Remission of intestinal Behcet's disease treated with anti-tumor necrosis factor alpha monoclonal antibody (Infliximab)

Behcet's disease (BD) is a chronic relapsing multisystem disease characterized by oral ulceration, genital ulceration and ocular lesions. Gastrointestinal involvement is rare, often difficult to treat and associated with a high mortality rate. We treated a 47-year-old Korean man with BD who had a recurrent intestinal ulcer with tumor necrosis factor alpha antibody (infliximab); he initially underwent right hemicolectomy due to uncontrolled intestinal bleeding. For patients with intestinal BD who fail to respond to conventional treatment, infliximab may be a safe and effective new therapeutic option.

A case of perivascular epithelioid cell tumor (PEComa) arising in the colon / 대한내과학회지

Perivascular epithelioid cell tumor (PEComa) is a rare family of related mesenchymal neoplasms that include angiomyolipoma, lymphangiomyomatosis and clear cell 'sugar' tumor of the lung. Although this type of tumor has been described in the literature in organs such as kidney, lung, uterus and urinary bladder, there are few reports of gastrointestinal tract-related tumor. We report here on a case of PEComa arising in the transverse colon. This occurred in a 41-year-old male who had no history of tuberous sclerosis complex. Histopathologically, the tumor consisted of nests or sheets of epithelioid cells with eosinophilic cytoplasm. The tumor cells were positive for HMB-45, vimentin and caldesmon, but they were negative for S-100 protein, cytokeratin and CD117, according to immunohistochemical staining. Careful follow up is warranted because the biological behavior of PEComa has not yet been documented. We present here a case of colonic PEComa that was confirmed by immunohistochemical staining and the histopathologic findings, and we include a review of the literature.

Detection of Cyclin D1 Protein in Inflammation, Dysplasia and Carcinoma of the Laryngeal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cyclin D1 is one of the proteins regulating G1-S transition in the cell cycle and is considered to play an important role in subsequent mitotic division. So it is a candidate of a proto-oncogene implicated in the pathogenesis of several human tumor types, including laryngeal squamous cell carcinomas. The purpose of this study was to investigate the development of tumorigenesis and clinicopathologic means of cyclin D1 protein in squamous cell carcinoma of the larynx. SUBJECTS AND METHOD: Sixty two patients, who have been treated with benign lesion (keratosis and chronic inflammation), dysplasia or squamous cell carcinoma of the larynx from March 1994 to December 1996 were investigated for this purpose. cyclin D1 protein was detected by immunohistochemical technique in the paraffin embedded tissues. RESULTS: The expression of cyclin D1 protein was detected in 6 out of 11 cases (54.5%) in benign lesion, 3 out of 5 cases (60.0%) in mild to moderate dysplasia, 12 out of 18 cases (66.7%) in severe dysplasia and carcinoma in situ, and 36 out of 44 cases (81.8%) in invasive squamous cell carcinoma of the larynx. Of these, the expression of cyclin D1 protein in invasive squamous cell carcinoma was the highest positive rate, and there was significant difference (p0.05). CONCLUSION: Cyclin D1 protein may be considered to play an important role in the development of the tumorigenesis in invasive squamous cell carcinoma of the larynx.

Fine Needle Aspiration Cytology of Alveolar Soft Part Sarcoma: A Case Report / 대한세포병리학회지

Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma, which occurs predominantly in adolescents and young adults. The cytological characteristics of this condition have been described only rarely in the literature. Here, we report a case of alveolar soft part sarcoma. A 28-year-old man presented with a mass in his right buttock, which had persisted for three years. The mass was subjected to a fine needle aspiration cytology (FNAC). The smears were cellular. The observed tumor cells were round or polygonal, and exhibited vesicular nuclei with prominent nucleoli and finely granular cytoplasm. Naked nuclei were frequently detected. Tumor cells were arranged singularly, but occasionally in a pseudoalveolar pattern.

