• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4365-4368
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• 2013

Background: Bronchioloalveolar carcinoma (BAC) is considered a subtype of adenocarcinoma of the lung. Recently BAC has been variously termed adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant invasive adenocarcinoma, and invasive mucinous adenocarcinoma. The aim of the study was to analyze and detect prognostic factors of patients with BAC over a 7-year period. Materials and Methods: This retrospective single-center study included 44 patients with BAC. The impact on survival of fifteen variables (gender, age, smoking status, cough, dyspnea, hemoptysis, fever, chest pain, sputum, metastasis number, Karnofsky performance status, pT, pN, TNM stage, cytotoxic chemoterapy) were assessed. Results: Median age was 55 years (38-83). Most patients were male (63.6%) and stage IV (59.1%). Twenty-one patients (47.7%) received cytotoxic chemotherapy (platinum-based regimens) for metastatic disease. Objective response rate was 33.3% (4 partial, 3 complete responses). Stable disease was observed in nine in patients (42.8%). Disease progression was noted in 5 (23.8%). The median OS for all patients was 12 months (95%CI, 2.08-22.9 months). Independent predictors for overall survival were: Karnofsky performance status (HR:3.30, p 0.009), pN (HR:3.81, p 0.018), TNM stage (HR:6.49, p 0.012) and hemoptysis (HR:2.31, p 0.046). Conclusions: Karnofsky performance status, pN, TNM stage and hemoptysis appear to have significant impact on predicting patient survival in cases of BAC.

• The Korean Journal of Cytopathology
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• v.3 no.2
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• pp.37-51
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• 1992

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.

• Advances in pediatric surgery
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• v.14 no.2
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• pp.189-195
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• 2008

Colorectal cancer is extremely rare in children. Unlike adult colorectal cancer, the overall prognosis of colorectal cancer in children is poor. Delayed diagnosis, advanced stages of the disease at presentation, and mucinous type of histology are the major determinants of poor outcome in childhood. A 13-year-old boy with abdominal pain visited our hospital. Physical examination andabdominal ultrasonography identified acute appendicitis with perforation. He underwent appendectomy and then the pathologic findings revealed mucinous adenocarcinoma. The cancer was located at the transverse colon and had metastases on peritoneal wall at $2^{nd}$ laparotomy. Extended right hemicolectomy was performed. He underwent palliative chemotherapy. After 4 months later, hepatic metastasis and aggravated peritoneal seedings developed. He died of renal failure and pneumonia 13 months after operation. We need to have a high index of suspicion for the possibility of a malignant colorectal tumor in any childhood case with nonspecific signs and symptoms.

• Clinical Endoscopy
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• v.55 no.2
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• pp.197-207
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• 2022

Background/Aims: Endoscopic visualization of the microscopic anatomy can facilitate the real-time diagnosis of pancreatobiliary disorders and provide guidance for treatment. This study aimed to review the technique, image classification, and diagnostic performance of confocal laser endomicroscopy (CLE). Methods: We conducted a systematic review of CLE in pancreatic and biliary ducts of humans, and have provided a narrative of the technique, image classification, diagnostic performance, ongoing research, and limitations. Results: Probe-based CLE differentiates malignant from benign biliary strictures (sensitivity, ≥89%; specificity, ≥61%). Needle-based CLE differentiates mucinous from non-mucinous pancreatic cysts (sensitivity, 59%; specificity, ≥94%) and identifies dysplasia. Pancreatitis may develop in 2-7% of pancreatic cyst cases. Needle-based CLE has potential applications in adenocarcinoma, neuroendocrine tumors, and pancreatitis (chronic or autoimmune). Costs, catheter lifespan, endoscopist training, and interobserver variability are challenges for routine utilization. Conclusions: CLE reveals microscopic pancreatobiliary system anatomy with adequate specificity and sensitivity. Reducing costs and simplifying image interpretation will promote utilization by advanced endoscopists.

