Comparison of Cellular Features Diagnostic of Papillary Thyroid Carcinoma in Liquid-Based (Cell Scan 1500TM) Preparations and Conventional Smears

이중달,박용욱,백운철,정파종,김종율 대한임상검사과학회 2013 대한임상검사과학회지(KJCLS) Vol.45 No.3

The study compared the cytological features of papillary thyroid carcinoma (PTC) in liquid-based preparations (LBPs) and conventional Pap (CP) smears from fine needle aspiration (FNA), and assessed the feasibility of LBP using the Cell Scan 1500TM processor on thyroid FNA samples. Thyroid FNA samples were obtained from 883 consecutive patients. Each sample was divided into two and used for LBPs and CP smears. All were screened independently in a double-blind manner. From the 883 cases, 95 cases were diagnosed as PTC in one or both types of preparation (10.8%). PTC was diagnosed via CP smears in 83 cases (87.4%) and via LBPs in 70 cases (73.7%). However, there were differences in categorization between the paired preparations: Twelve (12) PTCs were misinterpreted in CP smears and 25 PTCs in LBPs. There was a significant discrepancy in the rate of detection of the diagnostic features, with LBPs having a lower detection rate. One (1) case (1.2%) of CP smears and 16 cases (22.9%) of LBPs were categorized as unsatisfactory/nondiagnostic in a total of the 95 PTCs. To conclude, the detection rate of the diagnostic features of PTC is lower in Cell Scan 1500TM samples than in CP smears. However, there are some cases in which a diagnosis of PTC is made in LBPs, but not in CP smears. Therefore, definitive cancer diagnosis in thyroid FNA preparations is likely to result from agreement between direct smears and Cell Scan 1500TM preparations.

Comparison of Diagnostic Cytomorphology of Atypical Squamous Cells in Liquid-Based Preparations and Conventional Smears

이중달,오영하,이성옥,김종율 대한병리학회 2012 Journal of Pathology and Translational Medicine Vol.46 No.4

Background: The aims of this study were to compare the cytomorphologic features diagnostic of atypical squamous cells (ASC) in liquid-based preparations (LBPs) and conventional Pap (CP) smears and to cytomorphologically assess the performance of the Cell Scan 1500TM in cervical cytology practice. Methods: Cervicovaginal smears were obtained from 938 women. Two smears were obtained simultaneously from each individual, one for an LBP and the other for a CP smear; the smears were independently examined. ASC was diagnosed in 24 patients, and their samples were cytomorphologically and semiquantitatively analyzed. Results: A total of 24 of the 938 women (2.6%) were diagnosed with ASC by one or both methods. Results from LBPs and CP smears were in agreement in 13 of 24 cases of ASC diagnosis (absolute direct agreement, 54.2%; k<0.20; p-value from chi-square test=0.085). Diagnostic features of ASC in the LBPs included squamous cell atypia and atypical squamous metaplasia. Conclusions: The cellular features diagnostic of ASC present in one preparation can manifest themselves differently in the other. Changes in individual cells, particularly nuclear changes, are the most reliable features for diagnosing ASC. The Cell Scan 1500TM processor is more effective at detecting ASC than are CP smears.

유방의 침윤성 체모양 암종의 흡인세포학적 소견

이중달,박찬필,이상국,Lee, Jung-Dal,Park, Chan-Pil,Lee, Sang-Kook 대한세포병리학회 1993 대한세포병리학회지 Vol.4 No.1

A case of invasive cribriform carcinoma of the breast is presented with fine needle aspiration cytologic features. The aspiration was performed from a papable 2.0 cm mass in the upper outer quadrant of the right breast in a 53 year-old woman. The aspirate showed cellular smear composed of larger three dimensional tight clusters, smaller monolayered loose clusters, and many individual cells on the clean background. In the clusters, the tumor cells were bordering central lumina, quite similar to the cribriform in histology. The tumor cells in the clusters and individual tumor cells had uniform, small and round nuclei. The chromatin was finely granular, and nuclear membrane was smooth No discernible nucleoli were present (nuclear grade $1\sim2$). Unless the abundance of individual cells and the cribriform growth pattern are recognized in the smear, the cytologic diagnosis of invasive cribriform carcinoma is difficult.

