Cytopathologic Features of Secretory Carcinoma of Salivary Gland: Report of Two Cases

Secretory carcinoma of the salivary gland (SC) is a newly introduced rare salivary gland tumor that shares histological, immunohistochemical, and genetic characteristics with secretory carcinoma of the breast. Here, we report the cytologic features of two cases of SC confirmed by surgical resection. In these two cases, SC was incidentally detected in a 64-year-old female and a 56-yearold male. Fine needle aspiration cytology revealed nests of tumor cells with a papillary or glandular structure floating in mucinous secretions. The tumor cells demonstrated uniform, round, smooth nuclear contours and distinct nucleoli. Multiple characteristic cytoplasmic vacuoles were revealed. Singly scattered tumor cells frequently showed variable sized cytoplasmic vacuoles. The cytopathologic diagnosis of SC should be considered when characteristic cytological findings are revealed. Further immunohistochemistry and gene analyses are helpful to diagnose SC.

Glandular papilloma of the lung with malignant transformation / 영남의대학술지

Glandular papilloma of the lung is one of three histologic types of solitary endobronchial papillomas. It is known as an uncommon benign neoplasm. No malignant glandular papillomas have been reported. Herein, the first case of granular papilloma with malignant transformation is reported. A 74-year-old man with huge right lung mass extended upper and lower lobe was admitted to the hospital complaining of progressive cough and dyspnea. An open lung biopsy was performed. Microscopically, the tumor showed papillary growth pattern with thick fibrovascular cores. The stroma of the fibrovascular cores shown the infiltration of lymphoplasmacytic cells and proliferation of capillaries. The epithelial cells surrounding the papillary fronds were cilliated columnar cells with focal cellar atypia, and frequent mitoses. Suspicious pleural invasion foci were identified. The Ki-67 labeling index was about 24.3% and p53 labeling index was about 31.7%. Glandular papilloma is known as a benign neoplasm, which is lack of atypia and mitosis. In present case, there were several indications of malignant transformation, such as cellular atypia, frequent mitosis, architectural distortion, and pleural invasion. Pathologists must be aware that glandular papilloma can have a changes of malignant transformation. Further studies about disease behavior and molecular characteristics are needed.

A Case of Engorged Female Hard Tick in the External Auditory Canal of an Infant

An oval-shaped mass with a smooth surface was found in the ear canal of a 22-month-old male infant. Although the mass appeared to be almost entirely blocking the ear canal, it was successfully removed under a surgical microscope without general anesthesia at the outpatient department. Under an optical microscope with hematoxylin and eosin staining, the specimen was observed to have a cuticle with a serrated surface and a pore canal, as well as parts of the capitulum, salivary glands, muscles, midgut, and the legs. The specimen was identified as a hard tick of the family Ixodidae, based on gross and histological findings. This paper is the first report in Korea on the diagnosis and treatment of a tick bite in the ear canal.

Glandular papilloma of the lung with malignant transformation / 영남의대학술지

Glandular papilloma of the lung is one of three histologic types of solitary endobronchial papillomas. It is known as an uncommon benign neoplasm. No malignant glandular papillomas have been reported. Herein, the first case of granular papilloma with malignant transformation is reported. A 74-year-old man with huge right lung mass extended upper and lower lobe was admitted to the hospital complaining of progressive cough and dyspnea. An open lung biopsy was performed. Microscopically, the tumor showed papillary growth pattern with thick fibrovascular cores. The stroma of the fibrovascular cores shown the infiltration of lymphoplasmacytic cells and proliferation of capillaries. The epithelial cells surrounding the papillary fronds were cilliated columnar cells with focal cellar atypia, and frequent mitoses. Suspicious pleural invasion foci were identified. The Ki-67 labeling index was about 24.3% and p53 labeling index was about 31.7%. Glandular papilloma is known as a benign neoplasm, which is lack of atypia and mitosis. In present case, there were several indications of malignant transformation, such as cellular atypia, frequent mitosis, architectural distortion, and pleural invasion. Pathologists must be aware that glandular papilloma can have a changes of malignant transformation. Further studies about disease behavior and molecular characteristics are needed.

