No abstract available.
Herpesvirus 4, Human* ; Hodgkin Disease* ; In Situ Hybridization*

We reviewed five cases of Uterine leiomyomas, each with a conspicuously, yellow cut surface, among 198 consecutive cases of surgically removed uterine leiomyomas. Their gross findings were not significantly different from ordinary leiomyomas except for their pale to bright Yellowish cut surface. Microscopically, multiple small clusters of clear cells were widely scattered in otherwise hypercellular leiomyornas in 4 of the 5 cases. Of those, one case gave a positive reaction of Oil-Red O stain. Ultrastructurally, clear cells corresponded to the degenerating smooth muscle cells with intracytoplasmic lipid vacuoles. The rest of cells showed myofibers undergoing varying degrees of degeneration. Focal accumulation of foamy histiocytes was associated with carneous degeneration in one case. We conclude that the yellowish leiomyoma of the uterus seems, in part, to reflect accumulation of a lipid substance in degenerating hypercellular leiornyoma, or possibly collections of xanthoma cells in secondary degeneration.

Superficial angiomyxoma is a comparatively rare dermal and subcutaneous tumor. We report a case of superficial angiomyxoma of the thumb in view of its rarity and typical light and electronmicroscopic features. The patient was a 46-year-old male. who presented with an asymptomatic, slowly enlarging mass that developed in the left thumb over the 5 years. He had a history of trauma and electric burn in the same area 20~30 years ago. Simple X-ray and magnetic resonance imaging revealed 35x30mm, mass with destruction of distal phalangeal bone. On operation, the lesion was moderately well circumscribed and soft with lobulated nodules that elevated the overlying skin and destroyed the underlying bone. The cut surface of the mass was glistening and slimy. The mass was whitish gray and lobulated. Bony involvement was not present. Microscopically, the tumor was composed of stellated and spindle shaped stromal cells which were scattered throughout myxoid ground substance. Neither nuclear hyperchromasia nor plemorphisam was present. Small to medium sized thin walled blood vessels were scattered. There was a scanty infiltrate of inflammatory cells. The S-100 protein immunostaining was negative in tumor cells. On electron microscopy, the cytoplasm of the stromal cells contained well developed rough ednoplasmic reticulums and other features that indicated differentiation toward fibroblasts.

We describe a patient with cutaneous angiocentric immunoproliferative lesion (AIL) associated with the Epstein-Barr virus (EBV). An organ system survey revealed no evidence of internal involvement. A skin biopsy specimen .showed infiltrating cells involving mainly deeper dermis and subcutaneous tissue. An examination of the reticular dermis revealed polymorphous angiocentric and angioinvasive infiltrate containing some atypical lymphocytes and histiocytes. EBV encoded RNA (EBER) was demonstrated in lesional skin by the in situ hybridization technique. On the basis of these findings, we conclude that our case may represent a form of AIL associated with EBV showing histologic features of classical lymphomatoid granulomatosis.
Biopsy ; Dermis ; Herpesvirus 4, Human ; Histiocytes ; Humans ; In Situ Hybridization ; Lymphocytes ; Lymphomatoid Granulomatosis* ; RNA ; Skin ; Subcutaneous Tissue

