RESUMO
BACKGROUND: The Korean Bone and Soft Tissue Pathology Study Group of the Korean Society of Pathologists conducted a nationwide retrospective analysis of soft tissue sarcoma (STS) to provide the clinicopathologic characteristics of STS within the population of the Republic of Korea. METHODS: The cases of STS were collected during a 7-year period (2001-2007) from 19 institutes in Korea. All cases were classified according to the histologic criteria proposed by the World Health Organization. Clinicopathologic data were reviewed. RESULTS: Data from 722 patients (median age, 50 years) were collected. Data showed a slight male predominance. The most frequent types of STS in decreasing order were liposarcoma, malignant fibrous histiocytoma, leiomyosarcoma, and synovial sarcoma. STS occurred throughout the body, although approximately half (47.8%) were located in the extremities. The majority of STS was histologically classified as high grade with a large tumor size (>5 cm). The overall survival rate for the patients was 76.3% (median follow-up time, 26 months; range, 1 to 89 months). Histologic grade, tumor size, American Joint Committee on Cancer stage, tumor site, and resection status were prognostic. Significant independent adverse prognostic factors were large tumor size (>5 cm) and tumor site other than extremities. CONCLUSIONS: We reported the distribution and characteristics of STS in the Republic of Korea.
Assuntos
Humanos , Masculino , Academias e Institutos , Extremidades , Seguimentos , Histiocitoma Fibroso Maligno , Incidência , Articulações , Coreia (Geográfico) , Leiomiossarcoma , Lipossarcoma , Prognóstico , República da Coreia , Estudos Retrospectivos , Sarcoma , Sarcoma Sinovial , Taxa de Sobrevida , Organização Mundial da SaúdeRESUMO
We present the cytologic findings observed in a fine needle aspiration biopsy specimen of a rare myxoid variant of leiomyosarcoma with epithelioid features and the tumor had metastasized to the abdominal wall. The aspirate showed hypercellularity in a hemorrhagic background. Some large 3-dimensional aggregates of spindle cells were observed. Each cell had a solitary ovoid-to-elongated nucleus with finely granulated chromatin, one or two small distinct nucleoli and an irregular nuclear membrane. There were irregular fascicles of spindle cells with cigar-shaped, blunt-ended nuclei admixed with inflammatory cells. Epithelioid cells with a rather narrow, dense cytoplasmic rim and a well-defined cell border were embedded in a myxoid matrix in a cord-like and cluster arrangement. The matrix appeared as a pale green substance with sharply defined edges. There were very few mitoses. These cytologic features were the same as those of a uterine myxoid leiomyosarcoma that was surgically excised 7 years ago, and immunohistochemical staining revealed the smooth muscle origin of the tumor.
Assuntos
Parede Abdominal , Biópsia , Biópsia por Agulha Fina , Cromatina , Citoplasma , Células Epitelioides , Leiomiossarcoma , Mitose , Músculo Liso , Metástase Neoplásica , Membrana Nuclear , ÚteroRESUMO
BACKGROUND: Chromosome 15q15 near the thrombospondin-1 (THBS-1) gene may be associated with tumor progression and metastasis. To clarify the potential role of the15q15 region in progression of breast carcinoma, we investigated the loss of heterozygosity (LOH) and the microsatellite instability (MSI) status of chromosome 15q15. Methods : LOH and MSI were detected in 84 breast carcinoma specimens using PCR-based microsatellite analysis with three microsatellite markers. METHODS: LOH and MSI were detected in 84 breast carcinoma specimens using PCR-based microsatellite analysis with three microsatellite markers. RESULTS: Of 77 breast carcinomas containing the heterozygous alleles, 25 (32%) showed LOH in at least one microsatellite marker. Partial LOH and total LOH were detected in 14 (18.27%) and 11 (14.3%) cases. The total LOH were inversely correlated with node metastasis. A single LOH at D15S514 was inversely correlated with nuclear grade and a single LOH at the D15S129 allele was associated with increased expression of the THBS-1 gene. MSI-positive breast carcinomas detected in 14 (17%) cases showed no correlation with any clinicopathologic feature. CONCLUSIONS: These results indicate that loss of the chromosome 15q15 region delays the progression of breast carcinoma because the magnitude of LOH is large and involves the THBS-1 gene and additional genetic elements. The genes located on chromosome 15q15 probably play a tissue-type-dependent role in malignant growth of the tumor.
