Characteristics of Renal Cell Carcinoma Harboring TPM3-ALK Fusion

우창곡,윤석중,손승명,임영현,이옥준 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.3

The World Health Organization 2016 edition assigned anaplastic lymphoma kinase (ALK) rearrangement-associated renal cellcarcinoma (ALK-RCC) as an emerging renal tumor entity. Identifying ALK-RCC is important because ALK inhibitors have beenshown to be effective in treatment. Here, we report the case of a 14-year-old young man with ALK-RCC. Computed tomographyrevealed a well-demarcated 5.3-cm enhancing mass at the upper pole of the left kidney. There was no further history or symptomsof the sickle-cell trait. The patient underwent left radical nephrectomy. Pathologically, the mass was diagnosed as an unclassifiedRCC. Targeted next-generation sequencing identified a TPM3-ALK fusion gene. The present report and literature review demonstratethat TPM3-ALK RCC may be associated with distinct clinicopathological features. Microscopically, the tumors showed diffusegrowth and tubulocystic changes with inflammatory cell infiltration. Tumor cells were dis-cohesive and epithelioid with abundanteosinophilic cytoplasm and cytoplasmic vacuoles. If morphological features and TFE3 expression are present in adolescentand young patients, molecular tests for ALK translocation should be performed. This awareness is critically important, because ALKrearrangement confers sensitivity to ALK inhibitors.

Histologic Changes in Non–Small Cell Lung Cancer under Various Treatments: A Comparison of Histology and Mutation Status in Serial Samples

우창곡,손승명,이호창,한혜숙,이기형,김도훈,김응국,이옥준 대한암학회 2022 Cancer Research and Treatment Vol.54 No.3

PurposeHistologic change is a resistant mechanism in lung cancer. The most common histological change is the switch from adenocarcinoma (AdenoCa) to small cell carcinoma (SCC) against to tyrosine kinase inhibitors (TKI). However, it is not clear whether other treatment modalities are involved in the histologic changes.Materials and MethodsWe investigated histological changes in eight cases, after various treatments, and compared the molecular profiles between primary tumors and changed tumors using exome sequencing where tissue was available.ResultsThree cases of AdenoCa that were changed into SCC retained the initial mutations after TKI and/or surgical treatment. After treatment with TKI and immunotherapy, an <i>EGFR</i> (epidermal growth factor receptor)-mutant AdenoCa changed to squamous cell carcinoma (SqCa). SqCa in a patient treated with surgery was changed into combined AdenoCa and SqCa. These two cases showed the same genetic variations between the two distinct non–small cell carcinomas (NSCC). Three patients experienced two histologic changes, which the changed tumors returned to its original subtype or changed to a combined tumor after treatments. Four cases showed combined histology in the first or second change.ConclusionThe histology of NSCC can be changed to a single pattern or combined subtypes after various treatment modalities, and the phenotypic changes seem not fixed. Therefore, additional morphologic changes may occur regardless of their genetic status and types of treatments. To refine the new treatment strategy, consecutive repeated biopsies in progressive disease or recurrent tumor are necessary.

IgG4-Related Disease Presented as a Mural Mass in the Stomach

우창곡,육정환,김아영,김지훈 대한병리학회 2016 Journal of Pathology and Translational Medicine Vol.50 No.1

Isolated gastric IgG4-related disease (IgG4-RD) is a very rare tumefactive inflammatory condition, with only a few cases reported to date. A 48-year-old woman was incidentally found to have a subepithelial tumor in the stomach. Given a presumptive diagnosis of gastrointestinal stromal tumor or neuroendocrine tumor, she underwent wedge resection. The lesion was vaguely nodular and mainly involved the submucosa and proper muscle layer. Microscopically, all classical features of type I autoimmune pancreatitis including lymphoplasmacytic infiltration, storiform fibrosis, obliterative phlebitis, and numerous IgG4-positive plasma cells were seen. She had no evidence of IgG4-RD in other organs. Although very rare, IgG4-RD should be considered one of the differential diagnoses in the setting of gastric wall thickening or subepithelial mass-like lesion. Deep biopsy with awareness of this entity might avoid unnecessary surgical intervention.

