Peutz-Jeghers Syndrome with Multiple Genital Tract Tumors and Breast Cancer: A Case Report with a Review of Literatures

We report here on the multiple genital tract neoplasms in a 41-yr-old Korean woman with Peutz-Jeghers Syndrome (PJS). The patient presented with lower abdominal pain. Her previous medical history was PJS and breast cancer. Pelvic ultrasound showed a multilocular cyst at the right adnexal region, diagnosed as bilateral ovarian mucinous borderline tumors. An ovarian sex cord tumor with annular tubules was incidentally diagnosed together with a minimal deviation adenocarcinoma of the uterine cervix and mucinous metaplasia of both the Fallopian tubal mucosa and the endometrium. Although the cases of multiple genital tract tumors with PJS has rarely been reported, the present case appears to be the first in Korea in which the PJS syndrome was complicated by multiple genital tract tumors and infiltrating carcinoma of the breast. The clinical significance of the multiple genital tract tumors and breast cancer associated with PJS is reviewed.

Expression of Osteopontin and Clusterin in Transitional Cell Carcinoma of the Bladder: Comparison to the Pathologic Stage / 대한비뇨기과학회지

PURPOSE: This study was performed to evaluate the expressions of osteopontin (OPN) and clusterin in a transitional cell carcinoma (TCC) of the urinary bladder, and then compare their expression rates with the tumor invasiveness. MATERIALS AND METHODS: Twenty-five superficial and 25 invasive TCC were used for immunohistochemical staining. RESULTS: All 25 non-invasive TCC showed a strong positive reaction for OPN. Twenty of the invasive TCC showed a strong positive reaction for OPN, but 5 showed only a weak positive reaction. OPN expression was significantly decreased in the invasive TCC (p=0.02). Eighteen superficial TCC showed a weak positive reaction for clusterin, with 7 showing a negative reaction. Nine invasive TCC showed a strong positive reaction for clusterin, and 11 showed only a weak positive reaction. Five invasive TCC showed a negative reaction for clusterin. Clusterin expression was significantly increased in the invasive TCC (p=0.001). CONCLUSIONS: These results may suggest that OPN and clusterin could be used as markers to predict the biological behavior of a TCC.

Uterine Tumor Resembling Ovarian Sex-Cord Tumor: A Case Report of the Cytologic Finding / 대한세포병리학회지

Uterine stromal tumors with features of ovarian sex-cord differentiation are relatively rare. The neoplasms composed of sex cord-like components in more than 50% of the tumor are classified as group II. We report the cytologic findings of a case of uterine tumor resembling ovarian sex-cord tumor. The cervical smears of a 62-year-old woman with submucosal tumor showed loose aggregates of spindle cells as well as glandular or tubular structures of round cells with a distinct cell membrane and a prominent small nucleolus. Because uterine stromal tumor can have sex cord differentiation, its possibility should be considered in the interpretation of cervical smears.

Primary Spinal Oncocytic Paraganglioma

Paraganglioma is a generic term applied to tumors of paraganglia, regardless of location, and composed largely of paraganglionic chief cells. It is a rare tumor, especially in the spinal region. When it appears in the craniospinal axis, it is restricted to the cauda equina or filum terminale, and less commonly, the spinal nerve root. We report a case of oncocytic paraganglioma in the spinal nerve root of 13-year-old girl. The tumor was located in intradural and extramedullary areas from the 12th thoracic to the 1st lumbar vertebra. Histologically, the tumor cells with abundant eosinophilic cytoplasms show diffuse compact clusters, which are surrounded by fibers in a reticulin stain, like a nested pattern. The nuclei are round to ovoid in shape with mild atypia. Immunohistochemically, the tumor cells are positive for synaptophysin, neuron-specific enolase and vimentin but are negative for cytokeratin, chromogranin and glial fibrillary acidic protein. Some cells are positive for S-100 protein. The MIB-1 labeling index is low. Ultrastructurally, dense core neurosecretory granules are not found but mitochondrias are commonly noted.

