Cytologic Features and Distribution of Primary Sites of Malignant Cells in Cerebrospinal Fluid / 대한세포병리학회지

Cytologic evaluation of cerebrospinal fluid(CSF) is an effective mean for diagnosing many disorders involving the central nervous systems(CNS). One of the most important reasons for cytologic examination of CSF is to detect metastatic or primary neoplasms of the CNS. We did a retrospective study of 1,438 CSF specimens obtained between 1992 and 1996. A total of 1,205 adult and 233 pediatric CSF specimens from 947 patients were accessed at the Department of Pathology of Seoul National University Hospital and Children's Hospital, respectively. Among 1,438 CSF cytology specimens, 169 cases(11.8%, 77 patients) including 135 adult cases(59 patients) and 34 pediatric cases(18 patients) were positive for malignant cells. Diagnoses included 60 metastatic carcinomas(adult, 60; pediatric, 0); 46 malignant lymphomas(adult, 44; pediatric, 2); 21 leukemias(adult, 20; pediatric, 1); 4 retinoblastomas(adult, 0; pediatric 4); 2 rhabdomyosarcomas(adult, 0; pediatric, 2); 1 multiple myeloma(adult, 1; pediatric, 0), and 35 primary CNS neoplasms(adult, 10; pediatric, 25). The most commonly identified metastatic carcinomas in adults were adenocarcinoma. Their primary sites were the lung, gastrointestinal tract, and breast in order of frequency. The most common primary CNS neoplasm in children was medulloblastoma.

Microvessel Density and Vascular Endothelial Growth Factor Expression in Invasive Breast Carcinomas

Angiogenesis is essential for tumor growth and metastasis, however, the prognostic value of neovascularization is undetermined. The aim of this study is to evaluate the prognostic significance of microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression in breast carcinomas. An immunohistochemical stains for CD 31 (DAKO) to estimate MVD and VEGF (Santa Cruz) were done on 40 cases of invasive breast carcinoma. MVD was calculated as an average count of vessels per 200 power field in the most vascularized areas. VEGF expression was interpreted according to staining intensity and number of positive cells. Mean MVD was 35, and MVD was not correlated with lymph node metastasis or histologic grade, but high MVD (mean MVD>35) showed an increasing tendency in cases with larger size, negative ER/PR, and positive cathepsin D. All of the cases showed VEGF expression, but VEGF expression was not correlated with tumor size, histologic grade, lymph node metastasis, ER/PR status, and cathepsin D expression. These results suggest that MVD and VEGF expressions are not reliable prognostic factors.

Intrapulmonary Cystic Lymphangioma

Solitary intrapulmonary cystic lymphangioma in newborn or infant is an extremely rare disease. We describe a case of solitary intrapulmonary cystic lymphangioma in a 4-month-old boy with dyspnea and tachypnea. It was in the left lower lobe and type 1 congenital cystic adenomatoid malformation was suspected radiologically. The resected cyst was unilocular with a thin wall, and was 9.5cm in size. Histologically, the cyst was lined by flattened endothelial cells supported by a minimal fibrous stroma.

Crush Cytology Features and Differential Diagnosis of Meningiomas and Schwannomas in Central Nervous System / 대한세포병리학회지

This study was performed in order to evaluate the usefulness of the crush cytologic features and differential diagnosis between meningiomas and schwannomas in the central nervous system. Deeply seated and unusually located meningiomas and schwannomas with equivocal or erroneous frozen section diagnosis can be correctly diagnosed cytologically in crush preparations. Twenty-four meningiomas and nine schwannomas were studied by frozen section and crush preparation technique. These tumors displayed distinctive cytologic features. In meningiomas, the tumor tissue fragments were easy to crush, and the tumor cells were arranged in small clusters, flat sheets, papilla-like, whorling pattern or singly. Individual tumor cells displayed round or oval nuclei with finely granular chromatin pattern and inconspicuous small nucleoli. Occasionally psammoma bodies, nuclear pseudoinclusion or nuclear grooves were found. In schwannomas, tissue fragments were hard in consistency and difficult to crush. The crushed tissue presented as thick, irregular fragments with sharp borders. The cells showed ill-defined cytoplasm and round, oval, cigar-shaped or curved nuclei. It is important to emphasize that the smear pattern under low-power view and cytologic features are helpful in discriminating between these two tumors.

A Study on Expression of p53 Protein according to Histologic Types, Degree of Malignancy and Differentiation of the Ovarian Surface Epithelial Tumors

p53 gene alterations in the ovarian cancers are regarded as early events in the whole process of carcinogenesis. This study is intended to compare p53 protein expression rate in the ovarian surface epithelial tumors according to histologic types, degree of malignancy and differentiation. 134 cases of ovarian epithelial tumors including 26 cases of serous cystadenoma, 7 cases of serous borderline malignancy, 15 cases of serous cystadenocarcinoma, 40 cases of mucinous cystadenoma, 21 cases of mucinous borderline malignancy, 20 cases of mucinous cystadenocarcinoma, 4 cases of endometrioid carcinoma, and 1 case of clear cell carcinoma were studied. Immunohistochemistry using monoclonal p53 antibody(DO-7) was applied to the routine formalin-fixed paraffin embedded tissue. The results were as follows; 1. No immunohistochemical positivity of p53 protein was found in all 66 cases of benign serous and mucinous tumors studied. 2. There was no significant difference of p53 protein expression between serous and mucinous malignant tumors. 3. The expression rate of p53 protein exhibited a statistically significant difference between borderline(42%) and malignant(74%) ovarian surface epithelial tumors (p<0.05). 4. The expression rate of p53 protein of poorly differentiated carcinomas(100%) was higher than those of moderately (88%) and well differentiated carcinomas(60%), but there was no statistical significance. In summary, p53 protein expression might be a good indicator of malignant transformation of the ovarian surface epithelial tumors.

Primitive Neuroectodermal Tumor Associated with Mature Cystic Teratoma of the Ovary: A case report

Malignant transformation of benign cystic teratomas of the ovary is rare, with an incidence rate of 1-3%. The most common malignancy associated with benign cystic teratoma of the ovary is squamous cell carcinoma, which represents 90% of malignant transformations, followed by adenocarcinoma and carcinoid. Primary malignant neuroectodermal tumor in a mature cystic teratoma is extremely rare and microscopically can be subclassified as differentiated, primitive, and anaplatic. We experienced a case of primitive neuroectodermal tumor (PNET) associated with mature cystic teratoma of the ovary in a 11-year-old girl. Grossly, the ovary was a unilocular cyst which contained sebum material and disclosed several large, yellow to gray-tan polypoid excresences attached to the inner cystic wall. Except a large, fish-flesh, soft mass, the other polypoid masses were covered with sebum and contained small pieces of cartilage and tooth, and microscopically represented as mature teratoma. The large, fish-flesh, soft mass disclosed sheets and lobules of closely packed small cells with thin fibrovascular septa, which frequently replacing and encroaching the mature cystic teratoma. The small tumor cells were uniform and made up of round to oval nuclei with coarse chromatin and prominent nucleoli, very similar to those of PNET of the central nervous system.