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Biomedical subjects

E K Ham

Publications and source records attributed to E K Ham.

15 recordsLinked to original sources

Clinicopathologic study of Castleman's disease in Korea.

Castleman's disease represents an atypical lymphoproliferative disorder, infrequently associated with various immunologic abnormalities or subsequent development of malignancy such as Kaposi sarcoma, malignant lymphoma and plasmacytoma. Its clinicopathologic features depend on various etiologic factors such as Kaposi sarcoma herpesvirus (KSHV), oversecretion of IL-6, adhesion molecule and follicular dendritic cell dysplasia, etc. To investigate the relationship of Castleman's disease (CD) and the above factors, we reviewed 22 cases of CD. Four cases of KSHV positive CD were detected, all multicentric, plasma cell type, and these cases displayed prominent vascular proliferation, characteristic 'Kaposi-like lesion'. IL-6 and CD54 positive mononuclear cells were scattered in interfollicular areas of KSHV positive cases. Follicular dendritic cell hyperplasia, vascular proliferation, expression of IL-6 and CD54 did not show any significant difference between solitary vs multicentric type, and plasma cell type vs hyaline vascular type. Our study suggests that KSHV positive CD reveals unique pathologic features, and the probable relationship of KSHV and IL-6 and CD54 is discussed.

Adolescent↗

Overexpression of cyclin D1 and cdk4 in tumorigenesis of sporadic hepatoblastomas.

Abnormality of the cyclin D1/cdk4/p16INK4a/pRb pathway during tumorigenesis has recently been reported. Hepatoblastoma is a rare malignant liver tumor of childhood, but underlying abnormalities of cell-cycle regulating protein remain to be elucidated. The expression of cyclin D1, cdk4, p16 and retinoblastoma gene product (pRb) was studied by immunohistochemistry in 17 paraffin-embedded tissues consisting of both tumor and corresponding non-neoplastic tissues. Tumor tissues showed overexpression of cyclin D1 (13/17, 76%) and cdk4 (15/17, 88%). Eleven cases showed co-overexpression of both cyclin D1 and cdk4. No abnormal p16 or pRb expression was noted. In the group with a high score (+4) for cyclin D1 expression, a positive correlation with tumor recurrence was noted (P = 0.043). These data suggest that overexpressed cyclin D1 and cdk4 protein might play an important role in the tumorigenesis of hepatoblastoma and that in the group with high cyclin D1 expression, tumor recurrence may be more frequent.

Adolescent↗

Immunohistochemical localization of surfactant apoproteins in usual interstitial pneumonia associated with pulmonary carcinoma.

Surfactant apoproteins A and B (SP-A and SP-B) are antigenic determinants of pulmonary surfactant complexes. The role and functional significance of these proteins are largely unknown and the pattern of expression is probably related to the functional maturation of type II pneumocytes. Differential expression of SP-A and SP-B was reported in the developing human lung but little is known of their expression in the chronic injury. We studied 5 surgical cases of usual interstitial pneumonia (UIP) associated with carcinoma to evaluate the expression of pulmonary surfactant apoproteins. These cases were immunohistochemically examined by the streptavidin-biotin complex method using monoclonal antibodies HS-1 and HS-2 against pulmonary surfactant apoprotein A (SP-A) and B (SP-B), respectively. In UIP, SP-B was expressed strongly in type II pneumocytes and Clara cells but bronchiolar epithelium and metaplastic squamous cell lines in the honeycomb lesion were non-reactive. SP-A showed a similar pattern but much weaker reactivity when compared to that of SP-B. Type II pneumocytes in normal lung tissue exhibited weak immunoreactivity and no difference in the intensity of staining between SP-A and SP-B. Neither carcinomatous area nor metaplastic lining cells at honeycomb lesion show immunoreactivity to SP-A and SP-B. These results suggest that type II pneumocytes in the UIP are functionally immature in their expression of the apoprotein types and the metaplastic squamous cells or neoplastic transformed cells do not have molecular characteristics of type II pneumocytes.

