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방광의 요로상피세포종양의 ISUP/WHO등급에 대한 연구
심정원,노재윤,조남훈,김영식,박용욱,심상인,이동화,최영진,한운섭 대한병리학회 2006 Journal of Pathology and Translational Medicine Vol.40 No.4
Background : Pathologic grading, one of the most important prognostic factors of papillary urothelial neoplasia (PUN) of the urinary bladder, has been revised continuously. The current study focused on the analysis of interobserver agreement on PUN of the urinary bladder between 1973 WHO classification (WHO 1973) and 1998 WHO/ISUP classification. Methods : Seventy five cases from 15 institutions were collected, and after review by Korean Society of Urogenital Pathology (KSUP), 30 cases were selected as follows; group I, WHO grade 1 and papillary urothelial neoplasm of low malignant potential by ISUP (7 cases), group II, WHO grade 2 and low-grade papillary urothelial carcinoma (16 cases), and group III, WHO grade 3 and high-grade papillary urothelial carcinoma (7 cases). Seventy five general surgical pathologists who participated in this study were asked to grade the tumors based on WHO/ISUP classification. Interobserver agreement between the participants’ diagnosis and KSUP consensus diagnosis was analyzed by kappa value. Results : Interobserver agreement assessed by kappa value for all diagnostic groups was very low; for group I, kappa value was -0.900893722; for group II, -0.944650025, and for group III, -0.876728996. The overall kappa value of pathology residents was better than that of practicing pathologists. Conclusions : The 1998 WHO/ ISUP classification could not be easily translated from the 1973 WHO classification and because of poor interobserver agreement, it appears that further work would be needed before it can be practically applied.
심정원,고일향,Shim, Jung-Weon,Ko, Ill-Hyang 대한세포병리학회 1990 대한세포병리학회지 Vol.1 No.2
Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained. We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2 cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically. The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round, centrally located nuclei with single, prominent acidophilic mucleoli. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.
자궁의 악성 혼합 뮬러리안 종양 1례보고 : a case report
심정원,조혜제,고일향 인제대학교 1990 仁濟醫學 Vol.11 No.4
A case of malignant mixed Mu¨llerian tumor (M.M.M.T.) of the uterus is presented. Malignant mixed Mu¨llerian tumor (M.M.M.T.) containing both epithelial and stromal component is subdivided into two groups, homologous or carcinosarcoma and heterologous or malignant mixed mesodermal tumor, by the histologic finding of its stromal component. Relation with previous pelvic irradiation in M.M.M.T. is well known. A 62-year-old female patient visited Sangye Paik Hospital for her routine check-up, and pelvic mass of double man's fist size was found on rectal examination. She had been given pelvic radiation therapy three times about two years ago, for invasive sguamous cell carcinoma of the uterine cervix (stage IIIb). The Specimen by subtotal hysterectomy, showed a polypoid mass, filling the emdom etrial cavity and the cut surface of this mass disclosed smooth myxoid fish-flesh appearance with multifocal hemorrhage and necrosis. Microscopically, the tumor was mainly composed of sarcomatous component with minute adenocarcinomatous component. Cross-striation, which was demonstrated in the PTAH stain, was rarely present in the malignant, pleomorphic stromal cells.