Gene Promoter Hypermethylation in Tumors and Plasma of Breast Cancer Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To measure the hypermethylation of four genes in primary tumors and paired plasma samples to determine the feasibility of gene promoter hypermethylation markers for detecting breast cancer in the plasma. MATERIALS AND METHODS: DNA was extracted from the tumor tissues and peripheral blood plasma of 34 patients with invasive breast cancer, and the samples examined for aberrant hypermethylation in cyclin D2, retinoic acid receptor beta (RARbeta), twist and high in normal-1 (HIN-1) genes using methylation-specific PCR (MSP), and the results correlated with the clinicopathological parameters. RESULTS: Promoter hypermethylation was detected at high frequency in the primary tumors for cyclin D2 (53%), RARbeta (56%), twist (41%) and HIN-1 (77%). Thirty-three of the 34 (97%) primary tumors displayed promoter hypermethylation in at least one of the genes examined. The corresponding plasma samples showed hyperme thylation of the same genes, although at lower frequencies (6% for cyclin D2, 16% for RARbeta, 36% for twist, and 54% for HIN-1). Overall, 22 of the 33 (67%) primary tumors with hypermethylation of at least one of the four genes also had abnormally hypermethylated DNA in their matched plasma samples. No significant relationship was recognized between any of the clinical or pathological parameters (tumor size, axillary lymph node metastasis, stage, or Ki-67 labeling index) with the frequency of hypermethylated DNA in the primary tumor or plasma. CONCLUSION: The detection of aberrant promoter hypermethylation of cancer-related genes in the plasma may be a useful tool for the detection of breast cancer.

Cribriform-Morular Variant of Papillary Thyroid Carcinoma: A Report of Two Cases

Cribriform-morular variant of papillary thyroid carcinoma is an unusual and peculiar subtype of papillary thyroid carcinomas. It occurs both sporadically and in association with familial adenomatous polyposis. We report here on two cases of cribriform-morular variant of papillary thyroid carcinoma in a 33-year-old woman and in a 21-year-old woman. On gross examination, both cases were multicentric. The first case showed two well-encapsulated yellow solid masses in the right (2.0 cm) and the left lobes of the thyroid gland (0.5 cm). The second case showed four well-encapsulated gray-white solid lobulating masses and nodules in the right (4.5 and 1.2 cm) and the left lobes (1.1 and 0.8 cm) of the thyroid gland. Microscopically, both cases exhibited an intricate blending of papillary, cribriform, trabecular, spindle, and solid patterns of growth with morular areas. Typical nuclear features of papillary carcinomas were focally seen. Immunohistochemically, the tumor cells were positive for thyroglobulin, thyroid transcription factor-1 (TTF-1), and beta-catenin, but were negative for calcitonin.

Multiple primary lung cancer: Synchronous small cell lung carcinoma and squamous cell carcinoma / 대한내과학회지

No abstract available.

Synovial Sarcoma with Massive Myxoid Feature: A Case Report

Focal myxoid change in synovial sarcoma is not uncommon, although the presence of predominantly myxoid stroma is very rare. Recognition of synovial sarcomas with massive myxoid feature is important because these can easily be mistaken for other myxoid soft tissue neoplasms. We report a case of a synovial sarcoma with massive myxoid feature in the left thigh of a 54-year-old woman. Wide excision of an 8.5*7.0*5.0 cm, well-circumscribed and lobulated tumor was performed. The cut surface was gray, soft, and myxoid. Histological examination showed proliferation of spindle cells in the predominantly myxoid stroma. There were small areas with features more typical of synovial sarcoma, including uniform, spindled cells with fascicular growth patterns, collagenous stroma, mast cell infiltration, and hemangiopericytoma-like vascular patterns. Immunohistochemical examination showed focal positivity of the tumor cells for epithelial membrane antigen (EMA). Tumor cells were all negative for cytokeratin (AE1/AE3), cytokeratin 7, S-100 protein, smooth muscle actin, and desmin. Ultrastructurally, tumor cells showed desmosomes and microvilli. Our case underscores that, in order to make a correct diagnosis, immunohistochemical and ultrastructural examination is essential.

