간세포암의 다단계 발암과정

장자준 ( Ja June Jang ) 대한간암학회 2008 대한간암학회지 Vol.8 No.-

Fine Needle Aspiration Cytology of Follicular Neoplasm of the Thyroid

조경자,장자준,Cho, Kyung-Ja,Jang, Ja-June The Korean Society for Cytopathology 1993 대한세포병리학회지 Vol.4 No.2

갑상선의 세침흡인 세포학적 검사에서 가장 문제가 되는 점은 여포상 종양의 진단이다. 세포학적 소견만으로는 증식성 결절성 갑상선종, 여포성 선종 및 분화가 잘 된 여포상 암종 간의 감별 진단이 매우 어려운 경우가 많다. 저자들은 최근 4년 5개월 간에 조직학적으로 확진된 여포상 종양 중 수술 전에 적합한 세포학적 검사가 시행된 15예를 대상으로 그 세포학적 소견을 재검토하였다. 여포상 선종 6예의 흡인 도말은 공 모양 또는 합포체를 형성하는 다량의 여포성 세포를 함유하고 있었고, 경도의 핵 다형성 및 작은 핵소체가 각각 2예에서 관찰되었다. 배경은 출혈성으로 교질 성분은 매우 적거나 없었다. 여포상 암종 9예도 기본적으로 선종과 유사한 세포학적 소견을 보였는데, 세포밀도가 좀더 높고, 세포집단의 모양이 더 크고 불규칙하였으며, 흩어진 개별 종양세포가 많은 것이 차이점이었다. 핵의 다형성 및 눈에 띄는 핵소체가 선종에서 보다 많은 6예 및 5예에서 각각 관찰되었으나 그 정도는 심하지 않았다. 대부분의 암종과 1예의 선종에서 종양세포 집단에 밀착한 혈관 내피세포가 관찰되었다. 전반적으로 여포상 선종 및 암종은 미미한 차이를 보여서 세포학적으로 확실히 구별하기는 어려웠으나, 많은 수의 개별 세포와 종양세포 간에 포착된 혈관내피세포의 존재는 양성보다는 악성을 시사하는 소견으로 생각되었다. 여포상 종양의 세포학에 좀더 관심을 가짐으로써 그 발견율을 현저히 높일 수 있다고 생각된다. The major limitation of fine needle aspiration of the thyroid is in the evaluation of follicular tumors. it may be difficult or occasionally, impossible to distinguish on a cytologic basis, between hyperplastic nodular getter, follicular adenoma and well differentiated follicular carcinoma. We reviewed cytologic presentations of 15 histologically confirmed follicular neoplasms of the thyroid. Aspiration smears of 6 follicular adenomas were cell-rich with ball-like or syncytial aggregates of monotonous follicular cells, in contrast to honeycomb-like flat sheets of adenomatous goiter Mild nuclear pleomorphism and a small visible nucleolus were noted in 2 cases, respectively. Nine cases of follicular carcinoma showed very high cellularity, irregularly shaped cell clusters, and numerous isolated tumor cells. Nuclear pleomorphism and visible nucleoli were noted in 6 and 5 cases, respectively. Another characteristic finding, entrapped endothelial cells within the ceil clusters, was noted in 7 carcinomas and 1 adenoma. The background of the smears of all follicular neoplasms was hemorrhagic, with no or scanty colloid. We confirmed that the cytologic features of follicular adenoma and carcinoma were similar in general, with subtle differences in cell morphology, but the presence of isolated tumor cells and entrapped endothelial cells was suggestive of malignancy.

흰쥐에서 유리섬유의 피하삽입에 의한 경시적 병리조직학적 변화

이민재,조수헌,장자준,Lee, Min-Jae,Cho, Soo-Hun,Jang, Ja-June 대한예방의학회 1997 예방의학회지 Vol.30 No.1

To exanime in vivo tissue reactions of glass fibers, we injected glass fibers to rats subcutaneously. We made fibers of average dimensions of approximately $2{\mu}m$ in diameter and $60{\mu}m$ in length. After instilation of glass fiber we sacrificed rats sequentially at 1, 3 and 6 months. At 1 month after injection of glass fibers, the exposure area turned to yellow color and formed well-demarcated round mass. The average size of the mass was $1\times0.3cm$. Grossly detectable mass was decreased in size at 6 months compared to 1 or 3 months. Microscopically, strong foreign body reaction to glass fibers, inflammation and fibrosis were observed until 6 months. Foreign body reaction was increased up to 3 months, but it was decreased after 6 months. In scanning electron microscope, there was many bundles of glass fibers around the inflammation area, but the size of glass fibers were gradually reduced from 1 month to 6 months. These results suggest that subcutaneous exposure of glass fiber can provoke strong tissue reaction including foreign body granulomas, inflammation and fibrosis. But glass fiber itself did not produce any neoplastic changes.

