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( Ghil Suk Yoon ),( Yang Kyu Choi ),( Ha Na Bak ),( Beom Joon Kim ),( Myeung Nam Kim ),( Je Ne Choi ),( Hye Myung Rheu ),( Joo Ryung Huh ),( Jee Ho Choi ),( Sung Eun Chang ) 대한피부과학회 2009 Annals of Dermatology Vol.21 No.1
Background: Angioimmunoblastic T-cell lymphoma (AITL) is a complex lymphoproliferative disorder and often mimics a viral infection with frequent skin involvement. Epstein-Barr virus (EBV) and human herpes virus (HHV)-6 are reported to be associated with AITL, but there are conflicting results. Objective: We evaluated the association of EBV and HHV-6 with AITL. Methods: We reviewed the clinical, histological and immunophenotypical features of 19 cases of AITL. Among them, 11 lymph node biopsies of AITL were examined for HHV-6, -7, and -8 by polymerase chain reaction (PCR) using virus-specific primers. In situ hybridization of EBV early region RNA (EBER) was performed and T cell receptor (TCR) gene rearrangement was also investigated in some cases. Results: Among these 19 cases, maculopapular, plaque or nodular skin lesions accompanied AITL in 12 cases. Clonal TCR gene rearrangement was seen in 8/9 cases tested. EBER in situ hybridization was positive in 8 cases (57.1%). Among 7 cases with skin biopsies, five cases were consistent with cutaneous involvement of AITL, 1 case was a drug eruption, and the other case was Kaposi`s sarcoma. Except a HHV-8 (+) case who also had Kaposi`s sarcoma, all of these cases were negative for HHV-6, -7 and -8. Conclusion: Skin manifestation seems to be a cardinal component of AITL, be it in the context of presentation, progression or recurrent disease. Recognition of clinicopathological features of skin lesions in AITL as diagnostic clues should be stressed among dermatologists. The lack of HHV-6, -7 and -8 in lymph node biopsy of AITL argues against a pathogenic role for HHVs in AITL. (Ann Dermatol(Seoul) 21(1) 1∼5, 2009)
Malignant mixed mullerian tumor of the ovary
Kim, Mi Suk,Choi, Youn Seok,Choi, Jin Seok,Jeong, Kyung Jae,Yoon, Ghil Suk,Lee, Tae Sung 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.3
악성 혼합 Mu¨llerian 종양은 주로 자궁내막에서 생기는 드문 종양이다. 난소에는 매우 드물게 발생하며 전체 난소암의 1% 미만을 차지한다. 조직학적으로 상피부분과 간질부분으로 구성된 매우 진행이 빠른 종양이다. 난소암에서 자기공명영상으로 그 조직학적 진단을 예상한다는 것은 불가능하지만 우리는 이 증례에서 자기공 명영상으로 자궁내막형 선암으로 진단했었고 비록 악성 혼합 Mu¨llerian 종양으로 최종 조직결과가 나왔으나 그 조직의 대부분은 자궁내막형 선암으로 구성되어 있었다. 이 환자는 불과 3개월 전에 질식 초음파를 포함한 난소암 선별검사를 시행하였으나 그 결과는 음성이었다. 수술 중 종양의 크기는 15 cm로 매우 빠른 속도로 자란것으로 보였고 일부가 파열되어 있었다. 우리는 수술 전 자기공명영상으로 자궁내막형 선암으로 진단했던 난소암에서 악성 혼합 Mu¨llerian 종양으로 밝혀진 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Malignant mixed mu¨llerian tumors (MMMTs) are unusual neoplasms occurring mostly in the endometrium. In the ovary, they are very rare and represent less than 1% of all ovarian malignancies. They are highly aggressive neoplasms comprising histologically of both epithelial and mesenchymal components. The cell type cannot be determined on the basis of appearance at magnetic resonance (MR) imaging, computed tomography (CT), or ultrasonography (US) but we diagnosed this case as endometrioid adenocarcinoma by MR imaging. Although the pathologic evaluation revealed the ovarian MMMT, mesenchymal components was very minute in the background of endometrioid adenocarcinoma components. The patient received the screening tests of ovarian carcinoma including transvaginal ultrasonography only 3months ago and she got negative results. During the exploration, a 15-cm sized mass looked like it has rapidly grown and ruptured spontaneously preoperatively. Herein we report a case of ovarian MMMT, which was diagnosed preoperatively as endometrioid adenocarcinoma by MR imaging with review of literatures.
