Estrogen receptor(ER) is a soluble form of hormone receptor protein which is located in the nucleus and cytoplasm of a cell is found in 60% of cases of the cells of breast carcinoma. Fifty to sixty percent of ER positive breast carcinoma responds to antihormone therapy wheres the response rate is only 5% in ER negative tumors. Currently, the ER assay has become a standard index in the management and prediction of the prognosis of advanced breast carcinoma. Semiquantitative biochemical assay, dextran-coated charcol(DCC) assay, to measure ER from fresh tissue was first developed by Korenman in 1970 using isotope-labled ertradiol, has been widely utilized. In 1978, Kurzon newly developed immunocytochemical assay(ICA) employing monoclonal antibody against those hormone receptors to detect intracellular localization of ER and progesterone receptor (PR). The results of the assay have been reported by many investigators thereafter. The purpose of this study was to evaluate the hormonal receptors with a monoclonal antibody using an immunoperoxidase procedure to detect both estrogen and progesterone receptors (ER-immunocytochemical assay:ER-ICA and PR-immunocytochemical assay:PR-ICA) in 59 cases of paraffin embedded sections from formalin-fixed and routinely processed breast carcinoma tissue. Concomitantly, fine-needle aspiration biopsy cytology of the breast cancer from 29 women were assayed for ER/PR receptors. Results were compared with quantitative biochemical values determined from dextran-coated charcoal(DCC) assay on the fresh tumor tissue obtained subsequently from the surgery. ER-ICA showed positive result in 22 out of 36 DCC-positive cases(sensitivity, 61.1%) and negative in 23 out of 23 DCC-negative cases (specificity, 100.0%). PR-ICA was positive in 33 out of 35 DCC-positive cases(sensitivity, 94.3%) and negative in 16 out of 24 DCC-negative cases(specificity, 66.7%). The value of ER-ICA or PR-ICA positivity were roughly correlated with the concentration of ER/PR receptors analyzed by DCC method. The results of both methods were correlated with the nuclear grade of the tumor(ICA:p=0.002, DCC: p=0.015) but were not correlated with histologic grade(ICA: p=0.323, DCC: p=0.0164). ER-ICA positivity was correlated with lower incidence of axillary node metastasis (p=0.021) but no significant correlation between PR-ICA positivity and node metastasis(p=0.171). Both ER/PR-ICA positivity were not correlated with age(p=0.924) and tumor size(p=0.663). The score of ICA particularly ER was proportional to DCC level(ER: r=0.5, p=0.000, PR: r=0.2, p=0.000). ICA concordance with DCC of ER and PR were 76.3% and 83.1%, respectively. The concordance of PR-ICA and DCC was proportional but was statistically less significant. In aspiration biopsy cytology the concordance of ER/PR-ICA and DCC were 72.4% and 65.5%, respectively. Immunocytochemical staining to identify ER/PR receptors from the tissue of breast carcinoma would be tested as a mean to substitute for the conventional DCC method.
Female ; Humans ; Incidence ; Biopsy ; Neoplasm Metastasis ; Breast Neoplasms

This is a retrospective review of fine-needle aspiration cytology(FNAC) smears of 153 cases of thyroid disease performed during August 1989 to July 1995, which were confirmed histologically following surgical operations. FNAC results showed 63 cases(41.2%) of adenomatous goiter, 45 cases(29.4%) of papillary carcinoma, 29 cases(19.0%) of follicular neoplasm, 4 cases(2.6%) of follicular variant of papillary carcinoma, 4 cases(2.6%) of Hashimoto's thyroiditis, 4 cases(2.6%) of Hurthle cell neoplasm, 2 cases(1.3%) of medullary carcinoma and one case(O.7%) each of subacute thyroiditis and of anaplastic carcinoma. The overall accuracy of cytological diagnosis was 83.7%. These data strongly suggest thyroid FNAC is a reliable preoperative diagnostic tool, but FNAC has been less valuable in the diagnosis of follicular lesions than any other disease of the thyroid. Adenomatous goiter was not infrequently interpreted as follicular neoplasia that requires surgery for diagnostic .conformation and vice versa. The following findings are considered to be compatible with follicular neoplasm: 1) microfolticles, 2) nuclear grooving, 3) irregularity of nuclear membrane, and 4) irregular arrangement or crowding of follicular cells in groups. The FNAC criteria of adenomatous goiter are as follows: 1) atrophic follicular cells, 2) presence of macrophages, 3) abundant colloid, and 4) large follicles. It is recommended that aspiration of thyroid lesions in order to analyse with critical clinico pathological approach and surgery is considered only for nodules that are clinically suspicious or unresponsive to hormone therapy or when a diagnosis of follicular neoplasm is made.
Biopsy, Fine-Needle* ; Carcinoma ; Carcinoma, Medullary ; Carcinoma, Papillary ; Central Nervous System ; Colloids ; Crowding ; Diagnosis ; Endodermal Sinus Tumor ; Germinoma ; Goiter ; Macrophages ; Nuclear Envelope ; Retrospective Studies ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis ; Thyroiditis, Subacute