Myeloid Sarcoma of Peritoneum in Acute Myeloid Leukemia Patient with Inversion of Chromosome 16 / 대한내과학회지

Myeloid sarcoma is an extramedullary myeloid neoplasm that usually involves the skin, soft tissues, and lymph nodes. Myeloid sarcoma is found in 2.5-9.1% of acute myeloid leukemia patients, usually those with t (8;21), while inv (16) is rarely associated with myeloid sarcoma. Consequently, little is known of the characteristics and incidence of inv (16) in myeloid sarcoma. Myeloid sarcoma in acute myeloid leukemia patients with inv (16) is most often found in the abdominal lesions; the intestinal tract is involved most commonly, in the form of a mass. Here, we report an unusual myeloid sarcoma presenting as peritoneal carcinomatosis in acute myeloid leukemia with inv (16) that appeared to be ascites.

A Case of Mucosa-Associated Lymphoid Tissue Lymphoma of the Sigmoid Colon Presenting as a Semipedunculated Polyp

Mucosa-associated lymphoid tissue (MALT) lymphomas are characterized by lymphoepithelial lesions pathologically. Colonic MALT lymphomas are relatively rarer than lymphomas of the stomach or small intestine. Endoscopically, colonic MALT lymphoma frequently appears as a nonpedunculated protruding polypoid mass and/or an ulceration in the cecum and/or rectum. We report a unique case of a colonic MALT lymphoma presenting as a semipedunculated polyp. A 54-year-old man was found to have a 2-cm semipedunculated polyp in the sigmoid colon during screening colonoscopy. The polyp was removed by endoscopic mucosal resection. Histologic examination of the resected polyp revealed diffuse epithelial infiltration by discrete aggregates of lymphoma cells. We diagnosed the tumor as low-grade B-cell MALT lymphoma by immunohistochemical staining.

Relapsed plasmacytoma in central nervous system after complete remission of extramedullary plasmacytoma / 영남의대학술지

Extramedullary plasmacytoma (EMP) is a rare disease that occurs in 3% to 5% of patients with plasma cell disorder. It occurs most commonly in the upper respiratory tract and the oral cavity. Very few EMP cases have been reported in the central nervous system (CNS). We report herein an unusual case of EMP in the nasal cavity that recurred in the CNS without systemic involvement. A 67-year-old man visited our hospital due to a month-long bout with exophthalmos. He was diagnosed with EMP in the nasal cavity, paranasal sinus, and orbital cavity. He received radiotherapy to which he had complete responses. After 2 years, he visited our hospital because of a month-long headache. He was diagnosed with EMP recurrence in the CNS via brain magnetic resonance imaging and cerebrospinal fluid analysis. He was treated with whole brain radiotherapy and intrathecal chemotherapy with methotrexate, but he expired due to pneumonia.

Pleomorphic Adenoma of the Trachea: A Case Report

No abstract available.

Epithelioid Trophoblastic Tumor: Clinicopathologic and Immunohistochemical Analysis of Three Cases

Epithelioid trophoblastic tumor is an unusual type of trophoblastic tumor. Here we report on the clinicopathologic and immunohistochemical features of three cases of epithelioid trophoblastic tumor. All three patients were of reproductive age and presented with vaginal bleeding and mild elevation of human chorionic gonadotropin (hCG). All patients underwent a hysterectomy. The tumors consisted of epithelioid intermediate trophoblastic cells that were mononucleated and eosinophilic, or showed clear cytoplasm on microscopic examination. One case presented with a focal choriocarcinoma component. Immunohistochemically, the tumors displayed diffuse positivity for cytokeratin 18, E-cadherin, epidermal growth factor receptor, and p53 and focal positivity for p63 and hCG. However, expression of alpha-inhibin and placental alkaline phosphatase was almost negative. Tests for human placental lactogen and epithelial membrane antigen were also negative in all cases.

