Choriocarcinonla is very rare malignancy, accounting for less than 1% of all testicular germcell tumor. However, it is an important disease in the field of oncology, as it represents ahighly curable malignancy. and one in which the incidence is focused on young patients attheir peak of productivity. In nonserninomatous germ cell testis tumor, assessment of prognosticfactors is related to develop a basis for more rational therapy for each individual patient.Along with prognostic staging, appropriate treatment shoud be applied to each patient to improve disease-free survival. And. surgical resection of residual masses after cisplatin-based chemotherapy is an established adjuvant to chemotherapy, because complete remission can be improvedabout 10% with appropriately timed complete resection of residual diseases. So, we reporta case of a 27-year old male patient with testicular choriocarcinoma who presented with multiplelung metastases after radical orchiectomy. He recieved lung wedge resection after 8 cycles ofcisplatin, etoposide, ifosfamide combination chemotherapy. and complete remission was confirmed and maintained.

The diffuse interstitial lung diseases are a heterogeneous group of diffuse inflammatory disorders of the lower respiratory tract characterized by derangements of the alveolar walls and loss of functional alveolar capillary units. The most common causes of diffuse interstitial lung diseases are idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disorders, hypersensitivity pneumonitis and pneumoconiosis. Especially, the miliary tuberculosis is also leading cause in Korea, but pulmonary tuberculosis presenting as diffuse interstitial lung disease except miliary tubercuaosis is rare. We report a case of pulmonary tuberculosis presenting as diffuse interstitial lung disease associated with the tyrnphadenopathy of mediastinum and abdomen.

Benign urethral neoplasm, especially leiornyoma of the female urethra, is a very rare entity, with relatively few cases reported.

Recently we experienced 3 cases of leiomyoma in the female urethra and so reported with review of the literatures.

This study was undertaken in an attempt to identify histopathologic and immunohistologic findings of non-specific benign lymphnode hyperplasia. The materials used in this suty consist of 169 cases of benign lymphnode hyperplasia in the lymphnode specimen dissected due to mass during the period of 6 years and 10 months in the department of pathology. The following results were obtained. 1) The ratio male to female was 1:1.2. The frequency was most common between 20 to 29 years old age with the percents of 24. 2) The most common type of benign lymphnode hyperplasia was diffuse hyperplasia(54 cases, 32%). The follicular hyperplasia was noted in 40 cases(24%), sinus histiocytosis in 36 cases(21%) and mixed pattern in 39 cases(23%). 3) The degree of diffuse hyperplasia, sinus histocytosis and mixed pattern was mild to moderate, while the severe degree was common in follicular hyperplasia. 4) The histopathologic findings associated with benign hyperplasia were necrosis, abscess and granulomas. 5) The immunohistologic stainings showed more frequent positive cells for IgG and IgA than positive cells for IgM. The frequency of positive cells for IgG and IgA was mild to moderate in follicular hyperplasia, diffuse hyperplasia and mixed pattern of lymphnode hyperplasia. IgM positive cells was mild in degree of frequency in diffuse hyperplasia, sinus histocytosis and mixed patterns.

The fact that the administration of 1,2-dimethylhydrazine 2Hcl(DMH) to rats by weekly subcutaneous injections causes the development of epithelial tumors of the large intestine has been known. But the axact processes of of early morphologic changes of colonic lesion induced by DMH treatment in the rats have not been fully testified as yet. The objective of the dissertation research is to examine early morphologic changes of colonic lesion induced by DMH treatment in the rats. Total seventy cases including 14 control rats of Sprague Dawley male rats were analyzed by histopathologic changes. One is 20mg/kg/wk DMH treated rat group and the other is 40mg/kg/wk DMH treated rat group. DMH was injected s.c. at the start of each treatment weekly during 20 weeks, and the animals were killed at 1, 3, 5, 6, 7, 9, 12, 14, 17 or 20 weeks both in 20mg/kg/wk DMH treated group and in 40mg/kg/wk DMH treated group. The following results were obtained: Hyperplasia and mitosis of the crypt are presented in early phase of DMH treatment. Cellular dysplasia, carcinoma in situ, and invasive carcinoma are shown in later phase of DMH treatment. The same changes as the above are also identified in electron microscopic findings. The more doses of DMH are injected to rats, the more evident these findings are presented. The alkaline phosphatase activity in glandular epithelial cells are observed in cellular dysplasia and neoplastic changes. The alkaline phosphatase may be considered as tumor marker.

