The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP)
November 29th (Friday) ~30th (Saturday), 2019 Commodore Hotel, Busan, Republic of Korea
Korean Division of IAP
The Korean Society of Pathologists
The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP) Welcome Address
Dear Colleagues,
On behalf of the Korean division of IAP and the Korean Society of Pathologists, it is my great pleasure to welcome the participants to the 16th Korea-Japan Joint Slide Conference of International Academy of Pathology.
This conference consisted of a general discussion and special lectures on the first day. On the second day, there are slide conferences by five study groups, including bone and soft tissue pathology, pulmonary pathology, endocrine pathology, genitourinary pathology and, pancreatobiliary pathology. This joint conference, which first started in 1989, is now in its 16th event. Korea and Japan have had a long established friendship, and this conference will ensure extending our pathological knowledge and promoting our friendship. We think a friend who comes in difficult times is a real friend.
The venue of this meeting is Commodore Hotel Busan, which is one of the historical place and Busan have a lot of place to see and enjoy. I appreciate for the assistance by the members of Division of Busan, Ulsan, and Gyeongnam Society. I welcome you to Busan, and the organizing committee hopes all the participants to enjoy Busan in late autumn season.
Thank you very much.
Kyo Young Lee, M.D., Ph.D. President of the Korean Division of IAP Professor, The Catholic University of Korea, College of Medicine, Seoul, Korea
3 The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP) CONTENTS
Welcome Address 3
Conference Information 5
Hotel Information 8
Program in Detail 9
1) Day 1: Slide Conference of General Session 9
2) Day 2: 13th Joint Slide Conference of Bone and Soft Tissue Pathology 13
3) Day 2: 8th Joint Slide Conference of Pulmonary Pathology 17
4) Day 2: 4th Joint Slide Conference of Endocrine Pathology 20
5) Day 2: 3rd Joint Slide Conference of Genitourinary Pathology 23
6) Day 2: 1st Joint Slide Conference of Pancreatobiliary Pathology 26
Special Lecture 39
Case Abstract of Slide Conferences
1) Day 1: Slide Conference of General Session 29
2) Day 2: 13th Joint Slide Conference of Bone and Soft Tissue Pathology 43
3) Day 2: 8th Joint Slide Conference of Pulmonary Pathology 55
4) Day 2: 4th Joint Slide Conference of Endocrine Pathology 63
5) Day 2: 3rd Joint Slide Conference of Genitourinary Pathology 71
6) Day 2: 1st Joint Slide Conference of Pancreatobiliary Pathology 75
Poster Abstract 83
4 Conference Information
✤ Title: The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology ✤ Date: November 29 - 30th, 2019 ✤ Venue: Commodore Hotel, Busan, Republic of Korea ✤ Organized by: Korean Division of International Academy of Pathology and the Korean Society of Pathologists ✤ Official language: English ✤ Director of Conference: Dr. Kee-Taek Jang Tel: +82-2-795-3094 (line: 5) E-mail: [email protected], [email protected]
1. Registration Registration fee include - Name badge - Admission to all Session Rooms, Opening Ceremony, Exhibition, and Poster Presentations - Coffee breaks (November 29th - 30th, 2019) - Admission to Welcome Banquet on November 29th, 2019 (2F, Haemaru hall) - Lunch on November 30th, 2019 (1F, Onsaemiro restaurant) 1) Registration fee for Korean Participants
Pre-registration Onsite registration
Pathology board ₩100,000 ₩110,000 Trainee/Fellow/Military Doctor ₩50,000 ₩60,000 Emeritus members Free Free
2) Registration fee for Japanese Participants: Onsite payment only
Onsite payment only
Pathology board 5,000 Yen
Trainee/Fellow/Military Doctor 5,000 Yen
Accompanying person 3,000 Yen/ Person
5 3) Registration fee for Taiwanese Participants: Onsite payment only
Onsite payment only
Pathology board 1,300 TWD or 45 USD
Trainee/Fellow/Military Doctor 1,300 TWD or 45 USD
4) Pre-registration deadline: November 17th, 2019 5) Cancellation policy (1) Cancellation is accepted only before November 22nd, 2019. (2) Call to executive office of the Korean Society of Pathologists (Tel; +82-2-795-3094, line: 5) 6) CME score: 5 points (only for members of the Korean Society of Pathologists) 7) Parking permit: Parking Free 8) Registration desk hours
Date Time Location
November 29th 14:00 - 18:30 Haemaru Hall Lobby, 2F, Commodore Hotel
November 30th 08:00 - 12:00 Haemaru Hall Lobby, 2F, Commodore Hotel
2. Name Badge 1) Collection of name badge: Registration desk 2) All participants are required to wear their badge during conference in order to enter the slide conference sessions and poster presentations.
