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        Case Report : Hepatoid Carcinoma of the Pancreas Combined with Neuroendocrine Carcinoma

        ( Ji Ye Jung ),( Yoon Jae Kim ),( Hee Man Kim ),( Hong Jeoung Kim ),( Seung Woo Park ),( Si Young Song ),( Jae Bock Chung ),( Chang Moo Kang ),( Joo Yeon Pyo ),( Woo Ick Yang ),( Seung Min Bang ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.1

        Hepatoid carcinoma is a primary extrahepatic carcinoma whose morphology, immunohistochemistry, and behavior are similar to those of hepatocellular carcinoma. The most common sites of extrahepatic carcinoma are the stomach and ovary, but nine cases of hepatocellular differentiation of the pancreas have been reported in the literature. We report another case of hepatoid carcinoma of the pancreas that was associated with the development of a pancreatic endocrine carcinoma in a 46-year-old man. Serum alpha-fetoprotein (AFP) was elevated to 262.49 IU/mL and radiological examinations revealed a mass measuring 7.5 cm in diameter in the head of the pancreas. He underwent a conventional Whipple operation, and light microscopy showed adenocarcinoma that was immunopositive for AFP, hepatocyte antigen, cytokeratin, chromogranin, synaptophysin, and alpha-1 antichymotrypsin. Although hepatoid differentiation was not shown unequivocally histologically, other immunohistochemistry findings supported the diagnosis of hepatoid carcinoma combined with neuroendocrine carcinoma. The patient was healthy and had no evidence of recurrence at 4 months after the surgery. This report describes why hepatoid carcinoma should be considered as a differential diagnosis of a pancreatic mass, especially when serum AFP is elevated. (Gut Liver 2010;4:98-102)

      • Helicobactor pylori Infection and Gastric Carcinoma in Korea

        Kang, Seok Jin,Jee, Mi Kyung,Park, Yeon Joon,Choi, Yeong Jin,Kim, Byung Kee,Kim, Sun Moo CATHOLIC MEDICAL CENTER 1994 Bulletin of the Clinical Research Institute Vol.22 No.2

        Gastric carcinoma is the most frequent malignant disease and the leading cause of cancer death in Korean. And the incidence of gastric carcinoma can change dramatically from place to place and from one generation to the next, if has been hypothesized that its incidence is determined largely by environmental rather than genetic factors. One specific histologic type of gastric carcinoma, the so-called intestinal type, is particularly prone to the regional and temporal variations of an environmentally related malignant condition. The recent identification of Helicobacter pylori (H. pylori) in chronic inflammatory conditions of the stomach, however, has stimulated interest in its potential role in carcinogenesis. H. pylori has been linked to chronic atrophic gastritis, and established precursor of intestinal type of gastric carcinoma. We designed a study to estimate the prevalence of H. pylori in 41 patients of intestinal type of gastric carcinoma and 42 patients of diffuse type gastric carcinoma and in 88 age and sex matched control persons by histologic examination of stomach in Warthin-Starry staining. The results were as follow; 1. In gastric carcinoma, 85.37% of 41 patients of intestinal type carcinoma, and 59.2% of 42 patients of diffuse type carcinoma were positive for H. pylori. In control group, 27.7% of 88 persons were positive for H. pylori. 2. To compare to control group, intestinal type of gastric carcimona was higher incidence of H. pylori infection to than that of diffuse type of gastric carcinoma. These findings suggest that H. pylori infection of stomach may be related to the gastric carcinoma in Korean. And H. pylori is more frequently found in the intestinal type of gastric carcinoma than diffuse type of gastric carcinoma.

      • KCI등재

        Correlation of Expression of p53, Cylcin D1 and Galectin-3 in Papillary Carcinoma and Follicular Carcinoma

        Back, Oun-Cheol 대한임상검사과학회 2013 대한임상검사과학회지(KJCLS) Vol.45 No.1

        The thyroid is the organ that has the greatest risk of malignant tumors among the endocrine tumors. The papillary carcinoma occupies 80% of the entire thyroid tumors. Immunohistochemical staining of galectin-3 has usually been used in differentiating papillary carcinoma and follicular carcinoma. The p53 gene of the cell cycle is a tumor suppressor gene acting in on the control points. The cyclin D1 genes in the cell cycle, involved in the implementation of G1 and S phase, plays an important role in the progression of thyroid tumors. This research compares and analyzes correlation between papillary carcinoma, follicular carcinoma, p53, cyclin D1 and galectin-3 gene expression patterns. In a total of 30 cases from papillary carcinoma, 21 cases from p53 (70%), 27 cases in galectin-3 (90%), and 26 cases in cyclin D1 (86.7%) showed positive rate. The galectin-3 staining investigated, showed a significant difference between a papillary carcinoma and a follicular carcinoma. Follicular carcinoma from 15 cases, p53 in 13 cases (86.7%), galectin-3 in 5 cases (33.3%) and cyclin D1 in 12 cases (80%) showed a positive rate. The cyclin D1 in follicular carcinoma and staining between the p53 that had correlation was also investigated. In this study, as the examples of the expression of the 27 cases of galectin-3 (90%) in papillary carcinoma and 5 cases in follicular carcinoma (33.3%) indicate, it was concluded that there is a difference in the expression on both carcinoma. In addition, cyclin D1 and p53 has a positive rate in follicular carcinoma, when cyclin D1 in 12 cases (80%), there was a significant correlation that was investigated. Distinguishing between papillary carcinoma and follicular carcinoma can be identified by the expression of galectin-3. It is considered to get results that are more accurate in follicular carcinoma diagnosis depending on whether the cyclin D1 and p53 is expressed or not.