Small cell carcinoma of the lung is characterized by cells with finely stippled chromatin and scanty cytoplasm as well as a particularly aggressive clinical course and favorable response to the chemotherapy. Recently percutaneous fine needle aspiration(FNA) biopsy has become both widely established and highly respected for the diagnosis of lung cancer. However metastatic small cell carcinoma of lymph node should be cytologically differentiated from the small round cell tumor of particular sites, especially malignant lymphoma, because small cell carcinoma of classic oat cell type may simulate small cell non-Hodgkin's lymphoma. We report five cases of metastatic small cell carcinoma of intermediate cell type diagnosed by FNA of the enlarged lymph nodes of the neck and axilla. The cytologic smears contained diffuse small neoplastic cells larger than lymphocytes with dense, pyknotic nuclei and extremely scanty cytoplasm. Apparently viable large tumor cells have vesicular nuclei with granular, sometimes very coarse chromatin. The characteristic cytologic features of small cell carcinoma as compared to malignant lymphoma were as follows.: 1) small cells with dense pyknotic nuclei are evenly distributed in the background of apparently viable larger tumor cells, admixed with mature lymphocytes and phagocytic macrophages. 2) small loose aggregates of cells with nuclear molding are indicative of small cell carcinoma rather than non-Hodgkin's lymphoma. 3) the cytoplasmic and nuclear fragments of tumor necrosis are more dominant in the smears of small cell carcinoma. 4) nuclear membrane and nucleoli are generally indistinct in small cell carcinoma due to condensation of chromatin.
Avena ; Axilla ; Biopsy ; Biopsy, Fine-Needle* ; Carcinoma, Small Cell ; Chromatin ; Cytoplasm ; Diagnosis ; Drug Therapy ; Fungi ; Lung ; Lung Neoplasms ; Lymph Nodes* ; Lymphocytes ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Macrophages ; Neck ; Necrosis ; Needles ; Nuclear Envelope

Primary hepatic carcinoid tumors are extremely rare although the liver is a frequent site of metastases from intestinal carcinoids. Recently we investigated a case of primary hepatic atypical carcinoid in a 47-year-old man who had infested with Clonorchis sinensis for 20 years. The resected right lobe of the liver was almost completely occupied by a huge tumor, measuring 20 x 19 x 12 cm. The cut surfaces of the mass were solid, soft and pale yellow, accompanied by several small satellite nodules, measuring up to 1.5 cm in diameter. Microscopically, the tumor consisted of polygonal to columnar cells with eosinophilic granular cytoplasm forming Lym-numerous small acini and large trabeculae. Their nuclei were round to polygonal with coarse stone chromatin, had obscure to small nucleoli and frequent mitoses. There were multiple necrotic foci of varing sizes. The surrounding dilated bile ducts contained several degenerating worms on in of Clonorchis sinensis. The tumor cells were argyrophil-positive but argentaffin-negative. Immunohistochemically, the tumor cells were positive for cytokeratin, chromogranin and somatostatin but were negative for CEA, AFP, insulin, glucagon, ACTH, growth hormone and volve-prolactin. Ultrastructually, the tumor cells contained variable-sized numerous electron dense of neurosecretory granules.
Male ; Humans ; Neoplasm Metastasis

In the past, parasitic diseases were a major problem in public health in Korea. In recent years, however, nematodiasis that used be prevalent are no longer a serious problem. Instead some cestodiasis, particularly cysticercosis and sparganosis have become comparatively more important in recent years. Parasitic infestation of soft tissue is presented as a subcutaneous nodule or mass with nonspecific clinical manifestations.
Biopsy, Fine-Needle* ; Cysticercosis ; Korea ; Parasitic Diseases ; Public Health ; Sparganosis

Because the spleen is likely to play a specific role in immunity, we have tried to observe the influence of the abdominal neoplasms on splenic lymphoid tissue as well as the distribution and localization of immunoregulatory cells with a special attention to the marginal zone, using splenectomy specimens in the various kinds of 121 abdominal neoplasm patients. As a control group, twenty-six splenectomy specimens from patients with traumatic rupture were used. In splenic size and weight, there was a statistically meaningful increase in the patients with abdominal neoplasms. Among those patients, the evolving activated immune reaction (EVA) was 60.2%, the early activated immune-reaction (EAA) 39.0%, the mixed evolving activated and granulomatous reaction (MIX) 0.8%, unlike EVA 30.8%, EAA 69.2%, and MIX 0% in the normal control group. The reason for this change may be explained by activated lymphoid tissue in the form of EVA type. In conclusion, the splenic lymphoid tissue in the various kinds of abdominal neoplasms, mostly malignant, revealed the chronic immune activated state characterized by the increased number of prominent germinal centers and distinct marginal zones, the latter of which revealed the positive reaction for L26, IgM and IgG, and negative for IgD, as well as showing increased natural killer and dentritic reticulum cells identified by Leu7 and S-100 protein respectively. Therefore, we could at least find the significance of the immunologic role of the spleen in the case of abdominal neoplasms, mostly from malignancy.
Abdominal Neoplasms/*pathology ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Human ; Immunohistochemistry ; Infant ; Lymphocytes/pathology ; Male ; Middle Age ; Organ Weight ; Spleen/immunology/*pathology ; Support, Non-U.S. Gov't

