Lymphoid malignancies have been reported in association with chronic myelogenous leukemia, but the development of chronic myelogenous leukemia and T-cell lymphoma in the same patients is rare. We experienced a case of peripheral T-cell lymphoma developed in the course of chronic myelogenous leukemia. In December 1993, a diagnosis of chronic myelogenous leukemia was made. The patient was treated with hydroxyurea and busulphan. In June 1999, the patient was admitted because of a swelling in right submandibular area and throat pain. He underwent right tonsilectomy. The histologic and immunologic examination of tonsil revealed a peripheral T-cell lymphoma. This case is additional one to a few previously reported cases of concurrence of chronic myelogenous leukemia and T-cell lymphoma.
Busulfan ; Diagnosis ; Humans ; Hydroxyurea ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Palatine Tonsil ; Pharynx ; T-Lymphocytes

BACKGROUND AND OBJECTIVES: Cyclin D1 expression is closely related with ER in breast cancer. We conducted this study to evaluate whether therapeutic response to tamoxifen is varied with levels of cyclin D1 expression in ER positive breast cancer patients. METHODS: Immunohistochemical assay for cyclin D1 protein was performed in 66 patients treated with tamoxifen for more than 2 year. Patient survival and correlation between cyclin D1 expression and biologic data of the patients were analyzed. RESULTS: Cyclin D1 expression was detected in 46 (69.7%) and significantly reduced in poorly differentiated cancer (p=0.023). Cyclin D1 expression was high in the tumors expressing Myc (15/15 vs. 31/51; p=0.002), and was markedly increased in the tumors in which p27Kip1 expression was repressed (30/38, 78.9%). However, the difference was not ststistically significant (p=0.051). There was no significant relationship between cyclin D1 expression and S-phase. Patients with tumors expressing cyclin D1 showed better disease free survival and overall survival but the difference was not statistically significant. CONCLUSIONS: Cyclin D1 expression was associated with cell differentiation bit not useful in discriminating high risk group with tamoxifen treatment. Cyclin D1 may have a role other than cell cycle regulator in ER positive breast cancer, such as differentiation signal.
Breast Neoplasms* ; Breast* ; Cell Cycle ; Cell Differentiation ; Cyclin D1* ; Cyclins* ; Disease-Free Survival ; Estrogens* ; Humans ; Prognosis ; Tamoxifen*

BACKGROUND: Cyclin D1 expression is closely related with ER in breast cancer. We conducted this study to evaluate whether therapeutic response to tamoxifen is varied with levels of cyclin D1 expression in ER positive breast cancer patients. MATERIALS AND METHODS: Immunohistochemical assay for cyclin D1 protein was performed in 66 patients tasted with tamoxifen for more than 2years. Patient survival and correlation between cyclin D1 expression and biologic data of the patients were analyzed RESULTS: Cyclin D1 expression was detected in 46 (69.7%) and significantly reduced in poorly differentiated cancer (p=0.023). Cyclin D1 expression was high in the tumors expressing Myc (15/15 vs 31/51; p=0.002), and was markedly increased in the tumors in which p27Kip1 expression was repressed (30/38, 78.9%). However, the difference was not statistically significant (p=0.051). There was no significant relationship between cyclin D1 expression and S-phase. Patients with tumors expressing cyclinD1 showed better disease free survival and overall survival but the difference was not statistically significant. CONCLUSIONS: Cyclin D1 expression was associated with cell differentiation but not useful in discriminating high risk group with tamoxifem treatment. Cyclin D1 may have a role in process other than cell cycle regulator in ER positive breast cancer, such as differentiation signal.
Breast Neoplasms ; Cell Cycle ; Cell Differentiation ; Cyclin D1* ; Cyclins* ; Disease-Free Survival ; Estrogens* ; Humans ; Prognosis ; Tamoxifen*