      • KCI등재

        The Immunoexpression of Ki-67, Bcl-2, p53, and Tyrosine Kinase Receptors in Thymic Epithelial Tumors; Their Correlation with the WHO Histologic Subtypes and the Prognostic Value

        김미진 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.5

        Background : The clinicopathologic features of thymic epithelial tumors are inadequate as predictors of the progression of these tumors because of their heterogeneous histology and varied biological behavior. We attempted to detect the expression of tyrosine kinase receptors and oncogenic markers to determine the correlation between these markers and the WHO classification of the tumors. Methods : Forty-three surgically resected thymic epithelial tumors (37 thymomas and 6 thymic carcinomas) were immunohistochemically assessed on tissue arrays for c-KIT, her-2/neu, epidermal growth factor receptor (EGFR), p53. bcl-2 and Ki-67. Results : The Ki-67 labeling index was significantly increased in thymic carcinoma (p<0.05). The overexpression of p53 protein was observed exclusively in type B3 thymoma (67%) and thymic carcinoma (83%). Bcl-2 was expressed in type A and AB thymomas as well as in thymic carcinoma. C-KIT was only present in thymic carcinoma (p<0.05), whereas the EGFR expression was significantly high in all types of thymomas, except for thymic carcinomas. Her-2/neu was not identified in any type of thymoma. Conclusions : This study suggests that the Ki-67 LI, bcl-2, p53, c-KIT, and EGFR protein expression may be useful markers for the subclassification of thymic epithelial tumors according to WHO schema and WHO classification correlated with the tumor staging. The overexpression of c-KIT in thymic carcinoma reveals that these patients would likely benefit from an anti-c-KIT treatment. Background : The clinicopathologic features of thymic epithelial tumors are inadequate as predictors of the progression of these tumors because of their heterogeneous histology and varied biological behavior. We attempted to detect the expression of tyrosine kinase receptors and oncogenic markers to determine the correlation between these markers and the WHO classification of the tumors. Methods : Forty-three surgically resected thymic epithelial tumors (37 thymomas and 6 thymic carcinomas) were immunohistochemically assessed on tissue arrays for c-KIT, her-2/neu, epidermal growth factor receptor (EGFR), p53. bcl-2 and Ki-67. Results : The Ki-67 labeling index was significantly increased in thymic carcinoma (p<0.05). The overexpression of p53 protein was observed exclusively in type B3 thymoma (67%) and thymic carcinoma (83%). Bcl-2 was expressed in type A and AB thymomas as well as in thymic carcinoma. C-KIT was only present in thymic carcinoma (p<0.05), whereas the EGFR expression was significantly high in all types of thymomas, except for thymic carcinomas. Her-2/neu was not identified in any type of thymoma. Conclusions : This study suggests that the Ki-67 LI, bcl-2, p53, c-KIT, and EGFR protein expression may be useful markers for the subclassification of thymic epithelial tumors according to WHO schema and WHO classification correlated with the tumor staging. The overexpression of c-KIT in thymic carcinoma reveals that these patients would likely benefit from an anti-c-KIT treatment.

