Malignant peripheral nerve sheath tumor (MPNST) is a rare entity of all soft tissue sarcomas. It has four different types of glandular, melanocytic, rhabdomyoblastic, and epithelioid. Epithelioid MPNST is composed of predominantly epithelioid cells. In contrast, typical MPNST is consisted of spindle cells, which is arranged in a fascicular or whirling pattern. A 33-old man showed two skin-color to reddish brown protruding nodules on the left thigh. Microscopically, one nodule was made up of epithelioid cell, primarily. In addition, the other nodule was composed of epithelioid cells and spindle cells, which also showed Antoni A and B. Immunohistochemical study showed the cells being positive for S-100 protein (weak and focal) and neuron-specific enolase, and negative for HMB-45, smooth muscle actin. Herein, we report a case of two different forms of malignant nerve sheath tumor on the left thigh, which was not associated with neurofibromatosis-1.
Actins ; Epithelioid Cells ; Muscle, Smooth ; Nerve Sheath Neoplasms ; Neurilemmoma ; Neurofibromatoses ; Peripheral Nerves ; Phosphopyruvate Hydratase ; Prognosis ; S100 Proteins ; Sarcoma ; Thigh

Lichen scrofulosorum is a rare disease of children and young adults. The cutaneous lesions of LS are typically symptomless, tiny, flat-topped papular eruptions, which are skin-colored and follicular in distribution. Histopathologically, LS shows perifollicular noncaseating granulomas. LS is usually associated with extrapulmonary tuberculosis, especially of the lymph nodes and bones, and has also been reported in patients with pulmonary tuberculosis. However, the underlying focus is not always obvious, at the time of rash development, and could be diagnosed after the development of LS. Here, we describe a 43-year-old Korean woman with LS who developed tuberculous salpingitis 8 months later.
Adult ; Child ; Exanthema ; Female ; Granuloma ; Humans ; Lichens ; Lymph Nodes ; Rare Diseases ; Salpingitis ; Tuberculosis ; Tuberculosis, Pulmonary ; Young Adult

Juvenile xanthogranuloma is a benign cutaneous histiocytic proliferative disorder. It usually develops on the head and the trunk, but rarely develops in the digits. To date, only two cases of subungual juvenile xanthogranuloma have been reported in the literature. We present 2 young patients who had subungual juvenile xanthogranuloma.
Head ; Humans ; Xanthogranuloma, Juvenile

Recurrent annular erythema associated with anti-Ro/La antibody is a diagnostic term for annular erythemas that usually occurs in the face and the upper extremities of patients with positive anti-Ro/La antibodies. They have been reported in patients with Sjogren's syndrome, lupus erythematosus, or Sjogren's syndrome/systemic lupus erythematosus syndrome. Recently, there have been cases without any underlying autoimmune diseases. We, hereby, report an annular erythema, associated with anti-Ro/La antibody occurring in both soles, which is an unusual location for this disease.
Antibodies ; Autoimmune Diseases ; Erythema ; Humans ; Sjogren's Syndrome ; Skin Diseases, Genetic ; Upper Extremity

Nevus comedonicus is a relatively rare hamartoma, which originates from pilosebaceous unit. The disease usually occurs at birth or during childhood and most commonly unilateral or along with Blascko line. A 59-year-old man presented with black grouped dilated pores, with keratin plug on both eyelids. A histopathologic finding showed multiple keratin filled epidermal invaginations. We herein report an unusual case of bilateral nevus comedonicus developed in middle aged persons.
Eyelids ; Hamartoma ; Humans ; Keratins ; Middle Aged ; Nevus ; Parturition

BACKGROUND: The objective of this study was to evaluate a newly-developed EASYPREP liquid-based cytology method in cervicovaginal specimens and compare it with SurePath. METHODS: Cervicovaginal specimens were prospectively collected from 1,000 patients with EASYPREP and SurePath. The specimens were first collected by brushing for SurePath and second for EASYPREP. The specimens of both methods were diagnosed according to the Bethesda System. Additionally, we performed to REBA HPV-ID genotyping and sequencing analysis for human papillomavirus (HPV) on 249 specimens. RESULTS: EASYPREP and SurePath showed even distribution of cells and were equal in cellularity and staining quality. The diagnostic agreement between the two methods was 96.5%. Based on the standard of SurePath, the sensitivity, specificity, positive predictive value, and negative predictive value of EASYPREP were 90.7%, 99.2%, 94.8%, and 98.5%, respectively. The positivity of REBA HPV-ID was 49.4% and 95.1% in normal and abnormal cytological samples, respectively. The result of REBA HPV-ID had high concordance with sequencing analysis. CONCLUSIONS: EASYPREP provided comparable results to SurePath in the diagnosis and staining quality of cytology examinations and in HPV testing with REBA HPV-ID. EASYPREP could be another LBC method choice for the cervicovaginal specimens. Additionally, REBA HPV-ID may be a useful method for HPV genotyping.
Cytological Techniques ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Vaginal Smears