BACKGROUND: Mad1 protein is known to repress Myc target genes and antagonize Myc function. We underwent this study to investigate the clinical implication of Mad1 expression in human breast cancer. MATERIALS AND METHODS: We performed immunohistochemical assay for Mad1 protein together with Myc in human brest cancer, along with tissues from normal and benign diseases. The data from protein assay were merged with clinical and biologic parameters of the patients. RESULTS: Of 66 patients with invasive ductal cancer, Mad1 expression was detected in 22(33.3%). Intensity and area of Mad1 expression significantly decreased in DCIS and invasive cancers while high levels of Mad1 expression were persistent in benign breast lesions. Mad1 expression was significantly reduced in poorly differentiated tumors(P<0.001). Expression of Mad1 was not associated with tumor size, lymph node status, and stage of the disease. We could not observe any correlation between S-phase and expression status of Myc or Mad1. Mad1 expression was closely linked to differentiation of the cancer cells and inversely correlated with Myc expression(P=0.042). In survival analysis, Mad1 possessed a prognostic significance to predict recurrence of the disease but not overall survival after CMF chemotherapy. CONCLUSIONS: In human breast cancer cells, expression of Mad1 seems to be downregulated while expression of Myc is amplified. Altered expression of Mad1 may play a role in malignant transformation of human mammary epithelial cells and represent an aggressive phenotype in human breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Drug Therapy ; Epithelial Cells ; Humans* ; Lymph Nodes ; Phenotype ; Prognosis ; Recurrence

BACKGROUND: Recent findings in molecular pathology suggest that genetic translocation and/or overexpression of oncoproteins is important in salivary gland tumorigenesis and diagnosis. We investigated PLAG1, SOX10, and Myb protein expression in various salivary gland neoplasm tissues. METHODS: A total of 113 cases of surgically resected salivary gland neoplasms at the National Cancer Center from January 2007 to March 2017 were identified. Immunohistochemical staining of PLAG1, SOX10, and Myb in tissue samples was performed using tissue microarrays. RESULTS: Among the 113 cases, 82 (72.6%) were benign and 31 (27.4%) were malignant. PLAG1 showed nuclear staining and normal parotid gland was not stained. Among 48 cases of pleomorphic adenoma, 29 (60.4%) were positive for PLAG1. All other benign and malignant salivary gland neoplasms were PLAG1-negative. SOX10 showed nuclear staining. In normal salivary gland tissues SOX10 was expressed in cells of acinus and intercalated ducts. In benign tumors, SOX10 expression was observed in all pleomorphic adenoma (48/48), and basal cell adenoma (3/3), but not in other benign tumors. SOX10 positivity was observed in nine of 31 (29.0%) malignant tumors. Myb showed nuclear staining but was not detected in normal parotid glands. Four of 31 (12.9%) malignant tumors showed Myb positivity: three adenoid cystic carcinomas (AdCC) and one myoepithelial carcinoma with focal AdCC-like histology. CONCLUSIONS: PLAG1 expression is specific to pleomorphic adenoma. SOX10 expression is helpful to rule out excretory duct origin tumor, but its diagnostic value is relatively low. Myb is useful for diagnosing AdCC when histology is unclear in the surgical specimen.
Adenoma ; Adenoma, Pleomorphic ; Antibody-Dependent Cell Cytotoxicity ; Carcinogenesis ; Carcinoma, Adenoid Cystic ; Diagnosis ; Immunohistochemistry ; Oncogene Proteins ; Oncogene Proteins v-myb ; Parotid Gland ; Pathology, Molecular ; Salivary Gland Neoplasms ; Salivary Glands ; SOX Transcription Factors ; Translocation, Genetic

Methods: In this study, a group of patients (n=33, device group) underwent surgery with the new device used to apply caudal traction to both shoulders, and another group of patients (n=33, matched control group) had surgery with the tape traction. Data about the lowest vertebra visible on lateral fluoroscopic view, installation time, skin irritation under the traction area, and postoperative brachial palsy were recorded, and these parameters were analyzed using the t-test. Results: The mean numbers of visible cervical vertebra were 6.3±0.41 in the device group and 5.6±0.32 in the matched control group (p <0.01, unpaired t-test). The mean installation times were 83.9±5.15 minutes in the device group and 73.7±6.32 minutes in the matched control group (p <0.02). Seven patients from the matched control group presented with skin irritation. However, none of the patients from the device group had the condition (p =0.005, Pearson chi-square test). Postoperative brachial palsy was not observed in both groups. Conclusions The Cervision system is more effective and superior to tape traction in pulling the shoulders down to improve the visualization of the cervical vertebra on lateral fluoroscopic view during cervical spine surgery.

