A Case of Primary Gastric CD30-Positive Anaplastic Large-Cell Lymphoma

Gastric CD30-positive anaplastic large-cell lymphoma is a very rare disease. It is sometimes difficult to distinguish it from undifferentiated carcinoma, sarcoma and so on. We report here on a case of primary gastric anaplastic large-cell lymphoma. A 50-yr-old woman complained of epigastric pain and severe chest pain for 1 week. The gastroendoscopic examination revealed geographic mucosal irregularities with shallow ulceration at the antrum. She underwent a total gastrectomy. The gross finding of the resected stomach was an 8 x 4.5 cm sized ulceroinfiltrative lesion at the pyloric antrum along the lesser curvature. The microscopic examination revealed diffuse and solid proliferations of large atypical cells with pleomorphic nuclei. Immunohistochemically, the tumor cells were positive for CD30, vimentin and CD3, and this was a finding compatible with anaplastic large-cell lymphoma. To the best of our knowledge, this is the first such reported case in Korea.

A case of metastatic atypical carcinoid tumor of appendix: treatment with combination chemotherapy / 대한내과학회지

Carcinoid tumor is the most commen tumor of appendix. Metastases from the appendecial carcinoid tumor is rare, and the prognosis of metastatic appendecial carcinoid tumors are closely related to the histologic findings. Atypical, aggressive metastatic carcinoid tumors shows poor prognosis. We experienced a case of atypical aggressive carcinoid tumor of appendix with metastasis. We treated her with combination chemotherapy, etoposide and cisplatin, and achieved partial remission. The duration of remission was 5 months, and survival duration was 19 months. To the best of our knowledge, this is the first case of atypical appendiceal carcinoid tumor with distant metastasis in Korea, so we report this case and the result of chemotherapy.

Nuclear Morphometry of Fibroadenoma and Carcinoma of Breast: Comparison between fine needle aspiration cytology and biopsy / 대한세포병리학회지

Primary breast lesions diagnosed by fine needle aspiration cytology, confirmed by histologic examination were analyzed by morphometry to evaluate the difference between benign and malignant lesions, and the methods obtaining the sample. Four size factors and 5 form factors were evaluated in 22 fibroadenomas and 20 carcinomas by image analyzer(Zeiss Ibas 2000) using the H-E stained slides. Nuclear size was significantly larger in the carcinoma cells than fibroadenoma cells both in the cytology and biopsy specimens, but the form factors were not significantly different. Both fibroadenoma and carcinoma cells were significantly larger in cytologic smear than histologic section. The cells in the cytology were more regular and round than those in histology, but not statistically significant. Fibroadenomas having cellular proliferation and atypism exhibited larger size and more irregular nuclei than non-proliferative fibroadenoma, but not statistically significant. Therefore nuclear morphometric analysis can be a helpful method to diagnose the questionable breast lesions and is a method appropriate for use as a quality control procedure in the fine needle aspiration cytology.

Correlation of Tumor Angiogenesis and nm23-H1 Expression with Lymph Node Metastasis in Proper Muscle Gastric Cancer

We studied clinicopathologic features of 44 cases of PM (proper muscle) gastric cancer, correlated the lymph node metastasis and found the result of immunohistochemical staining for tumor angiogenesis using antibodies to Factor VIII-related antigen and nm23-H1, known as meatastasis inhibitory substance. The results were as follows: 1) The average age of these 44 cases of PM gastric cancer was 55.1 years old (range 35-81). The ratio of male to female was 2.2 : 1. The tumor was located at the antrum of stomach in 72.7% of the cases. The average size of the tumor was 4.1 cm (range 0.6-9). The gross features were comprised of Borrmann type I (6.8%), II (29.6%), III (56.8%), IV (6.8%), respectively. The microscopic type was a diffuse type in 70.5% and an intestinal type in 29.5%. There were lymph node metastasis in 25 of the 44 cases (56.8%). 2) The microvessel count was higher in the lymph node positive group (average 69.3) than in the lymph node negative group (average 45.6) (P=0.004). There was a higher microvessel density in diffuse type, over 4 cm of tumor size, proximally located tumor, older than 50 years, Borrmann type II and IV, but there was no statistically significant correlation. 3) The more decreased expression of nm23-H1 was found in the lymph node positive group (56.0%) than in the lymph node negative group (31.6%), but showed no statistical significance (P=0.0142). There was no significant correlation between the expression of nm23-H1 and the other clinicopathologic factors. We suggest that the microvessel count of the tumor angiogenesis may be a prognostic factor for predicting lymph node metastasis and also help to determine the therapeutic modalities of PM gastric cancer.

A Study on the Expression of p53 and nm23 Protein in the Colorectal Adenoma and Carcinoma

The expression of the nuclear phosphoprotein p53, a product of tumor suppressor gene, has been noted in a number of human tumors as a tumor suppressor. nm23 is a gene associated with low tumor metastatic potential and has been proposed to be a metastasis suppressor gene. To assess the role of p53 and nm23 expression in colorectal tumorigenesis and the association with clinicopathological parameters, an immunohistochemical study for mutant p53 and nm23 was done using mouse monoclonal antibodies in 43 colorectal carcinomas, 55 tubular adenomas and corresponding normal mucosa. In the tubular adenomas, p53 expression was significantly correlated with the degree of atypism(p<0.05) but not with other variables as well as with nm23. In the colorectal carcinoma, there were evidence of some correlation between metastasis, laterality and p53; laterality, depth of invasion and nm23 expression, but without statistical significance. Other clinicopathologic features were not significantly correlated. In the aspect of 'adenoma-carcinoma sequence', normal mucosa was totally negative for both p53 and nm23, and they were increasingly expressed through tubular adenoma to carcinoma with statistical significance(p<0.05). Therefore, it is suggested that both p53 and nm23 expressions occur in and around the time of transition to carcinoma from adenoma but are not significantly associated with the infiltrative behavior and metastasis.

Effect of different levels of the dietary protein on long term prognosis of experimental renal damage

We examined the effect of various levels of dietary protein on long term prognosis of Adriamycinnephropathy of S-D rat, fed with high protein (30%), intermediately low (10%), and strictly low (5%) protein diet for 15 weeks. 1) In rats fed with strictly low protein diets (5%), proteinuria and serum creatinine decreased and creatinine clearance and histological changes were relatively well preserved. But hypoproteinemia and weight loss were more marked and 2 rats died due to severe ascites and pleural effusion in cachexic state. 2) In rats fed with high protein diets (30%), general health condition and weight gain were relatively well preserved. But there were massive proteinuria, progressive increase in serum creatinine and progressive decrease in creatinine clearance. Focal glomerular sclerosis and severe tubulointerstitial change on histologic examination were marked. 3) With intermediately low protein diet (10%), renal function and pasma protein levels were relatively well preserved compared with high protein diet group. But weight gain did not increase normally. 4) We tentatively conclude that appropriately restricted dietary protein can prevent functional and histological renal damage. But too strict protein restriction aggravate nutitional state and general condition.

A case of Cushing's syndrome due to macronodular adrenal hyperplasia / 대한내분비학회지

No abstract available.