• Journal of Digestive Cancer Research
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• v.9 no.1
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• pp.8-18
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• 2021

Although many guidelines for pancreatic cystic neoplasms focus on the management of intraductal papillary mucinous neoplasm of the pancreas (IPMN) at the highest oncological risk, there are many issues that surgeons need to consider at the time to plan the surgical procedures based on characteristics of IPMN subtypes, such as multiplicity of branch duct-IPMN (BD-IPMN) and intraductal spreading of main duct-IPMN (MD-IPMN). For multifocal BD-IPMN, partial pancreatectomy would be selected to remove BD-IPMN with predictors of malignancy, while the other lesions without risk factors can be left, although total pancreatectomy might be considered if the patients have a strong family history of pancreatic cancer. Partial pancreatectomy would be also adequate procedure for MD-IPMN if negative surgical margin for high-grade dysplasia or invasive carcinoma were achieved. It has become to be well-known that patients with BD-IPMN are at increased risk for developing not only IPMN-associated pancreatic ductal adenocarcinoma (PDAC) but also PDAC independent from the IPMN. Hence, the detection of a concomitant PDAC is also an important focus for strategies after resection of BD-IPMNs. Our recent analysis of patients after partial pancreatectomy for MD-IPMN with negative surgical margin identified an unexpected recurrence pattern, which we called "monoclonal skip" recurrence. MD-IPMN seems to be disseminated in the pancreatic ductal systems and MD-IPMN with identical genetic background was detected in the remnant pancreas even in a long time after index surgery. We proposed strategies of postoperative surveillance based on characteristics and natural history of each morphological subtype.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.158-162
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• 2005

Purpose: In order to clarify the carcinogenesis mechanism from chronic atrophic gastritis toward gastric cancer, we measured the pepsinogen I and II and compared their ratio with several clinical findings. Materials and Methods: We measured the preoperative serum pepsinogen I and II by using a radio-immunoassay and compared their ratio with several clinical findings, such as tumor size, mucinous vs non-mucinous tumor, cell differentiation, tumor location, depth of invasion, lymph-node status, Lauren's classification, and peritumoral atrophy in 103 consecutive patients with gastric adenocarcinomas who had received resections at Bundang CHA Hospital during the period from July 2003 to February 2005. Results: There were significant differences in the serum pepsinogen I/II ratio between patients with mucinous vs non-mucinous tumors (n=4 vs 9 and mean pep I/II=1.29 vs. 2.99, p=0.0288), with tumor size more than and less than $10cm^2$ (n=55 vs. 48 and mean pep I/II=2.64 vs. 3.24, p=0.0491), and with or without peritumoral atrophy (n=94 vs. 9 and mean pep I/II=2.83 vs. 3.89, p=0.0466). In patients with peritomoral atrophy, the pepsinogen I/II ratio was also lower in larger tumors (n=48 vs. 46 and mean pep I/II=2.44 vs. 3.23, p=0.0083). Well-differentiated carcinomas showed significantly lower serum pep I/II ratios than signet-ring-ceil types. There was no correlation between serum pep I/II ratio and tumor location, depth of invasion, lymph-node status, or Lauren's classification Conclusion: We proved the existence of a correlation between serum pepsinogen level and musosal atrophy, but these results are not sufficient for clinical application of serum pepsinogen level as a screening tool for gastric cancer.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.212-215
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• 1998

Pulmonary mucinous cystic tumor of borderline malignancy is very rare and distinguished from bronchogenic cyst or adenocarcinoma of bronchoalveolar type. We present the case of a 63-year-old woman with a right lower lobe mass, found by chest radiographs. The preoperative diagnosis was made as bronchoalveolar cancer by percutaneous needle aspiration of mass. Right lower lobectomy and lymph node dissections were performed. The lobectomy specimen contained variable sized multilocular cystic mucous masses, filled with mucus. Microscopically, the cystic masses are lined with tall columnar mucinous epithelium but some area contains focal cellular atypism and bronchoalveolar cancer like foci. This foci are lack of cellular atypism consistent with bronchoalveolar cancer cell. After lobectomy the patient has remained free from recurrence and distant metastasis for following 12 months period. Pulmonary mucinous cystic tumor of borderline malignancy appears to have a favorable prognosis and should be distinguished from other lung neoplasms.