Mast Cells in 10-Dimethyl-1,2 Benzanthracene (DMBA)-Induced Rat Mammary Carcinomas: Relationship with Matrix Metallproteinase (MMP)-2 and MMP-9 Expression

BACKGROUND: It has been suggested that mast cells are involved in the tumor growth and progression by production of a variety of enzymes and growth factors. They were studied in the 10-dimethyl-1,2 benzanthracene (DMBA)-induced rat mammary tumors, and evaluated in relation with the production of tryptase, chymase, and matrix metalloproteinase (MMP)-2 and MMP-9. METHODS: Preneoplastic and neoplastic breast tissues of Sprague-Dawley female rats were obtained every week after DMBA treatment for 12 weeks. Toluidine blue stain was used for the identification of mast cells. Mast cell tryptase was studied by immunohistochemistry, and chymase by esterase stain. MMP-2 and MMP-9 were measured by Western blotting. RESULTS: The numbers of mast cells in breast cancers were higher than in preneoplastic tissues, and there was a positive correlation between the numbers of tryptase-positive cells and the tumor size. MMP-9 quantity was correlated with the numbers of toluidine blue and chymase positive cells, but not with tryptase-positive cells and tumor size. Both active and inactive forms of MMP-2 and MMP-9 were identified in zymogram. CONCLUSIONS: The mast cells are increased in the DMBA-induced breast cancers, and their tryptase and chymase may play a role in tumor progression with or without participation of MMP-2 and MMP-9.

DNA Ploidy Study in 1,673 Fresh Solid Tumors / 대한암학회지

PURPOSE: To evaluate the possible role of DNA content abnomrality in solid tumors as a diagnostic indicator in Korean patients, the incidence of aneuploidy in the major organs were analyzed and compared with the incidences which have been reported in the literatures. MATERIALS AND METHODS: Flow cytometric analysis of DNA content were performed on the 1673 fresh tissues of neoplastic lesions which were obtained for the last five years in Hospital. RESULTS: The frequency of aneuploidy was more than 50% in the primary malignant tumors of the stomach, colon, esophagus, liver, biliary tract, pancreas, head and neck organs, salivary gland, lung, breast, ovary, CNS and urinary tract. However, the frequency of aneuploidy was as low as 7% in papillary carcinoma of thyroid and about 30% in renal cell carcinoma and malignant lymphomas. High frequency of aneuploidy (more than 70%) was seen in the metastatic tumors in liver, brain, ovary and lymph nodes. Aneuploidy was also found in benign tumors of salivary gland, adenomas of endocrine organs, meningiomas, smooth muscle tumors and schwannomas. CONCLUSION: The results of present study were in concordant with those of the other domestic and foreign studies. Although aneuploidy can be observed in some benign tumors, DNA ploidy pattern is considered to be an important diagnostic and prognostic factors in malignant lesions of the various organs.

Evaulation of Angiogenesis and Matrix Metalloproteinase as Prognostic Markers in Squamous Cell Carcinoma of the Lung / 대한암학회지

PURPOSE: In squamous cell carcinomas of the lung, the angiogenesis and the expression rates of metalloproteinase were measured to examine whether they can be useful as prognostic markers and therapeutic potentials. MATERIALS AND METHODS: The angiogenesis and the expression rates of metalloproteinase were analyzed by counting the number of microvessels and immunohistochemically positive cells of MMP-1 and MMP-2 in 54 squamous cell carcinoma, respectively. RESULTS: Lymph node meatastasis group showed higher angiogenesis than non-metastasis one (p=0.008). Angiogenesis were elevated with increasing clinical stage. However, MMP-1 and MMP-2 expression rate as the presence or absence of lymph node metastasis and the clinical stages were statistically insignificant, respectively. Angiogenesis failed to demonstrate any significant correlation with the expression rates of MMPs. CONCLUSION: Our results suggests that angiogenesis level may provide informaton relevant to prognosis as well as treatment decisions.

Detection of Human Papillomavirus(HPV) in Sinonasal Inverted Papillomas Using Polymerase Chain Reaction(PCR) / 대한이비인후과학회지