실험적 간암발생 과정에서 C-myc Oncoprotein의 변화에 관한 Flow Cytometry 및 면역 조직화학적 연구

이중달,박경남,고영혜,신동호 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.2

Experimental hepatocarcinogenesis is a chronic process in which discrete cells or cell populations acquire step by step the different properties that lead to a cancer. Although protooncogenes have been thought as one of important factors playing a role in this multistep neoplastic transformation, their exact mechanism is not clarified. The present study undertook to examine the role of c-myc oncoprotein in hepatocar-cinogenesis with an emphasis on preneoplastic lesions. A total of 50 Sprague-Dawley rats were fed with experimental diet containing 0.05% 2-acetylaminofluorene and were killed at the two, four, eight, 12, 16 and 27 weeks after carcinogen exposure. The livers removed were examined grossly and microscopically, and the expression of cmyc oncoprotein was evaluated by immunohistochemical stain and flow cytometric analysis. Results obtained were as follows: 1. On the second week, altered hepatocyte foci including clear cell area were observed, and a few oval cells began tl appear in the periportal areas. On the fourth week, proliferation of oval cells became prominent and a few hyperplastic nodules appeared. On the eighth week, there was marked proliferation of oval cells, some of which were differentiated into both bile ducts and hepatocytes with frequent intermediate form . Hyperplastic nodules were increased in number and size. On the twelfth and sixteenth week, most of nodules were transformed to remodelling nodules: Cystic cholangioma appeared at this period. On the twenty seventh week, cholangiofibroma with cellular atypism, hepatocellular carcinoma and angiosarcoma were developed. 2. With the immunogistochemical stain, c-myc oncoprotein was expressed in the cytoplasm as well in the nuclei of normal, preneoplastic and neoplastic livers. There was no significance difference in the levels of cytoplasmic c-myc oncoprotein in different lesions. Nuclear c-myc oncoprotein was strongly expressed in the tumor, but on significant difference in preneoplasic lesions was noted. 3. With the flow cytometric examination, the oval cells and tumor cells showed a markediy increased level of c-myc oncoprotein. The level of c-myc oncoprotein in the hyperplastic nodules was slightly higher than that in the normal liver, and the remodelling nodule expressed similar level of c-myc oncoprotein to that in the normal liver. The above results suggested that c-myc oncogene was not a factor which directly regulated neoplastic transformation. Rather, c-myc oncogene activated by chemical carcinogen might induce proliferation of oval cells. Gene aberration and activation of new oncogenes in the oval cells suggested to lead to cancerous transformation of oval cells through multistep precancerous lesions.

기관지 확장증 때 Reid Index 의 변동에 관한 병리학적 연구

이중달,홍은경 한양대학교 의과대학 1986 한양의대 학술지 Vol.6 No.1

Reid index (RI) measurement was performed on 16 cases of resected lung specimen with severe bronchiectasis. Forty indices from the 16 cases were measured with Kontran Bildanalyse, Zeiss and the data were analysed with computer attached to the instrument. Thickness of he mucosa and of mucous gland in bronchiectasis were compared to those of the negative control and positive control groups. The negative control group consisted of children with no coughing or sputum production, and the positive control group consisted of adults of both sexes with variety of pulmonary diseases with coughing and sputum production. The following were results obtained: 1. RI in bronchiectasis averaged 0.53 with ranges between 0.33 and 0.77. the RI in bronchiectasis was significantly increased. and no overlapping was noted between bronchiectasis and negative control groups. 2. Average thickness of the wall (mucosa) in bronchiectasis measured 860 ㎛ with ranges between 357 ㎛ and 1,922 ㎛. The mucous gland measurd 451 ㎛ with ranges between 171 ㎛ and 898 ㎛ in thickness. The increase in RI in bronchiectasis was mainly due to hypertrophy and hyperplasia of the mucous gland rather than thinning of the wall. 3. No significant differences of RI between bronchiectasis and positive control groups were noted. These indicated that both groups represented hypertrophy of the mucous glands.