From April 1981 to March 1985, a clinical study was made at the Intcrnal Medicine department of Ewha Womans University Hospital on 13 patients with IgA nephropathy. The following results were obtained. 1) The mean age of patients was 27 years, the male to femle ratio was 1.2:1. The most common chief complaint was gross hematuria(38%). 2) In urinalysis, hematuria and proteinuria were noted 100% and 92%, respectively. Creatinine clearance was decreased than normal range of creatinine clearance. ASO titer, immunoglobulin and C3 level were normal range. 3) Kidney biopsy finding showed minor mesangeal change in 62% of patients. IgA deposition was noted in all patients.

For the study of relationship between gastric polyps and gastric carcinoma, the tissue carcinoembryonic antigen, so called tumor marker, was investigated by immunoperoxidase method with paraffin embedded block in the gastric epithelial polyps and adenocarcinoma. The representative lesions of the hyperplastic polyps(6 cases), adenomatous polyps(5 cases), and adenocarcinoma(6 cases) consisting of pyloreocardiac cell type, intestinal cell type and mucous cell type, were selected. The following results were obtained. 1) The reactions of tissue CEA in the adenocarcinoma were more strong than those of gastric hyperplastic and adenomatous polyps. 2) The CEA of adenomatous polyps was demonstrated within the cytoplasm of glands and along the glandular luminal border, while the hyperplastic polyps showed CEA only along the luminal border of the gland in weak positive reaction. 3) The adenocarcinoma showed the CEA in the stroma around the cancer cells and within the glandular lumens of the cancer tissue as well as the cytoplasm of the cancer cells and glandular luminal border. 4) Among the adenocarcinomas of the stomach, the pyloro-cardiac cell and mucous cell types demonstrated more strong positive reaction for CEA than that of intestinal cell type.

The uterine cervical neoplasia has been generally classified following categories included such as dysplasia, carcinoma in situ, microinvasive carcinoma, invasive carcinoma and therpeutic method depended upon types of classification. Recent advances in tumor markers offer new horizon in the pathology of uterine cervix. For instance, carcinoembryonic antigen(CEA), one of the best known tumor markers, has been detected in tissue section of cervical neoplasia. In view of rather than tissue loation of CEA and in the hope of chages of the CEA in cervical neoplasia, aothour has undertaken a study of preinvasive and invasive epithelial lesions of the uterine cervix by immunoperoxidase technique. Seventy-nine cases of uterine cervical neoplasia were subclassified and studied by peroxidase anti-peroxidase method(PAP) for the presence of carcinoembryonic antigen(CEA). The following results were obtained : 1) Normal squamous epithelium was lack of CEA but the cervical neoplastic epithelium showed CEA positivity in 73 of 79 cases(92.4%). 2) Preinvasive lesions, dysplasia and carcinoma in situ showed CEA-positivity cells in 37 of 39 cases(94.9%) while ivasive lesions had CEA-positivity cells in 29 of 33 cases(87.9%). 3) The squamous epithelium of dysplasia revealed CEA positivity in all cases. In mild to moderate dysplasia, CEA-positive cells were present at the ypper layers of squamous epithelium. However, the severe dysplasia showed positive cells throughout the water layers. 4) The pattern of CEA staining in carcinoma in situ was shown in epithelial leyers except basal cells but the intensity was more strong in the luminal border of carci-noma in situ with glandular involvement. 5) Antigen was present in 57.1% of small cell non keratinizing squamous carcinoma as compared with 100% in large cell keratinizing and large cell nonkeratizing tumors. 6) The pattern of CEA tissue distribution in invasive carcinoma was shown in tumor cells adjacent to stroma, and percentage(27.2%) of strong positivity was twice higher than that(2.8%) of perinvasive lesion. 7) In adenocarcinoma and adenosquamous carcinoma moderate to strong positivity for CEA was seen in glandular epitheium and stroma. These investigation has shown that CEA emerges as a useful tumor marker in cervical neoplasia. The localization of CEA by immunoperoxidase technique may add objectivity in the diagnosis of cervical neoplasia by virtue of positive staining pattern.