Diagnostic Importance of Recognition of Calcareous Corpuscles and Larva Part in the Diagnosis of Sparganosis by Fine Needle Aspiration Cytology: Reports of Three Cases of Mammary Sparganosis

Sparganosis of the breast is an uncommon disease. Cytological granulomatous inflammation is a common feature of sparganosis. The presence of larval fragments is necessary for a definitive diagnosis of sparganosis in a cytological specimen. However, calcareous corpuscles entrapped in necrotic debris can be very diagnostic for sparganosis in endemic areas. We experienced three cases of mammary sparganosis diagnosed by fine needle aspiration cytology before surgical excision. Two cases showed numerous calcareous corpuscles associated with necrotic debris thought to be degenerated parasitic bodies. The remaining case revealed a few degenerative calcareous corpuscles and parasitic bodies. The presence of calcareous corpuscles and/or degenerative parasitic bodies can be an aid in the differential diagnosis between sparganosis and other forms of granulomatous mastitis, particularly in endemic areas of sparganosis.

Mature Cystic Teratoma of the Fallopian Tube: A Brief Case Report

Mature cystic teratomas of the fallopian tube are unusual, being almost incidentally identified. Here we describe a case of mature cystic teratoma arising in the fallopian tube, in a 44-year-old female. The mass was found during a regular checkup without complication. Microscopically, components from each germ layer were identified.

Wound Healing Effect of Bacterial Synthesized Cellulose on Full Thickness Skin Defect in the Rat

PURPOSE: Cellulose is a natural substance from plants or bacteria. It is known that bacterial synthesized cellulose has an effect of wound healing. The aim of this study is to show the effect of bacterial synthesized cellulose from citrus on wound healing. METHODS: Three full-thickness skin defects were made on the back of Sprague-Dawley rats. Three wounds were treated by vaseline gauze(Group V), Algisite M(R)(Group A) and bacterial synthesized cellulose from citrus(Group C) was used for dressing on skin defect on rats. We analyzed the gross, histological and biochemistry finding. RESULTS: Group C showed more decrease of wound size compared to Group V(33% versus 7.2#) after 14 days. The histologic findings revealed Group C and Group A preceed the process of wound healing rather than Group V(More rapid collagen deposition and neovascularization and reduced inflammation). Also, the expressions of vascular endothelial growth factor(VEGF) and transforming growth factor(TGF)-beta1 were increased in the Group C and Group A compared with the Group V in 7 days. VEGF and TGF-beta1 expression were decreased in the Group C and Group A in 14 days, however Group V was not decreased at 14 day because of delayed wound healing process. CONCLUSION: Bacterial synthesized cellulose from citrus affects wound healing by reducing the inflammatory stage. And stimulates wound contracture by the deposition of extracellular matrix, thus preventing the formation of chronic wounds.

A Fibroma with Cystic Change Developing in an Accessory Ovary: A Brief Case Report

Accessory ovaries are rare entities defined as small portions of ovarian tissue situated near, and connected to, the normally placed ovary. Tumors arising in accessory ovaries are extremely rare. In particular, a fibroma arising from an accessory ovary has not been reported in the literature. We describe such a case with a fibroma developing in an accessory ovary. A 53-year-old multiparous woman presented with abdominal pain for 2 months. Pelvic computed tomography revealed 11.0x8.0x6.0 cm sized cystic mass with a thick septal wall in right adnexa. The preoperative diagnosis was a borderline ovarian tumor. Furthermore, a laparotomy showed a cystic mass connected to the right ovary by stalk. The bilateral eutopic ovaries were completely normal. Histologically, an accessory ovary was replaced by a fibroma accompanied by extensive cystic change.

The Role of Adipose Tissue-Derived Stem Cells in Ischemic Acute Renal Injury in Rats / 대한신장학회지