Imprint Cytologic Features of Epithelioid Sarcoma: A Case Report / 대한세포병리학회지

Epithelioid sarcoma is a malignant soft tissue neoplasm with an uncertain histogenesis. We report the imprint cytologic features of epithelioid sarcoma in the left shoulder of a 29-year-old male patient. Imprint cytologic findings showed dissociated and loose aggregates of anaplastic epithelioid cells on the necrotic, bloody, and inflammatory background. Tumor cells were round to polygonal shaped. Tumor cells had vesicular nuclei with abundant cytoplasm. The nuclei were irregular in shape and often eccentrically located. Some tumor cells were oval to spindle shaped. Binucleated and multinucleated cells were found. Intracytoplasmic vacuoles were present. On immunohistochemical stain, the tumor cells were positive for epithelial membrane antigen, vimentin, and CD34.

A Case of Coexistent Lichen Sclerosus et Atrophicus and Morphea / 영남의대학술지

Cases of coexistent lichen sclerosus et artrophicus and morphea have been reported. It is controversial that both diseases are single disease-spectrum or entirely separated. We encounterd a forty five year old female with a hypopigmented firm plaque on the left neck. Its histologic feature showed compact orthokeratosis, follicular plugging, atrophy of the stratum malpighii with vacuolar alteration of basal layer, and homogenization of the collagen in the upper dermis (lichen sclerosus et atrophicus). Increased thick collagen bundles were seen in the lower dermis (morphea).

Correlation Between Expression of p53, Bcl-2 Protein and Ki-67 Labelling Index and Lymph Node Metastasis in Early Gastric Cancer

BACKGROUND: The purpose of this study was to investigate the difference of cliniopathological variables and p53, bcl-2, and Ki-67 labelling index between early gastric cancer with and without lymph node metastasis. METHODS: The authors analyzed thirty patients who had early gastric cancer confined to submucosa (sm cancer) without lymph node metastasis and thirty patients who had sm cancer with lymph node metastasis. The expression of p53 protein, bcl-2 protein and Ki-67 labelling index were evaluated by immunohistochemistry. RESULTS: No significant correlation was found between lymph node metastasis and age, sex, tumor size, Lauren classification, histologic grade, and venous invasion. But lymphatic invasion was significantly correlated to lymph node metastasis (p<0.01). The p53 positive rate was 73.3% (22/30) and 66.7% (20/30) in sm cancer with and without lymph node metastatsis, respectively. The bcl-2 positive rate was 40.0% (12/30) and 30.0% (9/30) in sm cancer with and without lymph node metastasis, respectively. The Ki-67 labelling index (%) was 63.9+/-15.3 and 61.4+/-12.8 in sm cancer with and without lymph node metastasis, respectively. The lymph node metastasis was not significantly correlated to expression of p53 protein, bcl-2 protein or Ki-67 labelling index. CONCLUSIONS: Expression of p53, bcl-2 protein and proliferative activity of sm cancer may not influence lymph node metastasis. Lymphatic invasion is a significant predictor of lymph node metastasis.

Choroid Plexus Carcinoma: A Report of Two Cases

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.

Two Cases of Advanced Ovarian Serous Tumor of Borderline Malignancy / 대한부인종양콜포스코피학회잡지

Ovarian serous tumors of low malignant potential (borderline serous tumors) are intermediate in their clinical behavior between benign serous cystadenoma and malignant neoplasm, and are associated with 10 year survival rates in excess of 90%. Borderline ovarian serous tumors are characterized by absence of stromal invasion but presence of some characteristics of malignancy. Borderline ovarian tumors occur predominantly in premenopausal women, and associated with a very good prognosis. The principal treatment of borderline malignancy is surgical resection of the primary tumor. But approximatley 20% of patients with ovarian tumors of low malignant potential present with Stage III or IV disease at the time of diagnosis. The benefit of postsurgical therapy in this group of patients has not been well established. We report two cases of advanced ovarian serous borderline tumor, one of which was treated with 3 cycles of cisplatin-taxol chemotherpy.

