal parenchymal infiltration. However the metastasis was not yet proven in these cases.
Subject(s)
Female , Male , Humans , Neoplasm MetastasisABSTRACT
Fabry's disease is a rare hereditary metabolic disease caused by alpha-galactosidase deficiency, resulting in abnormal accumulation of galactosyl galactosyl galactosyl ceramide (ceramide trihexoside) in various organs. Articles in English reported approximately one hundred cases but only two cases in Korea. Recently the authors experienced a case of Fabry's disease of a male patient and studied the electronmicroscopy on skin biopsied tissue and enzyme assay of alpha -galactosidase activity in his peripheral blood leukocytes. The male patient was a 21-year-old soldier who suffered from anhidrosis with heat intolerance and generalized telangietatic papules (Angiokeratoma corporis diffusum) since childhood. Other clinical findings were ocular change, paroxysmal pain of lower extremities and proteinuria with oval fat bodies on urinalysis. The ultrastructural study of skin demonstrated abnormal lysosomal deposits of finger-prints or "zebra" body configuration in the endothelial cells, pericytes, perineural cells and intercalated ductal epithelium of sweat glands. Enzyme activity of alpha-galactosidase was markedly decreased in the peripheral blood leukocytes comparing to the normal control, which was conclusive to make a diagnosis of Fabry's disease.
Subject(s)
Child , Male , Female , HumansABSTRACT
Fabry's disease is a rare hereditary metabolic disease caused by alpha-galactosidase deficiency, resulting in abnormal accumulation of galactosyl galactosyl galactosyl ceramide (ceramide trihexoside) in various organs. Articles in English reported approximately one hundred cases but only two cases in Korea. Recently the authors experienced a case of Fabry's disease of a male patient and studied the electronmicroscopy on skin biopsied tissue and enzyme assay of alpha -galactosidase activity in his peripheral blood leukocytes. The male patient was a 21-year-old soldier who suffered from anhidrosis with heat intolerance and generalized telangietatic papules (Angiokeratoma corporis diffusum) since childhood. Other clinical findings were ocular change, paroxysmal pain of lower extremities and proteinuria with oval fat bodies on urinalysis. The ultrastructural study of skin demonstrated abnormal lysosomal deposits of finger-prints or "zebra" body configuration in the endothelial cells, pericytes, perineural cells and intercalated ductal epithelium of sweat glands. Enzyme activity of alpha-galactosidase was markedly decreased in the peripheral blood leukocytes comparing to the normal control, which was conclusive to make a diagnosis of Fabry's disease.
Subject(s)
Child , Male , Female , HumansABSTRACT
Nucleolar organizer regions (NORs) are loops of DNA which occur in the nucleoli of cells and which possess ribosomal RNA (rRNA) genes. The numbers and/or configurations of NORs have been thought to be related to cellular activities. To assess the applicability of NORs associated protein (Ag-NORs) in the field of diagnostic histopathology, a silver staining was done in paraffin sections of malignant lymphomas, tonsils and reactive lymph nodes and the numbers of Ag-NORs in the nuclei of low-grade and those of high-grade lymphomas were compared. A significant difference was found between the numbers of Ag-NORs in the nuclei of low-grade lymphoma (a mean of 1.3 per nucleus) and those of high-grade lymphomas (a mean of 4.2 to 8.3 per nucleus). The Ag-NORs were often observed in nuclei in areas where nucleoli themselves were not visible in H and E stain. It is suggested that this method would be of great value in the field of tumor histopathology.
Subject(s)
Humans , Histological Techniques , Korea , Lymphoma, Non-Hodgkin/ethnology , Nucleolus Organizer Region/pathology , Silver , Staining and LabelingABSTRACT
Nucleolar organizer regions (NORs) are loops of DNA which occur in the nucleoli of cells and which possess ribosomal RNA (rRNA) genes. The numbers and/or configurations of NORs have been thought to be related to cellular activities. To assess the applicability of NORs associated protein (Ag-NORs) in the field of diagnostic histopathology, a silver staining was done in paraffin sections of malignant lymphomas, tonsils and reactive lymph nodes and the numbers of Ag-NORs in the nuclei of low-grade and those of high-grade lymphomas were compared. A significant difference was found between the numbers of Ag-NORs in the nuclei of low-grade lymphoma (a mean of 1.3 per nucleus) and those of high-grade lymphomas (a mean of 4.2 to 8.3 per nucleus). The Ag-NORs were often observed in nuclei in areas where nucleoli themselves were not visible in H and E stain. It is suggested that this method would be of great value in the field of tumor histopathology.
