Gastritis is an inflammatory condition of the gastric mucosa induced by Helicobacter pylori infection, autoimmunity and chemical agents. Although Sydney system was devised for semiquantitative methods of gastritis, most physicians and pathologists consider it to be too complex and bothersome to use for routine diagnosis. Moreover, Sydney system does not reflect the overall gastritis condition and it cannot directly predict increased gastric cancer risk. To overcome these limitations, a new gastritis staging method, called Operative Link for Gastritis Assessment (OLGA) system was designed by the international group of gastroenterologists and pathologists. This system may achieve simplification of reports for the gastritis condition and it can aid in predicting gastric cancer risk and planning patient surveillance. Herein, we reviewed the routine evaluation methods, clinical implication and advantage/limitations of the OLGA system.
Aluminum Hydroxide ; Atrophy ; Autoimmunity ; Carbonates ; Gastric Mucosa ; Gastritis ; Helicobacter pylori ; Humans ; Metaplasia ; Stomach Neoplasms

Gastritis is an inflammatory condition of the gastric mucosa induced by Helicobacter pylori infection, autoimmunity and chemical agents. Although Sydney system was devised for semiquantitative methods of gastritis, most physicians and pathologists consider it to be too complex and bothersome to use for routine diagnosis. Moreover, Sydney system does not reflect the overall gastritis condition and it cannot directly predict increased gastric cancer risk. To overcome these limitations, a new gastritis staging method, called Operative Link for Gastritis Assessment (OLGA) system was designed by the international group of gastroenterologists and pathologists. This system may achieve simplification of reports for the gastritis condition and it can aid in predicting gastric cancer risk and planning patient surveillance. Herein, we reviewed the routine evaluation methods, clinical implication and advantage/limitations of the OLGA system.
Aluminum Hydroxide ; Atrophy ; Autoimmunity ; Carbonates ; Gastric Mucosa ; Gastritis ; Helicobacter pylori ; Humans ; Metaplasia ; Stomach Neoplasms

BACKGROUND: Diabetic nephropathy is the most common cause of end-stage renal disease and it has various pathologic features. We investigated the clinicopathologic differences between the histologic classes of diabetic nephropathy. METHODS: A total of 46 patients with diabetic nephropathy were evaluated. Morphologically, the renal lesions were divided into three categories: class 1, diffuse or nodular glomerulosclerosis: class 2, vascular change without evidence of glomerulosclerosis: and class 3, non-diabetic renal disease superimposed on diabetic glomerulosclerosis. We evaluated the laboratory findings and the histologic findings, including mesangial expansion, interstitial fibrosis and inflammation, arteriolar hyalinosis and tubular atrophy. RESULTS: The proportion of each class was 32 cases (70%), 4 cases (9%) and 10 cases (21%), respectively. The clinical and laboratory data showed no significant difference among the classes. For the groups of class 1, the group with nodular sclerosis showed a higher serum creatinine level than did the diffuse group (p=0.003). IgA nephropathy was the most common non-diabetic renal disease superimposed on diabetic glomerulosclerosis in our study. CONCLUSIONS: The patients with nodular glomerulosclerosis presented with a more progressed clinicopathological features than did the patients with class 1 diffuse glomerulosclerosis. We also found 21% of all the patients with diabetic nephropathy had superimposed non-diabetic renal disease in a Korean population.
Atrophy ; Creatinine ; Diabetes Mellitus ; Diabetic Nephropathies ; Fibrosis ; Glomerulonephritis, IGA ; Humans ; Inflammation ; Kidney ; Kidney Failure, Chronic ; Sclerosis

Gestational trophoblastic disease is an abnormal proliferations of trophoblastic tissue during pregnancy. Persistent gestational trophoblastic tumor develops in about 20% after evacuation of complete mole. Following evacuation of hydatidiform mole, the interpretation of serial serum human chorionic gonadotropin (hCG) regression patterns is important in monitoring the course of the disease. Because it is the most reliable and sensitive method for the early detection of gestational trophoblastic disease. We describe an uncommon case of complete hydatidiform mole in a 48-year-old woman, who has presented to us with complaints of bleeding. She experienced after the evacuation of a complete mole and no decreased in hCG levels over four consecutive serum hCG measurements. The patient underwent hysterectomy due to leiomyoma. Finally, pathologic diagnosis was confirmed persistent gestational trophoblastic disease.
Aged ; Amyotrophic Lateral Sclerosis* ; Anesthesia ; Anesthesia, Intravenous* ; Chorionic Gonadotropin ; Diagnosis ; Female ; Gestational Trophoblastic Disease* ; Hemorrhage ; Humans ; Hydatidiform Mole* ; Hysterectomy ; Leiomyoma ; Methods ; Middle Aged ; Muscle Relaxation* ; Pregnancy ; Propofol ; Trophoblastic Neoplasms ; Trophoblasts