점액양 연골 육종 1례의 세침 흡인 세포학적 소견

명나혜,조경자,장자준,조재일,심영목,Myong, Na-Hye,Cho, Kyung-Ja,Jang, Ja-June,Zo, Jae-Il,Shim, Young-Mog The Korean Society for Cytopathology 1990 대한세포병리학회지 Vol.1 No.2

70세 여자의 늑막에 발생한 점액양 연골육종의 세침흡인세포학적 소견을 기술하였다. 환자는 4개월간의 좌측 흉통과 2개월간의 호흡곤란을 호소하였고 흉부 X-선 및 전산화 단층촬영상 좌측 늑막강에 위치하여 흉벽을 침범하는 커다란 분엽상 저음영성 종괴와 늑막 삼출액이 관찰되었다. 종괴의 세침 흡인 도말은 세포 밀도가 매우 높았고, 세포질이 풍부한 나원형 세포들이 점액성 물질내에 산재되거나 간혹 뭉쳐 있었다. 풍부한 세포질은 불투명한 청색으로 소포를 함유하기도 하였으며 그 경계는 흩어진 세포에서는 비교적 분명했으나 세포집단에서는 불분명하였다. 핵들은 한쪽으로 치우쳐져 둥글거나 난원형을 보였고 염색질은 미세하였으며 다수의 작은 핵소체를 갖고 있었다. 세포들간의 다형성이나 유사분열은 잘 관찰되지 않았다. 이상의 소견은 연공육종의 세포학적 특징과 유사했으나 연골 성분이 관찰되지 않았고 점액성 물질이 매우 풍부하여 확진을 위한 생검이 시행되었고 조직학적으로 점액양 연골육종임이 확인되었다. A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was blulsh opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined ceil borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.

모기질 세포종의 흡인 세포학 - 전이성 암종으로 오진된 2예 보고 -

고재수,하창원,조경자,장자준,Koh, Jae-Soo,Ha, Chang-Won,Cho, Kyung-Ja,Jang, Ja-June The Korean Society for Cytopathology 1993 대한세포병리학회지 Vol.4 No.1

35세 및 22세 여자의 경부에 생긴 종괴의 세침흡인 세포학적 검사에서 악성이 의심되는 병변 및 악성 병변으로 오진되었던 모기질 세포종 2예의 세포학적 소견을 기술한다. 핵 세포질의 비율이 높고 뚜렷한 핵소체를 보이는 기저양 세포, 농염성 핵을 가진 각화된 편평상피세포, 이물형 거대세포 및 괴사성 배경을 보였고, 후속하여 보았을 때 이러한 소견은 모기질 세포종의 특이적인 소견으로서 악성 종양으로 보기에는 염색질의 분포가 균질하고 핵들의 다형성이 없는 점이 악성 종양과는 구별되는 소견이었고, 모기질 세포종은 경부 종괴 및 여하한 부위의 피하 종괴의 세침 흡인에서 상기의 소견을 보일 때 감별 진단의 하나로서 고려해야한 양성 병변이다. We describe cytologic findings of two cases of pilomatrixoma which had been cytologically misdiagnosed as suspicious malignant and malignant lesions in 35 year-old and 22 year-old females who presented a palpable neck mass. The cytologic smears showed many basaloid cells with a high nuclear-cytoplasmic ratio, nuclear hyperchromatism and prominent nucleoli, keratinized squamous cells with pyknotic nuclei, foreign body giant cells, and chronic inflammatory cells in necrotic back-ground. Retrospective view of this aspiration smear revealed that these findings were characteristic features of pilomatrixoma, and the evenly distributed chromatin pattern as well as the lack of nuclear pleomorphism were considered to be the differential points from malignant neoplasm. Pilomatrixoma is a benign neoplasm which should be included in differential diagnosis if the fine needle aspiration cytologic smear of a neck mass or subcutaneous mass of any site showed these features.