Clinical Characteristics and Abnormal p53 Expression of Lung Cancer Associated with Multiple Primary Cancer / 결핵

BACKGROUND: Nearly 10% of cancer patients will develop a second primary cancer within ten years after surgical removal of the primary tumor. The detection of risk factors for developing multiple primary tumors would be important. This study was conducted to evaluate the clinical characteristics and abnormal p53 expression of lung cancer associated with multiple primary cancer(MPC). METHOD: Clinical characteristics and abnormal p53 expression were compared between 20 cases of lung cancer(NSCLC; 16 cases, SCLC; 4 cases) associated with MPC and 26 cases of primary non-small cell lung cancer. RESULT: MPC associated with lung cancer was gastric cancer(8), lung cancer(2), esophageal cancer(2), colon cancer(2), laryngeal cancer(1), bladder cancer(1), small bowel cancer(1), adrenal cancer(1), hepatocellular carcinoma(1), and breast cancer(1), in order. The clinical stage of primary NSCLC was relatively advanced, but NSCLC associated with MPC was even distribution at each stage. The detected incidences of abnormal p53 expressions were 62.5% in NSCLC associated with MPC and 76.9% in primary NSCLC(p>0.05). CONCLUSION: There was no difference in abnormal p53 expression between non-small cell carcinoma associated with multiple primary cancer and primary non-small cell carcinoma.

Comprison of p53 Mutation in Non Small Cell Lung Cancer between Young patients and Old Patients / 결핵

BACKGROUND: Lung cancer in younger patients seems to be a more aggressive disease and their prognosis may be worse than that of older patients. Abnormal p53 expression in primary lung cancer may be an independent prognostic factor for poor prognosis. This study was conducted to determine the difference of abnormal p53 mutation in patients with primary non-small cell lung cancer (NSCLC) under 45 years of age and 55 years old or greater. METHOD: The present study was performed to compare the clinical and pathological features of primary NSCLC between patients younger than 45 years old and older than 55 years old and to evaluate the difference of abnormal p53 mutation between two groups. Immunohistochemical detection of abnormal p53 mutation was assessed in all primary NSCLC specimens by pathologist. RESULTS: Positive nuclear staining of p53 mutation was found in 76.0% of younger patients and in 76.9% of older patients with variable intensity of staining. And there was no significant coorelation between abnormal p53 mutation according to the disease stage or histologic subtype. CONCLUSION: In this investigation, these were no difference in p53 mutation between two groups.

Comprison of p53 Mutation in Non Small Cell Lung Cancer between Young patients and Old Patients / 결핵

BACKGROUND: Lung cancer in younger patients seems to be a more aggressive disease and their prognosis may be worse than that of older patients. Abnormal p53 expression in primary lung cancer may be an independent prognostic factor for poor prognosis. This study was conducted to determine the difference of abnormal p53 mutation in patients with primary non-small cell lung cancer (NSCLC) under 45 years of age and 55 years old or greater. METHOD: The present study was performed to compare the clinical and pathological features of primary NSCLC between patients younger than 45 years old and older than 55 years old and to evaluate the difference of abnormal p53 mutation between two groups. Immunohistochemical detection of abnormal p53 mutation was assessed in all primary NSCLC specimens by pathologist. RESULTS: Positive nuclear staining of p53 mutation was found in 76.0% of younger patients and in 76.9% of older patients with variable intensity of staining. And there was no significant coorelation between abnormal p53 mutation according to the disease stage or histologic subtype. CONCLUSION: In this investigation, these were no difference in p53 mutation between two groups.

Expression of MIB-1 in Endometrial Adenocarcinoma: Correlation with p53 Protein Expression and Histologic Prognostic Factors

The evaluation of the proliferative potential of malignant neoplasm is of major interest for predicting their biological behavior. MIB-1, a monoclonal antibody against the Ki-67 antigen, is a marker of cell proliferation, which is widely applied to human cancers recently. To assess the growth potential of uterine endometrial carcinoma, we performed immunohistochemical staining of MIB-1 in 34 cases of endometrial adenocarcinoma (endometroid type) from the paraffin sections. We evaluated its correlation with p53 overexpression and known prognostic factors including FIGO grade, nuclear grade, myometrial invasion, and estrogen and progesterone receptors. As a result, the MIB-1 labelling index was significantly correlated with FIGO grade, nuclear grade and myometrial invasion (p<0.05) and there was no significant correlation between MIB-1, ER or PR status. The expression of p53 protein showed significant correlation with FIGO grade and nuclear grade (p<0.05) and there was no significant correlation among p53 protein, myometrial invasion, ER and PR status. The MIB-1 labelling index revealed striking difference between p53 positive and p53 negative group (p<0.05). We concluded that MIB-1 labelling index is associated with poor prognostic parameter in endometrial adenocarcinoma, and may be a useful marker for predicting tumor of high grade and deep myometrial invasion, if MIB-1 labelling index is more than 50% and is accompanied by p53 overexpression.

