두개인두종의 치료성적과 조직학적 유형 및 PCNA지수의 연관성에 대한 연구

김기정,오창완,조병규,김정선,지제근,최길수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2

Craniopharyngiomas exhibit benign histologic features. However, such tumors have a relative high incidence of recurrence after surgical removal. In order to device reliable and efficient methods in identifying craniopharyngiomas with increased risk for recurrence after surgical removal, proliferating cell nuclear antigen(PCNA) expression as well as histological characteristics of the tumor were analyzed. There were 43 patients who had been surgically confirmed and had paraffin-embedded tissue from June, 1984 to May, 1993 avaliable for analysis from our department. Of the 43 patient, eighteen cases were in children(age of 15 years or less) and 25 cases were in adults. The mean follow-up period was 42.7 months. The histologic types were adamantinous in 30 cases, squamous papillary in 9 cases and mixed in 4 cases. There was no case of tumor recurrence in the squamous papillary group, while the recurrence rate was about 55% in the adamantinous group after surgical removal alone. The mean age of the adamantinous group was younger than that of the squamous papillary group(17.5 vs. 37.9 years old. P=0.0012), and the squamous papillary type was found only in adults(age over 20). In the group of 30 patients treated by surgical removal without radiation, the PCNA labelling index, calculated by counting the basal cell layer only, was significantly higher in the group with recurrence than without recurrence(9.51 vs. 6.58, P=0.001). However, the PCNA labelling index obtained by counting all cells in the four high-power (×400) fields failed to demonstrate any correlation with tumor recurrence. With a reference value of 8, PCNA index of the basal cell layer demonstrated the predictive sensitivity of 81.8% and specificity of 84.2% for tumor recurrence. There was no significant difference in PCNA labelling indices between adamantinous and squamous papillary types. As PCNA labelling index of the basal cell layer, as well as the histologic type, are sensitive indicators for prediction of tumor recurrence after surgical removal of craniopharyngiomas, therefore they should be considered as an index for biologic behavior of the tumor.

충수돌기의 대장형 유두상 선암종

강윤경,최기영,김용일,최국진 대한병리학회 1992 Journal of Pathology and Translational Medicine Vol.26 No.3

Prevalence of BRAFV600E Mutation in Follicular Variant of Papillary Thyroid Carcinoma and Non-Invasive Follicular Tumor with Papillary-Like Nuclear Features (NIFTP) in a BRAFV600E Prevalent Area

김혜린,김보현,김영금,김정미,오서영,김은희,이민진,김종호,전윤경,김상수,이병주,김용기,김인주 대한의학회 2018 Journal of Korean medical science Vol.33 No.27

Background: BRAFV600E mutation status and prevalence of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has not yet been reported in Korea. The aim of this study was to investigate the significance of the BRAFV600E mutation in the follicular variant of papillary thyroid carcinoma (FVPTC) and to determine the prevalence of NIFTP in BRAFV600E mutation-prevalent Korean patients. Methods: This study retrospectively analyzed 1,417 consecutive patients who underwent total thyroidectomy with routine prophylactic central lymph node dissection for papillary thyroid carcinoma (PTC). BRAFV600E mutation analysis was performed routinely using multiplex polymerase chain reaction by applying dual priming oligonucleotide. Clinicopathological characteristics and ultrasonographic findings were compared between BRAFV600E mutation- positive and -negative groups for FVPTC. Pathologists reviewed the pathology slides according to consensus diagnostic criteria for the encapsulated FVPTC and NIFTP. Results: The prevalence of the BRAFV600E mutation in all subtypes of PTC was 61.0% (861/1,411). FVPTC presented a BRAFV600E mutation rate of 27.3%. The FVPTC patients with BRAFV600E mutation were older than those with no BRAFV600E mutation (P = 0.021). The prevalence of NIFTP was 0.18% among all PTC patients (2/1,411) and the proportion of NIFTP among FVPTC was 9.1% (2/22). Conclusion: The BRAFV600E mutation is prevalent in Korean patients with FVPTC in a region with high frequency of the BRAFV600E mutation and very low prevalence of NIFTP compared with that reported in western studies.

