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Cytologic Features of Prostatic Adenocarcinoma in Urine: Comparison with Urothelial Carcinoma
김루시아,송주영,최석진,박인서,한지영,김준미,주영채 대한병리학회 2011 Journal of Pathology and Translational Medicine Vol.45 No.1
Background: Prostate adenocarcinoma (PACa) cells are rarely identified in urine cytology specimens and might be easily overlooked or misdiagnosed as urothelial neoplasm when clinically unsuspected. Methods: We reviewed 19 urine cytology specimens obtained from 13 patients with PACa and evaluated the characteristic features discriminating PACa from urothelial carcinoma (UCa). For comparison, 27 cases of high-grade UCa (HGUCa) and 10 cases of urothelial carcinoma in situ (UCis) were also evaluated. Results: The urine cytologic evaluation of PACa revealed clustered cells forming 3-dimensional syncytial fragments with occasional microacinar grouping in a clean background. Most tumor cells were small and uniform with a high nuclear-to-cytoplasmic ratio and indistinct cell borders. The nuclei were round-to-oval and the cytoplasm was scanty and thin. One or more centrally-located prominent nucleoli were characteristically noted in one half of the cases. The nucleoli had a well-defined, large, round and eosinophilic appearance. In four high-grade cases, large tumor cells were encountered and had relatively monotonous cells with smooth-outlined cell clusters, well-defined and thin cytoplasm, and round nuclei with characteristic prominent nucleoli. Conclusions: Combining the information of prostate cancer and the recognition of cytomorphologic features of PACa will help differentiate PACa from HGUCa and UCis.
김루시아,한지영,박인서,최석진,김준미,주영채,Kim, Lucia,Han, Jee-Young,Park, In-Suh,Choi, Suk-Jin,Kim, Joon-Mee,Chu, Young-Chae 대한세포병리학회 2007 대한세포병리학회지 Vol.18 No.1
Parathyroid tumors may be difficult to distinguish from thyroid follicular lesions, especially when a tumor is nonfunctioning. We report here two cases of asymptomatic parathyroid carcinoma preoperatively misdiagnosed as thyroid follicular lesions, and one case of parathyroid adenoma showing hyperparathyroidism, and review the cytologic features favoring the diagnosis of parathyroid neoplasm. The cytologic findings that are characterized by clean background, monomorphic small cells, cohesive three-dimensional papillary clusters, small tight clusters with scattered naked nuclei, and well-defined clear cytoplasm favor a diagnosis for the parathyroid lesions. Cytologic findings such as macrofollicular structure, presence of colloid and macrophages, and presence of perivacuolar cytoplasmic granules on May-Grunwald-Giemsa stain support a diagnosis of a thyroid follicular lesion. The cytomorphology of parathyroid tumors is so variable that the distinction from a thyroid lesion cannot be based on the presence or absence of a single feature only but on the cytologic features as a whole.
Clinicopathologic and Molecular Characteristics of Lung Adenocarcinoma Arising in Young Patients
김루시아,Kyu Ho Kim,윤용한,유정선,최석진,박인서,한지영,김준미,주영채 대한의학회 2012 Journal of Korean medical science Vol.27 No.9
Lung cancer rarely occurs in young patients. Recent studies have demonstrated that epidemiologic data are closely correlated to some molecular characteristics. We investigated the clinicopathologic characteristics of lung adenocarcinoma in young patients and evaluated immunohistochemically detected epidermal growth factor receptor (EGFR) mutation status and anaplastic lymphoma kinase (ALK) positivity. Among lung adenocarcinoma patients, 31 cases were of the ≤ 40 yr-old group and 261 cases of > 50yr-old group. Young patients were more likely to be females (67.7% vs 40.2%), and nonsmokers (58.1% vs 45.2%) and more often had high TNM stage (stage IV was 80.6% vs 52.1%) and had a high rate of distant metastasis (51.6% vs 28.0%) compared with older patients. The signet ring cell feature was more common (25.8% vs 11.5%) and lepidic growth pattern was rarely present (3.2% vs 16.5%) in the adenocarcinoma of young patients. There was no significant survival difference between the two age groups. The rate of EGFR mutation status and ALK positivity did not show a statistical difference between two groups. In conclusion, lung adenocarcinoma of young patients demonstrates distinct pathologic features with frequent presence of a signet ring cell feature and rare occurrence of lepidic growth pattern. Further investigation for other genetic abnormalities would be needed.