      • KCI등재후보

        수질성유방암의 임상병리학적 특성과 예후

        오재원,박세호,김주희,구자승,허호,양우익,박병우,이경식 한국유방암학회 2009 Journal of breast cancer Vol.12 No.1

        Purpose: Medullary carcinoma of the breast is a variant of breast cancer characterized by the histologic appearance of poorly differentiated cells surrounded by a prominent lymphoid stroma. Medullary carcinoma has been reported to carry a prognosis better than other invasive breast carcinomas, but it is frequently overdiagnosed due to the difficulty in diagnosis. The aim of this study was to assess the clinical manifestations and outcome of medullary carcinoma of the breast. Methods: We reviewed the data of 91 patients diagnosed with medullary carcinoma and 3,743 patients with invasive ductal carcinoma, not otherwise specified (NOS) from January 1980 to December 2005 at Yonsei University Severance Hospital. The clinicopathologic features, disease free survival (DFS) and overall survival (OS) for patients with medullary carcinoma were compared with those of the NOS patients. Results: With reviewing the pathologic slides, 69 (75.8%) patients had findings compatible with typical medullary carcinoma (TMC) and the remaining 22 (24.2%) patients were reclassified as atypical medullary carcinoma (AMC). Early stage cancer was more frequent at medullary carcinoma and lymph node positive cancer was less frequent at medullary carcinoma. The expression of ER/PR was positive in either the TMC (18.9%/16.2%) and AMC (15.0%/20.0%) as compared to the NOS (63.2%/57.2%), and the difference was significant (p<0.001). In contrast, the HER-2/neu expression rate was significantly higher in the TMC (47.4%) and AMC (45.5%) than in the NOS (28.3%, p=0.001). The 10-year disease free survival and 10-year overall survival of the atypical medullary carcinoma patients (67.8%, 77.8%) were in fact similar to the NOS carcinoma patients (68.3%, 74.7%). There was significant difference in 10-year disease free survival and 10-year overall survival between the TMC (77.8%, 86.0%) and NOS carcinoma (68.3%, 74.7%) patients (p=0.002, p=0.006). Conclusion: The clinical outcome of typical medullary carcinoma is favorable in spite of its aggressive pathologic features and it differs from atypical medullary carcinoma. For precise prediction of prognosis of medullary cancer, we should apply strict criteria for the diagnosis of subtype with medullary features.

      • SCIESCOPUSKCI등재

        Pathologic Finding of Thymic Carcinoma Accompanied by Myasthenia Gravis

        Kim, Se Hoon,Koh, Im Suk,Minn, Yang-Ki 대한신경과학회 2015 Journal of Clinical Neurology Vol.11 No.4

        <P><B>Background and Purpose</B></P><P>The World Health Organization (WHO) has classified thymic carcinoma and other thymomas (types A, AB, and B) as different neoplasms. Myasthenia gravis (MG) is an early sign of thymoma and theoretically does not accompany thymic carcinoma; however, cases of thymic carcinoma with MG have been reported. Whether thymic carcinoma can accompany MG has yet to be established.</P><P><B>Methods</B></P><P>The medical records of patients who underwent thymectomy for MG between 1990 and 2011 in a single hospital were reviewed. All cases with the diagnostic code of 'thymic carcinoma' or 'thymoma type C' (old terminology) were selected. A pathologist re-reviewed the pathologic specimens using the new WHO criteria. The rate of thymic carcinoma among these MG patients was then calculated.</P><P><B>Results</B></P><P>A total of 81 patients with MG had thymic tumors, 10 of whom had thymic carcinomas or thymoma type C. Seven cases of well-differentiated thymic carcinomas (type B3) were excluded, leaving three (3.7%) cases of thymic carcinoma with MG. All three of these cases were type B3 thymoma with a focal squamous cell carcinoma component that was very small and well demarcated. In addition, two out of the three tumors were found to be at an early clinical stage. All of the cases survived without recurrence over follow-up periods of at least 5 years.</P><P><B>Conclusions</B></P><P>Thymic carcinoma transformation from thymoma can occur during the early stages of thymoma. The association of this condition with MG is not as rare as was previously thought. Thymic carcinomas accompanying MG had a predominant B3 thymoma component with a focal thymic carcinoma area (squamous cell carcinoma).</P>

      • 한국인 갑상선 질환의 병리학적 연구 : 1095 례의 외과적 절제물을 대상으로 Based on 1095 Surgically resected specimen

        박성회,지제근,이현순,이정빈,안긍환,김용일,함의근,이상국 인제대학교 1983 仁濟醫學 Vol.4 No.4

        A prospective morphological study was made on 1095 thyroid specimens which were removed surgically under various diagnoses at Seoul National University Hospital during a period of 6 years from 1976 to 1981. All thyroid specimens were carefully examined grossly by 3-5mm serial cutting after fixation. Almost entire thyroid specimen was submitted for microscopic examination. Therefore microscopic slides of one specimen ranged from 4 to 106 in number. Clinical records including operation notes were also referred to confirm the diagnosis. All of the material was examined and reviewed critically by the authors and was classified according to modified WHO classification. Among 1095 surgically removed thyroids, adenomatous goiter was the most common single disease which accounted for 43% of the entire cases. It was followed by papillary carcinoma and follicular adenoma. Of the malignant tumors, papillary carcinoma was the most frequently reported tumor, accounting for 259 cases (76%) of the entire malignancy. There were also 57 follicular carcinomas, 13 anaplastic carcinomas and 7 medullary carcinomas. Characteristic ground glass nuclei and psammoma bodies were seen fairly frequently showing the incidence of 64% and 65% of papillary carcinoma respectively. However, squamous metaplasia was present in only 17% of the papillary carcinoma. There were 56 occult sclerosing carcinomas. Most of these were detected in the thyroids of adenomatous goiter. The occult sclerosing carcinoma was found in 9.2% of adenomatous goiters while it was found in only 4.3% of follicular adenomas. It was interesting to note palpation thyroiditis seen in the thyroid specimens. It was seen in 24% of the adenomatous goiters, 17% of follicular carcinomas and 14% of the papillary carcinomas.

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