In Korea chronic liver diseases are the important medical issues because of their high incidence, poor prognosis and no available therapeutic resume. It is believed that the etiologic agent of most of chronic liver diseases in Korea is hepatitis B virus. To find out the incidence of positivity and to understand the autoantibodies in some of the chronic liver diseases in Korea, anti-smooth muscle antibody and anti-nuclear antibody tests were performed on 43 patient serum with chronic active hepatitis, 13 patient serum with chronic persistant hepatitis and 20 patient serum with liver cirrhosis, who diagnosed by liver biopsies. The results of the study are summarized as follows: 1) The positivity of anti-smooth muscle antibody in chronic active hepatitis was 93.0%, that in chronic persistant hepatitis 60.0% and that in liver cirrhosis 80.0%. 2) The positivity of anti-nuclear antibody in chronic active hepatitis was 18.6%, that in chronic persistant hepatitis 15.4%, that in liver cirrhosis 5.0%. 3) The test efficiency of anti-smooth muscle antibody to differentiate chronic active hepatitis from chronic persistant hepatitis and liver cirrhosis was 48.7%. The above results suggest that the antismooth muscle antibody may be related to the "necrosis of liver cells", and further studies are needed to fine out any relationship between the autoantibody and the disturbance of immune regulatory function if there is, as this study suggested.
Incidence

For the identification of proliferating cells in tissue, the argyrophilic method for the demonstration of nucleolar organizer regions (Ag-NORs) have been described. To evaluate the applicability of Ag-NORs in surgical pathology, the authors have done Ag-NORs staining on 144 cases of routinely processed, formalin-fixed paraffin sections of various tissues; 15 normal tissues, 12 reactive and hyperplastic lesions, 30 benign neoplasms, 4 borderline lesions, and 83 malignant tumors. The results were summerized as follows; 1) In normal tissues, the mean numbers of Ag-NORs were highter in labile cells, especially in actively proliferating cells such as germ cells of testis, crypt epithelial cells in gastrointestinal mucosa, and lymphocytes from germinal center of tonsil and lymph node, than those of stable cells. 2) The mean numbers of Ag-NORs in reactive and hyperplastic lesions, benign neoplasms, and borderline lesions were similar to those of normal labile cells. 3) The mean numbers of Ag-NORs in carcinomas and sarcomas, (usually more than 2) significantly exceeded those of normal and non-malignant conditions. However, certain cases of carcinomas such as papillary carcinomas of thyroid, mucinous carcinoma of stomach, bronchioloalveolar carcinoma of lung, and adenoid cystic carcinoma of lung, and some of the leiomyosarcoma, malignant fibrous histiocytoma, and malignant schwannoma showed relatively lower numbers of Ag-NORs. 4) In non-Hodgkin's lymphomas, the high grade lymphomas showed more Ag-NORs than the low grade ones. From above results, it is suggested that the Ag-NORs technique is helpful in differentiation between malignant and non-malignant lesions. However, further evaluation on the significance of Ag-NORs upon the behavior of the cancer is to be made.

A 49-year old man was admitted to the Korea university hospital, department of surgery, for evaluation of anterior neck mass which was slowly growing for five years. His past history was unremarkable except for known hypertension for several years. Physical examination revealed high blood pressure, measuring 180 mmHg in systolic phase and 120 mmHg in diastolic phase. A soft nontender mass was palpated at anterior neck just above the sternal notch with smooth surface and its size was about 4 x 5 cm in cross. On laboratory examination, diabetic evidence such as high blood sugar (FBS 170 mg/dl, PP2hr. 234 mg/dl) and glucosuria. The CBC finding suggested polycythemia with high hemoglobin (18.0 g/dl) and hematocrit (54%) levels. The differential count and platelet count were within normal limits.
Male ; Humans

Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.

Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.

To determine the therapeutic plan and to predict the prognosis, it is a pivotal and important task to differentiate the exact nature of the various undifferentiated neoplasms. In order to solve this problem, the electron microscopy has once been considered only method in certain cases. Recently, however, the immunoperoxidase staining method which is less expensive and easier to usethan electron microscopy has been developed and introduced. To evaluate the diagnostic value of epithelial membrane antigen(EMA), carcinoembryonic antigen(CEA) and leukocyte common antigen(LCA) immunoperoxidase method, the authors applied these staining in 15 cases of which exact diagnoses were difficult with conventional routine and special stains, using the formalin-fixed and paraffin-embedded tissue sections. The results are as follows: 1) EMA was helpful in confirming the diagnosis or revising to the proper diagnosis of undifferentiated carcinoma in 4 of 6 cases and in excluding the possibility of hepatocellular carcinoma and melanoma in 2 cases, respectively. The negative stainabilities in one case of choriocarcinoma and one case of malignant fibrous histiocytoma was useful to exclude the possibility of squamous cell carcinoma and the positive stainability in one case of giant cell carcinoma to exclude the possibility of sarcoma. 2) The diagnostic value of CEA was similar to that of EMA; CEA was useful to differentiate from malignant lymphoma in one case of epithelial tumor in which CEA was positive and EMA negative. 3) LCA was useful to differentiate one case of malignant lymphoma from undifferentiated carcinoma and to confirm Ewing's sarcoma from malignant lymphoma in one case.
Diagnosis, Differential ; Carcinoma, Hepatocellular