평활근육종의 세침 흡인 세포학적 소견 -2예 보고-

하창원,명나혜,조경자,장자준,Ha, Chang-Won,Myong, Na-Hye,Cho, Kyung-Ja,Jang, Ja-June 대한세포병리학회 1990 대한세포병리학회지 Vol.1 No.2

Leiomyosarcoma of the soft tissue is a well-defined and characteristic entity histologically, but cytomorphological studes are lacking. A correlaive cytological study of 2 cases of leiomyosarcoma is presented. The smears from case 1 were rich in tumor cells and most cells were arranged in large sheets or clusters. The cells showed round to oval nuclei containing fine chromatin and small promiment nucleoli. The smears from case 2 were moderate in cellularity with loose clusters or isolated cells. The characteristic blunt-ended and cigar-shaped nuclei containing coarse chromatin and prominent nucleoli were identified in case 2. Nuclear atypia, prominent nucleoli and high cellularity permit diagnosis of malignancy, although the atypia is generally less pronounced than in the histology. The cytological diagnosis of leiomyosarcoma may be auxiliary in the diagnosis of recurrence or metastasis in the patients with alleged leiomyosarcoma.

유방의 분비성 상피암종의 세침 흡인 세포학적 소견 - 1례 보고 -

하창원,고재수,명나혜,조경자,장자준,Ha, Chang-Won,Koh, Jae-Soo,Myong, Na-Hye,Cho, Kyung-Ja,Jang, Ja-June 대한세포병리학회 1992 대한세포병리학회지 Vol.3 No.1

Secretory carcinoma is a very rare tumor of the breast, having characteristic histologic findings. A cytologic study of a secretory carcinoma is presented. The smears were abundant in tumor cells which were arranged in loosely adherent or large tight clusters in clear background. The individual cells were round or oval, monomorphic, and had abundant eosinophilic cytoplasm. The cytoplasm showed distinct borders and single or fine vacuolization. The nuclei were peripherally located, oval, and vesicular with small prominent nucleoli. As in histology, the cytologic features were so characteristic that a diagnosis of secretory carcinoma could be made by ctyologic study only.

유방의 세침 흡인 세포학

조경자,고재수,하창원,장자준,Cho, Kyung-Ja,Koh, Jae-Soo,Ha, Chang-Won,Jang, Ja-June 대한세포병리학회 1992 대한세포병리학회지 Vol.3 No.2

A number of studies have shown the value of fine needle aspiration cytology for the diagnosis of breast lesions, but reports on the comparison of cytologic and histologic variations of breast cancers are few. We reviewed histologically proven 106 breast aspirates with an emphasis on the cytology of ductal carcinomas and of an area of uncertain atypia. Positive and negative predictive values of breast aspiration cytology were 100% On review of the cases originally diagnosed as atypia of uncertain nature (19 %), features more suggestive of malignancy or benignancy were recognizable in most underdiagnosed cases and a half of overdiagnosed cases, respectively. However, indistinguishable atypism also remained. Thirty seven cases out of 53 infiltrating duct carcinomas revealed malignant cytology, with variations in background, cellularity, morphology of cell groups, and extent of isolated tumor cells. When classifying the infiltrating duct carcinomas into scirrhous, solid-tubular, and papillotubular types, scirrhous type frequently appeared as irregularly shaped tight or loose cell clusters, and solid-tubular type as round-margined cell balls.

디에틸나이트로사민 유발 마우스 간 발암과정에서 계통(C3H, ICR, BALB/c) 및 성별에 따른 세포증식능 및 아포프토시스의 차이

이민재(Min-Jae Lee),장자준(Ja-June Jang) 한국실험동물학회 1998 Laboratory Animal Research Vol.14 No.1

폐의 '소위 경화성 혈관종'의 세침 흡인 세포학적 소견 -2예 보고 -

명나혜,하창원,조경자,장자준,Myong, Na-Hye,Ha, Chang-Won,Cho, Kyung-Ja,Jang, Ja-June 대한세포병리학회 1991 대한세포병리학회지 Vol.2 No.1

So-called sclerosing hemangioma of the lung is a rare benign neoplasm which usually presents with a coin lesion detected through routine chest X-ray. We report two cases showing characteristic cytologic appearances which have been rarely reported. Both cases were young females with coin lesions in the lung. Fine needle aspiration of each case revealed unique but some different cytologic features. Case 1 showed bland-looking polygonal epithelial cells resembling bronchioloalveolar cells haying predominantly papillary configurations with loosely arranged solid sheets or isolated cells. Cytoplasms were plump, cyanophilic, and finely granular, with eccentric nuclei. The nuclei were usually monotonous, round-to-ovoid, and vesicular with a small but conspicuous nucleolus. In comparison to case 1, case 2 revealed largely loose pavement-like solid sheets or clusters rather than papillary patterns in the hemorrhagic background. The size of tumor cells were a little smaller than that of case 1. Bronchioloalveolar carcinoma and papillary adenocarcinoma of metastatic origin were considered to be one of the important differential diagnoses with these cytologic features. Histologically, both cases exhibited findings compatible with so-called sclerosing hemangioma of the lung.