위샘암 환자의 예후 인자로서 Thymosin-β4의 용성
김루시아,김예지,최석진,박인서,한지영,주영채,김준미 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.3
Background : Thymosin-β4 is an actin-sequestering protein that regulates actin polymerization. It is known to be associated with cell migration, angiogenesis and wound healing, as well as with tumor metastasis. Methods : We immunohistochemically evaluated the thymosin-β4 expression in gastric adenocarcinoma specimens, the relationship between this protein and the pathologic features and other tumor-related proteins, and its influence on the patient outcome. Results : We demonstrated that 40 specimens (26.3%) of 152 gastric adenocarcinomas showed positivity for thymosin-β4. The thymosin-β4 expression was statistically associated with advanced tumor stage (p=0.010), the nodal stage (p=0.029), the TNM stage (p= 0.008), and the presence of lymphovascular invasion (p=0.009). The thymosin-β4 protein expression was closely related to the positivity for VEGF (p=0.000), c-Myc (p=0.007), and cyclin D1 (p=0.005), but it was not associated with the E-cadherin (p=0.861) or β-catenin (p= 0.640) expressions. The median survival and disease relapse time of patients showing thymosin-β4 immunoreactivity were statistically shorter than those of patients without expression. Multivariate analysis showed that the tumor stage (p=0.003), nodal stage (p=0.005), thymosin-β4 expression (p=0.019) and Lauren's classification (p=0.037) were statistically important prognostic factors for gastric adenocarcinomas. Conclusions : The thymosin-β4 expression might be associated with disease progression of gastric adenocarcinomas and it should be regarded as an important prognostic factor for estimating patient survival.
내시경 초음파 유도하에 세침흡인 세포검사로 진단한 위의 위장관 기질 종앙 1예 보고
김루시아,김형길,주영채,박인서,최석진,한지영,김선희,이돈행,김준미,Kim, Lucia,Kim, Hyung-Gil,Chu, Young-Chae,Park, In-Suh,Choi, Suk-Jin,Han, Jee-Young,Kim, Sun-Hee,Lee, Don-Haeng,Kim, Joon-Mee 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2
We report here a case of a gastrointestinal stromal tumor (GIST) in the stomach that was diagnosed by endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA). A 67 year old male patient underwent regular check-ups for five years due to the presence of a submucosal tumor that was found in the fundus of the stomach incidentally. EUS-FNA was performed to evaluate the tumor, which had increased in size from 1 cm to 2.8cm. A cytologic smear revealed cohesive sheets or clusters of spindle cells with elongated nuclei. Immunohistochemical staining revealed a strong positive reaction for c-kit and CD34, without any reaction for smooth muscle actin and Ki-67. Therefore, a diagnosis of GIST was made.
Merkel 세포 암종의 압착도말 세포소견 -1예 보고-
김루시아,박인서,한지영,김준미,주영채,최석진,Kim, Lucia,Park, In-Suh,Han, Jee-Young,Kim, Joon-Mee,Chu, Young-Che,Choi, Suk-Jin The Korean Society for Cytopathology 2005 대한세포병리학회지 Vol.16 No.2
Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine carcinoma which commonly presents as a skin nodule, and can develop into regional lymph node metastases, as well as spread systematically. Here, we describe the cytological features of a touch imprint of MCC that arose on the face of a 62-year-old female. This touch imprint was acquired from an incisional biopsy specimen which had been submitted for frozen section. The touch preparation produced a highly cellular imprint of loosely cohesive groups of small- to medium-sized malignant cells exhibiting uniform round to oval nuclei, delicate nuclear membranes, fine chromatin, small nucleoli, and scanty cytoplasm, with occasional paranuclear button-like inclusions. We applied cytokeratin 20 to the touch imprint for immunochemistry, allowing us to visualize the tumor cells with paranuclear dot-like positivity. Both the cytological and immunocytological features were quite distinct.