Bronchiolitis Obliterans Organizing Pneumonia:Clinicopathologic Review of a Series of 45 Korean Patients Including Rapidly Progressive form

Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinicopathological syndrome associated with a variety of disease entities. The aim of this study was to review cases with initial diagnosis of BOOP applying uniform histopathologic criteria, and analyze the clinical characteristics of proven cases of BOOP including rapidly progressive form. A total of 81 cases, initially diagnosed as BOOP and with available tissue sections, was collected. Thirty six cases (44.4%) were excluded from the study, more than two thirds of which were given a revised diagnosis of interstitial pneumonitis/fibrosis other than BOOP. Thirty one patients were classified as idiopathic BOOP, 8 patients as secondary BOOP, and 6 patients as rapidly progressive BOOP. Open lung biopsy specimen from all six cases with lethal outcome showed more severe interstitial inflammation and septal fibrosis and/or alveolar exudate with a varying degree than those with good prognosis. There was no difference by the sexes. The two most frequent presenting symptoms were cough and dyspnea. Bilateral multifocal consolidation was a common radiological finding. More than 70% cases of idiopathic BOOP experienced clinical improvements. The diagnosis of BOOP is usually suggested by clinicoradiologic findings, but needs to be confirmed histopathologically, preferably through surgical open or video-assisted thoracoscopic biopsy.

The Study of Expression of p53 Protein and Its Clinical Significance in Transitional Cell Carcinoma of the Urinary Bladder / 대한비뇨기과학회지

To evaluate the prevalence of p53 gene expression and its role as a prognostic indicator in bladder carcinoma, we examined the paraffin-embedded tissue specimens from 43 patients with superficial and 31 patients with invasive bladder cancers. Nuclear expression of p53 proteins was detected by immunohistochemical analysis with microwave retrieve method, using the monoclonal antibody DO7 (Novocastra, UK). The p53 gene expression were divided into 4 categories (category 1: negative, category 2: 20%, diffuse, heterogeneous, weak intensity, category 4: >20%, diffuse, homogeneous, strong intensity). In total 74 cases, 67 (90.5%) showed positive (category 3 and 4) nuclear staining. Difference of nuclear expression between superficial and invasive cancer was not seen (96%, 84% respectively). But category 4 was more frequently seen in cases with invasive carcinoma compared to in superficial cancers (65% vs. 35%), and it was highly found in cases with grade 3 than grade 1 and 2 (79% vs. 27.5%) (p<0.005). Recurrence, progression, and survival in patients with superficial and invasive carcinoma between negative and weak intensity group (category 1,2,3) and strong intensity group (category 4) were not statistically significant. Our results showed higher positive rates than other studies may be due to using microwave retrieve method. These suggest that most bladder tumors have p53 mutations not only invasive but also superficial tumors and immunohistochemical stain using microwave retrieve method of bladder tumor specimens could be a good screening method for the presence of mutant p53 protein. The nuclear expression of p53 protein showed the trend of a stronger intensity in patients with invasive tumors and high histologic grade than in patients with superficial tumors and low histologic grade. These results also suggest that the degree of mutant p53 expression may be more useful for aggressive biological natures than the presence of mutant p53 protein.