Bum Hwan Koo

FINE NEEDLE ASPIRATION CYTOLOGY OF THE BREAST. EXPERIENCE AT AN OUTPATIENT BREAST CLINIC

OBJECTIVE To evaluate the accuracy of fine needle aspiration cytology (FNAC) of the breast at our institution and to perform quality assurance. STUDY DESIGN Two hundred forty-six cases with pathologic confirmation were selected and reviewed. A pathologist performed most of the aspirations at an outpatient breast clinic. We correlated cytologic and histologic findings and evaluated the influence of the size, location, grade, and pathologic subtypes and fibrosis in breast lesions on diagnostic results. RESULTS The likelihood ratios for malignant, suspicious, atypical, benign and unsatisfactory cytologic diagnoses were 98.71, 5.48, 1.09, 0.07 and 0.55, respectively. The absolute and complete sensitivities for malignant lesions were 64.5% and 90.3%, respectively. The specificity was 71.9%. False negative and positive rates were 4.3% and 0.7%, respectively. The predictive value for a malignant cytologic diagnosis was 98.4%. The rate of unsatisfactory samples was 9.3%. The rate of concordance between cytologic and histologic diagnosis was lower for large and diffusely growing lesions (benign and malignant), for malignancies with abundant fibrosis and of unusual types and for carcinomas of low grade. All axillary and recurrent chest wall lesions were diagnosed cytologically. Cell block sections were useful in a small number of cases. CONCLUSION Understanding the performance and limitations of FNAC can enhance its value as a diagnostic technique in the management of breast disease.

Hepatic Splenosis Diagnosed as Hepatocellular Carcinoma: Report of a Case

Abstract We report one case of splenosis. A 43-year-old male patient was referred to our hospital because of a hepatic mass. The hepatic lesion was incidentally found during an annual ultrasonographic follow-up since the patient was a known chronic hepatitis B carrier for the previous 10 years. Surgical records revealed a history of splenectomy in conjunction with a blunt abdominal trauma, which the patient had sustained 20 years prior to this admission. On abdominal computed tomography scanning, a 3.5-cm sized focal bulging mass was noted in segment 6 of the liver. An inferior phrenic artery angiogram showed a hepatic tumor and the patient was treated by chemoembolization for hepatocellular carcinoma. A partial resection of the liver with a portion of the diaphragm was done after the transcatheter arterial chemoembolization procedure. A pathologic examination revealed splenosis within the hepatic parenchyme.

Peutz-Jeghers syndrome with multiple genital tract tumors and breast cancer: A case report with a review of literatures

We report here on the multiple genital tract neoplasms in a 41-yr-old Korean woman with Peutz-Jeghers Syndrome (PJS). The patient presented with lower abdominal pain. Her previous medical history was PJS and breast cancer. Pelvic ultrasound showed a multilocular cyst at the right adnexal region, diagnosed as bilateral ovarian mucinous borderline tumors. An ovarian sex cord tumor with annular tubules was incidentally diagnosed together with a minimal deviation adenocarcinoma of the uterine cervix and mucinous metaplasia of both the Fallopian tubal mucosa and the endometrium. Although the cases of multiple genital tract tumors with PJS has rarely been reported, the present case appears to be the first in Korea in which the PJS syndrome was complicated by multiple genital tract tumors and infiltrating carcinoma of the breast. The clinical significance of the multiple genital tract tumors and breast cancer associated with PJS is reviewed.

Comparison of hepatocellular carcinoma in American and Asian patients by tissue array analysis

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Although some epidemiologic and etiologic differences between Asian and Western HCC are known, detailed comparative studies with pathologic correlations have not been performed.

Fast-Growing Pseudoangiomatous Stromal Hyperplasia of the Breast: Report of a Case

Pseudoangiomatous stromal hyperplasia (PASH) is a rare type of benign mesenchymal proliferative disease of the breast. Histologically, it is composed of a proliferation of spindle cells with inter-anastomosing vascular-like arrangement in the interlobular or interductal stroma. Clinically, pseudoangiomatous stromal hyperplasia is usually found in premenopausal women as a discrete, painless mass, which is firm and movable. We report a case of pseudoangiomatous stromal hyperplasia of the breast, which mimicked a malignant mass in that it grew rapidly and ultrasonography showed a lobulating contoured heterogeneous echotexture.

Safety of single-incision laparoscopic cholecystectomy for acute cholecystitis

Single‐incision laparoscopic cholecystectomy (SILC) is a common procedure performed worldwide. In this study, we evaluated the safety and efficacy of SILC for acute cholecystitis.

Infiltration of intratumoral T cells and regulatory T cells are associated with p53 expression and ER status in early breast cancer: a Korean breast cancer study.

CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts Abstract #5049 Background: Immune responses, such as rich lymphocyte infiltrate, have shown associated with improved clinical outcomes in patients with breast cancer. Recently, number of tumor-infiltrating regulatory T cell has been identified as a poor prognostic marker. There is, however, not enough data evaluating the associations between the clinicopathologic factors and quantity or quality of TILs in Asian breast cancer patients. Material and methods: CD4-, CD8-, and Foxp3-positive tumor-infiltrating lymphocytes (TILs) were detected by immunohistochemistry using the paraffin-embedded samples from the 40 patients with early stage (I-III) breast cancer. Expression status of ER, PR, HER-2, p53, and Ki-67 were also evaluated by immunohistochemistry. Clinical data, such as pathologic stage, patients age, were available for statistical analysis. Results: Statistically significant correlation between ER expression and CD8/CD4 ratio of the TILs (Spearman r=0.447, p=0.024) was observed. Other clinicopathlogical factors, such as PR, tumor size, nodal metastasis, tumor grade, did not show significant correlation with ratio of the TILs. Additionally, tumors with more dense accumulation of p53 protein were associated with recruitment of higher number of Foxp3-positive regulatory T cells (Spearman r=0.52, p=0.0002). Ki-67, a proliferation index of the tumor cells, was also statistically significantly associated with infiltration of regulatory T cells (Spearman r=0.46, p=0.019). Discussion: Our data showed that ER-positive tumors had higher ratio of CD8/CD4 TILs, which is opposite result from the previous studies. In addition, p53 overexpression and high proliferation index of the breast cancer were associated with high regulatory T cell infiltration, but not with total TIL. The role of the p53 overexpression of the tumor cells in determining immune balance and its prognostic implication will be evaluated in the future study. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5049.

Medullary Carcinoma of the Breast After Radiation Therapy for Hodgkin's Disease in a Young Woman: Report of a Case

A 28-year-old woman who had received mantle-field radiation therapy for Hodgkins disease (HD) almost 10 years earlier was referred to our hospital for investigation of a palpable mass in her left breast. Mammography, sonography, and fine-needle aspiration were done and the results showed medullary carcinoma of the breast, an uncommon type of breast cancer in young women. We review the literature on the secondary development of breast cancer after radiation therapy for HD.