Granulosa cell tumor of the testis is extremly rare in adult males and granulosa cell tumor occurring in the paratesticular area has not been reported. We report a paratesticular granulosa cell tumor in a 34-year-old man who presented with a 5.5 cm sized scrotal mass. The tumor was present in the paratesticular area near the head of epididymis. It was located in the tunica and completely separated from the testis by thick fibrous tissue. Microscopically, the tumor exhibited solid, microfollicular, and trabecular patterns. The tumor cells had ovoid to elongated nuclei with longitudinal intranuclear grooves and one or two nucleoli and scanty cytoplasm. Mitoses were relatively frequent with an average number of 9/10 HPFs. The tumor extended into the visceral tunica vaginalis and showed multiple lymphatic tumor emboli. Immunohisto chemical stains revealed diffuse strong positivity for inhibin, vimentin, and keratin and diffuse weak positivity for estrogen and progesteron receptor. Placental alkaline phosphatase (PLAP) and epithelial membrane antigen (EMA) were negative. On electron microscopic examination, tumor cells were polygonal and had large indented nuclei. The cytoplasm contained a moderate number of small round mitochondria, abundant rough and smooth endoplasmic reticula, and a few lipid droplets. Small aggregates of intermediate filaments and intercellular junctions were observed. The patient was alive and well 5 months after orchiectomy. This is the first case of adult granulosa cell tumor arising in the paratesticular area.
Adult ; Alkaline Phosphatase ; Coloring Agents ; Cytoplasm ; Epididymis ; Estrogens ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Head ; Humans ; Inhibins ; Intercellular Junctions ; Intermediate Filaments ; Male ; Mitochondria ; Mitosis ; Mucin-1 ; Orchiectomy ; Testis ; Vimentin

c-erbB-2 oncogene is a normal cellular proto-oncogene coding transmembrane glycoprotein structurally similar to the epidermal growth factor receptor. Amplification of this oncogene in a variety of human adenocarcinomas has been reported and is particularly well documented in breast carcinoma. It has been suggested that amplification of this oncogene is indicative of poor prognosis and is valuable only second to the lymph node status. Using immunohistochemical staining for the c-erbB-2 protein, overexpression of this protein was analysed in 228 primary breast cancer specimens and the frequency of overexpression and the relationship between overexpression and the other established prognostic variables are evaluated. Ninty three cases out of 228 cases(40.8%) show postive oncoprotein overexpression and using the chi-squared test for a trend, a significant correlation was found between c-erbB-2 protein staining and the histological grade, lymph node status, and estrogen receptor status(P<0.05). No significant association was found between staining and the patient's age and tumor size. Most of the tumors with histological types known to have good prognosis showed negative expression. Above findings strongly suggest that expression of c-erbB-2 oncogene is another independent indicator of poor prognosis in breast carcinoma.
Humans ; Adenocarcinoma ; Breast Neoplasms

Tumor DNA content measured by flow cytometry may be a predictor in the prognosis of epithelial ovarian cancer, but the results have been inconsistent. It is recognized that these conflicting results are at least partly due to the variation of DNA content between the samples from the same patient(i.e., intratumoral DNA heterogeneity). The purposes of this retrospective study were to investigate the frequency and the nature of DNA heterogeneity in epithelial ovarian cancer and to evaluate the prognostic significance of DNA heterogenetiy itself. Thirty-two patients with stage II to IV epithelial ovarian cancer who were managed at Asan Medical Center between May 1993 and April 1996 were analysed. Measurements of the nuclear DNA content were performed on samples from primary and metastatic lesion using paraffin embedded archival tissues by Epics(Coulter Inc.) flow cytometry. In two cases, the metastatic tumor was minute and did not reveal a separable peak on repeated examination. DNA heterogeneity was defined as different ploidy pattern or difference of the DNA indices than 0.15 between primary and metastatic tumors. DNA heterogeneity was found in 11 cases(36.7%), and the number of cases with homogeneous diploid and that with homogeneous aneuploid tumor were 5(16.7%) and 14(46.7%) respectively. In evaluation of prognostic significance of DNA heterogeneity using correlation with serum CA 125 level after second course of chemotherapy and residual tumor size after cytoreductive surgery among these three groups, the patients with DNA heterogeneity were considered to show intermediate prognosis between those with homogeneous diploid and homogeneous aneuploid tumor. In conclusion, DNA heterogeneity in epithelial ovarian cancer is considerable in frequency and may have prognostic value.
Aneuploidy ; Chungcheongnam-do ; Diploidy ; DNA* ; Drug Therapy ; Flow Cytometry ; Humans ; Neoplasm, Residual ; Ovarian Neoplasms* ; Paraffin ; Ploidies* ; Population Characteristics* ; Prognosis ; Retrospective Studies