• Korean Journal of Veterinary Research
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• v.48 no.3
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• pp.311-316
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• 2008

A 7-year-old female Shih Tzu dog with lots of masses in the whole mammary gland was presented to the surgery department of the Veterinary Teaching Hospital in the Cheju National University. After surgical excision, all mammary samples were referred to Pathology Department of Veterinary Medicine. Grossly, masses were measuring up to $6.5{\times}4{\times}1cm$ and on cut surface of masses in right 1st, 3rd, 4th, 5th and left 1st, 3rd, 4th, 5th mammary masses were well delineated and firm, sulphur yellow, solid round to oval shape. Microscopically, most neoplastic sweat glands were severely proliferated in dermis and subcutis. Most tubules were lined by round to oval shaped epithelium with eosinophilic cytoplasm, hyperchromatic nuclei with high mitotic figures and severe central necrosis. The neoplastic epithelium also had PAS-positive diastase-resistant cytoplasmic granules, but negative with Perls iron stain. The left 2nd mass was well delineated, and had several dark brown areas and yellowish white glittered areas. Mass was well circumscribed with dense connective tissue. Neoplastic areas contained irregular sized mammary gland with papillary grown luminal epithelial cells in single or double cells layer with mitotic figures and small amounts of proliferated myoepithelial cells. Proliferated myoepithelial cells also produced slightly basophilic mucinous materials. Based on the gross, histopathologic and special staining characteristics, this dog was diagnosed as 90% of apocrine sweat gland aenocarcinoma and 10% mammary. complex adenomas in mammary masses. In our best knowledge, this is the first report for concurrent occurrence of apocrine sweat gland adenocarcinoma and mammary gland complex adenoma in mammary masses of the same dog.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.464-475
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• 2021

Objective: This study aimed to evaluate the tumor doubling time of invasive lung adenocarcinoma according to the International Association of the Study for Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) histologic classification. Materials and Methods: Among the 2905 patients with surgically resected lung adenocarcinoma, we retrospectively included 172 patients (mean age, 65.6 ± 9.0 years) who had paired thin-section non-contrast chest computed tomography (CT) scans at least 84 days apart with the same CT parameters, along with 10 patients with squamous cell carcinoma (mean age, 70.9 ± 7.4 years) for comparison. Three-dimensional semiautomatic segmentation of nodules was performed to calculate the volume doubling time (VDT), mass doubling time (MDT), and specific growth rate (SGR) of volume and mass. Multivariate linear regression, one-way analysis of variance, and receiver operating characteristic curve analyses were performed. Results: The median VDT and MDT of lung cancers were as follows: acinar, 603.2 and 639.5 days; lepidic, 1140.6 and 970.1 days; solid/micropapillary, 232.7 and 221.8 days; papillary, 599.0 and 624.3 days; invasive mucinous, 440.7 and 438.2 days; and squamous cell carcinoma, 149.1 and 146.1 days, respectively. The adjusted SGR of volume and mass of the solid-/micropapillary-predominant subtypes were significantly shorter than those of the acinar-, lepidic-, and papillary-predominant subtypes. The histologic subtype was independently associated with tumor doubling time. A VDT of 465.2 days and an MDT of 437.5 days yielded areas under the curve of 0.791 and 0.795, respectively, for distinguishing solid-/micropapillary-predominant subtypes from other subtypes of lung adenocarcinoma. Conclusion: The tumor doubling time of invasive lung adenocarcinoma differed according to the IASCL/ATS/ERS histologic classification.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.1
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• pp.72-75
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• 2018

Colorectal carcinoma is a well-known malignancy in adults. However, it is rare in children. Besides, it also has different behaviour in paediatric age-group and usually presents with non-specific symptoms like abdominal pain, weight loss, and anaemia. This usually leads to delay in diagnosis. Adenocarcinoma in children has unfavourable tumour histology (mucinous subtype) and advanced disease stage at presentation which lead to poorer prognosis in children. Family history, genetic typing and sibling screening are essential components of management as this malignancy is frequently seen associated with hereditary syndromes. We describe a case of unusual presentation of rectal carcinoma in a 12-year-old girl.