Adult↗

Adrenal carcinosarcoma--a case report.

Carcinosarcoma of the adrenal gland is an extremely rare variant of adrenocortical carcinoma, characterized by a biphasic pattern of carcinoma and sarcoma-like components. We report a case of adrenal carcinosarcoma occurring in a 61-year-old Korean man who presented with right flank pain of one month duration radiating to the back and right iliac crest. The tumor measured 12 x 12 x 7 cm and adhered to the liver and right upper pole of the kidney. The carcinomatous component of the tumor showed polygonal cells in a broad anastomosing trabecular pattern with delicate slit-like vascular channels; the sarcomatous component showed uniform spindled cells in a fascicular pattern. Both the carcinomatous and sarcomatous portions of the tumor were positive for pan-cytokeratin, and vimentin stained only the sarcomatous areas.

Adrenal Gland Neoplasms↗

Pulmonary paragonimiasis: clinical and experimental studies.

Pulmonary paragonimiasis is a disease caused by a lung fluke. It is endemic to East Asia, but there have been several case reports in North America. Human infestation occurs by ingestion of raw or incompletely cooked freshwater crab or crayfish infected with metacercaria. A retrospective study was performed with 78 patients who lived in South Korea and had chest radiographic findings of pleuropulmonary disease; it was subsequently shown that they had paragonimiasis. The diagnosis was based on positive results of serologic tests for Paragonimus-specific antibody or on the detection of eggs in sputum samples. Radiologic findings from these 78 patients were correlated with the pathologic and radiologic findings from a study of experimentally induced pulmonary paragonimiasis in 21 cats. Findings from the correlative study document that the typical radiologic manifestations of pulmonary paragonimiasis vary with the stage of the disease. Early findings include pneumothorax or hydropneumothorax, focal airspace consolidation, and linear opacities and are caused by the migration of juvenile worms. Later findings include thin-walled cysts, dense masslike consolidation, nodules, or bronchiectasis and are due to worm cysts.

Adult↗

Hematogeneous pulmonary metastasis. An experimental study using VX-2 carcinoma in rabbits.

The purpose of this study was to develop an experimental model of pulmonary metastases using VX-2 tumor, and to describe sequential radiologic and pathologic findings with special attention to the interstitial changes around the metastatic nodules. Through ear veins of 25 rabbits, VX-2 tumor cell suspension was injected with 0.8-mm scalp needles. Chest radiographs were taken every other day after tumor injection. The rabbits were sacrificed at scheduled times from 3 to 30 days after tumor injection. The inflated and fixed lungs were examined with visual inspection, low-kV radiography, high resolution CT (HRCT), microradiography of the sliced lung and with histopathologic studies. Hematogeneous pulmonary metastases occurred in 24 of 25 rabbits. In addition to the metastatic nodules, perinodular and peribronchovascular infiltrations were seen on low-kV radiography, HRCT, microradiography and histologic studies.

Animals↗

Glomus tumor of the trachea. Report of a case with ultrastructural observation.

Extracutaneous glomus tumors are unusual and their occurrence in the trachea has been recognized with extreme rarity. We present a case of surgically resected glomus tumor of the trachea in a 54-year-old woman who was initially misdiagnosed as having bronchial asthma because of expiratory wheezing. The tumor, located 7 cm below the vocal cord and 5 cm above the carina, was an intraluminally protruding polypoid mass that measured 1.5 X 1.2 cm and arose from the posterior wall of the trachea with a broad base. Microscopically, the tumor was predominantly of the solid type, but a small proportion of a glomangiomatous component was admixed. Ultrastructural study confirmed the presence of myofibrillar bundles with focal densities and fine pinocytotic vesicles along the plasma membrane. A structure similar to a nonneoplastic glomus was demonstrated in the submucosal layer of the posterior wall away from the tumor margin. This suggests that the tracheal glomus tumor occurs more often in the posterior wall where neuromuscular complex structures may develop more readily.

