• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.202-205
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• 2020

Trichoepithelioma is a benign hair follicle tumor that can undergo malignant transformation into basal cell carcinoma in rare cases. Due to the similar clinical and histological features of trichoepithelioma and basal cell carcinoma, distinguishing between these types of tumors can be a diagnostic challenge. Punch biopsy obtains only a small sample of the entire lesion, and thus inherently involves a risk of misdiagnosis between histologically similar diseases. Therefore, if the possibility of misdiagnosis can reasonably be suspected, clinicians should conduct an excisional biopsy or immunohistochemical staining (e.g., CD10 and Bcl-2) to ensure an exact diagnosis. Although trichoepithelioma is benign, the surgical excision of solitary trichoepithelioma should be considered in order to avoid the possibility of malignant transformation, which has occasionally been documented for multiple familial trichoepitheliomas. Herein, we report a case that was initially misdiagnosed as trichoepithelioma before ultimately being diagnosed as basal cell carcinoma through excision and immunohistochemical staining.

• 한국임상수의학회지
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• 제38권6호
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• pp.279-284
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• 2021

A 10-year-old spayed female Yorkshire terrier dog with a history of pleural effusion and dyspnea for a week was referred to the Veterinary Teaching Hospital. Radiography revealed pulmonary edema and pleural effusion. A mass infiltrating the right atrial lumen and especially the supra-tricuspid valve was identified with echocardiography. The mass was diagnosed as intracardiac neoplasia. Symptomatic treatment was prescribed to alleviate the symptoms of heart failure. Despite symptomatic treatment, the patient died a few days later. After obtaining consent from the owner, necropsy and histopathological evaluation were performed. The result was consistent with cardiac leiomyoma, and the diagnosis was confirmed by immunohistochemical staining. To the authors' knowledge, this case is the first report of intracardiac leiomyoma in a dog in Korea.

• 대한세포병리학회지
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• 제8권2호
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• pp.115-119
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• 1997

Cytologic diagnosis of reactive or malignant effusion is sometimes difficult. Especially, differentiation of benign reactive mesothelial cells from malignant cells in body effusion is more difficult. Recently, immunohistochemistry has been used to diagnose difficult cases. Phospholipase $C(PLC)-{\gamma}1$ is one of the isoenzyme of the PLC which plays central role in signal transduction involving cellular growth, differentiation and transformation by phosphorylating many protein component. Increased expression of $PLC-{\gamma}1$ in human breast carcinoma, colorectal carcinoma and stomach cancers are reported. To evaluate the efficacy of positive $PLC-{\gamma}1$ immunostaining in the diagnosis of malignancy in effusions, paraffin-embedded cell blocks of pleural fluid and ascites from 10 patients(5 metastatic adenocarcinomas, and 5 reactive mesothelial cells) were immunostained with a monoclonal antibody to $PLC-{\gamma}1$. $PLC-{\gamma}1$ immuostained all the adenocarcinomas in cell block(5/5) with intense membrane pattern, however, none of the reactive mesothelial proliferations stained with the diagnostic membrane pattern. Thus, our study strongly supports the conclusion that $PLC-{\gamma}1$ immunopositivity is likely to become a useful adjunct for the diagnosis of malignancy in effusions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권4호
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• pp.225-229
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• 2019

Individuals with human immunodeficiency virus (HIV) infection present with unique intraoral manifestations of various neoplasms. Intraoral HIV-associated Burkitt's lymphoma is a rare presentation, especially in patients of Indian origin and may present as an initial sign of HIV. The objective of this paper is to report a rare case of Burkitt's lymphoma in an HIV-positive Indian patient along with a special emphasis on differential diagnosis. A 30-year-old Indian female presented with a solitary, well-defined, exophytic mass extending anteroposteriorly and buccolingually from the 35th to 38th regions with no evidence of intraosseous extension. An incisional biopsy was performed, and histopathology showed sheets of neoplastic lymphoid cells with numerous tingible body macrophages with clear cytoplasm, presenting a starry sky appearance, suggesting a diagnosis of BL. The tumor cells were positive for CD10, CD20, c-myc, and Epstein-Barr virus, with a nearly 100% Ki-67 proliferative index. The patient tested positive for HIV. This report indicates the importance of immunohistochemical analysis to differentiate Burkitt's lymphoma from other similar lesions like diffuse large B-cell lymphoma. Thorough knowledge of the clinical presentation, etiopathogenesis, histopathology, and immunoprofile of intraoral HIV-associated Burkitt's lymphoma is essential among clinicians and pathologists.