PURPOSE: The aim of this study is to explore the role of human adipose tissue-derived adult stem cells (ASCs) in repair of acute ischemic renal injury. METHODS: Acute ischemic tubular necrosis was induced in Spraque-Dawley rats (n=15) by clamping bilateral renal pedicles for 40 minutes. Before releasing the clamps, iron labeled stem cells (1x106/0.3 mL) were directly injected to one side of renal cortex and phosphate-buffered saline (PBS) injections were done as a control to the opposite kidney. The examination on both kidney was done after 1, 2 and 4 weeks (n=5 each). The evaluation of the degree of tubular necrosis and the location of stem cells was done by light and electron microscopically. RESULTS: The rats were all alive without rejection. Morphologically, recovery rate was increased up to about 20% in ASCs injection group in 2 weeks-group (p<0.001). Few Prussian-blue positive cells were demonstrated in 2 weeks-group and more cells were present in 4 weeks-group. The cells which were positively stained in Prussian-blue stain were mainly located in peritubular spaces. Electron microscopically, fine iron granules with electron density were found in the cytoplasm of peritubular endothelial cells. CONCLUSION: As a result, the endothelial cells might be differentiated from injected ASCs. It seems that stem cells help repairing the tubular epithelium in acute renal failure model, not by tubulogenesis but by vasculogenesis. This outcome suggests that the possibility of therapeutic use of ASCs without immunosuppression of recipients in acute ischemic renal injury.

p16INK4a, PTEN, E-cadherin, Bcl-2 and Ki-67 Expression in Prostate Cancer: Its Relationship with the Metastatic Potential and Known Prognostic Factors

BACKGROUND: At present, adequate prognostic markers for prostate cancer progression are still lacking, in spite of intensive investigation. Accordingly, our study examined the relationship between expression of candidate biomarkers and metastasis in prostate cancer patients. Correlation of molecular markers with prostate-specific antigen (PSA) level, Gleason sum score and tumor stage were also evaluated. METHODS: A total of 105 prostate tumor specimens and specimens from 19 cases of nodular hyperplasia were obtained through Yeungnam University Hospital from 2007 to 2008. Immunohistochemical analyses for p16INK4a, phosphatase and tensin homolog (PTEN), E-cadherin, Ki-67 and Bcl-2 were performed. RESULTS: Overexpression of Bcl-2 was significantly related to bone (p = 0.006) and nodal metastases (p = 0.017). Other biomarkers were not related to metastatic potential. There were statistically significant relationships between increased PSA level and loss of expression of PTEN (p = 0.019) and E-cadherin (p = 0.001). High Ki-67 index was significantly correlated with nodal metastasis (p = 0.029) as well as with loss of p16INK4a expression (p = 0.002) and high Gleason score (p = 0.011). CONCLUSIONS: High Gleason score, Bcl-2 overexpression and increased Ki-67 labeling have significant predictive value in assessing the potential for prostate cancer metastasis. In addition, a high Ki-67 index is related to high Gleason score and loss of p16INK4a expression.

Automated Silver-enhanced In Situ Hybridization for Evaluation of HER2 Gene Status in Breast Carcinoma: Comparison with Fluorescence In Situ Hybridization and Immunohistochemistry

BACKGROUND: The human epidermal growth factor receptor 2 (HER2) is amplified in 20-25% of breast cancers. HER2 overexpression or amplification is associated with a worse clinical outcome and it can predict the benefit from anthracycline and anti-HER2 therapies. The HER2 status has usually been assessed by immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) in clinical samples. A new silver-enhanced in situ hybridization (SISH) technique was recently introduced. Therefore we evaluated the usefulness of SISH for detecting HER2 amplification. METHODS: Tissue microarrays (TMAs) were constructed with 144 invasive breast cancer tissue samples. We performed IHC, FISH and SISH for HER2 on the tissue sections from the TMAs and we interpreted the results according to the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines. The concordant rates between the two different tests were calculated. RESULTS: HER2 was overexpressed and amplified in 16.9%, 16.9%, and 18% of the cases by IHC, FISH and SISH, respectively. The concordant rates between IHC and FISH, IHC and SISH, and FISH and SISH were 95.1%, 95.7%, and 97.8%, respectively. CONCLUSIONS: SISH can be an alternative test for evaluating HER2 amplification because the 97.8% concordance with FISH satisfies the ASCO/CAP requirement of > 95% concordance with an alternative validated method.

