Stomach cancer is the most common malignant neoplasm among Korean men and considered as one of the most important malignant disease in many countries. Thus, many studies have been established about factors affecting prognosis of stomach cancer. These include studies of histopathological pattern which were performed by Mulligan and Rember (1954), Lauren (1965), Ming (1977), and Teglbjerg and Vetner(1977). The present study is aimed to evaluate the useful factors to predict the prognosis of patient of stomach cancer in relation to the histopathological patterns. The material consisted of 284 cases which were diagnosed as gastric carcinoma at the Department of Pathology, Yonsei University, College of Medicine from January, 1981 through December, 1982. After the classification of gastric carcinoma by Ming (1977), Willis (1967), and Mulligan and Rember (1954), age and six of the patients, histopathologic patterns, depth of invasion, degree and major component of inflammatory reaction, lymphatic permeation and metastatic incidence to the regional lymph nodes were investigated, and the results obtained were as follows; 1) The overall male to female ratio was 1.4 : 1 and mean age was 51.6 years old. The mean age of patients with EGC was 46.8 years old, while that of patients with invasive cancer was 52.2 years old, indicating about 5 years difference. 2) The classification of 284 cases by Ming's method showed 36.3% of expanding type and 63.7% of infiltrative one. The incidence of metastasis to regional lymph nodes was 58.3% in expanding type and 72.4% in infiltrative one. 3) The classification of 284 cases by Willis' method showed 45.8% of adenocarcinoma and 23.2% and of signet ring cell carcinoma. Adenocarcinoma anaplastic carcinoma had high degree of desmoplasia. Among them, moderately well differentiated adenocarcinoma and anaplastic carcinoma showed markedly lower metastatic rate to regional lymph nodes than others. 4) The classification of 284 cases by Mulligan and Rember's method showed 15.1% of intestinal cell carcinoma, 21.5% of pyloro-cardiac gland cell carcinoma and 61.6% of mucous cell carcinoma. Highly differentiated intestinal cell and pylorocardiac gland cell carcinomas and desmoplastic mucous cell carcinoma had high degree of desmoplasia. Among them, highly differentiated intestinal cell carcinoma and desmoplastic mucous cell carcinoma showed markedly low metastatic rate to regional lymph nodes. 5) Adenocarcinoma with good differentiation showed higher mean age and male predominancy in comparison to carcinoma with poor differentiation. 6) The degree of inflammatory reaction did not show significant difference in relation to the patterns of gastric carcinoma and the rate of regional node metastasis. However, according to the cell types involved in inflammatory reaction, plasma cell-predominant inflammatory reaction showed low metastatic rate to regional lymph nodes. 7) The more the degree of desmoplasia was observed, the less the rate of metastasis to regional nodes was noted and the difference was statistically significant. 8) The rate of metastasis to regional nodes showed marked difference by the depth of cancer invasion; confined to mucosa, 0% : to submucosa, 15.4%; to muscular layer, 66.7%; and to serosa and perigastric area, 76.5%. In summary, the results of this study indicated several factors suggesting good prognosis, such as; (1) expanding growth pattern, (2) good differentiation, (3) high degree of desmoplasia as stromal reaction, (4) plasma cell-predominant infiltration, and (5) lesser deep invasion. These factors were better evaluated by Mulligan and Rember's classification.
Female ; Male ; Humans ; Incidence ; Adenocarcinoma ; Neoplasm Metastasis ; Stomach Neoplasms