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Alelos , Mama , Neoplasias da Mama , Perda de Heterozigosidade , Instabilidade de Microssatélites , Repetições de Microssatélites , Metástase Neoplásica , SuccinimidasRESUMO
BACKGROUND: The incidence of Crohn's disease in the upper digestive tract, and especially in the stomach, is recently increasing. Focal inflammatory reaction without Helicobacter pylori (H. pylori) infection is thought to be the characteristic pathologic findings suggesting Crohn's disease in the stomach. Yet gastric involvement of Crohn's disease has not been studied in Korea. We studied the endoscopic and pathologic findings of patients with Crohn's disease in the stomach by taking biopsies. METHODS: Thirty patients with Crohn's disease who underwent gastroduodenoscopy followed by biopsies were included in the study. The pathology of the gastric biopsy specimens and the presence of H. pylori were evaluated. RESULTS: Among 30 cases, 22 cases (73.3%) were H. pylori negative and 8 cases (26.7%) were H. pylori positive. For the H. pylori negative cases, all but one cases showed pit abscess and focal lymphocytic collections in the antrum. Granulomas were found in 6 cases (20%) and they were exclusively located in the antrum. CONCLUSIONS: In the stomach, pit abscess and focal lymphocytic collections that are not associated with H. pylori infection are the characteristic pathologic findings found in Crohn's disease.
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Humanos , Abscesso , Biópsia , Doença de Crohn , Trato Gastrointestinal , Granuloma , Helicobacter pylori , Incidência , Coreia (Geográfico) , Patologia , EstômagoRESUMO
Inflammatory (xanthomatous) pseudotumors of the breast are very rare and this case is the first reported case in Korea. A healthy, pregnant 29-year-old woman presented with a right breast mass. Ultrasonography of the breast revealed a 1.8 x 1.9 x 1.1 cm, sized lobulated, partially spiculated mass in the upper and outer quadrant of the breast. Macroscopically, the mass was well circumscribed, bright yellow, and lobulated. Microscopically, the tumor was composed of foamy histiocytes with multifocal neutrophilic infiltration, accompanying chronic inflammatory cellul infiltration, fibrosis and ductal-lobular atrophy.
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Adulto , Feminino , Humanos , Atrofia , Mama , Fibrose , Granuloma de Células Plasmáticas , Histiócitos , Coreia (Geográfico) , Neutrófilos , UltrassonografiaRESUMO
Aspergillous hypophysitis is an unusual cause of sella turcica enlargement, and this malady has a clinical presentation as a pituitary tumor, and especially as a pituitary adenoma. We report here on a case of aspergillous hypophysitis that developed in a 37-year-old healthy woman. She first experienced a blurred vision with amenorrhea and galactorrhea. Three months later, the CT scan revealed an intrasellar mass. The patient underwent a transsphenoidal exploration of the sella turcica for a presumed pituitary tumor. Histologically, the pituitary displayed necrotizing granuloma with the acutely branching fungal hyphae of Aspergillus.
Assuntos
Adulto , Feminino , Humanos , Gravidez , Amenorreia , Aspergilose , Aspergillus , Galactorreia , Granuloma , Hifas , Hipófise , Neoplasias Hipofisárias , Sela Túrcica , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Matrix metalloproteinase-9 (MMP-9) is a matrix-degrading enzyme that's believed to play a crucial role not only for tumor invasion and metastasis, but also for a variety of stromal reactions, including neovascularization. The aim of this study was to investigate the expression of MMP-9 and to compare its expression with the angiogenesis activity in human osteosarcoma. METHODS: Archival tumor tissue samples from 20 patients with osteosarcoma were analyzed by performing immunohistochemistry for the expression of MMP-9 and CD34. The vascularity was measured as the average microvascular density (MVD) of the CD34-positive vessels. The clinical information was obtained through searching the computerized retrospective database from the tumor registry. RESULTS: MMP-9 was expressed in 90% (18/20) of the tumors we examined. The MVD ranged from 10.5 to 179.7 with a mean of 64.9. There was no significant correlation between the MMP-9 expression and the MVD (p=.613). The MMP-9 expression was not associated with any of the clinicopathologic variables, whereas the MVD showed an increasing tendency according to the metastasis status (p=.073). CONCLUSIONS: We demonstrated that MMP-9 activation is likely to occur in human osteosarcoma. However, there was no direct involvement of MMP-9 with tumor angiogenesis. It is noteworthy that MVD may aid physicians to predict the presence of distant metastasis in osteosarcoma patients.