3. Poster Presentation 1) Poster size: 90cm x 120cm 2) Presentation time: 15:00 ~ 18:00, November 29th (Friday), 2019
4. Commodore Hotel Registration 1) Group discount rate: 100,000 Won (including 10% VAT, excluding breakfast) 2) Breakfast at Onsaemiro (1st Floor): 16,000 Won/Person (7:00-10:00) 3) Contact telephone number: +82-51-466-9101 4) Registration deadline: November 15th (Friday), 2019 5) Please fill out reservation form and submit to Commodore Hotel üvia e-mail ([email protected])
5. Welcome Banquet 1) Date: November 29th (Friday), 2019 2) Time: 18:30 ~ 20:30 3) Location: Haemaru Hall, 2F, Commodore Hotel
6 6. Hotel Information 1) Please visit hotel homepage (Http: //www.commodore.co.kr) for precise information of Commodore Hotel.
7. Half-Day City Tour 1) We are very sorry that we could not prepare the half-day optional tour in this conference (due to return flight itinerary to Japan).
8. Slide Images for Cases We scanned slides (general discussion on Day 1) and uploaded images with virtual microscope system. Please visit the following link for uploaded information. We are sorry that the virtual slide is accessible with one web browser (internet explorer). 1) Case discussion http://sktc.codns.com/collibio/CollibioWorkspace.html?wid=IAP-2019&uid=guest 2) Slide conference by each study group (1) Bone and Soft Tissue Pathology http://sktc.codns.com/collibio/CollibioWorkspace.html?wid=IAP-2019&uid=guest (2) Pulmonary Pathology http://sktc.codns.com/collibio/CollibioWorkspace.html?wid=IAP-2019-2&uid=guest (3) Endocrine Pathology http://sktc.codns.com/collibio/CollibioWorkspace.html?wid=IAP-2019-4&uid=guest (4) Genitourinary Pathology http://sktc.codns.com/collibio/CollibioWorkspace.html?wid=IAP-2019-1&uid=guest
7 Commodore Hotel Busan Information
1. Venue 1) Japanese: http://www.commodore.co.kr/jpn/html/main/index.php 2) English: https://www.commodore.co.kr/eng/html/main/index.php
2. Transportation to Commodore Hotel Busan from Gimhae Airport 1) Limousine Bus from Gimhae international airport (most recommended route) (1) Please go to Bus Stop 2 (1st Floor of International terminal) (2) Please take the airport limousine bus to the Busan Station (釜山驛) (6,000 Korea won: 560 yen or 5 USD) (3) Please get off at Busan Station (not Busan Jin) and move to taxi stop in front of Busan Station. It will take 5 minutes by walking. (4) Please take a taxi to the Busan Commodore hotel (it will take 10 minutes). (5) Free shuttle bus from Busan Station: there is a hotel shuttle bus from Busan Station (in front of Tokyo-in hotel), however hotel shuttle bus depart around 12:05 pm and 12:45 pm in front of Tokyo-in hotel. 2) Taxi from Gimhae international airport: it will take 40 minutes (18,000 Korean won: 1,700 yen or 17 USD)
8 The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP)
Day 1: 2019. 11. 29. (Friday) Haemaru hall, 2F, Commodore Hotel, Busan, Korea
14:30~14:50 Registration
14:50~15:00 Opening remark & Welcome address
Kyo Young Lee, M.D., President of the Korean Division of IAP Robert Y. Osamura, M.D., President of IAP Introduction of Korean participants: Kee-Taek Jang, M.D. Introduction of Japanese participants: Toyonori Tsuzuki, M.D.