Oncocytic Type Intraductal Papillary Mucinous Neoplasm Mimicking Mucinous Cystic Neoplasm of the Pancreas - A Case Report -

장태정,이종임 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.3

Oncocytic type intraductal papillary mucinous neoplasm is a newly defined subgroup of intraductal papillary mucinous neoplasms. A 35-year-old woman presented complaining of epigastric pain for one month. Enhanced computed tomography revealed a multilocular cystic mass in the distal body and tail of the pancreas. Endoscopic retrograde cholangiopancreatography showed no communication between the mass and the main pancreatic duct. The patient underwent a distal pancreatectomy and splenectomy. Microscopical examination showed a fibrous cyst wall; polypoid tumors exhibiting thin stalks, with extensive arborizing papillary growths from these stalks; and a focally cribriform pattern, lined by plump cells with abundant eosinophilic and granular cytoplasm. Red granules were detected in the cytoplasm of tumor cells on modified Gomori trichrome stain. Ultrastructurally, the tumor cells contained abundant cytoplasm packed with numerous mitochondria and intracellular and intercellular lumina. We describe an oncocytic type intraductal papillary mucinous neoplasm having the clinical characteristics of a mucinous cystic neoplasm. Oncocytic type intraductal papillary mucinous neoplasm is a newly defined subgroup of intraductal papillary mucinous neoplasms. A 35-year-old woman presented complaining of epigastric pain for one month. Enhanced computed tomography revealed a multilocular cystic mass in the distal body and tail of the pancreas. Endoscopic retrograde cholangiopancreatography showed no communication between the mass and the main pancreatic duct. The patient underwent a distal pancreatectomy and splenectomy. Microscopical examination showed a fibrous cyst wall; polypoid tumors exhibiting thin stalks, with extensive arborizing papillary growths from these stalks; and a focally cribriform pattern, lined by plump cells with abundant eosinophilic and granular cytoplasm. Red granules were detected in the cytoplasm of tumor cells on modified Gomori trichrome stain. Ultrastructurally, the tumor cells contained abundant cytoplasm packed with numerous mitochondria and intracellular and intercellular lumina. We describe an oncocytic type intraductal papillary mucinous neoplasm having the clinical characteristics of a mucinous cystic neoplasm.

Unilateral Multifocal Type 2 Papillary Renal Cell Carcinoma in Adolescence. A Case Report

윤솔,최재휘,이신우,제성욱,화정석,현재석,정기현,박현오,이종실,최시민 대한비뇨기종양학회 2019 대한비뇨기종양학회지 Vol.17 No.1

Papillary renal cell carcinomas (RCCs) can be classified into 2 subtypes (types 1 and 2), depending on their characteristic cytogenetics, immunostaining profiles, and gene-expression profiles. Compared with type 1 papillary RCCs, type 2 papillary RCCs are relatively rare and show more aggressive features. For those reasons, they are associated with a worse prognosis. A 13-year-old patient was admitted to the hospital with right kidney mass. A laparoscopic radical nephrectomy was performed, and results of the histopathologic examination confirmed it to be type 2 papillary RCC. Type 2 papillary RCCs are rarely found in unilateral and multifocal forms, especially in adolescence. Here, we report the unique case of papillary RCC at a young age. (Korean J Urol Oncol 2019;17: 70-73)

Unilateral Multifocal Type 2 Papillary Renal Cell Carcinoma in Adolescence. A Case Report