DNA Sequencing of p53 Gene Mutation in Colorectal Carcinomas

Mutations in the p53 gene occur during the development of colorectal carcinomas, and play an important role in the conversion of adenoma into carcinoma. To detect the p53 gene mutation and its pattern of expression in colorectal carcinomas, polymerase chain reaction for exons 5, 6, 7, and 8, recombinant gene cloning, and automated DNA sequencing were performed with 30 fresh colorectal carcinomas. Each tissue was also analyzed by immunohistochemical staining for p53 protein. p53 protein was detected in 25 of 30 (83.3%) colorectal carcinomas by immunohistochemical study. p53 mutation was detected in 4 of 30 (13.3%) colorectal carcinomas. The distribution of these mutations among these exons investigated was as follows: Three mutations in exon 5 (66.7%) and 1 mutation in exon 7 (33.3%). One case with mutation in exon 5 had mutations at three different codons. Mutations in exon 5 were found at codon 153 (GGG to AGG: Gly to Arg), 170 (TGC to GGC: Cys to Gly), 186 (CTA to TTA: silent mutation), 158 (GCG to ACG: Ala to Thr), and 176 (ACG to ATG: Thr to Met). Mutation in exon 7 was found at codon 248 (AGG to AGA: silent mutation). Four of them were missense mutations. Two of 6 mutations were silent mutations. Five transition mutations and 1 transversion mutation were also detected. All cases with mutations by automated DNA sequencing showed positive p53 protein immunohistochemical stainining. In conclusion, p53 gene mutation was detected in 4 of 30 (13.3%) colorectal carcinomas, located in codon 153, 158, 170, 176, and 186 of exon 5 and codon 248 of exon 7. Further studies are needed to evaluate the significance of the codon 153 mutation which was not recognized in other studies on colorectal carcinomas.

Carcinoma Showing Thymus-Like Differentiation (CASTLE) of the Thyroid Gland: A case report

Carcinoma Showing Thymus-Like Differentiation (CASTLE) is a rare tumor, which occurs in the thyroid gland and surrounding soft tissue, or soft tissue of the neck. It is thought to originate from ectopic thymus or branchial pouch remnants. We report a case of CASTLE of the thyroid gland in a 42-year-old woman. Grossly, a nodular, partly well demarcated, grayish yellow, 3.0 2.0 cm sized, solid mass was found in the right thyroid gland. Microscopically, the tumor was divided into lobules of variable size and shape, nests and cords with thin and thick fibrous septa which were infiltrated by lymphocytes and plasma cells. The tumor cells were large, polygonal and had vesicular nuclei with prominent nucleoli and eosinophilic cytoplasm. Some cells, especially in the central portion of the nests had abundant eosinophilic cytoplasm and showed squamoid feature.

Fine Needle Aspiration Cytology of Pigmented Villonodular Synovitis: A Case Report / 대한세포병리학회지

Pigmented villonodular synovitis is a destructive, fibrohistiocytic proliferation producing innumerable villous and nodular synovial protrusions. Its common locations are knee, ankle, foot, and hip. Although histologic feature of this tumor is well known, there have been few reports on the fine needle aspiration cytology findings. We report the cytologic features of a biopsy-proven case of pigmented villonodular synovitis. The patient was a 21-year-old male with a mass of the right knee for 2 years. On fine needle aspiration cytology, the aspirates was composed of abundant mononuclear histiocytic cells, singly and in clusters, multinucleated giant cells, and hemosiderin pigments.