The main objective of the present study was to obtain further information on the histopathologic changes in the bile ducts at chronic stage of Clonorchis sinensis infection for the establishment of relationship between clonorchiasis and cholangiocarcinoma. BALB/C male mice were used. Approximately 500 metacercariae were given orally to each mouse. Three mice were sacrificed once monthly from the 10th month through the 20th month after infection. The hepatobiliary tissues were fixed in 10% formalin solution, sectioned serially, and stained with hematoxylin and eosin for histopat-hologic examination. The results obtained are summarized as follows; 1) The bile ducts showed moderate adenomatousproliferation, mucinous cell metaplasia and goblet cell metaplasia from the 10th month up to the 13th month after infection, then gradual regression. As time elapsed, scattered abortive acini were aslo regressive. 2) Most of the stromal fibrous tissues were replaced by excessive collagen fibers which persisted throughout the observation. The pictures were considered to be irreversible. 3) Polymorphonuclear leucocyte and eosinophil infiltrations was slight in the degree, while chronic mononuclear leucocyte infiltration was moderate throughout the observation. 4) Even though no any evidence of malignant change of epithelial cells was demonstrated thoughout the observation, Clonorchis infection was considered to be an impotant predisposing factor in carcinogenesis in the bile ducts.

Abnormal germ cells in the lumens of the seminiferous tubules are present in the testis of the cryptorchism. Three cases among the eight cases of testicular biopsies in the cryptorchism showed abnormal germ cells. However, the patterns of carcinoma in situ(CIS) were not found. The characteristics of the abnormal germ cells are enlarged nuclei with prominent mucleoli and pale cytoplasm in the light microscope examinations. The ultrastructural features of these abnormal cells were different from the normal germ cells. The abnormal germ cells could be recognized with the light and electron microscopic examinations.

Since 1972, the necrotizing lymphadenitis, histiocytic necrotizing lymphadenitis without granulocytic infiltration etc. Seven cases of necrotizing lymphadenitis has presented in this study. Most of them were young men characterized by persistent lymphadenopathy with or without fever. The histopathologic features of lymphnodes showed focal or diffuse well circumscribed paracortical necrotizing lesion, abundant karyorrhectic debris and aggregates of large mononuclear cells. However, there were no infiltrates of plasma cells and neutrophils. The remaining areas of lymphnodes showed severe degree of paracortical hyperplasia without significant hyperplasia of lymphoid follicles in the cortex.

The objective of this sutdy was to obtain further information on the relationship between oncogenesis of cholangiocellular carcinoma of the liver and the infection with a liver fluke, Clonorchis sinensis in the earlier stage of the infection. A group of 24 BALB/C male mice were used. Approximately 500 metacercariae were given orally to each mouse. Three mice were killed on the scheduled day, 3rd, 5th, 7th, 10th, 15th, 20th, 25th and 28th day after infection, respectively and histopathologic changes of the bile ducts were examined using hematoxylin and eosin stain method. The histopathologic findings observed were summarized as follows ; 1) Mice killed on the 3rd day showed a mild epithelial hyperplasia with the formation of papillae and adenomatous tissue proliferation. Bile ducts were dilated and the stroma was infiltrated by inflammatory cells, mainly eosinophils and polymorphonuclear leucocytes. Occasionally mitotic figures and atypia of epithelial cells were seen. Worms were found in the distal peripheral smaller branches of the bile duct. 2) Mice killed on the 7th day gave a mild connective tissue proliferation in addition to more striking pictures in the bile ducts. Chronic mononuclear leucocytes appeared in the stroma. 3) Bile duct chagnges including epithelial hyperplasia, adenomatous tissue formation, connective tissue proliferation and inflammatory cell infiltration were greater in the degrees in mice killed on the 10th day after infection. Mucinous cell metaplasia and collagen fiber proliferation were also observed. 4) From the 15th day throughout the 28th day after infection, mice showed the most striking pictures of peithelial hyperplasia, adenomatous tissue formation and mucinous cell metaplasia. The stroma demonstrated the excessive eosinophil and chronic mononuclear leucocyte infiltrations, while polymorphonuclear leucocytes were decreased.

Most optic gliomas are benign astrocytomas that might better be considered hamartomas than true neoplasms. Optic gliomas rerely becomemalignant and their morbidity is mainly due to enlargement of the tumor. The presenting symptoms and signs are variable depending on the location of the tumor. We experienced a huge optic chiasm and optic nerve glioma which caused hydrocephalus, vomiting, gait disturbance and decreased visual acuity in 4 years old boy.

We had experienced one case of amyloidosis, especially involving kidney associated with nephrotic syndrome and liver who was admitted to Ewha University Hospital due to abdominal distension and extremities edema.

Diagnozis was made characteristic clinical and histopathologic finding with crystal violet and congo red staining produced green birefringence under polarized light.