Epstein-Barr virus(EBV) is associated with a wide spectrum of benign and malignant disorders including leukoplakia, Hodgkin's lymphoma, central nervous system lymphoma, peripheral T cell lymphoma and nasopharyngeal undifferentiated carcinoma. There are several distinctive aspects of biology of the virus that are important in investigation of virus in clinical specimens. The abundant expression of the EBER mRNA transcripts makes possible the sensitive detection of latent expression in EBV-associated tumors. Although there has been a dramatic increased interest in the direct characterization of EBV in clinical specimens, there have been few studies about the effective and reliable positive controls in performing in situ hybridization technique for EBV, especially on paraffin-embedded tissue. We applied Burkitts lymphoma cell line as positive control in EBV in hydridization using Oncor Kit. The cell block of Burkitt lymphoma cell line(CCL85 EB-3) showed strong and specific positivity for EBER in situ in nuclei of EBV infected cells.
Biology ; Burkitt Lymphoma ; Carcinoma ; Cell Line* ; Central Nervous System ; Herpesvirus 4, Human* ; Hodgkin Disease ; In Situ Hybridization* ; Leukoplakia ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; RNA, Messenger*

Littoral cell angioma (LCA) of spleen is an uncommon vascular neoplasm of littoral cell origin. It is well established that LCA may be associated with other malignancy or autoimmune disorders. We describe a 34-year-old woman with viral hepatitis C associated liver cirrhosis who presented with the incidental finding of LCA. She showed ascites, esophageal varix and drowsy mentality. Abdominal computed tomography (CT) showed multiple benign looking nodules in both hepatic lobes, but no abnormality in spleen. Liver transplantation and splenectomy were performed. Microscopic findings revealed narrow anastomosing vascular channels lined with plump cells that exfoliated into the lumen. Immunohistochemically the lining cells were positive for CD31, CD68 and negative for CD34, consistent with LCA. Herein, a second case of an incidentally detected LCA with cirrhosis, viral hepatitis C associated in Korea is reported.
Adult ; Ascites ; Esophageal and Gastric Varices ; Female ; Fibrosis ; Hemangioma ; Hepatitis ; Hepatitis C ; Humans ; Incidental Findings ; Korea ; Liver ; Liver Cirrhosis ; Liver Transplantation ; Spleen ; Splenectomy ; Splenic Neoplasms ; Vascular Neoplasms

The diffuse large B-cell lymphoma category of the Revised European American Classification of Lymphoid Neoplasms (REAL) encompasses different morphologic lymphoma subtypes in a single entity, especially the diffuse large cell (DLC) and the immunoblastic (IBL) subtypes by Working Formulation (WF). The aim of this study is to determine the influence of the morphologic subdivision within this category with respect to clinical outcome and proliferative index using Ki-67 immunostainig combined with image analysis. We retrospectively reviewed 74 patients from 1990 to 1996, who were diagnosed with diffuse large B-cell lymphoma. All cases were reclassified according to REAL and Working Formulation (WF), and Ki-67 immunostaining was performed in all the cases. Fifty-eight cases (78.4%) were classified as DLC and 16 cases (21.6%) as IBL, according to WF. Twenty one cases (28.4%) showed nodal involvement and 53 cases (71.6%), extranodal involvement. All cases were found to display a variable degree of nuclear Ki-67 staining. A proliferative index of 50% or higher identified a group of patients (77%) who had poor clinical results. Overall survival was significantly reduced in these patients displaying high Ki-67 associated proliferative index compared to those with a low proliferative index (p=0.007). 5-year survival estimates were 93% in the low proliferative index group and 55% in the high proliferative index group. A multivariate regression analysis incorporating commonly used clinical prognostic factors confirmed the independent effect of proliferation index on survival. Moreover, all of the 16 IBL cases showed Ki-67 positivity of 50% or higher, which correlates with the poor clinical outcome compared to 70.7% of DLC (p=0.014). We conclude that subdivision of the diffuse large B-cell lymphoma category of the REAL classification is necessary in terms of prognostic significance in correlation with Ki-67 proliferative index.
B-Lymphocytes* ; Classification ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Large B-Cell, Diffuse ; Retrospective Studies