Assuntos
Humanos , Imuno-Histoquímica , Metaloproteinase 9 da Matriz , Metástase Neoplásica , Osteossarcoma , Estudos RetrospectivosRESUMO
The glomus tumor or glomangioma is an uncommon benign tumor that arises from the modified smooth muscle cells of the glomus body, a neuromyoarterial receptor sensitive to temperature, that regulates arterial flow. It is most commonly found in the skin particularly in the nailbeds or fingertips, but approximately 70 cases described in the stomach. The author experienced a glomus tumor of the stomach was found in a 43 year old female patient who had discomfort in upper abdomen for 40 days. Clinically, this uncommon gastric tumor mimics most of the benign and malignant lesions of the stomach and the most important aspect of this tumor is its histologic identification and differentiation from the more common gastric lesion. Microscopically the tumor was composed of cellular lobules of various sizes separately by irregular fibrous and muscular trabeculae. Ultrastructural study showed basal lamina, pinocytotic vesicles and numerous subplaomalemmal plaque.
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Feminino , HumanosRESUMO
Eosinophilic cellulitis is a rare dermatosis first described by Wells, and characterized by recurrent episodes of sudden outbreaks of erythematous cutaneous swellings often painful or pruritic. Microscopically, the lesion shows diffuse tissue eosinophilia and fibrinoid flame figures, evolution of associated focal necrobiosis, and formation of focal microgranulomas associated with eosinophils. The cause is still unknown but the triggers which have been thought to precipitate the disease include insect bites, parasitic infections such as toxocara, onchocerciasis, nasopharyngeal carcinoma, rheumatoid arthritis and spider bites. However many cases are idiopathic. The author experienced a case of eosinophilic cellulitis of a 52-year-old woman with multiple cutaneous tender plaques of cellulitis for approximately 10 years with history of repeated remission and recurrent episodes. Biopsy was taken from ulcerated edematous nodule of inguinal region under the clinical impression of deep fungal infection, pyoderma gangrenosum and polyarteritis nodosa. Cultures for fungal and common organisms were negative. Histologically, the entire dermis was infiltrated by numerous eosinophils and scattered histiocytes. There were scattered flame figures showing necrobiotic foci in the collagen with accumulation of eosinophils, granulated free cosinophilic granules and histiocytes.
