Synchronous Multiple Primary Malignant Neoplasm Involving the Uterine Endometrium and Ovary / 대한산부인과학회잡지

Multiple primary malignant neoplasm means that more than 2 cancers are independently developed in one individual. In general, the neoplasms are diagnosed simultaneously or within 6 month interval. Simultaneous presentation of carcinomas involving ovary and uterus is not a common event and presents a diagnostic dilemma when they are of the same histology. We experienced a rare case of multiple primary malignant neoplasm involving the uterine endometrium and the ovary synchronously. Thus we report this case with a review of literatures.

A Case of Pseudomyxoma Peritonei with Primary Borderline Mucinous Tumors of the Ovary and Appendix / 대한산부인과학회잡지

Pseudomyxoma peritonei is a poorly understood condition characterized by mucinous ascites and multifocal peritoneal mucinous tumors. Pseudomyxoma peritonei is most commonly associated with mucinous tumors of the ovary and appendix. When two lesions are morphologically similar, it is difficult to determine whether one reflects a metastasis or whether the tumors are independent. Many studies concluded that most cases in which both the appendix and ovary were involved were primary appendiceal tumor with secondary involvement of the ovary, but we have experienced one case of pseudomyxoma peritonei originated from independent primary borderline mucinous tumors of the ovary and appendix. So we report this case with the brief review of literatures

Expression of Sialosyl Tn Mucin Antigen in Gastric Adenocarcinoma and Its Relationship with Prognostic Factors

Sialosyl Tn mucin antigen (STn) is a carbohydrate antigen of tumor associated mucin formed by the premature 2~6 sialation of N-acetylgalactosamine. STn has been expressed in several tumor types and showed prognostic significance in colonic carcinoma. The authors evaluated the expression of STn immunohistochemically and correlated its expression with clinicopathologic variables in 100 gastric cancers. In early gastric cancer, STn was expressed in 24 cases out of 50 cases (48%). In advanced gastric cancer, STn was expressed in 48 of 50 (96%). The difference in STn expression between advanced gastric cancer and early gastric cancer was statistically significant. The difference in STn expression between tumors with lymph node metastasis and those without lymph node metastasis, between tubular adenocarcinoma and signet ring cell carcinoma, and between intestinal type and diffuse type adenocarcinoma was statistically insignificant in early or advanced gastric adenocarcinoma. These results suggest that the STn expression plays a role in the tumor progression in both early and advanced gastric adenocarcinomas.

Gastrointestinal Polyposis in Koreans: A Nationwide Survey of Clinicopathologic Analysis of 112 Surgically Resected Cases

Gastrointestinal polyposis (GIP) is a rare disease characterized by formation of the numerous polyps in the gastrointestinal tract and presenting several extraintestinal manifestations. Most of the diseases are transmitted in an autosomal dominant pattern. In Korea, the epidemiological study as well as the pathological analysis of the GIP is not well established. We therefore analysed 38 items of GIP using surgically resected specimens. The materials in this study were collected from the 12 institutions and case reports in Korean literature between 1980 and 1991. The clinicopathologic findings were reevaluated by several members of the study group for gastrointestinal pathology. The results are as follows: (1) A total of 112 cases were included in this study: 83 cases were collected from 12 institutions and 29 cases were collected from Korean literature. The cases were classified as familial adenomatous polyposis (FAP), 59 cases; Gardner's syndrome, 3 cases; juvenile polyposis, 12 cases; Peutz-Jeghers syndrome, 35 cases; multiple colonic adenomas, 3 cases. (2) Among 59 cases of FAP, the range of age at operation was 14 to 61 years, and a family history was positive in 25 cases. The number of polyps in colorectum was 100~8,000. Of the 37 cases in which the examination of polyp density was available, 16 cases (43%) showed the highest density in the rectum and the sigmoid colon. The carcinomatous change within polyp(s) was present in 18 cases (31%), and associated advanced single or multiple colonic carcinomas existed in 37 cases (63%). Twenty-six (45%) tumors out of total 58 carcinomas were in the rectum. Twenty-five patients were evaluated for the upper gastrointestinal lesions, and 11 patients (44%) had pathologic lesions; multiple fundic gland polyps in 3 cases (12%), gastric and duodenal adenomas in 2 cases (8%), gastric adenomas in 2 cases (8%), duodenal adenomas in 2 cases (8%), gastric carcinoma and adenoma in 1 case (4%), gastric carcinoma in 1 case (4%). (3) Among 3 cases of Gardner's syndrome, the range of age at operation was 25 to 31 years, a family history was identified in 2 cases. One case was associated with an advanced colonic carcinoma and carcinomatous change within polyp. Extra gastrointestinal lesions were sebaceous cyst, epidermal cyst, osteoma and desmoid tumor. (4) Among 12 juvenile polyposis, the range of age at operation was 8 to 51 years and 5 patients had a family history. The carcinomatous change within polyp was found in 2 cases (17%) and associated advanced colonic carcinoma was in 4 cases (33%). The associated different type of polyps was tubular adenomas in 9 cases (75%), hyperplastic polyps in 4 cases (33%) and villous adenomas in 2 cases (17%). (5) Among 35 Peutz-Jeghers syndrome, the range of age at first operation was 6 to 42 years, family history was positive in 11 cases. The carcinomatous change within polyp was found in 1 case (3%), and associated advanced colonic carcinoma in 1 case (3%). The epithelial misplacement was observed in 4 cases (11%), and tubular or villous adenomatous feature in 4 cases (11%). In summary, the most frequent GIP for the surgical resection in Korea is FAP and the FAP is associated with high incidence of coexisting advanced and intramucosal carcinomas. Hamartomatous polyposis syndromes, such as juvenile polyposis and Peutz-Jeghers syndrome are another frequent disease for the surgical resection and are also associated with an increased risk of cancer.