BACKGROUND: The pancreas is surrounded by soft tissue known as the peripancreatic space (PPS). Pathologic lesions of the PPS are infrequent and have only rarely been reported in the cytopathology literature. METHODS: A retrospective review of cytopathology files at two large institutions revealed 42 cases of PPS lesions obtained by transabdominal fine needle aspiration (FNA) or endoscopic ultrasound-guided FNA over a 16-year period. Clinicoradiologic findings and follow-up information were also reviewed. RESULTS: Patients ranged in age from 23-83 years (mean, 60 years) with an equal gender distribution. The major clinical presentations included pain, jaundice, nausea/vomiting, and abnormal liver enzymes. Radiographic characteristics included lymphadenopathy and cystic/solid soft tissue masses with a size range of 1.5 to 8 cm. Cytologically, 4 (9.5%) cases were nondiagnostic, 9 (21.5%) were diagnosed as benign, 4 (9.5%) were atypical or suspicious for cancer, and 25 (59.5%) were malignant. Six of 25 (24%) patients had metastasis of a prior known malignancy. CONCLUSIONS: FNA of PPS masses is a rare occurrence. The majority of lesions are metastatic carcinomas from a variety of primary sites. Flow cytometry and immunoperoxidase studies are useful adjuncts to determine the tumor origin. The sensitivity of PPS aspiration for a malignant diagnosis is 90% with a positive predictive value of 100%.
Adenocarcinoma ; Biopsy, Fine-Needle ; Flow Cytometry ; Follow-Up Studies ; Humans ; Jaundice ; Liver ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreas ; Retrospective Studies

BACKGROUND: The aim of this study was to determine the cytologic features of anaplastic lymphoma kinase (ALK) expressing pulmonary adenocarcinoma. METHODS: We analyzed the cytopathological findings of 15 cases of endobronchial ultrasound guided aspiration and a case of bronchial washing. These cases were selected based on the histomorphology of ALK-rearranged lung adenocarcinoma. RESULTS: Cytology showed mucinous (81.3%) and hemorrhagic (50%) backgrounds. The cells were arranged in tubulopapillary or tubulocribriform patterns (93.8%), and clusters (56.3%) admixed with signet ring cell features (87.5%). The tumor cells were monotonous and uniform with vesicular nuclei and a small nucleolus. CONCLUSIONS: The characteristic findings were sheets showing a tubulopapillary or tubulocribriform appearance, with vesicular nuclei and a bland chromatin pattern (p<0.001). Scattered signet ring cells were helpful in suggesting ALK-positive adenocarcinoma (p<0.001).
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Chromatin ; Lung ; Lymphoma ; Mucins ; Phosphotransferases ; Receptor Protein-Tyrosine Kinases

BACKGROUND: The incidence of early colorectal epithelial neoplasm (ECEN) is increasing, and its pathologic diagnosis is important for patient care. We investigated the incidence of ECEN and the current status of its pathologic diagnosis. METHODS: We collected datasheets from 25 institutes in Korea for the incidence of colorectal adenoma with high grade dysplasia (HGD) and low grade dysplasia in years 2005, 2007, and 2009; and early colorectal carcinoma in the year 2009. We also surveyed the diagnostic terminology of ECEN currently used by the participating pathologists. RESULTS: The average percentage of diagnoses of adenoma HGD was 7.0%, 5.0%, and 3.4% in years 2005, 2007, and 2009, respectively. The range of incidence rates of adenoma HGD across the participating institutes has gradually narrowed over the years 2005 to 2009. The incidence rate of early colorectal carcinoma in the year 2009 was 21.2%. The participants did not share a single criterion or terminology for the diagnosis of adenoma HGD. The majority accepted the diagnostic terms that distinguished noninvasive, mucosal confined, and submucosal invasive carcinoma. CONCLUSIONS: Further research requirements suggested are a diagnostic consensus for the histopathologic diagnosis of ECEN; and standardization of diagnostic terminology critical for determining the disease code.
Academies and Institutes ; Adenoma ; Colorectal Neoplasms ; Consensus ; Incidence ; Korea ; Neoplasms, Glandular and Epithelial ; Pathology, Surgical ; Patient Care

BACKGROUND: Self-made tissue punches can be effectively used to punch holes in blank recipient paraffin blocks and extract tissue cores from the donor paraffin blocks for the low-cost construction of tissue microarrays (TMAs). However, variable degrees of section distortion and loss of the tissue cores can occurs during cutting of the TMAs, posing technical problems for in-house manual construction of high-density TMAs. We aimed to update the method for in-house manual TMA construction to improve the quality of high-density TMAs. METHODS: Blocks of agarose gel were subjected to the standard tissue processing and embedding procedure to prepare recipient agarose-paraffin blocks. The self-made tissue punches and recipient agarose-paraffin blocks were used to construct TMAs, which were completely melted and re-embedded in paraffin to make finished TMA blocks. RESULTS: The donor tissue cores were completely integrated into the surrounding paraffin of the recipient blocks. This method enabled us to construct high-density TMAs with significantly less section distortion or loss of tissue cores during microtomy. CONCLUSIONS: Simple and inexpensive construction of high-density and high-quality TMAs can be warranted by using paraffinized agarose gels as recipient blocks.
Gels ; Humans ; Paraffin ; Sepharose ; Tissue Array Analysis ; Tissue Donors