A rare variant of glioblastoma characterized by giant or monster cells is now well recognized. However, this tumor had been remained in controversy on its pathogenesis, and the tumor had been considered to be a sarcoma until 1968, when the electronemicroscopic study demonstrated the presence of filaments mesuring 80 in diameter in the perikarya in giant cells as well as in smaller, better differentiated cells. The peroxidase antiperoxidase stain of glial fibrillary acid protein shows positive glial fibrillary fibers in their cytoplasm, accordingly the giant cells has been recognized as being of astrocytic origin. This concept has been redocumented by light microscopy since PTAH-positive astrocytic fibers are present in large numbers of neoplastic cells. The two cases reported here were frontal and occipital giant cell glioblastomas in 58 years old male and 44 years old women, respectively. On light microscopy, the tumor showed numberous characteristic giant or monster cells as well as the same features seen in the usual glioblastoma. The electron microscopy and special stains, PTAH and GFAP confirmed that the giant cells were in glial origin.
Female ; Male ; Humans

Blood group isoantigens (BGS) A, B and H comprise a group of carbohydrate cell surface markers found not only on the erythrocytes but in wide variety of epithelial cells and body fluid on 80% of the human population. There has been increasing interest in the changes in blood group A, B and H antigen expression in various epithelial malignancies. These changes included deletion of A, B determinants, accumulation of precursor substances, increment or neosynthesis of imcomplete blood group antigens and synthesis of sialylated substances bearing blood group carbohydrate chains. Also these changes have been explained as an evidence of immunologic dedifferentiation analogous to the morphologic dedifferenctiation of anaplasia. isoantigens may be altered in epithelial tissues that show repair and regeneration, metaplastic changes and dysplasia. We studied that the changes of blood group isoantigens A, B and H in 30 cases of adenocarcinoma of the colon, 27 cases of adjacent mucosa and 19 cases of metastatic lymph nodes by immunohistochemical study. In ascending, transverse and rectosigmoid colon, the blood group isoantigens A, B and H are positive in 57.1%, 0% and 57.1% of adenocarcinomas and 100%, 50% and 0% in adjacent mucosae, respectively. In ascending colon,the frequency of the metastasis and recurrences in Blood group isoantigen positive and negative cases are 75% and 66.6% and in rectosigmoid colon, those are 50.5% and 90.0%, respectively. In tumors of the ascending colon, there was no significant correlation between antigen content and frequency of metastasis. However, the cancer of the rectosigmoid colon with bloodgroup isoantigen positive were associated with a lower frequency of metastasis than those without blood group isoantigen. (p=0.045). The data suggests that the immunohistochemical studies of blood group isoantigen may be of value in estimating the clinical behavior of certain colon carcinoma.
Humans ; Adenocarcinoma ; Neoplasm Metastasis

Cytokeratins are a family of polypeptides of intermediate filaments which in diverse epithelia are expressed in diffeent, yet specific combinations. To evaluate the diagnostic value of keratin, immunohistochemical staining was done in formalin-fixed, paraffin-embedded normal and neoplastic tissues by PAP and StreptABC methods. The antiserum for cytokeratin in monoclonal antibody which gives the specificity for 40, 46, 50, 52, 56, 58, and 65-67 Kd keratin classes. The results are as follows: 1) The staining was positive for cytokeratin in all of the squamous epithelium, ductular epithelial cells of various glands, respiratory and urinary tract epithelium, and mesothelial cells. 2) No staining for cytokeratin was ovserved in respiratory alveolar epithelium, acinar cells of various glands, renal glomeruli, hepatocytes, and many mesoderm-derived tissues such as muscle, hematopoieitc and lymphoid tissues, nerve, bone, cartilage, and fibroblasts. 3) Squamous cell carcinomas, transitional cell carcinomas, mesotheliomas, and some of the adenocarcinomas (stomach, colon, uterine cervix, biliary tract and breast) exhibited positive staining for cytokeratin. Epithelial cells of thymoma, adenomatoid tumor, plemorphic adenoma of salivary gland, papillary carcinoma of thyroid, lymphoepithelioma, and craniopharyngioma were also positive. 4) Some of the adenocarcinomas (prostate and pancreas), renal cell carcinoma, ovarian stromal and germ cell tumors, hepatocellular carcinoma, malignant melanoma, and mesoderm-derived tumors including malignant lymphoma were uniformly negative for staining. 5) From the above results, the immunohistochemical study in paraffin-embedded tissues using monoclonal antibody for cyto keratin may be useful to differentiate various tumors, especially in differential of hepatocellular carcinoma from bile duct adenocarcinoma, lymphoepithelioma and other undifferentiated carcinomas from lymphoma, thymoma from lymphoma, and squamous cell carcinoma from melanoma. It will be helpful in the diagnosis of transitional cell carcinoma in which the differentiation from renal cell carcinoma and prostatic adenocarcinoma be difficult.
Adenocarcinoma ; Adenoma ; Carcinoma, Hepatocellular

Three cases of granular cell tumor in esophagus removed endoscopically are present. Immunohistochemical and electron microscopic studies confirmed that this tumor is originated from schwann cell.