Sol Yoon(윤솔),Jae Hwi Choi(최재휘),Sin Woo Lee(이신우),Seong Uk Jeh(제성욱),Jeong Seok Hwa(화정석),Jae Seog Hyun(현재석),Ky Hyun Chung(정기현),Hyun Oh Park(박현오),Jong Sil Lee(이종실),See Min Choi(최세민) 대한비뇨기종양학회 2019 대한비뇨기종양학회지 Vol.17 No.1

Papillary renal cell carcinomas (RCCs) can be classified into 2 subtypes (types 1 and 2), depending on their characteristic cytogenetics, immunostaining profiles, and gene-expression profiles. Compared with type 1 papillary RCCs, type 2 papillary RCCs are relatively rare and show more aggressive features. For those reasons, they are associated with a worse prognosis. A 13-year-old patient was admitted to the hospital with right kidney mass. A laparoscopic radical nephrectomy was performed, and results of the histopathologic examination confirmed it to be type 2 papillary RCC. Type 2 papillary RCCs are rarely found in unilateral and multifocal forms, especially in adolescence. Here, we report the unique case of papillary RCC at a young age.

Main duct and mixed type intraductal papillary mucinous neoplasms without enhancing mural nodules: Duct diameter of less than 10 mm and segmental dilatation of main pancreatic duct are findings support surveillance rather than immediate surgery

Kim, Tae Hyeon,Song, Tae Jun,Lee, Seung Ok,Park, Chang Hwan,Moon, Jong Ho,Pih, Gyu Young,Oh, Dong Wook,Woo, Sang Myoung,Yang, Yun Jung,Kim, Myung Hwan Elsevier 2019 PANCREATOLOGY Vol.19 No.8

<P><B>Abstract</B></P> <P><B>Objective</B></P> <P>The guidelines for pancreatic intraductal papillary mucinous neoplasms (IPMNs) recommend surgical resection of all main-duct (MD) and mixed-type IPMNs in surgically fit patients. We conducted this study to identify the rates of high-grade dysplasia (HGD) and invasive carcinoma according to the morphological features of the main pancreatic duct (MPD) in patients with MD and mixed IPMN.</P> <P><B>Methods</B></P> <P>We performed a retrospective study of 259 patients with histologically proven MD and mixed-type IPMNs who underwent surgery at six academic institutions.</P> <P><B>Results</B></P> <P>The rate of HGD and invasive carcinoma was 11.1% (24/216) in patients without enhancing mural nodules (MNs) and 69.8% (30/43) in patients with MNs. Multivariate analysis showed that MPD diameter of ≥10 mm [odds ratio (OR), 2.5; 95% confidence interval (CI), 1.155–5.505; <I>P</I> = 0.02], diffuse MPD dilatation (OR, 3.2; 95% CI, 1.152–8.998; <I>P</I> = 0.02), and presence of enhancing MNs in MPD (OR, 9.6; 95% CI, 3.928–23.833, P < 0.0001) were significant predictors of HGD and invasive carcinoma. Of the 216 patients without enhancing MNs, 79 patients (36.6%) having both segmental MPD dilatation and MPD diameter of <10 mm showed significantly lower rates of HGD and invasive carcinoma (3/79, 3.8%) than patients having both diffuse MPD dilatation and MPD diameter ≥10 mm (9/36, 25%, <I>P</I> = 0.001).</P> <P><B>Conclusions</B></P> <P>MD and mixed-type IPMNs having segmental MPD dilatation with MPD dilation <10 mm and no enhancing MNs on imaging showed a significantly lower rate of HGD and invasive carcinoma, and watchful follow-up instead of immediate surgical resection might be possible in these patients.</P>

A Case of Multiple Endocrine Neoplasia Type 1 Combined with Papillary Thyroid Carcinoma

김혜진,박종숙,김철식,강은석,차봉수,임승길,김경래,이현철,안철우 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.3