Subject(s)
Humans , Histological Techniques , Korea , Lymphoma, Non-Hodgkin/ethnology , Nucleolus Organizer Region/pathology , Silver , Staining and LabelingABSTRACT
Cytokeratins are a family of polypeptides of intermediate filaments which in diverse epithelia are expressed in diffeent, yet specific combinations. To evaluate the diagnostic value of keratin, immunohistochemical staining was done in formalin-fixed, paraffin-embedded normal and neoplastic tissues by PAP and StreptABC methods. The antiserum for cytokeratin in monoclonal antibody which gives the specificity for 40, 46, 50, 52, 56, 58, and 65-67 Kd keratin classes. The results are as follows: 1) The staining was positive for cytokeratin in all of the squamous epithelium, ductular epithelial cells of various glands, respiratory and urinary tract epithelium, and mesothelial cells. 2) No staining for cytokeratin was ovserved in respiratory alveolar epithelium, acinar cells of various glands, renal glomeruli, hepatocytes, and many mesoderm-derived tissues such as muscle, hematopoieitc and lymphoid tissues, nerve, bone, cartilage, and fibroblasts. 3) Squamous cell carcinomas, transitional cell carcinomas, mesotheliomas, and some of the adenocarcinomas (stomach, colon, uterine cervix, biliary tract and breast) exhibited positive staining for cytokeratin. Epithelial cells of thymoma, adenomatoid tumor, plemorphic adenoma of salivary gland, papillary carcinoma of thyroid, lymphoepithelioma, and craniopharyngioma were also positive. 4) Some of the adenocarcinomas (prostate and pancreas), renal cell carcinoma, ovarian stromal and germ cell tumors, hepatocellular carcinoma, malignant melanoma, and mesoderm-derived tumors including malignant lymphoma were uniformly negative for staining. 5) From the above results, the immunohistochemical study in paraffin-embedded tissues using monoclonal antibody for cyto keratin may be useful to differentiate various tumors, especially in differential of hepatocellular carcinoma from bile duct adenocarcinoma, lymphoepithelioma and other undifferentiated carcinomas from lymphoma, thymoma from lymphoma, and squamous cell carcinoma from melanoma. It will be helpful in the diagnosis of transitional cell carcinoma in which the differentiation from renal cell carcinoma and prostatic adenocarcinoma be difficult.
Subject(s)
Adenocarcinoma , Adenoma , Carcinoma, HepatocellularABSTRACT
Blood group isoantigens (BGS) A, B and H comprise a group of carbohydrate cell surface markers found not only on the erythrocytes but in wide variety of epithelial cells and body fluid on 80% of the human population. There has been increasing interest in the changes in blood group A, B and H antigen expression in various epithelial malignancies. These changes included deletion of A, B determinants, accumulation of precursor substances, increment or neosynthesis of imcomplete blood group antigens and synthesis of sialylated substances bearing blood group carbohydrate chains. Also these changes have been explained as an evidence of immunologic dedifferentiation analogous to the morphologic dedifferenctiation of anaplasia. isoantigens may be altered in epithelial tissues that show repair and regeneration, metaplastic changes and dysplasia. We studied that the changes of blood group isoantigens A, B and H in 30 cases of adenocarcinoma of the colon, 27 cases of adjacent mucosa and 19 cases of metastatic lymph nodes by immunohistochemical study. In ascending, transverse and rectosigmoid colon, the blood group isoantigens A, B and H are positive in 57.1%, 0% and 57.1% of adenocarcinomas and 100%, 50% and 0% in adjacent mucosae, respectively. In ascending colon,the frequency of the metastasis and recurrences in Blood group isoantigen positive and negative cases are 75% and 66.6% and in rectosigmoid colon, those are 50.5% and 90.0%, respectively. In tumors of the ascending colon, there was no significant correlation between antigen content and frequency of metastasis. However, the cancer of the rectosigmoid colon with bloodgroup isoantigen positive were associated with a lower frequency of metastasis than those without blood group isoantigen. (p=0.045). The data suggests that the immunohistochemical studies of blood group isoantigen may be of value in estimating the clinical behavior of certain colon carcinoma.