Asthma↗

Clear-cell chondrosarcoma--a case report.

Clear-cell chondrosarcoma, a recently specified entity, is a low-grade malignant tumor and has characteristic clinical, roentgenographic and pathologic findings which separate it from conventional chondrosarcoma and other benign tumors. Therefore, correct diagnosis is important from the viewpoint of both prognosis and therapeutic approach. We report a case of typical recurrent clear-cell chordirosarcoma. Typical round cells with clear cytoplasm, large nuclei, and small nucleoli were wellnoted. The clear cytoplasm was faintly positive in PAS staining. Electronmicroscopic study showed that these cells were of chondroid origin, showing indented nuclei, large dilated endoplasmic reticulum cisternae, bundles of actin-like filaments and a few glycogen particles.

Chondrosarcoma↗

Malignant tumors among Koreans-relative frequency study on 19,140 cases during 1978 to 1986.

A statistical analysis was made on 19,140 primary malignant tumors histopathologically diagnosed at Seoul National University Hospital during 9 year period from 1978 to 1986. The study was performed to understand the recent trend of the relative frequency of the primary malignant tumors among Koreans and to compare it with the previous studies using same hospital materials, twice presented in 1968 and 1978, respectively. Sex distribution of the cases was 10,025 (52.38%) males and 9,115 (47.62%) females. Among males the frequency rank was stomach (33.88%), lung and bronchus (8.73%), leukemia (7.02%), liver (4.79%) and oral cavity (4.70%). And among females it was uterine cervix (24.48%), stomach (20.45%), thyroid (7.87%), breast (6.48%) and leukemia (4.78%). The relative frequency of malignant tumors in this study was generally similar to the previous data published in 1978 at this department, except for the fact that stomach and lung cancers were more commonly seen in both sexes during this study period than the previous periods of years.

Cohort Studies↗

An evaluation of frozen section biopsy in 4434 cases.

Frozen section diagnosis is a highly useful method of diagnosis. There were 4434 frozen sections, 24 false positive diagnosis, 65 false negative diagnosis and 30 deferred diagnosis. This method achieves the highest accuracy when there is a cooperation between experienced surgeon and reliable and careful pathologist. It is wise to defer the diagnosis of consult to other pathologist in difficult situation.

Biopsy↗

Syringomatous adenoma of nipple--a case report.

A syringomatous adenoma of the nipple is a benign locally infiltrating neoplasm histologically similar to the syringoma of the skin. Morphologically similar lesions have been described as adenoma of the nipple or florid papillomatosis. Patient was a 33 year old woman who was admitted with a history of bloody nipple discharge from her right breast. With a clinical impression of Paget's disease explorative mastectomy was performed. Microscopically typical tubular and duct like structures with syringomatoid features were present throughout the stroma of the nipple.

Adenoma↗

Fine needle aspiration cytology of palpable breast lesions. Histologic subtype in false negative cases.

OBJECTIVE: To evaluate the use of fine needle aspiration cytology (FNAC) in the management of benign and malignant breast disease in an outpatient breast clinic and to determine the guidelines for reporting on FNAC of breast lesions, we evaluated the test results in correlation with the histologic diagnosis. STUDY DESIGN: We evaluate the test results of 669 cases of FNAC of the breast in 17 months in our outpatient breast clinic in correlation with the histologic diagnosis, histologic subtype according to the Japan Mammary Cancer Society classification and mammography results in false negative cases. RESULTS: Among 669 cases, 25.3% were inadequate for cytologic diagnosis. An analysis of the results using the two-by-four contingency table, including cases with inadequate cytologic diagnosis, showed that 10.6% and 1.0% had false negative and false positive cytologic diagnoses, respectively; sensitivity and specificity were 76.9% and 91.6%, respectively. The false negative rate of 10.6% was higher than expected, and those belonged mostly to the "inadequate" cytologic diagnosis category even though they were discrete, obviously malignant masses clinically. To try to explain this, we compared the cytologic results and histologic subtype according to the Japan Mammary Cancer Society classification and the mammography results. Of 73 cases of infiltrating ductal carcinoma in which retrospective reexamination of the histology slide was possible, 27 (37.0%) were papillo-tubular type, 11 (15.1%) were solid-tubular type and 35 cases (47.9%) were scirrhous type. Although the scirrhous subtype was only 37.0% in the group in which a cytologic diagnosis of carcinoma was possible, more than two-thirds of the cases of false negative cytology were scirrhous type and had malignant mammographic findings. This finding was statistically significant. CONCLUSION: In cases of ductal carcinoma of scirrhous subtype, the FNAC tended to be inadequate and false negative, but mammography showed better discrimination in such cases.