The Usefulness and Limitations of Intraoperative Frozen Section Analysis of Sentinel Lymph Nodes in Patients with Breast Cancer / 한국유방암학회지

PURPOSE: Intraoperative frozen sectioning (FS) of sentinel lymph nodes (SLNs) is widely used to determine whether total axillary lymph node dissection should be performed in patients with breast cancer. We evaluated the usefulness and limitations of the FS protocol, which has been used in our institution for the intraoperative SLN examination. METHODS: We analyzed the FS results of SLNs in 807 invasive breast carcinoma patients who underwent intraoperative SLN biopsy between January 2005 and December 2007. Lymph nodes larger than 5 mm were sliced at 2 mm intervals and all the slices were submitted for FS. The remaining tissue of the SLN was formalin-fixed and paraffin-embedded for permanent sectioning (PS). If the FS result was negative for tumor cells, then immunohistochemical stain for pancytokeratin was performed. The metastatic SLNs were graded according to the AJCC cancer staging manual (6th edition). The results of FS and PS were compared with regard to the pathologic diagnosis. RESULTS: The average number of SLNs was 2.9 per patients. A total of 204 (25.3%) patients were reported to have a metastatic SLN(s) on the FS. Among the 603 patients with negative FS results, 34 (5.6%) patients showed metastasis on the PS. Another 10 (1.7%) patients who had negative results on FS showed isolated tumor cells on the PS or on the cytokeratin immunohistochemistry. Twenty-nine of the 34 (85.3%) false negative cases showed micrometastasis on the PS. Ten (29.4%) false negative results were caused by interpretation errors and 24 (70.6%) were caused by technical problems. CONCLUSION: The false negative rate of our protocol for FS of a SLN was low. The failure of FS was largely caused by the failure to detect micrometastasis. FS is a reliable method for an intraoperative SLN examination if a very stringent protocol is used.

Primary Pulmonary Glomus Tumor, Diagnosed by Preoperative Needle Biopsy: Report of One Case and Literature Review

Glomus tumors commonly occur in dermal and subcutaneous tissue in the subungal region of a finger. Some glomus tumors occur extracutaneously, including lung. Only 15 cases of primary pulmonary glomus tumor have been described in literature. In this report, we describe a case of primary pulmonary glomus tumor, which is the first case diagnosed before surgical resection. A 51-year-old man underwent a needle biopsy of a well defined coin-like mass in left lower lobe of the lung on chest radiography. Microscopic examination revealed a tumor composed of perivascularly arranged round to ovoid epithelioid cells with abundant eosinophilic cytoplasm. Tumor cells are immunoreactive for smooth muscle actin and vimentin, but negative for desmin, cytokeratin (AE1/AE3), chromogranin, or synaptophysin. A diagnosis of glomus tumor was then made. The lung mass was resected by wedge resection after being diagnosed by preoperative lung needle biopsy. Although primary pulmonary glomus tumor is rare, most cases follows a benign course. For proper treatment of the patient, glomus tumor should be considered as a differential diagnosis of solitary lung mass.

Imprint Cytology of Granular Cell Tumor: A Case Report / 대한세포병리학회지

Granular cell tumor is a rare tumor of the soft tissue and this is characterized by proliferation of large cells with granular appearing eosinophilic cytoplasm. We report the imprint cytologic features of a case of granular cell tumor in the left calf of a 52-year-old woman. Microscopic examination showed moderate cellularity. The tumor cells were arranged both as single cells and in clusters. The cells were large polygonal-shaped and they had small round nuclei with finely granular chromatin and occasionally conspicuous nucleoli. The cytoplasm was abundant eosinophilic and granular. Naked nuclei and spindle-shaped tumor cells were occasionally noted. No mitosis and necrosis were present. The background showed cytoplasmic granular materials. The tumor cells showed positivity for S-100 protein. Ultrastructurally, abundant lysosomes were present in the cytoplasm of the tumor cells.

Angiomatoid Fibrous Histiocytoma: A Case Report / 영남의대학술지

Angiomatoid fibrous histiocytoma is a rare soft tissue tumor that generally affects children and young adults. We report a case of angiomatoid fibrous histiocytoma in an 11-year-old boy who complained of a back mass for 3 years. Surgical excision was performed. The excised specimen showed a 4.0 x 3.6 x 3.0 cm, well circumscribed, grayish white tumor, with multicystic changes. Histological examination showed proliferation of spindle or round shaped tumor cells. There was a dense fibrous pseudocapsule with prominent chronic inflammatory cell infiltrates.