Cancer of the alimentary tract in children is an extremely rare occurence, and it accounts for no more than 5% of all pediatric neoplasms. Malignant neoplasms of the stomach are particularly uncommon in childhood. The majority of such lesions are malignant lymphomas or soft tissue sarcomas, with less than 5% identified as carcinomas. We report a case of signet ring cell carcinoma of stomach in 15-year-old girl. This patient had a clinical manifestation of cough with sputum, fever, abdominal distension due to ascites, hepatomegaly, and cervical lymphadenopathy for 40 days. There was no known gastrointestinal symptoms. Metastatic signet ring cell carcinoma was suspected by aspiration biopsy cytology of cervical lymph node, and confirmed later by excisional biopsy. Endoscopy confirmed a small mucosal erosion in the anterior wall of the antrum and histopathology confirmed the diagnosis of signet ring cell carcinoma.
Child ; Male ; Female ; Humans ; Biopsy ; Neoplasm Metastasis ; Stomach Neoplasms

A histopathologic study including iramunohistochemical stains was made in 30 patients who were presented with gastrointestinal lymphoma. The occurrence was 13 in the stomach, 8 in the ileocecum, 7 in the small intestine and 2 in the colon. The disease more frequently affected males than females and the average ages were 53 years in the patients of gastric lymphoma and 44 years in the patients of intestinal lymphoma. Gastric lymphomas were usually presented with a single lesion, and the antrum and/or body were the most common sites. But intestinal lymphomas were presented with a single or multiple lesion, and the ileocecum was the most common site. The most common gross type of gastrointestinal lymphomas was the ulceroinfiltrating type and most are of the diffuse large noncleaved cell type of B-cell lymphoma, histologically. There were 2 cases of T-cell lymphoma presented in the intestine as the superficially ulcerative gross pattern and diffuse immunoblastic cell type. The distinct MALToma was seen in only one case of stomach but the feature was partially remained in each two cases of stomach and intestine. Their coexistent findings may suggest that diffuse large of immunoblastic component arises through blastic transformation of the low-grade M ALToma component.
Female ; Male ; Humans

Urine cytology is of limited value in the diagnosis of renal cell carcinoma with reported detection rates of 0~80%. The aim of this study is to demonstrate the usefulness of urine cytology in renal cell carcinoma, In the eleven histologically proven cases of renal cell carcinoma, urinary smears were reevaluated. The cytologic results were as follows; positive for malignant cells in 3 cases (27%), suspicious in 2 cases (18%) and negative in 6 cases (55%). The average diameter of the tumor of the 5 cases reported as positive or suspicious for malignant cells was 9.7cm and 3 had invaded the renal pelvis. The other 6 tumors, reported as negative, were 5.7cm in average diameter and one of them showed involvement of the renal pelvis. These results suggest that urine cytology is considered unsatisfactory in the early detection of renal cell carcinoma. However. careful examination of urinary smear could improye the detection rate especially in more advanced cases involving the renal pelvis as well as those of larger tumors.
Carcinoma, Renal Cell* ; Diagnosis ; Kidney Pelvis

Thirty cases of kikuchi's lymphadenitis, diagnosed by fine needle aspiration cytology, were reviewed to determine the main cytologic features helpful in reaching a diagnosis. The patients(mean age 26.6 years. male: female=1:3.8) presented with lymphadenopathy(cervical 24, submandibular 3, and axillary 1) with or without fever and local tenderness. Excisional biopsy was done for confirmation in 5 cases and the remaining 25 cases showed the similar cytologic and clinical features. In the aspiration smears of all cases. there was a heterogenous cellular mixture including frequent extracellular karyorrhectic nuclear debris, phagocytic histiocytes, plasmacy toid monocytes, and a variable number of polymorphous lymphocytes such as immunoblasts. activated large lymphocytes, and small mature lymphocytes, The characteristic cytologic features of kikuchi's lymphadenitis were the following: (1) frequent extracelluar karyorrhectic nuclear debris in the background: (2) phagocytic histiocytes with eccentrically placed crescentic nuclei and abundant pale cytoplasm containing phagocytized karyorrhectic debris: (3) plasmacytoid monocytes, which were medium-sized cells with eccentrically placed round nuclei and amphophilic cytoplasm: (4) no neutrophilic background.
Biopsy ; Biopsy, Fine-Needle* ; Cytoplasm ; Diagnosis ; Fever ; Histiocytes ; Humans ; Lymphadenitis* ; Lymphocytes ; Male ; Monocytes ; Neutrophils