Clinicopathological Analysis of Hepatocellular Adenoma According to New Bordeaux Classification: Report of Eight Korean Cases

BACKGROUND: Hepatocellular adenoma (HCA) is a rare benign tumor of the liver. A subtype classification of HCA (hepatocyte nuclear factor 1alpha [HNF1alpha]-mutated, beta-catenin-mutated HCA, inflammatory HCA, and unclassified HCA) has recently been established based on a single institutional review of a HCA series by the Bordeaux group. METHODS: We used histologic and immunohistochemical parameters to classify and evaluate eight cases from our institution. We evaluated the new classification method and analyzed correlations between our results and those of other reports. RESULTS: Seven of our eight cases showed histologic and immunohistochemical results consistent with previous reports. However, one case showed overlapping histologic features, as previously described by the Bordeaux group. Four cases showed glutamine synthetase immunohistochemical staining inconsistent with their classification, indicating that glutamine synthetase staining may not be diagnostic for beta-catenin-mutated HCA. HNF1alpha-mutated HCA may be indicated by the absence of liver fatty acid binding protein expression. Detection of amyloid A may indicate inflammatory HCA. HCA with no mutation in the HNF1alpha or beta-catenin genes and no inflammatory protein expression is categorized as unclassified HCA. CONCLUSIONS: Although the new classification is now generally accepted, validation through follow-up studies is necessary.

Acute Geometric Changes of the Mitral Annulus after Coronary Occlusion: A Real-Time 3D Echocardiographic Study

We performed real-time 3D echocardiography in sixteen sheep to compare acute geometric changes in the mitral annulus after left anterior descending coronary artery (LAD, n=8) ligation and those after left circumflex coronary artery (LCX, n=8) ligation. The mitral regurgitation (MR) was quantified by regurgitant volume (RV) using the proximal isovelocity surface area method. The mitral annulus was reconstructed through the hinge points of the annulus traced on 9 rotational apical planes (angle increment=20 degrees). Mitral annular area (MAA) and the ratio of antero-posterior (AP) to commissure-commissure (CC) dimension of the annulus were calculated. Non-planar angle (NPA) representing non-planarity of the annulus was measured. After LCX occlusion, there were significant increases of the MAA during both early and late systole (p<0.01) with significant MR (RV: 30+/-14 mL), while there was neither a significant increase of MAA, nor a significant MR (RV: 4+/-5 mL) after LAD occlusion. AP/CC ratio (p<0.01) and NPA (p<0.01) also significantly increased after LCX occlusion during both early and late systole. The mitral annulus was significantly enlarged in the antero-posterior direction with significant decrease of non-planarity compared to LAD occlusion immediately after LCX occlusion.

The First Human Case of Hepatic Dirofilariasis

Most of human dirofilariasis are pulmonary or subcutaneous infections, but there have been a few reports of human dirofilariasis in unusual sites, such as large vessels, mesentery, peritoneal cavity, and spermatic cord. We present the first case of human hepatic dirofilariasis, which was surgically diagnosed. A 39-yr-old man without any evidence of systemic symptom was found incidentally to have a hepatic nodule during routine physical check-up. The histologic findings of the resected lesion showed a granulomatous lesion with central necrosis containing up to 35 transverse sections of a nematode, ranging 30-80 micrometer in diameter. Thin (1.5-5 micrometer) cuticle with transverse striations surrounded polymyarian and muscle bundles occupied a sixth of both sides of outer body cavity. Central portion of the body cavity was occupied with an intestine-like tubular structure and a larger reproductive tube. These microscopic findings were consistent with degenerated Dirofilaria immitis. Antibody test by enzyme-linked immunosorbent assay for patient serum reacted positively against adult D. immitis antigen.

Coloning of the variable region of D8S210 locus and its application to the forensic individual identification for Korean population / 대한법의학회지

A multi-locus probe. called pHK-450. detecting multiple variable DNA fragments, was constructed by cloning of the 450 bp fragments into pCR(TM) vector, which could be obtained from amplification of the variable region of the D8S210 locus of human genome with a primer set of UF1. UR1, and UR2. The sequence data shows that the variable region is entirely G-C rich on one strand consisting of tetranucleotide repeat unit (GGAA)n at both margins and internally diversed regions with simple irregular repeat units of GGAA, GGAG, or GGGAA. The genetic complexixty of the resulting individual-specific DNA patterns was investigated by studying a Korean pedigree(both parents and 10 children). HaeIII and HinfI-generated DNA fragments are inherited to their children in a Mendelian manner with segregation ratio of 1:1.05 and 1:1.14. respectively. In the HinfI-digested genomic DNAs, the segregation of up to 25 variable DNA fragments from both parents could be analysed in a single sibship. Most of these variable DNA fragments detected by pHK-450 probe are not paired as allele, which suggests that they may be derived from 23 heterozygous loci. In the HaeIII-digested genomic DNA, 26 variable DNA fragments are segregated from both parents to 10 children. Excluding one allelic and three linked DNA fragments, 22 out of 26 scored DNA fragments may be derived from 23 hetrozygous loci. To determine the variability of DNA fragments, DNA samples from 113 unrelated Korean were digested with HinfI and hybridized using pHK-450 probe. Pairwise comparisons of individual variable DNA fragments show that the polymorphic patterns were highly specific to an individual. The mean probaility(X) that fragments in A individual is present in B individual is 0.0337. From the degree of maxiaml sharing, band approximate estimates of mean allele frequency and homozygosity is calculated being 0.187 and the mean heterozygossity is 89.69%. For pHK-450 probe, the probability that all 10 resolved DNA fragments in the 5-30 kb size range in an individual A are also present in a second unrelated individual B is (0.337)(10) or 7.1 X 10(-6).The above results suggest that the Muiti-locus probe, pHK-450, is suitable for rapid polymorphic marker generation and can be applied to individual identification in forensic medicine

Malignant Eccrine Acrospiroma: A case report

A case of malignant eccrine acrospiroma of the anterior chest wall is reported. This mass had been present for 20 years and during rescent 5 years it showed frequent ulceration and bleeding suggesting malignant transformation. Microscopically, several foci malignant transformation from preexisting benign eccrine acrospiroma are seen and in immunohistochemical staining, the tumor cells both benign and malignant portion, show positive reaction to cytokeratin.