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Feminino , Humanos , Pessoa de Meia-Idade , Biópsia , Celulite (Flegmão)/patologia , Celulite (Flegmão)/terapia , Eosinofilia/patologia , Eosinofilia/terapiaRESUMO
Eosinophilic cellulitis is a rare dermatosis first described by Wells, and characterized by recurrent episodes of sudden outbreaks of erythematous cutaneous swellings often painful or pruritic. Microscopically, the lesion shows diffuse tissue eosinophilia and fibrinoid flame figures, evolution of associated focal necrobiosis, and formation of focal microgranulomas associated with eosinophils. The cause is still unknown but the triggers which have been thought to precipitate the disease include insect bites, parasitic infections such as toxocara, onchocerciasis, nasopharyngeal carcinoma, rheumatoid arthritis and spider bites. However many cases are idiopathic. The author experienced a case of eosinophilic cellulitis of a 52-year-old woman with multiple cutaneous tender plaques of cellulitis for approximately 10 years with history of repeated remission and recurrent episodes. Biopsy was taken from ulcerated edematous nodule of inguinal region under the clinical impression of deep fungal infection, pyoderma gangrenosum and polyarteritis nodosa. Cultures for fungal and common organisms were negative. Histologically, the entire dermis was infiltrated by numerous eosinophils and scattered histiocytes. There were scattered flame figures showing necrobiotic foci in the collagen with accumulation of eosinophils, granulated free cosinophilic granules and histiocytes.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Biópsia , Celulite (Flegmão)/patologia , Celulite (Flegmão)/terapia , Eosinofilia/patologia , Eosinofilia/terapiaRESUMO
Leiomyomas are benign tumors of smooth muscle origin and are very rare in the female genital tract. To date, approximately 35 cases of urethral leiomyoma have been reported in the literature. A 34-year-old woman presented with a 3-year history of a mass at the urethral meatus. Physical examination showed 2 x 1.5 cm lump at the urethral meatus, posterior lip. Histologically the tumor was mainly composed of benign cigar shaped smooth muscle izells which were arranged in interlacing fascicles without cellular atypia or mitosis. Immunohistochemistry confirmed leiomyoma with positive staining for vimentin, desmin and muscle specific actin.
Assuntos
Feminino , HumanosRESUMO
During tumor progression, a subset of cells acquires metastatic properties, presumably through a series of genetic alterations. CD44 variant glycoproteins containing sequences encoded by exon v6 are related to tumor progression of human colorectal cancer. But their expression in normal colonic epithelium is controversial and studies of CD44 on each step of colorectal carcinogenesis are scanty. We studied CD44v6 expression in the normal colonic mucosa, adenoma, carcinoma in situ, and invasive colorectal carcinomas of different Astler-Coller stages. Endoscopically or surgically resected 36 normal colonic mucosa, 19 adenomas, 8 cases of carcinoma in situ, and 25 cases of carcinoma were selected. After immunohistochemical stain with CD44v6 antibody, positivity was graded as 0 to 4 based on the estimated percentage of positively stained tumor cells. The intensity of positive staining cells was also graded as 0 to 3. In all but one cases (97.2%), normal colorectal mucosa was negative for CD44v6. Positive rates in adenoma, carcinoma in situ, Astler-Coller stage A/B and C/D carcinoma were 73.6%, 88.9% and 87.5%, respectively. There was no statistically significant difference in the positivity between these groups. The staining intensity was significantly higher in the cases of stage C/D carcinoma group than those of adenomas (p<0.05). The percentage of positivity for CD44v6 was higher in stage C/D carcinoma group than adenoma, carcinoma in situ, and stage A/B carcinoma group (p<0.05). Expression of CD44v6 in the normal colonic mucosa was extremely rare and the positivity was increased according to the progression of colorectal tumors. Furthermore, it is more important to interpret the CD44v6 positivity according to the estimated percentage of positively stained tumor cells.
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Humanos , Adenoma , Carcinogênese , Carcinoma in Situ , Colo , Neoplasias Colorretais , Epitélio , Éxons , Glicoproteínas , Mucosa , Metástase NeoplásicaRESUMO
To evaluate the role of p53 and NDP-K/nm23(nm23) protein as a prognostic factor and their relation to metastasis of cancer, we studied metastatic and nonmetastatic gastric carcinoma specimens by immunohistochemical staining. Among the 101 specimens examined, 37(36.6%) showed positivity in staining for p53 protein and 64(63.4%) showed no detectable p53 protein in tumor cells. p53 overexpression was correlated with depth of invasion, lymphatic invasion, lymph node metastasis and distant metastasis. Out of 101 specimens, 35 cases had no staining for nm23. 62 cases(61.4%) exhibited a cytoplasmic staining on most cells and 42 cases (41.6%) had nuclear staining. In 16 of 101 cases(15.8%), a mild to moderate membranous staining was observed in some cells. Cytoplasmic nm23 expression was negatively correlated with lymph node metastasis(P < 0.01) and distant metastasis(P < 0.01). The nuclear nm23 expression showed negative correlation with depth of invasion(P < 0.01), lymphatic invasion(P < 0.01), lymph node metastasis(P < 0.01), and distant metastasis(P < 0.04). The membranous nm23 expression revealed negative correlation with lymphatic invasion(P < 0.02), lymph node metastasis(P < 0.01) and distant metastasis(P < 0.02).