In 1927, Hamperl carried out histochemical studies on gastric cancer and found one case which contained many Fontana reactive argentaffin cells. Thereafter the gastric and intestinal adenocarcinomas which contain enterochromaffin cells such as argentaffin cell and argyrophil cell have been reported by several investigators. As the results, many reports revealed that 1.7 to 8% of gastric carcinomas and about 3% of intestinal carcinomas contained argentaffin cells, and 13 to 20% of gastric carcinomas and 12 to 15% of intestinal carcinomas contained argyrophil cells. The present study is aimed to evaluate the frequency of argentaffin and argyrophil cells in gastric and intestinal carcinoma in relation to the histopathological patterns. The material consisted of 282 cases of gastric adenocarcinoma and 83 cases of intestinal carcinoma which were diagnosed at the Department of Pathology, Yonsei University College of Medicine from January 1982 through December 1983. All cases were stained with hematoxylin-eosin for histological classification and with silver impregnation techniques for argentaffin and argyrophil granules. Staining for mucin was also performed using PAS stain. The results obtained were as follows: 1) Among 282 cases of gastric carcinomas, Grimelius positive argyrophil cells are noted in 43 cases (15.2%) and Fontana-Masson positive argentaffin cells are noted in 5 cases (1.8%). 2) Among 83 cases of intestinal carcinomas, Grimelius positive argyrophil cells are noted in 15 cases (18.2%) and Fontana-Masson positive argentaffin cells are noted in 1 cases (1.2%). 3) In gastric carcinoma, argyrophil cells are present in 31 cases (17.5%) among 176 male patients and and in 12 cases (11.3%) among 106 female patients. 4) In intestinal carcinoma, argyrophil cells are present in 9 cases (20.4%) amogn 44 male patients, and in 6 cases (15.4%) among 39 female patients. 5) According to classification by Willis, argyrophil cells are present in 12 cases (11.1%) among 108 well to moderately well differentiated adenocarcinoma, 14 cases (14.4%) among 99 poorly differentiated adenocarcinoma, 6 cases (30%) among 20 mucinous carcinoma, and 11 cases (21.1%) among 52 undifferentiated carcinoma. There is no significant difference in the frequency of argyrophil cells in relation to the histological type. 6) According to general classification of intestinal carcinoma, argyrophil cells are present in 9 cases (21.4%) among 42 well to moderately well differentiated adenocarcinoma, 3 cases (15%) among 25 poorly differentiated adrcinom adenocarcinoma and and cases (18.7%) among 16 mucinous carcinoma. The argentaffin cells were noted only in one case, which was the case of well to moderately well differentiated adenocarcinoma. In summary, the results of this study indicates that the frequency of enterochromaffin cells was 15.2% in stomach carcinoma and 18.2% in intestinal carcinoma. According to histological type, the Grimelius positivity was higher in mucinous and undifferentiated type, and higher frequency was noted in male than female.
Female ; Male ; Humans ; Adenocarcinoma ; Stomach Neoplasms

Colonization of mammary cancers by melanocytes with heavy pigmentation of cancer cells by melanin can occur very rarely. It is not certain which mechanism operates to achieve this transfer. However, the melanocytes might inject melanin through their dendritic processes or alternatively, the cancer cells phagocytose the terminal parts of the dendritic processes with subsequent dispersal of the contained melanin contained melanin granules. We report a case of infiltrating ductal carcinoma of breast with melanocyte colonization and pigmentation in a 59-year old female.
Female ; Humans

Chromomycosis is a chronic localized infection of the cutaneous and subcutaneous tissues and characterized by verrucoid, ulcerated and crusted lesions with sclerotic margins. It histologically show confluent granulomatous nodules containing large giant cells of the foreign body type. The organisms are differ from other yeastform fungi by the characteristic chestnut-brown color and by the septate division. A case of 51 year old woman with chromomycosis at submental area is presented.
Female ; Humans

To elucidate the histologic pattern of alcoholic liver disease (ALD) in Korea, liver biopsies from 173 chronic alcoholics with clinical liver diseases were classified according to the pathologic parameters. One hundred and seventeen cases, the sum of 91 of 116 serum HBsAg negative and 26 of 57 HBsAg positive patients, had the histologic evidence of ALD. Fatty change(23.9%), alcoholic fibrosis (AF)(23.1%) and cirrhosis (23.1%), comprised the three major ALDs, and only 8.5% of cases fit the criteria of alcoholic hepatitis. Chronic sclerosing hyaline disease (CSHD), chronic active alcoholic hepatitis (CAAH) and AF, where non-cirrhotic fibrosis is the predominant change, comprised 44.5% of ALD. Both features of ALD and HBV liver disease (HBV-LD) were found in 17 cases that included 8 AF and 7 cirrhosis. These 17 patients tended to consume less alcohol than patients with other types of pure ALD except alcoholic heaptitis. Patients with the serum HBsAg positive ALD (37.4years) were about 8 years younger than those with the serum HBsAg negative ALD (45.1years). More or less fatty change and foamy degeneration were seen in 77.4% and 31.6% of ALD respectively. Mallory bodies, megamitochondria, iron deposition and perihepatocellular fibrosis were found in 20.5%, 29.9%, 42.7% and 77.8%, respectively. These findings indicate that non-cirrhotic chronic ALD such as CSHD, CAAH and AF are the important histologic patterns of ALD in Korea, and that chronic alcohol consumption and HBV may act synergistically in developing liver disease.
Biopsy

Dermatofibrosarcoma protuberans is an uncommon, locally aggressive fibroblastic tumor, characterized by infrequent metastasis and a marked tendency of local recurrence after excision. Histologically, it shows large uniformed spindle shaped cells arranged in a cartwheel or storiform pattern. We report a case of dermatoribrosarcoma protuberans on the lower abdomen of a man aged of thirty, treated with Mohs micrographic surgery and purse-string suture repair.
Abdomen ; Dermatofibrosarcoma* ; Fibroblasts ; Mohs Surgery* ; Neoplasm Metastasis ; Recurrence ; Sutures*