Histopathological characteristics of progressive multifocal leukoencephalopathy in a patient with acquired immune deficiency syndrome (AIDS)

우창곡,김효종 충북대학교 동물의학연구소 2024 Journal of Biomedical and Translational Research Vol.25 No.1

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease by John Cunningham virus (JC virus) infection in oligodendrocytes. The radiographic and clinical features, along with the identification JC in cerebrospinal fluid polymerase chain reaction, are sufficient for the diagnosis of PML in immunodeficiency. However, it is difficult to suspect PML without the patient history of immunodeficiency. A 32-year-old man presented with headache for a month without any medical history. Based on clinical and image features, the differential diagnoses included demyelinating lesion and neoplasms. Microscopically, biopsy specimen showed multifocal demyelinating and degenerative white matter, consistent with PML. Oligodendrocytes cells with increased nuclei and plum-colored inclusions were admixed with perivascular lymphocytic and histiocytic infiltration, and loss of myelin. Atypical astrocytes had large or multiple nuclei. After brain biopsy, human immunodeficiency virus infection was confirmed by serum chemiluminescent immunoassay. It is unlikely that PML would be considered without the information of immunosuppression. Therefore, it is very important to be aware of the histological features of PML.

Peritoneal Carcinosarcoma and Ovarian Papillary Serous Carcinoma Are the Same Origin: Analysis of TP53 Mutation and Microsatellite Suggests a Monoclonal Origin

우창곡,김규래,서대식,김주영,성창옥,최진 대한병리학회 2014 Journal of Pathology and Translational Medicine Vol.48 No.6

2005~2009년 동안 충북대학교 병원에서 진단한 폐암 분석

우창곡, 김은중, 이옥준 충북대학교 의과대학 충북대학교 의학연구소 2010 忠北醫大學術誌 Vol.20 No.1

-본문참고-

종계장 및 부화장 환경 시료에서 살모넬라균의 분리 및 동정

최지현, 우창곡, 모인필 충북대학교 동물의학연구소 2006 Journal of Biomedical and Translational Research Vol.7 No.2

본문참고

PoulShot^® MG-F 백신의 마이코플라즈마 감염증에 대한 산란계 농장에서의 야외 효능 평가

전은옥,우창곡,원호근,모인필,Jeon, Eun-Ok,Woo, Chang-Gok,Won, Ho-Keun,Mo, In-Pil 한국가금학회 2010 韓國家禽學會誌 Vol.37 No.2

본 연구에서는 Mycoplasma gallisepticum F 주 생독 백신(PoulShot$^{(R)}$ MG-F)의 안전성과 효능을 평가하였다. 충청북도 진천과 경기도 안성 지역의 산란계 농장을 선정하여, 백신과 야외주 공격 접종에 따른 혈청 역가 변화, 상부 호흡기에서의 마이코플라즈마균 재분리, 조직학적 병변과 백신 접종군 및 백신 미접종군 간의 산란율 및 오파란율의 차이를 농장별로 평가하였다. 백신 접종에 의한 혈청 역가 변화는 백신 접종 후 3주부터 확인되었으며, 농장에 따라 접종 후 23주에서 31주까지 지속됨으로써 백신 항체가 오랫동안 유지되는 것을 확인할 수 있었다. 또한 상부 호흡기에서 MG-F 재분리 및 PCR에 의한 유전자 검출도 백신 접종 후 31주까지 양성이었다. 이러한 항체 및 항원의 지속적인 검출은 상부 호흡기에 MG-F 백신주의 집락 형성이 오랫동안 지속된다는 것을 의미하는 것이다. 동일한 방법으로 백신 접종군에 대한 야외주 공격 접종 후 상부 호흡기에서의 백신주 집락 형성을 분석한 결과, 공격 접종 후 3주까지 백신주의 집락 형성율이 야외주보다 동등하거나 높은 것으로 확인됨으로써 야외주 공격에 대한 백신주의 방어력이 입증되었다. MG-F의 안전성과 생산성 측면에서의 효능을 야외 농장에서 검증하기 위하여 두 실험 농장에서 백신 접종군과 백신 미접종군간의 산란율 및 오파란율을 비교하였다. 그 결과, MG-F 접종에 따른 임상적 부작용과 산란율 하락은 발견되지 않았으며, 오히려 백신 접종군의 오파란율이 백신 미접종군보다 평균 1~3% 낮은 것으로 분석됨으로써 백신 접종에 의한 난질 개선 효과가 있음이 확인되었다. 따라서, PoulShot$^{(R)}$ MG-F 생균백신을 산란계에 접종하였을 때 임상적으로 안전하였으며, 오랜 기간 야외 감염에 방어할 수 있는 항체 형성과 상부 호흡기에서의 지속성이 확인됨으로써 마이코플라즈마 야외 감염을 효율적으로 방어할 수 있을 것으로 판단된다. Mycoplasma gallisepticum (MG) infection results in severe economic loss in the poultry industry. In the previous reports, F strain, one of the MG live vaccine strains, could protect the bird from field infection of MG strains. In this study, efficacy of PoulShot$^{(R)}$ MG-F vaccine againset mycoplasma gallisepticum infection was evaluated for filed application in commercial layers. Commercial layers from two different farms received with PoulShot$^{(R)}$ MG-F, MG-F live vaccine at 9~14 weeks of age. Serological immune response to MG vaccine, the persistency of MG vaccine strain in the upper respiratory tracts and egg production rate were evaluated in the vaccinated, contacted or nonvaccinated flocks. The serological response was first detected at 3 weeks after vaccination (WAV) and persisted for 31 WAV. The MG vaccine strains were also persisted for 31 WAV based on the reisolation and PCR detection. There was no difference between the vaccinated or non-vaccinated flocks in the egg production rate but in the abnormality rate of eggs. Based on the above results, we suggested that the PoulShot$^{(R)}$, MG-F live vaccine was fully immunogenic and had characteristics of long persistence in the upper respiratory trachea which will reduce economic loss caused by MG infection in the layer farms.