• 대한두개안면성형외과학회지
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• 제23권3호
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• pp.125-129
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• 2022

Most malignant lymphomas of the head and neck region are non-Hodgkin lymphomas (NHL), and diffuse large B-cell lymphoma is the most common subtype. The prevalence of malignant lymphoma among parotid tumors is low, approximately 1% to 4%. The most common symptom of parotid lymphoma is a unilateral, non-tender, firm mass that slowly grows in size over time. As its clinical manifestations are nonspecific, a comprehensive assessment is required for an accurate diagnosis. The initial work-up includes imaging tools, such as computed tomography and magnetic resonance imaging. However, NHL of the parotid gland is difficult to distinguish from other types of benign tumors prior to biopsy; histopathological evaluation and subsequent immunohistochemical staining are needed for the final diagnosis. Once a definitive diagnosis is established, patients should be referred to an oncologist for staging. Treatment is mainly based on systemic chemotherapy, whereas radiotherapy is indicated for certain cases. Here, we report the case of a 53-year-old man who presented with a progressively enlarging mass in the right parotid area, which was later diagnosed as malignant lymphoma of the parotid gland after superficial parotidectomy.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.491-495
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• 2016

Background: Small B-cell non-Hodgkins lymphoma (NHL) is difficult to be distinguished from non-neoplastic reactive processes using conventional haematoxylin-eosin (HE) staining due to different interpretations among pathologists with diagnosis based on morphologic features. Ancillary examinations such as immunohistochemical (IHC) staining are essential. However, negative or doubtful results are still sometimes obtained due to unsatisfactory tissue processing or IHC technique. The polymerase chain reaction (PCR) as a molecular diagnostic technique is very sensitive and specific. Clonality detection of heavy chain immunoglobulin (IgH) gene rearrangement has been widely used to establish diagnosis of B-cell NHL. Aims: To elaborate interobserver variation in small B-cell NHL diagnosis based on morphologic features only and to confirm sensitivity and specificity of the PCR technique as an ancillary method. Materials and Methods: A toptal of 28 samples of small B cell NHL and suspicious lymphoma were interpreted by 3 pathologists in Sardjito General Hospital based on their morphology only. The reliability of assessment and the coefficient of interobserver agreement were calculated by Fleiss kappa statistics. Interpretation results were confirmed with IHC staining (CD20, CD3, Bcl2). PCR was performed to analyze the clonality of IgH gene rearrangement. Results: Interobserver agreement in morphologic evalution of small B cell NHL and chronic lymphadenitis revealed kappa coefficient 0.69 included in the substantial agreement category. The cases were divided into 3 groups based on morphology and IHC results; lymphoma, reactive process and undetermined group. PCR analysis showed 90% sensitivity and 60% specificity. Conclusions: The present study revealed a substantial agreement among pathologists in small B-cell NHL diagnosis. For difficult cases, PCR is useful as complementary method to morphologic and IHC examinations to establish definitive diagnosis.

• 대한임상검사과학회지
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• 제39권2호
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• pp.128-135
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• 2007

This study was designed to investigate the correlation between the expression rate of p53 and p21 proteins by immunohistochemical staining and tumor prognostic factors including the tumor size, histological differentiation and Dukes' stage of tumor prognostic factors in colon cancer, and to acquire necessary data for the presumption of diagnosis, treatment and prognosis of colon cancer patients. From January 2000 to January 2003 at Hanyang University Guri Hospital, the paraffin blocks of 35 patients diagnosed with colon cancer whose pathologic reports were possible to review were selected. Harris hematoxylin & eosin (H&E) staining and immunohistochemical staining by ABC (Avidin Biotin Conjugate) method were performed. The histological differentiation grade and stage were classified according to the classification of the World Health Organization (WHO) and modified Dukes's stage from H&E staining. The expression rate of p53 and p21 proteins were analyzed by immunohistochemical staining. The results was analyzed statistically by SPSS (Windows version 8.0). As a result, the expression rate of p53 protein was 11.4% (4 cases) in clear differentiation, 48.6% (17 cases) in moderate differentiation, and 17.1% (6 cases) in poor differentiation. In other words, the poorer the differentiation, the higher the expression rate of p53 protein (p<0.05). The expression rate of p21 was 17.1% (6 cases) in clear differentiation, 40.0%(14 cases) in moderate differentiation, and 8.6% (3 cases) in poor differentiation, According to the progression of histological malignant degeneration, the expression rate of p21 protein decreased distinctively (p<0.05). However, the correlation between the two above mentioned proteins and the tumor-size and Dukes' stage was not of statistical significance. In the comparison of the expression rate of p53 protein with that of p21 protein, in 10 cases, p53 protein expression was positive while p21 protein expression was negative, and in 6 cases, p53 protein expression was negative whereas p21 protein expression was positive. Consequently a statistically significant inverse correlation between the expression rate of p53 protein and that of p21 protein was observed (p<0.05). In conclusion, we found a significant correlation between histological differentiation and the expression rate of p53 and p21 proteins (p<0.05), and a significant inverse correlation between the expression rate of p53 protein and that of p21 protein (p<0.05). Also, it could be confirmed that the over expression of p53 and p21 proteins is closely associated with the occurrence of colon cancer and its progress. Therefore, it is thought that this study may be greatly beneficial to the presumption of diagnosis, treatment and prognosis of colon cancer patients.