BACKGROUND: Signal transducers and activators of transcription 3 (STAT3) and protein kinase substrate p36 may be involved in cell proliferation, differentiation and growth. METHODS: Immunohistochemistry for STAT3 and p36 was performed in 46 patients with hepatocellular carcinoma (HCC). RESULTS: STAT3 staining was present in the cytoplasm and/or nucleus, while p36 staining was present in the nucleus. STAT3 and p36 expression occurred in 78.3% (36/46) and 47.8% (22/46) of HCC patients, respectively. However, no correlation was found between STAT3 and p36 protein expression (p>0.05). Enhanced expression of STAT3 was negatively correlated with portal vein invasion (p=0.033). Expression of STAT3 in the nucleus was correlated with tumor grade (p=0.004). Enhanced expression of p36 was correlated with tumor grade (p=0.031). HCC was correlated with HBV infection (p=0.032). The patients'5-year survival was related to expression of p36 (p=0.044), but not to total STAT3 or nuclear STAT3 (p>0.05). CONCLUSIONS: The enhanced expression of STAT3 in the nucleus and the enhanced expression of p36 are associated with the aggressive phenotype of HCC. Enhanced p36 expression may contribute to poor survival of patients with HCC.
Carcinoma, Hepatocellular ; Cell Proliferation ; Cytoplasm ; Humans ; Immunohistochemistry ; Phenotype ; Portal Vein ; Protein Kinases ; STAT3 Transcription Factor ; Transducers

We present a rare case of solitary fibrous tumor (SFT) located in the intramedullary (IM) and intradural extramedullary sites of cervical spine, mimicking thrombosed aneurysm and meningioma. Herein, we present a case of spinal intradural SFT in a 59-year-old woman. She presented to the outpatient clinic with a right-sided motor weakness for over a year. The case was initially misinterpreted as a thrombosed aneurysm of the posterior spinal artery. Cervical spine magnetic resonance imaging revealed a well-circumscribed intradural mass with isosignal intensity on T1 and T2-weighted images with markedly T2 dark signal focus and homogenous intense enhancement at the level of C6. Computed tomography showed a slightly high-density mass without evidence of calcification or cystic component. Surgical removal was performed. However, due to combined IM component with adhesion, incomplete tumor resection was done. Pathologic analysis revealed hypocellular spindle cells with a thick collagenous stroma and immunohistochemical staining confirmed SFT. Spinal intradural SFT is a rare spindle cell tumor. Radiologists should consider SFT as a differential diagnosis if T2-weighted imaging shows an intradural located mass with markedly dark signal intensity focus.

Mazabraud syndrome (MS) is a rare and sporadic disorder. It is mainly characterized by fibrous dysplasia (FD) of single or multiple bones and intramuscular myxomas (IM). Data on the prevalence since it was first reported, clinical features, and prognosis are extremely scarce. We report a case of a 59-year-old woman with IM and polyostotic FD. She also had multiple cafe’-au-lait spots suggestive of McCune-Albright syndrome (MAS). On magnetic resonance imaging, there are masses with well-defined heterogeneous enhancement, accompanied by an inner cyst in the vastus lateralis muscle and femur. These radiological results are identical to those of FD. After surgical intervention with excision of intramuscular soft-tissue mass, a diagnosis of IM of MS was confirmed. Given that cafe’-au-lait spots also appeared, the patient was diagnosed with a variant of MS with some of the clinical characteristics of MAS.

Hairy polyps are a rare malformations of bigerminal origin that comprise of both ectodermal and mesodermal elements. Meningothelial elements are an extremely rare pathologic finding in hairy polyps. Here we report a case of a hairy polyp with a meningothelial element, which originated from the hard palate. A 1-year-old boy was evaluated for an intraoral mass accompanied by multiple congenital anomalies. A small polypoid mass was noted at the midline of the hard palate. The lesion had central fibroconnective tissue with an unusual stromal component showing reticulated anastomosing pseudovascular patterns. Immunohistochemical staining of the cells lining the pseudovascular spaces and the interstitial cells revealed vimentin and epithelial membrane antigen positivity.

Cystitis glandularis is a benign metaplastic proliferative lesion of the urinary bladder which usually occurs in the setting of chronic irritation and infection or in some cases as a congenital process. Sometimes it presents as a tumor mass-like florid lesion, grossly mimicking malignancy. We report a case of 59-year-old man with multiple mass lesions around the trigone and the neck portion, which suggested the possibility of malignancy in clinical and radiological evaluations. Final diagnosis was confirmed by transurethral resection. The surface urothelial lining was intact. The submucosa showed von Brunn's nests, cystitis glandularis and cystitis cystica in the edematous lamina propria. There were numerous glands lined by tall columnar, mucin producing epithelium without atypia, conforming to the appearance of the intestinal variant of cystitis glandularis. The cystitis glandularis may mimic a neoplasm on gross evaluation. The intestinal variant of cystitis glandularis is particularly likely to be problematic when florid.
Cystitis* ; Diagnosis ; Epithelium ; Humans ; Middle Aged ; Mucins ; Mucous Membrane ; Neck ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Carcinosarcoma of the stomach is a rarely occurring malignant biphasic tumor that consists of both carcinomatous and sarcomatous components simultaneously in a single tumor. The common carcinoma component is tubular or papillary adenocarcinoma and the mesenchymal sarcomatous components are variable and these include leiomyosarcoma, rhabdomyosarcoma, osteosarcoma and chondrosarcoma. However, neuroendocrine carcinomatous differentiation in the carcinomatous component is extremely rare. We present here a rare gastric carcinosarcoma that demonstrated neuroendocrine carcinomatous and leiomyosarcomatous differentiation in a 47-year-old man.
Adenocarcinoma, Papillary ; Carcinosarcoma ; Chondrosarcoma ; Humans ; Leiomyosarcoma ; Middle Aged ; Muscle, Smooth ; Neurosecretory Systems ; Osteosarcoma ; Rhabdomyosarcoma ; Stomach