15:00~16:00 Part 1 (2 cases from Korea, 2 cases from Japan)
15:00-15:15 J-1 Moderator: Noriyoshi Fukushima Jichi Medical University, Japan Submitter: Takeo Yamamoto Kyushu University, Japan Discussant: Hye Jeong Choi Ulsan University Hospital, Ulsan, Korea
15:15-15:30 K-1 Moderator: Se Jin Jang Asan Medical Center, University of Ulsan, Seoul, Korea Submitter: Yoon-La Choi Samsung Medical Center, Sungkyunkwan University, Seoul, Korea Discussant: Takeshi Fujii Toranon Hospital, Japan
15:30-15:45 J-2 Moderator: Kenji Notohara Kurashiki Central Hospital, Japan Submitter: Hiroshi Yamaguchi Tokyo Medical University, Tokyo, Japan Discussant: Kee-Taek Jang Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
9 15:45-16:00 K-2 Moderator: Hye Jung Choi Ulsan University Hospital, Ulsan, Korea Submitter: Haeryoung Kim Seoul National University Hospital, Seoul, Korea Discussant: Takuma Tajiri Tokai University Hachioji Hospital, Japan
16:00-16:30 Poster Exhibition and Coffee break (Between Huirak hall I & II)
16:30~17:30 Part 2 (2 cases from Korea, 2 cases from Japan)
16:30~16:45 J-3 Moderator: Masanori Hisaoka University of Occupational and Environmental Health, Japan Submitter: Waki Hosoda Aichi Cancer Center, Japan Discussant: Ha Young Woo Yonsei University Severance Hospital, Seoul, Korea
16:45~17:00 K-3 Moderator: Seoung-Mo Hong Asan Medical Center, Seoul, Korea Submitter: Kee-Taek Jang, Sanhyun Shin Samsung Medical Center, Sungkyunkwan University, Seoul, Korea Discussant: Yoshiki, Naito Kurume University Hospital, Japan
17:00~17:15 J-4 Moderator: Hiroshi Minato Ishikawa Prefectural Central Hospital, Japan Submitter: Masafumi Ito Japanese Red Cross Nagoya Daiichi Hospital, Japan Discussant: Myoung Ju Go Daedong hospital, Busan, Korea
17:15~17:30 K-4 Moderator: Kyu Sang Lee Seoul National Bundang Hospital, Korea Submitter: Kee-Taek Jang, Kiwoong Sung Samsung Medical Center, Sungkyunkwan University, Seoul, Korea Discussant: Akira Satou Aichi Medical University Hospital, Japan
10 17:30~17:50 Special Lecture I Chair: Kyo Young Lee The Catholic University of Korea, College of Medicine, Seoul, Korea Lecturer: Minjung Jung Kosin University Gospel Hospital, Busan, Korea “Pathologic Diagnosis for Breast Cancer on Therapeutic Perspectives”
17:50~18:10 Special Lecture II Chair: Se Jin Jang Asan Medical Center, Seoul, Korea Lecturer: Bomi Kim Inje University Haeundae Paik Hospital, Busan, Korea “Overview of Placental Pathology”
18:10~18:20 Piano Performance Minjin Lee Seoul Red Cross Hospital
18:20~18:30 Photo time
18:30~20:30 Welcome Banquet (2F, Harmaru hall)
11 Day 2: 2019. 11. 30. (Saturday) Commodore Hotel, Busan, Korea
The 13th Korea-Japan-Taiwan Joint Slide Conference of Bone and Soft Tissue Pathology The 8th Korea-Japan Joint Slide Conference of Pulmonary Pathology The 4th Korea-Japan Joint Slide Conference of Endocrine Pathology The 3rd Korea-Japan Joint Slide Conference of Genitourinary Pathology The 1st Korea-Japan Joint Slide Conference of Pancreatobiliary Pathology
08:00~09:00 Registration 09:00~12:00 Slide Conferences: The 13th Bone & Soft Tissue pathology conference: Haemaru hall I (2F) The 8th Pulmonary pathology conference: Haemaru hall II (2F) The 4th Endocrine pathology conference: Haemaru hall III (2F) The 3rd Genitourinary pathology conference: Huirak hall I (2F) The 1st Pancreatobiliary pathology conference: Huirak hall II (2F) 12:00~12:10 Photo time 12:10~13:00 Lunch Onsaemiro restaurant (1st Floor) Commodore Hotel
12 The 13th Korea-Japan-Taiwan Joint Slide Conference of Bone and Soft Tissue Pathology
Day 2: 2019. 11. 30. (Saturday) Haemaru hall I, Commodore Hotel, Busan, Korea
Slide Conference Program
08:00~08:20 Registration
Session 08:20~11:40 Photo 11:40~12:00
General information Presentation time：20 min/each case (8 min for discussant, 7 min for submitter, and 5 min for free discussion).
