BACKGROUND: Although surgical resection with chemotherapy is considered effective for patients with advanced gastric cancer, it remains the third leading cause of cancer-related death in South Korea. Several studies have reported that mesothelial markers including mesothelin, calretinin, and Wilms tumor protein 1 (WT1) were positive in variable carcinomas, associated with prognosis, and were evaluated as potential markers for targeted therapy. The aim of this study was to assess the immunohistochemical expression of mesothelial markers (mesothelin, calretinin, and WT1) in gastric adenocarcinoma and their relations to clinocopathological features and prognosis. METHODS: We evaluated calretinin, WT1, and mesothelin expression by immunohistochemical staining in 117 gastric adenocarcinomas. RESULTS: Mesothelin was positively stained in 30 cases (25.6%). Mesothelin expression was related to increased depth of invasion (p = .002), lymph node metastasis (p = .013), and presence of lymphovascular (p = .015) and perineural invasion (p = .004). Patients with mesothelin expression had significantly worse disease-free survival rate compared with that of nonmesothelin expression group (p = .024). Univariate analysis showed that mesothelin expression is related to short-term survival. None of the 117 gastric adenocarcinomas stained for calretinin or WT1. CONCLUSIONS: Mesothelin expression was associated with poor prognosis. Our results suggest that mesothelin-targeted therapy should be considered as an important therapeutic alternative for gastric adenocarcinoma patients with mesothelin expression.

Thyroid nodules are uncommon in children and adolescents compared with adults, but the risk of malignancy is much higher. In adults, fine needle aspiration biopsy (FNAB) has been used extensively to select patients for surgical exploration with a high degree of reliability. The purpose of this study was to assess the utility of FNAB for the management of thyroid nodules in children and adolescents. We reviewed our experience with 60 FNABs of thyroid nodules in 51 children and adolescents. Of the 60 aspirates, 45 aspirates (74%) were diagnosed as "benign", 5 aspirates (8%) as "suspicious for malignancy", and 6 aspirates (10%) as "malignant", and 4 aspirates (7%) as "unsatisfactory". Thyroidectomy was performed in 17 patients, and 5 with a cytological diagnosis of "benign" revealed nodular hyperplasia in three and follicular adenoma in two; 5 with a cytological diagnosis of "suspicious" revealed nodular hyperplasia in one, follicular adenoma in two, and papillary carcinoma in two; and 6 with a cytological diagnosis of "malignant" revealed papillary carcinoma. One patient with a cytological diagnosis of "unsatisfactory" revealed papillary carcinoma. The diagnostic accuracy was 81% with 100% sensitivity and 63% specificity. The positive and negative predictive values of FNAB were 73% and 100%, respectively. We conclude that FNAB is a good screening test for thyroid nodules in children and adolescents because of its high sensitivity.
Thyroid Nodule/*diagnosis/*pathology ; Thyroid Neoplasms/*diagnosis/*pathology ; Sensitivity and Specificity ; Reproducibility of Results ; Predictive Value of Tests ; Male ; Humans ; Female ; Child, Preschool ; Child ; Biopsy, Fine-Needle/*methods ; Adult ; Adolescent

BACKGROUND: The abnormal expression of c-kit is implicated in the pathogenesis of a variety of solid tumors. The Rb pathway and p53 act as cell cycle regulators. The purpose of this study was to assess the expression of c-kit, Rb, p53, p16 and cyclin D1 and their relationship to clinical and pathological parameters in patients with non-small cell lung carcinomas (NSCLC(s)). METHODS: Tissue microarrays consisting of 2 mm cores from the corresponding blocks were constructed from 54 NSCLC(s). Immunohistochemical staining for c-kit, Rb, p53, p16 and cyclin D1 was performed. C-kit immunostaining was considered positive if > or =10% of tumor cells were immunoreactive along the membrane and/or in cytoplasm. For Rb, p53, p16 and cyclin D1, tumor cells showing a nuclear staining pattern were interpreted as positive. RESULTS: We found that c-kit was expressed in 13 (24%) cases, Rb was lost in 39 (72%) cases, p53 was expressed in 28 (52%) cases, p16 was lost in 42 (78%) cases and cyclin D1 was expressed in 33 (61%) cases. The c-kit expression was significantly higher in adenocarcinoma (39%) than in squamous cell carcinoma (8%). We did not find any correlation between c-kit, Rb, p53, p16 and cyclin D1 expression and clinicopathological parameters such as: age, tumor size, lymph node involvement, disease stage and distant metastasis. There was a direct correlation between p53 expression and Rb loss. CONCLUSIONS: These results suggest that c-kit may be a useful therapeutic target for patients with c-kit positive tumors, and that the disruption of Rb and p53 pathways may play an important role in the development and progression of NSCLC(s).
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cell Cycle Proteins ; Cell Cycle* ; Cyclin D1 ; Cytoplasm ; Humans ; Lung* ; Lymph Nodes ; Membranes ; Neoplasm Metastasis

