Adenoma ; pathology ; Carcinoma ; pathology ; Carcinoma in Situ ; pathology ; Gastric Mucosa ; pathology ; Humans ; Neoplasm Invasiveness ; Precancerous Conditions ; pathology ; Stomach Neoplasms ; classification ; pathology

Adenoma, Oxyphilic ; classification ; pathology ; Carcinoma, Renal Cell ; classification ; metabolism ; pathology ; Humans ; Kidney ; pathology ; Kidney Neoplasms ; classification ; genetics ; pathology ; therapy ; Molecular Biology ; methods ; trends

Gastric epithelial neoplasia is a very common disease entity in Korea, encompassing gastric adenoma and adenocarcinoma. There are still discrepancies in pathologic diagnosis of gastric epithelial neoplasia between Western and Japanese pathologists after Vienna consensus classification. With increasing use of endoscopic therapy such as endoscopic mucosal resection and endoscopic submucosal dissection, it is very important to agree on the consensus criteria in the diagnosis of gastric epithelial neoplasia among pathologists in Korea. On this background, the current concepts, and contemporary issues of definition, diagnostic and classification criteria of gastric epithelial neoplasia were reviewed.
Adenocarcinoma/classification/*pathology ; Adenoma/classification/*pathology ; Biopsy ; Consensus Development Conferences as Topic ; Endoscopy, Gastrointestinal ; Epithelial Cells/pathology ; Humans ; Japan ; Observer Variation ; Stomach Neoplasms/classification/*pathology ; *Terminology as Topic

Adenoma ; classification ; pathology ; Carcinoma in Situ ; classification ; pathology ; Carcinoma, Squamous Cell ; classification ; pathology ; Colorectal Neoplasms ; classification ; pathology ; Esophageal Neoplasms ; classification ; pathology ; Gastrointestinal Neoplasms ; classification ; pathology ; Humans ; Hyperplasia ; classification ; pathology ; Neoplasm Staging ; Precancerous Conditions ; classification ; pathology ; Stomach Neoplasms ; classification ; pathology ; World Health Organization

BACKGROUND: Mucin producing cystic neoplasms, such as mucinous cystic tumor (MCT) and intraductal papillary mucinous tumor (IPMT) of the pancreas, are uncommon but become increasing in their incidences. The pathologic classification and biologic potential of these neoplasmsremain the subject of controversy. METHODS: The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists analyzed the clinicopathologic characteristics of 85 casesof MCT and 72 cases of IPMT and examined the expression patterns of p53, CEA and MUC1. RESULTS: IPMT was located largely in the head, and showed connection with the main pancreatic duct (MPD, 68.1%), no ovarian-like stroma (0/72), and presence of intervening intratumoralnormal or atrophic parenchyma. On the other hand, MCT was located largely in thetail (73%), and showed common ovarian-like stroma (66/80), rare connection with the MPD(7/85) and no intervening pancreatic parenchyma. CEA and p53 immunoexpressions weresignificantly increased from adenoma through borderline to carcinoma, but MUC 1 was expressedonly in the invasive carcinoma among cases of MCT and IPMT. CONCLUSIONS: The tumorlocation, ovarian-like stroma, connection with the MPD and intratumoral intervening nonneoplastictissue were helpful in the differential diagnosis between IPMT and MCT. CEA and p53expressions can be indicators of malignancy, while MUC 1 expression can indicate invasion.
Adenoma ; Classification ; Diagnosis, Differential ; Hand ; Head ; Incidence ; Korea* ; Mucins* ; Pancreas* ; Pancreatic Ducts ; Pathology ; Prevalence*

Adenocarcinoma ; Adenoma ; Adult ; Cysts ; Female ; Humans ; Male ; Middle Aged ; Thyroid Neoplasms ; classification ; diagnosis ; pathology

Adenocarcinoma, Follicular ; classification ; metabolism ; pathology ; Adenoma ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Carcinoma, Papillary ; metabolism ; pathology ; Diagnosis, Differential ; Humans ; Signal Transduction ; Thyroid Neoplasms ; classification ; metabolism ; pathology

OBJECTIVETo study the serrated lesions of colon and to compare the malignant potential between traditional serrated adenomas (TSA) and conventional adenomas (CAD).

METHODSA total of 5347 cases of colorectal polyps encountered in five regional hospitals during a five-year period were retrospectively reviewed. The serrated lesions were classified on the basis of histologic examination. One hundred and eighty-seven cases of CAD (including 160 cases of tubular adenoma and 27 cases of villous adenoma) and 36 cases of invasive adenocarcinoma were randomly selected as the controls. The degree of dysplasia and expressions of Ki-67, p53 and beta-catenin in TSA and CAD were compared.