진단세포학

이중달 대한의학협회 1989 대한의학협회지 Vol.32 No.8

흡인세포학적 진단

이중달 대한의학협회 1990 대한의학협회지 Vol.33 No.12

췌장암의 경피성 세침 흡인 세포학적 검색

이중달,류근신,고진석,이철용,Lee, Jung-Dal,Lyu, Keun-Shin,Ko, Jin-Seok,Lee, Chul-Yong 대한세포병리학회 1992 대한세포병리학회지 Vol.3 No.2

The fine needle aspiration (FNA) cytology findings in 19 cases of primary neoplasia of the pancreas are reported. The aspirates were obtained under ultrasound guidance in 16 cases and under direct vision intraoperatively in three cases. These cases represented 79% of 24 diagnoses in a series of 30 pancreatic FNAs. Of these 30 cases no cytologic diagnoses were made in six cases (20%) because of insufficient or inadequate samples The cytologic diagnoses were confirmed by histologic examination following resection or biopsy of the tumors. The diagnoses included 9 duct ceil adenocarcinomas, 1 mucinous adenocarcinoma, 2 mucinous cystadenocarcinomas, 1 acinar cell carcinoma, 1 papillary cystic tumor 3 islet ceil tumors, 1 neuroendocrine carcinoma and 1 leiomyosarcoma. The cytologic features of the neoplasia were detailed and the differential diagnosis was discussed. The important criteria for the cytodiagnosis of pancreatic tumors were reviewed. This review leads us to think that nonoperative (percutaneous) cytologic approaches to the diagnosis of pancreatic tumor are advantageous for the management of patients, and that correct cytologic diagnosis with pancreatic FNAs can easily be made, if adequate samples are obtained.

월례집담회 : 특발성 간질성 폐섬유증식증의 병리학적 고찰

이중달 ( Jung Dal Lee ) 대한결핵 및 호흡기학회 1984 Tuberculosis and Respiratory Diseases Vol.31 No.3

2-acetylaminofluorene의 투여에 의한 실험적 간암 발생과정에서 Cyclin D₁의 발현상태

이중달,금주섭,공구,안성기 한양대학교 의과대학 1996 한양의대 학술지 Vol.16 No.2

Uncontrolled proliferation is a universal property of tumor cells. Deregulation of cell cycle regulators(cyclin D₁and cyclin-dependent kinase 4 inhibitor, etc) results in uncontrolled proliferation of cells. Recently, cyclin D₁, one of the cell cycle regulators has been accepted as a cellular proto-oncogene. Although the role of it is not well understood, deregulated overexpression of cyclin D₁occurs in several types of human cancers. To investigate the role of cyclin D₁ in multistep hepatocarcinogenesis, the author undertook an experimental hepatocarcinogenesis induced in 50 rats by feeding 2-acetylaminofluorene in diet. The animals were periodically sacrified and each liver was examined grossly and microscopically. And the immunohistochemical stain for cyclin D₁(Novocastra, Newcastle, U.K.) was performed and assessed. 1. At the third week of the experiment, the oval cells proliferated markedly. The altered cell lesions were noted at the fourth week. The clear cell areas were seen in the eighth week. At the third month, hepatic nodules developed, and carcinomatous nodules were noted in the seventh month. 2. The immunohistochemical stain of cyclin D₁ for oval cells and altered hepatic cell foci were exclusively negative. However, regenerating and adenomatous nodules were positive in four of 23 nodules (17%) and 17 of ten nodules (70%), respectively. And overexpression of cyclin D₁in hepatocellular carcinoma occurred in four of eight cases (50%). The above results hepatocinogenesis induced by 2-AAF, especially in transition period from altered cell lesion to regenerating nodule or from regenerating nodule to adenomatous nodule. However, the overexpression of cyclin D₁seems no active role in the transition from adenomatous lesion to hepatocellular carcinoma.