• 대한임상검사과학회지
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• 제48권4호
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• pp.371-377
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• 2016

탈회방법은 골수조직의 병리학적 진단을 위해서 항상 시행되는 과정이다. HCl 탈회용액과 같이 주로 사용하고 있는 산성용액은 탈회과정 동안에 조직내의 항원성에 손상을 입힌다. 특히, 골수조직 내의 RNA나 DNA에 심하게 손상을 준다. 따라서 조직의 항원성을 보존하기 위한 표준화된 탈회방법이 필요하다. 본 연구는 일반적으로 가장 많이 사용되는 HCl 기반의 상품화된 탈회용액과 직접 제조한 EDTA 탈회용액이 골수조직의 탈회과정에 어떤 영향을 미치는지 분석하였다. 환자로부터 채취된 73예의 골수생검조직을 HCl 탈회와 EDTA 탈회의 두 그룹으로 나누어 탈회과정을 진행하였다. 골수생검조직의 탈회과정 후 결과의 차이는 hematoxylin & eosin 염색과 reticulum 염색, Ki-67, CD20, CD138의 항체를 이용한 면역조직화학염색, DNA 추출 및 분석, in situ hybridization, IGH gene rearrangement 와 같은 분자병리검사를 시행하여 분석하였다. 일반적인 염색과 특수염색에서는 두 탈회용액간의 차이는 없었다. 또한 세포증식 표지자와 같은 세포막 혹은 세포질에서 발현되는 항체는 탈회용액간의 차이 없이 잘 염색되었다. 반면 HCl 탈회 용액에 처리한 후 핵 내 단백질인 Ki-67의 염색상은 현저히 불량한 것으로 관찰되었다. HCl 탈회용액과 비교하여 EDTA 탈회용액에서의 골수생검조직 내의 DNA와 RNA가 잘 보존되었음을 다양한 분자병리검사를 통해 확인할 수 있었다. 특히 HCl 탈회용액에 처리한 28예와 EDTA 탈회용액에 처리한 12예의 DNA의 순도와 농도을 비교한 결과 통계학적으로 유의한 수준으로 차이가 있음을 확인하였다. 이로써 EDTA 탈회용액이 조직 내의 항원성을 잘 유지시키며, 면역조직화학염색과 분자병리검사에 적합한 방법임을 확인 할 수 있었다.

• IMMUNE NETWORK
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• 제10권6호
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• pp.239-246
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• 2010

Background: Monoclonal antibodies (mAbs) recognizing Class III epitope of CD34 are essential for flow cytometric diagnosis of leukemia. Methods: 27H2 mAb was developed from a mouse alternatively immunized with human acute leukemia cell lines, KG1 and Molm-1. Using flow cytometric analysis of various leukemic cell lines and peripheral blood, immunohistochemical study of frozen tonsil, we characterized 27H2 mAb. Antigen immunoprecipitated with 27H2 mAb immunobloted with anti-CD34 mAb. A case of bone marrow sample of acute lymphoblastic leukemia (ALL) patient was obtained at CBNU Hospital. For epitope identification enzyme treatment with neuraminidase and O-sialoglycoprotein endopeptidase (OSGE) and blocking assay with known classIII mAb (HPCA-2) were done. Results: Only KG1 and Molm-1 revealed positive immunoreactivity. Immunohistochemical staining disclosed strong membranous immunoreactivity on high endothelial venules. Antigen immunoprecipitated by 27H2 mAb showed approximately 100 kDa sized band immunoblotted with anti-CD34 under non-reducing conditions. Epitope recognized by 27H2 mAb disclosed resistancy to both neuraminidase and OSGE treatment and completely blocked with known class III mAb preincubation. CD34 positive leukemic cells in BM of pre B cell ALL patient detected by FITC-conjugated 27H2 and HPCA-2 were identified with similar sensitivity. Conclusion: A novel murine mAb recognizing class III epitope of human CD34 with high affinity, which is useful for flow cytometric diagnosis of leukemia, was developed.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8203-8210
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• 2016

Adenocarcinomas (AC) are the most frequently encountered carcinomas. It may be quite challenging to detect the primary origin when those carcinomas metastasize and the first finding is a metastatic tumor. This study evaluated the role of sex hormone binding globulin (SHBG) positivity in tumor cells in the subclassification and detection of the original organ of adenocarcinomas. Between 1994 and 2008, 64 sections of normal tissue belonging to ten organs, and 116 cases diagnosed as adenoid cystic carcinoma and mucoepidermoid carcinoma of the salivary gland, lung adenocarcinoma, invasive ductal carcinoma of the breast, adenocarcinoma of stomach, colon, gallbladder, pancreas and prostate, endometrial adenocarcinoma and serous adenocarcinoma and mucinous adenocarcinoma of the ovary, were sent to the laboratory at the Department of Pathology at the Yuzuncu Yil University School of Medicine, where they were stained immunohistochemically, using antibodies against SHBG. The SHBG immunoreactivity in both the tumor cells and normal cells, together with the type, diffuseness and intensity of the staining were then evaluated. In the differential diagnosis of the adenocarcinomas of the organs, including the glandular structures, impressively valuable results are encountered in the tumor cells, whether the SHBG immunopositivity is evaluated alone or together with other IHC markers. Further extensive research with a larger number of cases, including instances of cholangiocarcinoma and cervix uteri AC [which we could not include in the study for technical reasons] should be performed, in order to appropriately evaluate the role of SHBG in the differential diagnosis of AC.