In an attempt to evaluate the expression of hepatitis B surface antigen(HBs Ag), transforming growth factor-ct(TGF-alpha), and proliferating cell nuclear antigen(PCNA) in hepatocellular carcinoma(HCC), an immunohistochemical investigation(ABC method) was performed using 31 surgically resected HCCS. The authors examined the expression rate and patterns, histopathologic correlation, and inter-relationships among these expressions. The results were summarized as follows. 1) Among 25 seropositive HCCS, 15 cases showed tissue expression of HBs Ag(60.0%), being expressed as a predominantly cytoplasmic pattern. Its expression rate in low grade HCC was significantly high(76.9%), in contrast to a low rate in high grade HCC(41.7%)(P<0.05). Adjacent nonenoplatic tissue showed a higher expression rate(82.6%). 2) TGF-alpha was expressed in 23 of 31 cases of HCC(74.3%). The intensity and extent of its expression did not correlate tyros with histopathologic features. Bile duct epithelium, juxtaposed and/or entrapped liver cells, and cirrhotic nodules were variably expressed, of which intense peripheral reaction within the nodules was frequently noted. 3) PCNA was expressed throughout the neoplastic tissue of HCC. Its index was significantly high(34.4 13.6), being compared to low index index(3.5 2. 1) in the nonneoplastic tissue(P<0.005). High grade tumors revealed a higher index than the low grade tumors(P<0.05). Conclusively, this data confirms that PCNA index offers useful information about cell proliferation associated with histologic degrees of malignancy of HCC, albeit TGF-alpha is also involved in cellular proliferation of both liver cell and bile duct epithelium. Changes in incidence and cellular localization of HBs Ag expression between the neoplastic and nonneoplastic tissues suggest that an integrated viral genome could be functionally altered during hepatocarcinogenesis. A significant inter-relationship among these expressions was not observed.
Incidence ; Carcinoma, Hepatocellular

Intercellular adhesion molecule I(ICAM-1; CD 54), a 90 kD glycoprotein, counter-receptor for lymphocyte function-associated antigen-I(LFA-1) on T-cells, is critically important to a wide variety of adhesion-dependent leukocyte functions, including antigen presentation and target cell lysis. Induction of ICAM-1 on the keratinocytes(KCs) is an important regulator in initiation, maintenance, and resolution of cutaneous inflammation, which is modulated with cytokines produced by activated T-lymphocytes. This study was designed to further our understanding on modulation effects of ultraviolet B(UVB), gamma interferon(IFN-;v), and retinoic acid(all trans) upon expression of ICAM-1 on cultured human KCs, with emphasis on their correlation. Cell surface expression of ICAM-1 in cultured human KCs was analyzed with the use of indirect immunofluorescence and fluorescence activating cell sorting(FACS) by flow cytometry. The results of this study were as follows: 1) Expression of ICAM-1 was significantly induced with IFN-,-(20 U/ml)(p<0.005). 2) UVB irradiation of 30mJ/cm2 significantly suppressed ICAM-1 expression of KCs 24 hours after irradiation(p<0.05). However, at 72 hours after irradiation, ICAM-1 expression of KCs was considerably increased in comparison to that of initial phase (24 hours after irradiation). 3) High concentrations(10(-5)M) of retinoic acid reduced UVB-induced expression of ICAM-1 in late phase(72 hours after irradiation), although retinoic acid showed induction effect of ICAM- I expression of KCs. In summary, these results indicate that ICAM- I may contribute to the biphasic effect of UVB on delayed hypersensitivity in vivo. Also, retinoic acid, a vitamin A derivative, may have a cutaneous photoprotective effect through a regulation of UVB-induced ICAM-1 expression on the KCs.
Humans

Primary carcinoid tumor of the kidney is extremely rare ; only 29 previous reports have been described in the world literature, 3 cases of which were known to arise in horseshoe kidneys. Because of the scarcity of primary renal carcinoid tumor, its clinicopathologic features and prognosis are not well characterized, and its histogenesis is unknown. We present a case of primary carcinoid tumor arising in the horseshoe kidney of a 43-year-old man. The lesion is morphologically identical to those of gastrointestinal or respiratory tracts. In addition, this tumor contains clusters of intestinal epithelium with goblet cells and mature bony trabeculae. The cytoplasm of the tumor cells are immunoreactive for keratin, NSE, and synaptophysin, but are negative with Grimelius and Fontana-Masson stains. Membrane-bound cytoplasmic neurosecretory granules are observed by electron microscopic examination. This is the first case of primary renal carcinoid tumor arising in a horseshoe kidney documented in Korea. We describe the gross features, light and electron microscopic, and immunohistochemical findings of renal carcinoid and review the literature, with speculations on the possible histogenesis of this unusual neoplasm.