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Regulação Neoplásica da Expressão Gênica , Imuno-Histoquímica , Pessoa de Meia-Idade , Metástase Neoplásica , Núcleosídeo-Difosfato Quinase/análise , Prognóstico , Proteína Supressora de Tumor p53/genética , Neoplasias Gástricas/química , Fatores de Transcrição/genéticaRESUMO
Helicobacter pylori(H. pylori) infection is considered the most important cause of chronic active gastritis and peptic ulcer. To determine the prevalence, distribution and it's relationship to degree of inflammation, gastric biopsy specimens were obtained from 331 nonulcer dyspepsia(NUD) patients consisting of 52 H. pylori negative normal volunteers and 279 H. pylori infected patients. Lymphoid follicles, degree of acute and chronic inflammation(Grade 0 to 3), and degree of H. pylori(Grade 0 to 4) were observed. The prevalence of H. pylori in NUD was 84.29%. The lymphoid follicles were found in 138 patients(41.7%) and only 5 patients(l.5%) without H. pylori showed lymphoid follicles. There was strong a relationship between lymphoid follicles and degree of acute and chronic inflammation and intensity of H. pylori infection(P<0.001). Acute and chronic inflammation were more serious in the antrum than body in H. pylori infected patients. There was no relationship between lymphoid follicles and the site in the stomach of H. pylori infection(P<0.078), but the body portion had an increased frequency of lymphoid follicles compared to the in antrum. Our results indicate that the prevalence of H. pylori infection in Korea is higher than in Western people and the degree of acute and chronic inflammation are strongly correlated with the presence of lymphoid follicles. The lymphoid follicles are believed to be absent from the normal stomach and their presence is strongly associated with H. pylori infection. The fact there is an that increased frequency of lymphoid follicles in H. pylori infected patients, and that they are more prevalent in the body of the antrum, support the concept that H. pylori may be a precursor in the development of primary gastric lymphoma.
Assuntos
BiópsiaRESUMO
Primary bone marrow lymphomas are infrequent. We report a case of primary bone marrow T-cell lymphoma in a 33-year old patient who has been treated as a hypocellular marrow. There was no enlarged lymph nodes or organomegaly. The peripheral blood smears showed several lymphoid atypical cells. The bone marrow biopsy revealed markedly increased cellularity and disclosed malignant lymphoma, diffuse, large-cell, immunoblastic type The lymphoma cells disclosed positive reaction in leukocyte common antigen (CD45) and UCHL-1 (CD45RO) antibodies which is compatible with a T-cell phenotype. The patient was received allogeneic bone marrow transplantation.
Assuntos
Adulto , Humanos , Anemia Aplástica , Anticorpos , Antígenos Comuns de Leucócito , Biópsia , Transplante de Medula Óssea , Medula Óssea , Linfonodos , Linfoma , Linfoma de Células T , Fenótipo , Linfócitos TRESUMO
Primary adenocarcinoma of the seminal vesicle is an extremely rare tumor, and its prognosis has been known to be poor. Herein, we report an adenocarcinoma of the seminal vesicle. The patient was a 50-year-old man who complained of a two-month history of terminal hematuria and lower abdominal discomfort. A pelvic magnetic resonance imaging study. Indicated a seminal vesicle cyst with focal intraluminal growth. Right seminal vesiculectomy was performed. Grossly, the seminal vesicle revealed a markedly cystic change with focal, friable, intraluminal papillary growth. The intraluminal mass showed a noninvasive adenocarcinoma with a tubular and tubulopapillary pattern, accompanied by necrosis. Immunohistochemically, the tumor was positive for cytokeratin and carcinoembryonic antigen and negative for prostate specific antigen and prostatic acid phosphatase.