In an attempt to better define the cytologic characteristics of schwannomas, we have reviewed aspirates and corresponding histologic sections from 23 schwannomas. Of this number, the original cytologic diagnoses were: schwannoma in 14 cases (61%), benign soft tissue tumor in 2 cases (9%), and insufficient specimen in 7 cases (30%). The cytologic findings common to all cases of schwannoma included fragments of tightly cohesive fascicles with variable cellularity and corresponding Antoni type A area. The Antoni type B area, consisting of scattered spindle cells and some histiocytes and lymphocytes against a myxoid background, was seen in 14 cases. Fibrillary stroma was seen in 12 cases. The tumor cells had spindle- or oval-shaped nuclei, with pointed ends and indistinct cell borders. Nuclear palisading was seen in 10 cases, and distinctive Verocay bodies were seen in 5 cases. In ancient schwannomas, there were no Verocay bodies. Most schwannomas have distinct cytomorphologic features that allow correct diagnosis. The major problem with fine needle aspiration cytology of these tumors is the high frequency of poor cellularity, particularly in lesions with cystic degeneration. Of 7 cases with insufficient specimen, 4 showed marked cystic changes and 1 showed marked hyaline changes on histologic sections. In conclusion, we believe that if cytopathologist reminds the situation such as cystic degeneration or hyaline degeneration, the correct diagnosis of the schwannoma will be easily made.
Biopsy ; Biopsy, Fine-Needle ; Histiocytes ; Hyalin ; Lymphocytes ; Neurilemmoma

We experienced a case of a gallbladder carcinoma detected incidentally by elevated serum alpha- fetoprotein. The patient had a symptom of mild intermittent indigestion, and a routine medical examination revealed elevation of serum alpha-fetoprotein. A mass, 4 cm 3 cm, was located in the gallbladder and it had not infiltrated the liver. The serum level of alpha-fetoprotein decreased after a cholecystectomy. The gallbladder mass was an adenocarcinoma of hepatoid differentiation. Cytoplasms of the tumor cells had positive reactivity to immunohistochemical staining of alpha-fetoprotein. In the course of postoperative follow up, the serum alpha-fetoprotein level increased continuously, and abdominal CT scanning proved multiple intrahepatic metastases.
Adenocarcinoma ; alpha-Fetoproteins ; Cholecystectomy ; Cytoplasm ; Dyspepsia ; Fetal Proteins ; Follow-Up Studies ; Gallbladder* ; Humans ; Liver ; Neoplasm Metastasis ; Tomography, X-Ray Computed

BACKGROUND: The most consistent chromosomal abnormality in ependymomas, is loss of 22q (17-75%) and gain of 1q (0-50%). However, significance of this abnormality is uncertain. METHODS: Genomic imbalances in 27 Korean ependymomas, including 21 low grade ependymomas, 4 anaplastic and 2 myxopapillary ependymomas, were analyzed by degenerate oligonucleotide primed-PCR-comparative genomic hybridization. RESULTS: Common gains were found in 17 (63%), 20q (59%), 9q34 (41%), 15q24-qter (33%), 11q13 (30%), 12q23 (26%), 7q23-qter (26%), 16q23-qter (30%), 19 (26%), and 1q32-qter (22%). DNA amplification was identified in 12 tumors (44%). Chromosomal loss was a less common occurrence in our study, but was found in 13q (26%), 6q (19%), and 3 (11%). CONCLUSION: The recurrent gains or losses of the chromosomal regions which were identified in this study provide candidate regions that may be involved in the development and progression of ependymomas.
Chromosome Aberrations ; Comparative Genomic Hybridization ; DNA ; Ependymoma* ; Nucleic Acid Hybridization* ; Polymerase Chain Reaction