Clear Cell Sarcoma of the Kidney(CCSK) is a rare malignant childhood tumor which is distinguished from Wilms tumor by its pathologic features, clinical presentation and frequent occurrence of metastasis to bone. We report a case of CCSK from a 2 year-old girl in the right kidney, followed by metastasis to thoracic vertebrae and left temporal lobe. Histogenesis of this tumor is controversial, although some studies suggest primitive mesenchymal origin. This case was studied with the aids of immunohistochemistry and electron microscopy in an effort to verify the histogenesis of the tumor. Vimentin was reactive in tumor cell, but cytokeratin, GFAP, S-100 protein and desmin were not stained, which confirmed the previous reports by others. Ultrastructural observation of the tumor cells showed neither features of epithelial cell nor differentiated mesenchymal cells.
Child ; Male ; Female ; Humans ; Neoplasm Metastasis

Microcystic meningioma, a distinct morphological variant of meningiomas, is histologically characterized by a vacuolated appearance with multiple cystic spaces lined by vacuolated or stellate-shaped tumor cells. We report a case of microcystic meningioma occuring in right frontoparietal area of 42-year-old woman, with emphasis on differential diagnosis, along with a review of literatures. Immunohistochemically, most of the tumor cells demonstrated positive immunoreactivity for both epithelial membrane antigen and vimentin. Electron microscopy showed that the extracellular space was extensive, where eletron-lucent material was occasionally seen. The tumor cells had long cytoplasmic processes showing complex interdigitation and a large number of desmosomes.
Female ; Humans ; Diagnosis, Differential ; Meningioma

Epithelioid hemangioendothelioma of liver is a very rare tumor of vascular origin, the most peculiar feature of which is that it is composed of endothelial cells closely resembling epithelial cells. We present a primary epithelioid hemangioendothelioma of liver in a 40-year-old male. This tumor was composed of an ill-defined yellowish white, 7 x 4cm sized, firm, solid mass and small satellite nodules in the right lobe of liver. Microscopically, two types of tumor cells-dendritic and epithelioid-were identified. The neoplastic cells infiltrated into sinusoids and intrahepatic veins. The background of tumor showed marked sclerotic change and focal proliferation of bile ductules. Confirmation of the endothelial origin of these cells was provided by positive immunoperoxidase staining for factor VIII-related antigen, and by electron mi-croscopic demonstration of Weibel-Palade body. This is the first case of epithelioid heman- gioendothelioma of liver documented in Korea. We report this case in view of its scarcity and distinctive morphologic features that allow differentiation from sclerosing carcinoma and angiosarcoma.

Epithelioid smooth muscle tumor is relatively rare and potentially malignant, especially in retroperitoneum. Distinct criteria for malignancy still have not been clarified in this epithelioid variant arising in retroperitoneum. We report a deceptively benign-appearing epithelioid leiomyosarcoma in a 50-year-old female. She was admitted with abdominal discomfort and dysuria. Abdominal CT showed a well-demarcated, 10 10 cm sized, solid mass in retroperitoneum. Concomitant metastatic lesions were noted in right lung field. Surgical excision of retroperitoneal mass and right lung lobectomy were performed. The retroperitoneal mass showed yellowish-tan, well-delineated and lobulated appearance. Histologically, this tumor was composed of predominantly epithelioid, round to oval cells with distinct clear cytoplasm and slightly atypical nuclei. Mitosis was rare (0~1/50 HPF). Lung lesions were morphologically similar to that of retroperitoneum.
Cytoplasm ; Dysuria ; Female ; Humans ; Leiomyosarcoma* ; Lung ; Middle Aged ; Mitosis ; Smooth Muscle Tumor ; Tomography, X-Ray Computed