Methods: Data analysis was carried out to identify the variables that had a significant impact on survival. For all patients with spinal metastasis from lung cancer who received non-surgical treatment, the Tomita score, revised Tokuhashi score, modified Bauer score, Van der Linden score, classic SORG algorithm, SORG nomogram, and NESMS were calculated. The performance of the scoring systems was assessed by using receiver operating characteristic (ROC) curves at 3 months, 6 months, and 12 months. The predictive accuracy of the scoring systems was quantified using the area under the ROC curve (AUC). Results: A total of 127 patients are included in the present study. The median survival of the population study was 5.3 months (95% confidence interval [CI], 3.7–9.6 months). Low hemoglobin was associated with shorter survival (hazard ratio [HR], 1.49; 95% CI, 1.00–2.23; p =0.049), while targeted therapy after spinal metastasis was associated with longer survival (HR, 0.34; 95% CI, 0.21–0.51; p <0.001). In the multivariate analysis, targeted therapy was independently associated with longer survival (HR, 0.3; 95% CI, 0.17–0.5; p <0.001). The AUC of the time-dependent ROC curves for the above prognostic scores revealed all of them performed poorly (AUC <0.7). Conclusions The seven scoring systems investigated are ineffective at predicting survival in patients with spinal metastasis from lung cancer who are treated non-surgically.

Primary cardiac lymphomas (PCL) are extremely rare. Clinical manifestations may be variable and are attributed to location. Here, we report on a case of PCL presenting with atrioventricular (AV) block. A 55 year-old male had experienced chest discomfort with unexplained dyspnea and night sweating. His initial electrocardiogram (ECG) revealed a first degree AV block. Along with worsening chest discomfort and dyspnea, his ECG changed to show second degree AV block (Mobitz type I). Computed tomography (CT) scan showed a cardiac mass (about 7 cm) and biopsy was performed. Pathologic finding confirmed diffuse large B-cell lymphoma. The patient was treated with multi-drug combination chemotherapy (R-CHOP: Rituximab, cyclophoshamide, anthracycline, vincristine, and prednisone). After treatment, ECG changed to show normal sinus rhythm with complete remission on follow-up CT scan.
Antibodies, Monoclonal, Murine-Derived ; Atrioventricular Block ; Biopsy ; Drug Therapy, Combination ; Dyspnea ; Electrocardiography ; Follow-Up Studies ; Heart Neoplasms ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Male ; Sweat ; Sweating ; Thorax ; Vincristine ; Rituximab

It is well known that different expression of Apo-1/Fas (CD95) plays important roles in various tumors and hepatocellular carcinoma (HCC) pathogenesis. Apo-1/Fas mediated apoptosis is one of the important pathways of apoptosis and is known to mediate apoptotic cell death by fas ligand (FasL). To examine the possible relationship between Apo-1/Fas gene polymorphism and HCC susceptibility, MvaI restriction fragment length polymorphism (RFLP) of Apo-1/Fas gene was examined in 94 Korean HCC patients and 240 control subjects. No statistically significant difference in the genotypic distribution and allelic frequencies was found between the control and the HCC. It is, therefore, concluded that Apo-1/Fas gene polymorphism is not associated with HCC susceptibility. Further studies are needed in order to clarify the relationships between genotypes of Apo-1/Fas gene and HCC pathogenesis.
Apoptosis ; Carcinoma, Hepatocellular* ; Cell Death ; Fas Ligand Protein ; Genotype ; Humans ; Polymorphism, Restriction Fragment Length

Background/Aims: Little attention is paid to chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in Korea due to the rarity of the disease. With its rising incidence, we aimed to evaluate recent changes in treatment patterns and survival outcomes of patients with CLL/SLL. Methods: A total of 141 patients diagnosed with CLL/SLL between January 2010 and March 2020 who received systemic therapy were analyzed in this multicenter retrospective study. Results: The median patient age was 66 years at diagnosis, and 68.1% were male. The median interval from diagnosis to initial treatment was 0.9 months (range: 0–77.6 months), and the most common treatment indication was progressive marrow failure (50.4%). Regarding first-line therapy, 46.8% received fludarabine, cyclophosphamide, plus rituximab (FCR), followed by chlorambucil (19.9%), and obinutuzumab plus chlorambucil (GC) (12.1%). The median progression-free survival (PFS) was 49.3 months (95% confidence interval [CI], 32.7–61.4), and median overall survival was not reached (95% CI, 98.4 mo– not reached). Multivariable analysis revealed younger age (≤ 65 yr) (hazard ratio [HR], 0.46; p < 0.001) and first-line therapy with FCR (HR, 0.64; p = 0.019) were independently associated with improved PFS. TP53 aberrations were observed in 7.0% (4/57) of evaluable patients. Following reimbursement, GC became the most common therapy among patients over 65 years and second in the overall population after 2017. Conclusions Age and reimbursement mainly influenced treatment strategies. Greater effort to apply risk stratifications into practice and clinical trials for novel agents could help improve treatment outcomes in Korean patients.