Urachal adenocarcinoma is a rare tumor, and it has similarities with nonurachal adenocarcinoma; therefore, it is sometimes difficult to make a diagnosis. We present a typical case of urachal adenocarcinoma that had all the diagnostic criteria including the presence of an urachal remnant. A 65-year-old woman presented with complaints of a painless gross hematuria. Pelvic CT and cystoscopy showed an intraluminal protruding mass centered in the bladder wall. When diagnosed as adenocarcinoma with a signet ring cell component being noted by frozen biopsy, partial cystectomy with resection of the median umbilical ligament and peritoneum was carried out for a suspected urachal adenocarcinoma. The tumor morphology showed as typical mucinous adenocarcinoma. Characteristic tubular structures showing the typical histology of an urachal remnant was found in the perivesical fat. On immunohistochemical staining, the urachal adenocarcinoma showed a pattern similar to colonic adenocarcinoma, while the urachal remnant showed strong positivity for CK7 and Chromogranin A.
Adenocarcinoma* ; Adenocarcinoma, Mucinous ; Aged ; Biopsy ; Cellular Structures ; Chromogranin A ; Colon ; Cystectomy ; Cystoscopy ; Diagnosis ; Female ; Hematuria ; Humans ; Ligaments ; Peritoneum ; Urachus ; Urinary Bladder

Gastrointestinal stromal tumors (GISTs) are rarely noted in association with neurofibromatosis-1 (NF-1, von Recklinghausen disease) as an individual gastrointestinal manifestation. We report here a case of multiple GISTs with an abundant skeinoid fiber in the jejunum of a 43-year-old woman diagnosed as NF-1. Histologically, the tumors were composed of uniform spindle-shaped cells with a fascicular pattern, almost indistinguishable from the histology characteristic of usual GISTs. However, multiple synchronous tumor occurrence, abundant skeinoid fiber, and presence of microscopic miniatures of stromal tumors are additional characteristic features of this case.
Adult ; Female ; Human ; Intestinal Neoplasms/*pathology ; Jejunum/innervation/*pathology ; Myenteric Plexus/pathology ; Neurofibromatosis 1/*pathology ; Stromal Cells/*pathology

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract (GIT). Although interstitial cells of Cajal has been suggested as origin of this tumor, the cytological and ultrastructural features of GISTs are heterogeneous and unclear. A total 10 cases of normal gastrointestinal tissue (control), 13 GISTs of the stomach (8), small intestine (3), mesocolon (1) and liver (1), and 2 gastrointestinal autonomic nervous tumor (GANT) of small intestine were ultrastructurally studied. Normal interstitial cells of Cajal (ICC) were abundantly present around the myenteric plexuses or individually scattered through the wall of GIT. ICC was characterized by slender cytoplasmic processes, well-developed endoplasmic reticulum (ER), mitochondria, Golgi apparatus, caveolae and intermediate filaments. The GISTs and GANTs had overlapping ultrastructures. The most common and important ultrastructural features of GISTs were rich villous cytoplasmic processes, dispersed intermediate filaments and abundant SER, and those of GANTs were neurosecretory granules and skenoid fibers. Compared with ICC, the GISTs and GANTs had remarkably reduced caveolae and gap junctions. Our study suggested that ultrastructural analysis gives much information to investigate lineage differentiation of neoplastic cells and make a differential diagnosis of these tumors from other mesenchymal tumors and between GISTs and GANTs.
Adult ; Aged ; Autonomic Nervous System/*pathology/ultrastructure ; Comparative Study ; Cytoplasm/pathology/ultrastructure ; Female ; Gastrointestinal Neoplasms/*pathology/ultrastructure ; Human ; Immunohistochemistry ; Male ; Microscopy, Electron ; Middle Aged ; Peripheral Nervous System Neoplasms/*pathology/ultrastructure ; Stromal Cells/*pathology/ultrastructure ; Support, Non-U.S. Gov't ; Tumor Markers, Biological ; Vacuoles/pathology/ultrastructure

An endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare skin tumor that most commonly occurs on the eyelids of elderly women. This tumor is morphologically analogous to endocrine ductal carcinoma in situ and solid papillary carcinoma of the breast. We describe one case of a 51-year-old male with an EMPSGC co-existing with mucinous carcinoma of the eyelid. The tumor was composed of dilated ducts with a smooth border and was partially filled with a papillary proliferation. Tumor cells were uniform, small-to-medium in size, and oval-to-polygonal with light eosinophilic cytoplasm. Nuclei were bland with diffusely stippled chromatin and inconspicuous nucleoli. Tumor cells expressed chromogranin, synaptophysin, estrogen and progesterone receptors, cytokeratin 7, and epithelial membrane antigen.
Adenocarcinoma, Mucinous ; Aged ; Breast ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Neuroendocrine ; Carcinoma, Papillary ; Chromatin ; Cytoplasm ; Eosinophils ; Estrogens ; Eyelids ; Female ; Humans ; Keratin-7 ; Light ; Male ; Middle Aged ; Mucin-1 ; Mucins ; Receptors, Progesterone ; Skin ; Sweat ; Sweat Gland Neoplasms ; Sweat Glands ; Synaptophysin