The human papillomavirus(HPV) is a subfamily of the Papovaviridae family as a double stranded DNA virus, and HPV is the etiological agent of squamous cell papillomas in different anatomic regions including the skin and the mucous membranes of oral cavity, esophagus, respiratory and anogenital tracts. Inverted papilloma of the nasal cavity and paranasal sinuses is uncommon benign lesion, in which there is a inversion of the neoplastic epithelium into the underlying stroma. The local aggressiveness, high rate of recurrence, associated malignancy, and tendency of multicentricity have led to the advocation of radical removal of the tumor. The cause of sinonasal inverted papilloma remains unknown. However, the involved etiologic factors are thought to be smoking, allergy, environmental factors, HPV, and chronic infections. The purpose of this study was to detect HPV in sinonasal inverted papilloma, to examine the relationship between cellular dysplasia and recurrence of inverted papilloma, to examine the relationship between HPV and recurrence of inverted papilloma in forty two sinonasal inverted papillomas(inverted papilloma without dysplasia 30 cases, inverted papilloma with dysplasia 6 cases, inverted papilloma associated squamous cell carcinoma 5 cases, inverted papilloma transformed squamous cell carcinoma 1 case). For these purposes, paraffin-embedded tissues were subjected to polymerase chain reaction using type-specific primers pairs. Following results were obtained: 1) The HPV was detected in 5(12%) out of 42 cases of inverted papilloma, one contained human papillomvirus 6, two contained human papillomavirus 11, and two contained human papillomavirus 16. 2) The recurrence of inverted papilloma occurred in 1(16%) out of 6 cases exhibited dysplasia, in 3(10%) out of 30 cases not exhibited dysplasia. 3) The recurrence of inverted papilloma occurred in 2(66%) out of 3 cases positive for HPV, in 2(6%) out of 33 cases negative for HPV. In conclusion HPV was thought to be the etiological factor of sinonasal inverted papilloma. Also there was a relationship between HPV and recurrence of inverted papilloma. Further work is in progress to determine the possible mechanisms by which HPV induces oncogenesis in inverted papilloma.

Amplification and Overexpression of Cyclin D1 in Head and Neck Squamous Cell Carcinomas / 대한이비인후과학회지

BACKGROUND: Overexpression of the cell cycle control gene, cyclin D1 may, at least in some tumor types, provide a prognostic marker. Cyclin D1 is expressed during the G1 phase of the cell cycle and becomes associated with its catalytic partner CDK4 or CDK6. This association may overcome the G1 arrest. OBJECTIVES: To establish the frequency of cyclin D1 protein overexpression and to evaluate its correlation with cyclin D1 gene amplification and its correlation with clinico-pathologic variables that are used in clinical practice. MATERIALS AND METHODS: The cyclin D1 gene amplification was estimated with the differential polymerase chain reaction(PCR) and cyclin D1 protein overexpression was evaluated with immunohistochemical study in 32 cases of resectable head and neck squamous cell carcinoma(SCC). The presence or absence of cyclin D1 protein overexpression was correlated with anatomical sites, T stage, nodal involvement, pathologic grade and survival rate. RESULTS: Six SCC cases(18.7%) showed the amplification of cyclin D1 gene. A highly statistical correlation between cyclin D1 gene amplification and cyclin D1 protein overexpression was noted(p0.05). But overexpression of cyclin D1 protein was associated with a poor survival of these cases(p<0.05). CONCLUSIONS: Overexpression of cyclin D1 is the independent prognostic factor for the head and neck squamous cell carcinoma. The cyclin D1 gene amplification results in the overexpression of cyclin D1 protein. But additional genetic mechanisms are involved in the protein overexpression. Therefore, cyclin D1 oncogene may be important in tumorigenesis in the head and neck squamous cell carcinoma.

Expression of TGF-β, PDGF, Type I and II Collagen, and Osteonectin During Fracture Healing in Rat / 대한정형외과학회잡지

To define the basic sequential events of the healing process in normal fracture and evaluate the role of growth regulatory molecules and extracellular matrix components, the expression of transforming growth factor β(TGF-β), platelet-derived growth factor(PDGF), type I and II collagen, and chemistry during the healing process of an experimental fracture of tibia in 41 adult rats for 7 weeks using ABC methods. The phases of inflammation, reparation, and remodeling followed each other in sequence. The inflammatory phase was characterized by hemorrhage, edema, and infiltration of inflammatory cells on the first day. During the reparative phase, the undifferentiated mesenchyme undergoes rapid chondrogenesis, followed by endochondral ossification and supplemented by appositional bone formation. At day 3, the expression of TGF-β and PDGF was noted in the undifferentiated mesenchymal cells and from day 5, these two growth factors were detected in the osteoblasts and extracellular matrix in areas of endochondral ossification and newly formed periosteal bone. From day 3, the expression of type I collagen and osteonectin was noted in the osteoblasts and extracellular matrix in both endochondral ossification and appositional bone growth as a marker of ossification. From day 3, type III collagen was mainly expressed in the plump mesenchymal cells showing chondroid differentiation and chondroid matrix as a marker of cartilaginous reparative phase. From day 14, these growth factors and extracellular matrix components were decreased in staining intensity and at the 5th week, the histology and immunostaining pattern were similar to the mature bone.