Actinomycosis, in which the principal causative agent in man is known to Actinomyces israelii, is a chronic, suppurative diseases characterized by extensive fibrosis, multiple abscesses, and formation of sinus tracts that drain suppurative exudates. On the basis of the anatomical sites involved; it can be subclassified into the cervicofacial form, which is the most common form, pulmonary form and abdominal form. Kidneys are rarely affected. Clinically, radiologically, and at operation it is difficult to differentiate the renal actinomycosis from renal tuberculosis and renal carcinoma. The prognosis is excellent after nephrectomy followed by appropriate antibiotic therapy. We presented a case of renal actinomycosis with a brief review of the literatures.
Male ; Humans

To investigate the mechanism of monocrotaline-induced pulmonary arterial hypertension, authors performed immunohistochemical study using antibody to von Willebrand factor(vWF), cell kinetic study using 5-bromodeoxyuridine and ultrastructural study after single subcutaneous injection of monocrotaline(MCT) to Wistar rats. The results of this study demonstrated that the expression of vWF by pulmonary endothelial cells was markedly increased from day 3 until 2 months after MCT injection. The labeling index of pulmonary microvessel endothelium began to increase after six days and was maximal on the third weeks, and thereafter it remained slightly increased above basal level. Electron microscopic study revealed attachment of inflammatory cells an platelets to endothelium from 6 hours and degranulation of attached platelets 24 hours after MCT injection. Evidences of endothelial injury began to appear from 12 hours after MCT injection. Evidences of endothelial injury began to appear from 12 hours and was maximal after 48 hours. From the third day, ultrastructural change of cell regeneration and hypertrophy began to appear and was continuosly observed until 2 months. In addition, we evaluated the changes in the number of pulmonary neuroendocrine cells using antibody to gastrin releasing peptide but it demonstrated no change until 2 months suggesting no role of neuroendocrine cells in the development of pulmonary hypertension of Wistar rats at early stage. In conclusion, the results indicate that pulmonary hypertension by MCT injection is due to increased vascular resistance caused by vasoconstriction and hyperplasia of endothelium with musculariz ation of the pulmonary arterioles induced by endothelial dysfunction and some biologic substances released form endothelium and platelets.
Rats ; Animals

To evaluate the prognostic predictor and clinicopathologic characteristics of the gastrointestinal (GI) mesenchymal neoplasm, we examined 75 cases of GI mesenchymal tumors surgically resected during 8 years from 1983 to 1990. Various histological parameters referrable to the prognosis, including the Ag-NORs count, were analysed. Fifty cases were followed-up for 1 to 7 years. Sixteen out of these fifty cases died during this period. The location of tumor was the stomach in 33 cases, the small intestine in 31 cases and the large intestine in 11 cases, and the tumor size was variable from 2 to 35 cm in diameter. The GI mesenchymal neoplasm appeared as an extraluminal mass in 50 cases, an intramural mass in 17 cases, and an intraluminal mass in 8 cases. Each tumor was composed of spindle or epithelioid cells, the former cell type being more common than the latter (45 vs 30 cases). Mitotic count of the tumor showed the best correlationship with the survival of patients(p<0.05), although the tumor size and necrosis appeared to have some values. The Ag-NORs count was variable and was not significantly correlated with the patient's prognosis(p>0.05). These results indicate that the mitotic count is the most valuable pathological predictor for the prognosis in GI mesenchymal neoplasms.

Cell reactions to metastatic tumors in the regional lymph nodes were studied by light and electron microscope in 20 cases; i.e. reactive hyperplasia (3), tuberculosis (3), metastatic carcinomas from the breast (4), from the stomach (2), from the lung (2), metastatic epidermoid carcinoma (2), metastatic malanoma (2), and reticulum cell sarcoma (2). The lymph node response was usually germinal center predominence type and the pyroninophilic cell response was a similar pattern of nonspecific germinal centers with prominent reactive hyperplasia. In two cases of undifferentiated tumors, one from the breast and another from the lung, large numbers of pyroninophilic cells were found within the tumor tissue. However, the majority of lymphoid cells surrounding tumor cell or tumor masses were pyronin negative lymphocytes. Electron microscopic observations revealed that the cells surrounding tumor cells were mostly medium sized lymphocytes, occasionally blast cells and mature plasma cells. The contact border between the tumor cells and the surrounding cells was mostly tight and smooth, but occasionally loose with irregular processes, and widely separated in the case with plasma cells. Degenerative changes of adjacent cytoplasm of either the tumor cells or the lymphocytes were not frequent, but in some instances focal degeneration of adjacent cytoplasm, particularly on the side of the lymphocytes, was noted.
Human ; Lymph Nodes/ultrastructure* ; Lymphatic Metastasis ; Lymphocytes/ultrastructure ; Neoplasm Metastasis ; Neoplasms/ultrastructure* ; Plasma Cells/ultrastructure