RESULTSAmongst the 5347 colorectal polyps studied, 258 cases (4.8%) of serrated lesions were found, which included 112 cases (43.4%, 112/258) of hyperplastic polyp, 78 cases (30.2%, 78/258) of TSA and 26 cases (10.1%, 26/258) of sessile serrated adenoma. Sixty-two cases of TSA were identified from 3 hospitals, in which moderate dysplasia was found in 13 cases. High-grade intraepithelial neoplasia and ICA were found in 6 cases (9.6%). Compared with the 187 cases of CAD, moderate dysplasia were found in 27 cases and high-grade intraepithelial neoplasia and invasive adenocarcinoma were found in 25 cases (13.3%, χ(2) = 19.373, P = 0.000). There was statistically significant difference between TSA and CAD in the degree of dysphasia. The expression of Ki-67, p53 and beta-catenin in TSA and CAD showed no significant difference (P > 0.05).

CONCLUSIONSThe incidence of serrated lesions is lower in northern Chinese population than that in Caucasians. TSA has obvious malignant potential; but the rate associated with high-grade intraepithelial neoplasia and invasive adenocarcinoma is lower than that in CAD.

Adenocarcinoma ; metabolism ; pathology ; Adenoma ; classification ; metabolism ; pathology ; Adenoma, Villous ; classification ; metabolism ; pathology ; Cell Transformation, Neoplastic ; pathology ; Colonic Polyps ; metabolism ; pathology ; Colorectal Neoplasms ; classification ; metabolism ; pathology ; Humans ; Intestinal Polyps ; metabolism ; pathology ; Ki-67 Antigen ; metabolism ; Precancerous Conditions ; metabolism ; pathology ; Rectum ; pathology ; Retrospective Studies ; Tumor Suppressor Protein p53 ; metabolism ; beta Catenin ; metabolism

OBJECTIVETo clarify the various diagnostic connotations of pseudomyxoma peritonei (PMP) and to study their prognostic implications.

METHODSClinicopathologic features and follow-up data of 40 patients with PMP diagnosed in The General Hospital of PLA were retrospectively reviewed. The cases were histologically classified into 3 subcategories: disseminated peritoneal adenomucinosis (DPAM), peritoneal mucinous carcinomatosis (PMCA), and PMCA with intermediate or discordant features (PMCA-I/D). The survival rate was calculated using Kaplan-Meier method and the difference was statistically analyzed.

RESULTSTwelve of the 40 patients died on follow up. The duration of survival ranged from 2 to 348 months (medium = 37.5 months). In general, the 3-year, 5-year and 10-year survival rates were 79.0%, 69.4% and 53.0%, respectively. The mean age of the patients at the time of diagnosis was 50.3 years (age range = 22 to 76 years). The male-to-female ratio was 1:1. The age and sex of patients, frequency of operation and presence of ovarian involvement did not correlate with duration of survival. On the other hand, the presence of appendiceal tumor, parenchymal invasion of abdominal viscera, cellularity, architecture, nuclear atypia and mitotic activity of the peritoneal lesion significantly correlated with survival. There was also significant difference in survival between DPAM, PMCA-I/D and PMCA subcategories (P = 0.018). The difference in survival rate between PMCA-I/D and PMCA subgroups however was not statistically significant (P = 0.096). The outcome of DPAM was significantly better when compared with the combined group of PMCA-I/D and PMCA (P = 0.006).

CONCLUSIONSIn general, the 10-year survival rate of PMP was low, despite the relatively benign-looking or low-grade pathologic appearance. Peritoneal lesions with higher cellularity, conspicuous nuclear atypia and higher mitotic activity are associated with a lower survival rate. The prognosis was even worse in the presence of appendiceal carcinoma or parenchymal invasion of abdominal viscera. It is thus advisable to subclassify PMP into DPAM, PMCA and PMCA-I/D, due to the difference in prognostic implication.

Adenocarcinoma, Mucinous ; pathology ; surgery ; Adenoma ; pathology ; surgery ; Adult ; Aged ; Appendectomy ; Appendiceal Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Peritoneal Neoplasms ; classification ; pathology ; surgery ; Pseudomyxoma Peritonei ; classification ; pathology ; surgery ; Retrospective Studies ; Survival Rate ; Young Adult

Acanthoma ; metabolism ; pathology ; surgery ; Adenoma ; metabolism ; pathology ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Keratin-14 ; metabolism ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Keratosis ; metabolism ; pathology ; surgery ; Male ; Poroma ; classification ; metabolism ; pathology ; surgery ; Sweat Gland Neoplasms ; classification ; metabolism ; pathology ; surgery