This is the first report of papillary thyroid carcinoma combined with multiple endocrine neoplasia type 1 (MEN1) in Korea. MEN1 is a hereditary disease comprising neoplastic disorders such as pituitary, parathyroid and pancreatic neuroendocrine tumor, such as gastrinoma. But papillary thyroid cancer was never regarded as its component before in Korea. Herein we present a 39-year-old woman who manifested typical features of MEN1 with a coincidental papillary thyroid carcinoma. Although the family history of MEN1 was definite, her genetic analysis of DNA had revealed no germline mutation in MEN1 gene locus. Unidentified culprit gene unable us further genetic study to find LOH (loss of heterogeneity) in 11q13, the possible explanation of papillary thyroid carcinoma as a new component of MEN1. As we have first experienced a case of MEN1 combined with papillary thyroid carcinoma in Korea, we report it with the review of literature.

Identification of Differentially Expressed Genes in Papillary Thyroid Cancers

이기영,Song Mei Huang,Shengjin Li,김진만 연세대학교의과대학 2009 Yonsei medical journal Vol.50 No.1

Purpose: Techniques designed to identify differentially expressed genes (DEGs) in tumors have become important in modern pathology. Genefishing technique(TM) using the annealing control primer (ACP) system has recently been developed to screen for DEG transcripts. We tried to identify DEGs involved in papillary thyroid cancer (PTC) by using Genefishing technique™. Materials and Methods: We utilized a new differential display method, designated with Genefishing technique™, to analyze DEGs in 21 cases of PTCs. Results: Comparing the gene expression profiles between PTC and normal thyroid, we detected 17 genes that were differentially expressed in PTCs and performed cloning with sequencing in 10 genes. We confirmed the expression patterns of 2 DEGs by RT-PCR assay and identified the same results in 17 out of 21 (81%) PTCs. The 2 DEGs over-expressed in PTCs were identified as DC-STAMP and type I collagen A1. They are novel genes identified first in PTCs. Conclusion: We confirmed 2 DEGs in PTCs as DC-STAMP and type Ⅰ collagen A1 by using Genefishing technique™. Although the detailed functions of those 2 genes and their products remain to be determined, the genes will provide insights into mechanisms of carcinogenesis or tumor progression in PTCs.

Highly prevalent BRAF V600E and low-frequency TERT promoter mutations underlie papillary thyroid carcinoma in Koreans

김수연,김태은,김광순,배자성,김정수,정찬권 대한병리학회 2020 Journal of Pathology and Translational Medicine Vol.54 No.4

Background: The presence of telomerase reverse transcriptase (TERT) promoter mutations have been associated with a poor prognosis in patients with papillary thyroid carcinomas (PTC). The frequency of TERT promoter mutations varies widely depending on the population and the nature of the study. Methods: Data were prospectively collected in 724 consecutive patients who underwent thyroidectomy for PTC from 2018 to 2019. Molecular testing for BRAF V600E and TERT promoter mutations was performed in all cases. Results: TERT promoter alterations in two hotspots (C228T and C250T) and C216T were found in 16 (2.2%) and 4 (0.6%) of all PTCs, respectively. The hotspot mutations were significantly associated with older age at diagnosis, larger tumor size, extrathyroidal extension, higher pathologic T category, lateral lymph node metastasis, and higher American Thyroid Association recurrence risk. The patients with C216T variant were younger and had a lower American Thyroid Association recurrence risk than those with hotspot mutations. Concurrent BRAF V600E was found in 19 of 20 cases with TERT promoter mutations. Of 518 microcarcinomas measuring ≤ 1.0 cm in size, hotspot mutations and C216T variants were detected in five (1.0%) and three (0.6%) cases, respectively. Conclusions: Our study indicates a low frequency of TERT promoter mutations in Korean patients with PTC and supports previous findings that TERT promoter mutations are more common in older patients with unfavorable clinicopathologic features and BRAF V600E. TERT promoter mutations in patients with microcarcinoma are uncommon and may have a limited role in risk stratification. The C216T variant seems to have no clinicopathologic effect on PTC.