Assuntos
Humanos , Pessoa de Meia-Idade , Fosfatase Ácida , Adenocarcinoma , Antígeno Carcinoembrionário , Hematúria , Queratinas , Imageamento por Ressonância Magnética , Necrose , Prognóstico , Antígeno Prostático Específico , Glândulas SeminaisRESUMO
Development of an invasive squamous cell carcinoma within a branchial cleft cyst (branchiogenic carcinoma) is very rare and this case is the first description of cytologic findings in Korea. A 62-year-old man presented with a 5-month history of an enlarged right neck mass. Fine needle aspiration cytology of the mass showed low cellularity and the background containing proteinaceous debris, inflammatory cells, and histiocytes suggested a cystic nature. Abundant lymphocytes, a few anucleated squames, and rare atypical squamous cells with pyknotic nuclei and abnormal keratinization were also noted. After excision of the mass, histologic findings were consistent with a branchiogenic carcinoma. We recommend to raise the possibility of carcinoma (primary or metastatic) when we observe a few dyskeratotic cells in a cystic mass within the neck area, especially in an old male.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Biópsia por Agulha Fina , Branquioma , Carcinoma de Células Escamosas , Histiócitos , Coreia (Geográfico) , Linfócitos , PescoçoRESUMO
Primary clear cell adenocarcinoma of uterine cervix is rare and cytomorphology in the vaginal smear have not been previously described in Korean literatures. The cytologic characteristics of clear cell adenocarcinoma of the uterine cervix include : malignant cells with abundant, finely vacuolated cytoplasm ; hobnail appearance ; and distinctive basement membrane-like hyaline materials within cellular aggregates. A 36-year-old woman presented with vaginal bleeding. Cytologic examination of vaginal smear and histopathologic examination of a radical hysterectomy specimen allowed the diagnosis of hemorrhagic tumor in the uterine cervix as a clear cell adenocarcinoma. Cytologic findings were very characteristic. The tumor cells had abundant, pale, finely vacuolated cytoplasm with indistinct cytoplasmic membrane. The nuclei were round to oval with finely dispersed chromatin. Extracellular basement membrane-like hyaline substance, which stained a light green color in Papanicolaou's preparation, was frequently observed within the cancer cell clusters.
Assuntos
Adulto , Feminino , Humanos , Adenocarcinoma , Adenocarcinoma de Células Claras , Membrana Celular , Colo do Útero , Cromatina , Citoplasma , Diagnóstico , Hialina , Histerectomia , Verde de Metila , Hemorragia Uterina , Esfregaço VaginalRESUMO
Multinucleated giant cells of osteoclast-like appearance can be seen in a type of anaplastic carcinoma of thyroid and only a few case reports for fine needle aspiration cytologic findings are found in the literatures. Recently, we experienced a case of anaplastic carcinoma of thyroid with many osteoclast-like giant cells in a 72-year-old woman. The cytologic features and immunohistochemical results are described with special emphasis on differential diagnosis.
Assuntos
Idoso , Feminino , Humanos , Biópsia por Agulha Fina , Carcinoma , Diagnóstico Diferencial , Células Gigantes , Glândula TireoideRESUMO
"Hyalinizing spindle cell tumor with giant rosettes" (HSCTGR) is a recently described tumor, which is regarded as an unusual variant of low-grade fibromyxoid sarcoma. Proof of a metastatic potential was lacking. The patient in the report was a 35-yr-old woman who showed multiple bilateral pulmonary nodules with massive pleural effusion in the right side. She had a history of a mass excision in the right thigh 11 yrs ago at another hospital, which was reported as a "leiomyoma". Two years before this presentation, the patient received a routine chest radiograph which demonstrated bilateral multiple pulmonary nodules. A lobectomy of the left upper lung was performed. The histological findings revealed a well-circumscribed nodule that was characterized by a spindle-shaped fibrous to hyalinized stroma with criss-crossing short fascicles and giant collagen rosettes surrounded by a rim of spindle-shaped cells. Electron microscopy confirmed the fibroblastic nature of the tumor. This case, in addition to at least two other cases reported in the literature, demonstrates that the HSCTGR is a malignant neoplasm with the capacity to metastasize after a long hiatus.