Comparison of Distribution of Fibronectin and Fibrinogen in Placenta between Normotensive and Preeclamptic Pregnancies / 대한산부인과학회잡지

In order to find out the distribution of fibronectin and fibrinogen in placenta among pregnancy induced hypertensive (PIH) patients, 6 normotensive pregnancies and 17 PIH patients were chosen. The placentas were obtained right after delivery and soaked in the 10% formalin solution. The score was measured in terms of the positiveness of the stain in immunohistochemical stain by using I antibody with the rabbit antihuman fibronectin and the rabbit anti-human fibrinogen. Comparison between two groups are as following: 1.The placenta of PIH patients showed significantly reduced positiveness of fibronectin in their fetal villous vessels and villous stroma. 2. In the PIH patients, the positiveness was reduced in the group giving the birth to intrauterine fetal growth retardation compared to giving birth to normal baby. 3. In both normotensive and PIH patients, the villous basement membrane did not show the staining response to fibronectin, while showing heavy staining response to fibrinogen. 4. The positiveness of fibrinogen in fetal vessels, villous basement membrane, intervillous space and stroma were almost same in both normotensive and PIH patients. From above results, we can conclude that there is abnormality in the distribution of fibronectin especially in the fetal vessels and the villous stroma of placenta among PIH patients. The cause of this result needs further study.

Roentgenogram of the Issue: Osteolytic Bone Lesion of the Rib / 결핵

A 29-year-old male patient was admitted due to subacute onset of right chest pain. He had no history of trauma, chest surgery or other medical disease. Chest roentgenogram showed an expansile, radiolucent lesion on the posterior segment of right seventh rib. Computed tomogram of the chest also showed lytic expansile mass with septation. He took an en-bloc resection of the involved rib. Pathologically there were multiple cystic spaces, filled with blood and collagenofibrous tissue proliferation and locally areas of new bone formation and giant cells of osteoclastic type, which was compatible with aneurysmal bone cyst. We report a case of aneurysmal bone cyst of the rib with a brief review of literature.

Intraosseus leiomymoma : A Case Report

We report a rare case of expansile leiomyoma arising from the ilium of a 12-year-old girl. A plain radiographand CT both showed a lesion consisting of a well-defined area of expansile soft tissue mass with a thin scleroticrim and septae, surrounded by thin overlying cortex. MRI revealed a well-defined area of inhomogeneously higher signal intensity than that of surrounding muscle but of similar signal intensity than that of the red marrow of the opposite ilium on proton and T2W1. Inhomogeneous but intense enhancement was noted on Gd-enhanced T1W1. Angiography revealed hypervascularity and tumor staining. Microscopic examination on immunochemical staining with actin revealed a spindle cell tumor supporting the smooth muscle cell origin of the mass.

The Study of Histopathologic Grade, PCNA and AgNORs Staining in the Recurrent Urinary Bladder Cancer

The prognosis of transitional cell carcinoma(TCC) of the urinary bladder is related to histopathologic parameters, among which the clinical stage and histopathologic grade are most important prognostic determiantors. Recently the immunohistochemical assessment of proliferating cell nuclear antigen(PCNA) and nucleolar organizer region number(AgNORs) can obtain the PCNA, and AgNORs stainings were studied in 55 the sequential biopsies of 22 recurrent TCCs of the urinary bladder. 6 cases showed the increased changes of grade, of which 5 cases was independently to the change of grade. The AgNORs in 18 cases showed increase in 10 cases. The comparison between PCNA count and AgNORs score according to grade was performed in the changes between grade II and III, both PCNA count and AgNORs score were increased with in crease of grade. However, The change of the PCNA count was stastically significant, but not AgNORs score.

Fine Needle Aspiration Cytology of Subacute Necrotizing Lymphadenitis: Three Cases Report / 대한세포병리학회지

Three cases of subacute necrotizing lymphadenitis diagnosed by fine needle aspiration(FNA) of enlarged lymph nodes are reported. The FNA smears contained randomly activated lymphoid cells, necrotic debris and histiocytes. The same patterns were found in subsequently examined excised lymph nodes from these cases. The differential diagnosis of this entity is discussed and the value of preparing FNA cell blocks and accompanying AFB stain with culture is emphasized.