The Status of Pathology Specimen Bank in Other Countries
Bae, Han Ik,Yoon, Ghil Suk 대한병리학회 2005 Journal of Pathology and Translational Medicine Vol.39 No.6
Pathology specimen has been collected for purposes of education and research, particularly with respect to basic, developmental and translational studies in many areas of cancer research including molecular biology, immunology, and genetics. Even though no policy or ethical guideline drafted to regulate research tissue bank in Korea, advanced countries has been concerned ethical issues in the collections, storages, specimen transports and informatics for pathology specimen bank. Informed consent and confidentiality for protection of personal data records, which can be directly or indirectly associated with linked data from the donors' point of view, are the key to banking all over the world. The institutional review board (IRB) is important to ensure the scientific and ethical quality of pathologic specimen research. Increasing molecular genetic testing is also resulting in an increased demand of quality control for high quality nucleic acids. Most recently, the use of stored human tissue for education and research has become an object of increased ethical concern in Korea. Korean Association of Pathologists (KAP) has in urgent need of the policies and a standardized operating procedure, regulating a good collection practice of pathology specimen bank.
( Seok Jong Lee ),( Hyun Jung Lim ),( Yoon Hyuk Choi ),( Yong Hyun Chang ),( Weon Ju Lee ),( Do Won Kim ),( Ghil Suk Yoon ) 대한피부과학회 2013 Annals of Dermatology Vol.25 No.1
Background: There are various histological prognostic parameters of cutaneous malignant melanoma, including tumor thickness and ulceration. Tumor-infiltrating lymphocytes (TIL) are among these parameters and can be further classified into three categories: ``absent``, ``non-brisk`` and ``brisk``. Brisk TIL usually indicates better clinical prognosis. Microscopic satellite (Ms) is defined as a nest of tumor cells that is greater than 0.05 mm in diameter and definitely separated from the main tumor. Even though the incidence of Ms varies according to Breslow thickness, the presence of Ms generally indicates poor prognosis. Objective: Clinical significance of both TIL and Ms has been extensively studied in western populations but much less so in Asian countries, including Korea, where acral melanoma is the most common subtype. Methods: We reviewed 90 patients with acral melanoma diagnosed at Kyungpook National University Hospital in Korea. Tissue specimens were examined using hematoxylin-eosin and HMB45 immunohistochemical staining. They were also evaluated by the presence and categorization of TIL (absent, non-brisk and brisk) and the presence of Ms. We further evaluated their impact on survival events (recurrence, distant metastasis and death). Results: The number of survival events by TIL type was 22 in the absent category (22/64, 34.4%), 3 in the non-brisk category (3/25, 12.0%) and 0 in the brisk category. For Ms, survival events were present in 7 patients in Ms-present group (7/11, 63.6%) and 21 patients in Ms-absent group (21/79, 26.6%). Conclusion: We suggest the possibility of TIL and Ms as prognostic indicators for acral melanoma in Korean population. (Ann Dermatol 25(1) 61∼66, 2013)
자궁경부질 도말 검사 정도 관리과정으로서의 세포 및 조직진단의 비교 분석과 10% 무작위 재선별과의 비교 분석
윤길숙,허주령,손경희,김온자,공경엽,Yoon, Ghil-Suk,Huh, Joo-Ryung,Son, Kyung-Hee,Kim, On-Ja,Gong, Gyung-Yub 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.2
Although the success of the Papanicolaou test as a screening tool of cervical cancer is evident, there still exists $2{\sim}5%$ of discrepancy rate by both human and machine. To improve the qualilty of cervico-vaginal cytology, the authors compared cervicovaginal smear with cervical biopsy diagnoses, and analysed the causes of discrepancies. Among 30,922 cervicovaginal smears from June 1996 to April 1997 at our hospital, there were 271 cases of cervicovaginal smear with subsequent cervical punch or LEEP cone biopsies within several months. The biopsies and smears from a total of 98 discordant cases were reviewed. The discrepancy was attributed to sampling errors in 43 cases(43.9%), and to cytologic diagnosis in 49 cases(50.0%). Among these, 43 cases were interpretative errors(categories A;19, B;16 and C;8) whereas six cases were screening errors(categories B:2 and C:4). Among cervical biopsy cases, errors were present in four. As for 10% random rescreening, cytotechnologists reviewed 3,196 of 30,922 smears during the same period, There were 43 cases of screening error(categories A;27, B;16). Cytologic/histologic correlation was superior to 10% random rescreening of negative cases. The most effective method for quality improvement in cervicovaginal cytology was to implement both quality control(rescreening) and qualify assurance(cytologic/histologic correlation) programs.