Biopsy, Needle↗

Fine needle aspiration cytology of gastric epithelioid leiomyosarcoma metastasized to the liver. A case report.

BACKGROUND: There have been only a few reports on fine needle aspiration (FNA) cytology of epithelioid leiomyosarcoma, especially of the stomach, and a summary of the cytologic findings in this tumor is needed. CASE: A case of epithelioid leiomyosarcoma of the stomach metastasized to the liver and was composed cytologically of peculiar binucleated cells. CONCLUSION: Similar findings in most cases are that the cells are round or polygonal, with eccentrically located nuclei. The most variable findings relate to the texture of the cytoplasm, which varies from granular to dense to vacuolar. FNA cytology of epithelioid leiomyosarcoma can show cells that are mononuclear, binucleated or multinucleated, with eccentric nuclei and dense to vacuolar cytoplasm, with the variations probably depending on fixation status.

Biopsy, Needle↗

Differential diagnosis of adenoid cystic carcinoma from pleomorphic adenoma of the salivary gland on fine needle aspiration cytology.

OBJECTIVE: To evaluate the distinguishing morphologic features of pleomorphic adenoma and adenoid cystic carcinoma on fine needle aspiration cytology. STUDY DESIGN: A retrospective study was undertaken to compare the cytomorphology of 9 adenoid cystic carcinomas with that of 12 pleomorphic adenomas of the salivary gland among histologically proven cases. RESULTS: The most consistent finding for differentiating adenoid cystic carcinoma from pleomorphic adenoma in our study was the amount of cytoplasm of individual tumor cells. Plasmacytoid appearance is a reliable finding for pleomorphic adenoma, and it enables us to rule out adenoid cystic carcinoma. All 12 cases of pleomorphic adenoma showed tumor cells containing abundant cytoplasm in clusters and isolated cells, with plasma cell-like appearance in 9 cases, especially in isolated cells. In contrast with pleomorphic adenoma, most adenoid cystic carcinomas showed little cytoplasm. Hyaline spherical globules were found in four of nine adenoid cystic carcinomas but were not found in any case of pleomorphic adenoma. It was specific but not sensitive to adenoid cystic carcinoma. Fibrillary chondromyxoid ground substance and a mixture of epithelial cells with stroma were found in two-thirds of the pleomorphic adenomas in our cases. The pattern of cell clusters was helpful to differentiate pleomorphic adenoma from adenoid cystic carcinoma. Large, loose clusters with a spindle cell core suggested pleomorphic adenoma. Small, dense trabeculae with a smooth margin and dense clusters containing clear, round spaces were more suggestive of adenoid cystic carcinoma. Overall cellularity, proportion of isolated cells, orientation of cellular clusters and degree of cellular overlapping gave almost no help in making the distinction between the lesions. CONCLUSION: A plasmacytoid appearance of individual tumor cells with abundant cytoplasm was a reliable finding in pleomorphic adenoma for differentiating it from adenoid cystic carcinoma. Practically, nuclear features were not enough to distinguish the two lesions in isolated cases.

Adenoma, Pleomorphic↗