We sdiscussed this case with review of literatures.

One hundred and twenty cases of endometrial tissue curettaged from the patients of primary and secondary sterility were studied by the methods of histopathologic and histochemical examination.

The following results were obtained:

1) The cases aged from 25 to 29 were most frequent.

2) The pathologic lesions of the endometrium were present in 12 cases. The cases of chronic endometritis were most common and were 6(5.0%). There were 2 cases of cystic hyperplasia and 2 cases of atrophy. Each one case of tuberculosis and endometrial polyp was also present.

3) Most cases among 108 cases after excluding 12 cases of pathologic lesions showed mild degree of glandular tortuosity and secretory activity with mild to moderate degree of predecidual change of stromal cells.

4) The glandular secretion of PAS positive material was mild in many cases of endometrium. However, there were many cases of absence of PAS positive material. The stromal cells showed negative or mild positive PAS staining in almost all cases.

5) The alcian blue staining revealed positivity in the glandular cytoplasm of all cases and positivity in the luminal secretion of many cases.

6) The differences of histopathology and histochemical reaction between primary and secondary sterility were not significant.

Endodermal sinus tumor is characterized by perivascular structures(Schiller-Duval bodies). which simulate endodermal diverticula of yolk sac origin. Endodermal sinus tumor has generally been reported to be in ovary and testis. Very few cases of endodermal sinus tumor originating from extragonadal sites such as mediastinum, pelvis, vagina, sacrococcygeal region, pineal gland have been described. The authors report a case of endodermal sinus tumor arising from pineal gland and briefly review literatures.

The present study carried out to obtain further information on the relationship between primary carcinoma of the liver and infection with a liver-fluke, Clonorchis sinensis. A group of 50 male albino mice were used. Approximately 500 metacercariae were given orally to each mouse. Maturity of worms was followed up by fecal examination. Distribution of worms in the hepatobility system was also checked by using 5 egg positive mice at the end of the 1st month of infection. For histopathological examination, 4-5 mice were sacrificed monthly through the 9th month of infection. The liver tissues including common bile duct and the gall bladder were fixed in 10% formalin, sectioned serially, and stained with hematoxylin and eosin. The results obtained are summarized as follows; 1. The initial day of egg output was the 28th day in average ranging from 22nd to 33rd day of infection. 2. Recovery rate of worms was revealed as low as 16.8%, and of which 64.5% was found in the intrahepatic ducts, 33.2% in common bile duct and 2.3% in the gall bladder. 3. Parasites were found in the intrahepatic ducts throughout the observation. 4. At the end of the 1st month of infection, epithelial cells of bile ducts showed varying degrees of hyperplasia and desquamation, marked adenomatous tissue proliferation, enormous acini formation with remarkable mucinous cell metaplasia and definite atypia. Stratification was scanty. Periductal and portal spaces demonstrated the extensive chronic mononuclear leucocytes and the moderate fibrosis. Similar pictures persisted up to the 4th month of infection. 5. After the 5th month, all of the outstanding features of epithelial cells showed gradual regression. On the other hand, the most striking picture in this period was the great increase of collagen fibers in periductal and portal spaces. Although tumors were not found in the present study, overall results obtained were strongly suggestive to make an inference that clonorchiasis is responsible for the neoplastic transformation of epithelial cells of intrahepatic bile ducts in experimentally infected albino mice.

The histopathologic study of the curettaged endometrial tissue taken from the patient with the clinical impression of dysfunctional uterine bleeding was performed. The total 221 cases of this study were classified as 76 cases of proliferative phase, 46 cases of secretory phase, 25 cases of menstrual phase, 25 cases of hyperplasia, 18 cases of chronic inflammation, 11 cases of irregular shedding, etc. Even age distributions were present in the patient of proliferative, secretory and menstrual phases. However, most cases of hyperplasia, irregular shedding, atrophy and adenocarcinoma of the endometrium were found at the age of more than 40. The metaplastic changes of endometrial tissue were present in about 1/3 of total cases. Almost all of these metaplastic changes were epithelial metaplasia. The most common type of epithelial metaplasia was tubal metaplasia which was observed mostly in the hyperplasia including cystic and adenomatous hyperplasia. The varieties of metaplastic changes occurred in the proliferative phase, secretory phase, chronic endometritis and menstrual phase in order. There were only 2 cases of mesenchymal metaplasia which was osseous and smooth muscle metaplasia.