Protein Phosphatase Magnesium-Dependent 1δ (PPM1D) Expression as a Prognostic Marker in Adult Supratentorial Diffuse Astrocytic and Oligodendroglial Tumors

정휘정,우창곡,이보라,강신광,남수정,최진 대한병리학회 2018 Journal of Pathology and Translational Medicine Vol.52 No.2

Background: Protein phosphatase magnesium-dependent 1δ (PPM1D) is a p53-induced serine/threonine phosphatase, which is overexpressed in various human cancers. A recent study reported that a mutation in the PPM1D gene is associated with poor prognosis in brainstem gliomas. In this study, we evaluated the utility of PPM1D as a prognostic biomarker of adult supratentorial diffuse astrocytic and oligodendroglial tumors. Methods: To investigate PPM1D protein expression, mRNA expression, and copy number changes, immunohistochemistry, RNAscope in situ hybridization, and fluorescence in situ hybridization were performed in 84 adult supratentorial diffuse gliomas. We further analyzed clinical characteristics and overall survival (OS) according to PPM1D protein expression, and examined its correlation with other glioma biomarkers such as isocitrate dehydrogenase (IDH) mutation, and p53 expression. Results: Forty-six cases (54.8%) were PPM1D-positive. PPM1D expression levels were significantly correlated with PPM1D transcript levels (p = .035), but marginally with PPM1D gene amplification (p = .079). Patients with high-grade gliomas showed a higher frequency of PPM1D expression than those with low-grade gliomas (p < .001). Multivariate analysis demonstrated that PPM1D expression (hazard ratio [HR], 2.58; p = .032), age over 60 years (HR, 2.55; p = .018), and IDH1 mutation (HR, 0.18; p = .002) were significantly independent prognostic factors; p53 expression had no prognostic significance (p = .986). The patients with tumor expressing PPM1D showed a shorter OS (p = .003). Moreover, patients with tumor harboring wild-type IDH1 and PPM1D expression had the worst OS (p < .001). Conclusions: Our data suggest that a subset of gliomas express PPM1D; PPM1D expression is a significant marker of poor prognosis in adult supratentorial diffuse astrocytic and oligodendroglial tumors.

Pulmonary vein aneurysm in a New Zealand White rabbit: a case report

김종민,우창곡,김사훈,정의숙,김길수,강병철 한국실험동물학회 2022 Laboratory Animal Research Vol.38 No.1

Background: Pulmonary venous aneurysm (PVA) is a rare condition characterized by aneurysmal dilatation of the pulmonary vein in humans. The diagnosis is incidental usually as there are no clinical symptoms. This case report describes a histological diagnosis of PVA in a New Zealand White rabbit. Case presentation: A 1.5-kg male New Zealand White rabbit was acclimatized in an animal room for 5 weeks until the experiment began. However, the rabbit was found dead, with signs of nasal hemorrhage. Necropsy revealed tracheal and pulmonary hemorrhage, and the epistaxis had a pulmonary origin. PCR and ELISA to detect antigens and antibodies pertaining to the rabbit hemorrhagic disease virus showed negative results. Multiple ballooning lesions (50–200 μm size) in the pulmonary veins were observed on histological examination, and PVA was diagnosed. Death was attributed to a spontaneous rupture of the PVA and massive hemorrhage into the lung parenchyma that extended into the trachea and nasal passages. Conclusions: To the author’s best knowledge, this is the first report of a PVA in a rabbit.