The inflammatory pseudotumor of the lung is a non-neoplastic pulmonary mass lesion, composed of a variey of inflammatory cells including plasma cells, histiocytes(often xanthomatous), mast cells, lymphocytes, and spindle shaped mesenchymal cells. Although the pathogenetic etiology of this lesion is not estabilished, it has been claimed that it is associated with local inflammatory reaction. From 1984 to 1986, we experienced three cases of pathologically confirmed inflammatory pseudotumor of the lung. All three cases revealed similar gross and microscopic features, with only minor differences in components on microscopic level. All specimens were products of lobectomy. They showed a relatively well defined, yellowish white and solid mass, measuring about 5.0 cm in diameter. Histologically, the lesions, which were well demarcated from the uninvolved region, were characterized by dense infiltration of plasma cells and xanthomatous histiocytes admixed with lymphocytes, spindle shaped mesenchymal cells and polymorphonuclear leukocytes. At periphery, bronchi and bronchioles were entrapped by these cells. In focal areas, spindle shaped mesenchymal cells were aggregated, resulting in formation of thick bundles in which plasma cells were infiltrated. In case 1 and 2, myxoid change of stromal tissue was noted. Also noted were foci of osteoid metaplasia of the stromal layer in case 1. The authors report three cases of inflammatory pseudotumor of the lung, with comparative observation of each case, associated with literature review, with emphasis on the pathogenesis of this rather infrequent lesion. And some reviews were made on differential diagnosis between inflammatory pseudotumor and non-neoplastic or neoplastic lung mass including so called sclerosing hemangioma.
Diagnosis, Differential

The inflammatory pseudotumor of the lung is a non-neoplastic pulmonary mass lesion, composed of a variey of inflammatory cells including plasma cells, histiocytes(often xanthomatous), mast cells, lymphocytes, and spindle shaped mesenchymal cells. Although the pathogenetic etiology of this lesion is not estabilished, it has been claimed that it is associated with local inflammatory reaction. From 1984 to 1986, we experienced three cases of pathologically confirmed inflammatory pseudotumor of the lung. All three cases revealed similar gross and microscopic features, with only minor differences in components on microscopic level. All specimens were products of lobectomy. They showed a relatively well defined, yellowish white and solid mass, measuring about 5.0 cm in diameter. Histologically, the lesions, which were well demarcated from the uninvolved region, were characterized by dense infiltration of plasma cells and xanthomatous histiocytes admixed with lymphocytes, spindle shaped mesenchymal cells and polymorphonuclear leukocytes. At periphery, bronchi and bronchioles were entrapped by these cells. In focal areas, spindle shaped mesenchymal cells were aggregated, resulting in formation of thick bundles in which plasma cells were infiltrated. In case 1 and 2, myxoid change of stromal tissue was noted. Also noted were foci of osteoid metaplasia of the stromal layer in case 1. The authors report three cases of inflammatory pseudotumor of the lung, with comparative observation of each case, associated with literature review, with emphasis on the pathogenesis of this rather infrequent lesion. And some reviews were made on differential diagnosis between inflammatory pseudotumor and non-neoplastic or neoplastic lung mass including so called sclerosing hemangioma.
Diagnosis, Differential

Synovial sarcoma is one of the most common malignant soft tissue tumors in paraarticular regions. However, it is very rare to occur without any apparent relationship to synovial or articular structures. We report a case of synovial sarcoma manifested as a subcutaneous nodule in the upper lip. A 12-year-old boy complained of a palpable tender mass in the upper lip for several months. Under the impression of a benign soft tissue neoplasm, surgical excision was done. The mass, 1.5 cm in maximum diameter, was easily separated from surrounding tissues. Microscopically, this tumor showed a characteristic biphasic pattern of synovial sarcoma. On immunohistochemical and ultrastructural studies, the tumor cells showed evidence of epithelial differentiation. There was no evidence of joint-related, primary lesions or metastatic foci. This report describes a case of synovial sarcoma arising in very unusual location and size for histologically typical synovial sarcoma.
Neoplasm Metastasis