A malignant mixed mesodermal tumor of the bladder from 70-year-old woman is presented. Malignant mixed mesodermal tumor is a designation applied to carcinosarcoma characterized by the presence of heterologous mesenchymal elements. The tumor tends to be large, bulky, intraluminal tumors that grows rapidly and infiltrates widely. The tumor occurs predominantly in elderly men, and aggresive surgical treatment is indicated because of the poor prognosis. Histologically this neoplasm was composed of epithelial components of transitional and squamous cell carcinoma, and mesnechymal components of fibrosarcoma, chondrosarcoma, and osteogenic sarcoma.

Dieulafoy's disease is the vascular anomaly characterized by the presence of arteries of persistent large caliber in the submucosa, and in some instances, the mucosa, typically with a small, overlying mucosal defect. Only a few cases of this lesion occuring in the bronchial system have been reported to date. The etiology of Dieulafoy's disease is still unclear, but chronic bronchial injury and/or congenital vascular malformation have been postulated. We encountered a case of bronchial Dieulafoy's disease that developed in a 69-year-old woman who had been treated for pulmonary tuberculosis for 4 months. Her chief complaint was hemoptysis and the bronchoscopic finding showed an intrabronchial protruding lesion produced by the arteries beneath the bronchial mucosa of the anterior segment of right upper lobe. She has been well after the surgical resection of right upper lobe.

Citations

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• Clinical characteristics and treatments for bronchial Dieulafoy's disease
  Wenfang Chen, Pingping Chen, Xiuyu Li, Xinglin Gao, Jing Li
  Respiratory Medicine Case Reports.2019; 26: 229.     CrossRef

Benign prostatic hyperplasia and prostatic carcinoma are the most frequent and important two lesions of the prostate. Sometimes we encounter the situations to solve the problems for the differential of cancerous lesions form various histopathologic changes in the microscopic examination of the prostate tissue obtained by curettage or resection in the patients of benign prostatic Hyperplasia. This study was undertaken to make an accurate histopathologic diagnosis of the prostate through the recognition of various microscopic changes similar to those of prostatic cancer and to understand the possibility of percancerous lesion in the dysplasia of the prostate.

Authors reviewed total 1,023 cases of prostatic tissre obtained during the last ten years from 1981 to 1990 at Ewha Womans University Tongdaemun Hospital, Wonju Christian Hospital and Yong-Dong Severance Hospital.

The results are as follows:

1) Among total 1,023 cases, 922 cases were benign prostatic hyperplasia and 101 cases were prostatic carcinoma.

2) Dominant age groups are seventies and eighties decades.

3) Nonspecific inflammation is found in almost cases of benign prostatic hyperplasia and the incidence of granulomatous inflammation was 2.7%, that of nonspecific granulomatous inflammation was 1.8% and that of tuberculosis was 1.0%.

4) The incidence of stromal nodule in benign prostatic hyperplasia was 30.5%, basal cell hyperplasia, 29.7%, sclerosing adenosis, 2.1% and dysplasia, 3.5%.

5) Among total 983 cases of prostate, 54 cases(5.5%) were dysplasea. The incidence of dysplasia in benign prostatic hyperplasia was 3.9% and that in prostatic carcinoma was 29.5%. The incidence of grade III dyplasea was 0.3% in benign prostatic hyperplasia and 13.1% in prostatic carcinoma. Therefore, of presence and occurance of associated carcinoma in the grade III dysplasia is highly present.

Adenocarcinomas are uncommon tumors of the urinary bladder. accounting for 0.5% to 2.2% of all bladder malignancies over world.

Separating urachal tumors from non-urachal tumors are important in their prognosis. Authors report thirty-nine cases analyzed according to their clinical aspects at presentation and according to their gross and histopathologic features, such as location, size, shape, stage, d1fferentiation, cell types on microscopic examination. Twenty-one tumors were primary; 8 tumors were non-urachal, 11 tumors were urachal and others from colon, stomach, rectum and ovary. Urachal tumors. In histopathologic types fo primary adenocarcinoma in the urinary bladder, adenocarcinoma, NOS are most common. In urachal adenocarcinomas, enteric types cystitis cystica, cystitis glandularis, necrosis and calcification are also seen. But around urachal tumors, cystitis cystica and cystitis glandularis are not observed.

Sometimes, routine clinical and pathologic study cannot differentiate the histogenesis and the classification of adenocdarcinoma in the urinary bladder. Further studies are needed.