08:20~08:40 Opening Ceremony 1) Opening Remarks: Prof. Joon Hyuk Choi Department of Pathology, Yeungnam University Hospital, Korea 2) Opening Address from Japan: Prof. Yoshinao Oda Department of Anatomic Pathology, Kyushu University, Japan 3) Opening Address from Taiwan: Prof. Hsuan-Ying Huang Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan 4) Introduction of the Japanese Participants: Dr. Yuichi Yamada Department of Anatomic Pathology, Kyushu University, Japan 5) Introduction of the Taiwanese Participants: Dr. Jen-Wei Tsai Department of Anatomical Pathology, EDA Hospital/University, Taiwan 6) Introduction of the Korean Participants: Dr. Kyung Jin Seo Department of Hospital Pathology, Uijeongbu St. Mary Hospital Catholic University of Korea, Korea
13 08:40~10:00 Case Presentation (1) 08:40~09:00 Case B-J-1 Moderator: Prof. Hsuan-Ying Huang Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan Submitter: Dr. Taro Mori Department of Diagnostic Pathology, Kyushu University Hospital, Japan Discussant: Dr. Kiyong Na Department of Pathology, Kyung Hee University Hospital, Korea
09:00~09:20 Case B-K-1 Moderator: Dr. Yoshinao Oda Department of Pathology, Kyushu University, Japan Submitter: Dr. Sang Kyum Kim Department of Pathology, Yonsei University Severance Hospital, Korea Discussant: Dr. Pao-Shu Wu Department of Pathology, MacKay Memorial Hospital, Taiwan
09:20~09:40 Case B-T-1 Moderator: Prof. Yong-Ku Park Department of Pathology, Kyung Hee University Hospital, Korea Submitter: Dr. Jen-Wei Tsai Department of Anatomical Pathology, EDA Hospital/University, Taiwan Discussant: Dr. Yuichi Yamada Department of Pathology, Kyushu University, Japan
09:40~10:00 Case B-J-2 Moderator: Prof. Anhi Lee Department of Hospital Pathology, Catholic University Medical College, Korea Submitter: Dr. Yu Toda Department of anatomic pathology, Kyushu University Graduate School, Japan Discussant: Dr. Shih-Yao Lin Department of Pathology, Taipei Veterans General Hospital, Taiwan
10:00~10:20 Coffee Break
14 10:20~11:40 Case Presentation (2) 10:20~10:40 Case B-K-2 Moderator: Prof. Chien-Feng Li Department of Pathology, Department of Pathology, Chi-Mei Medical Center, Taiwan Submitter: Dr. Kyung Un Choi Department of Pathology, Pusan National University Yangsan Hospital, Korea Discussant: Dr. Taro Mori Department of Pathology, Kyushu University, Japan
10:40~11:00 Case B-T-2 Moderator: Dr. Masanori Hisaoka Department of Pathology, University of Occupational and Environmental Health, Japan Submitter: Dr. Shih-Chiang Huang Department of Anatomic Pathology, Chang Gung Memorial Hospital, Chang Gung Medical University, College of Medicine, Taoyuan, Taiwan Discussant: Dr. Chang Young Yoo Department of Hospital Pathology, St. Vincent Hospital Catholic University Medical College, Korea
11:00~11:20 Case B-K-3 Moderator: Prof. Jen-chieh Lee Department of Pathology, National Taiwan University Hospital, Taiwan Submitter: Dr. Yoon-La Choi Department of Pathology, Samsung Medical Center Sungkyunkwan University School of Medicine Hospital, Korea Discussant: Dr. Chih-Hsueh Chen Department of Pathology, Taipei Veterans General Hospital, Taiwan
11:20~11:40 Case B-T-3 Moderator: Dr. Joon Hyuk Choi Department of Pathology, Yeungnam University Hospital, Korea Submitter: Dr. Yen-Wei Chien1, Hsuan-Ying Huang2, Yu-Chien Kao3 1Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 2Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
15 3Department of Pathology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan Discussant: Dr. Kyung Jin Seo Department of Hospital Pathology, Uijeongbu St. Mary Hospital Catholic University of Korea, Korea
11:40~12:00 Photo time
12:10~13:00 Lunch Onsaemiro (1st Floor) Commodore Hotel
16 The 8th Korea-Japan Joint Slide Conference of Pulmonary Pathology
Korean Cardiopulmonary Pathology Study Group (KCPSG) Japanese Pulmonary Pathology Society (JPPS)
Day 2: 2019. 11. 30. (Saturday) Haemaru hall II, Commodore Hotel, Busan, Korea
Slide Conference Program
09:00~09:20 Registration
Session 09:20~12:00 Photo 12:00~12:10
General information Presentation time：20 min/each case (8 min for discussant, 7 min for submitter, and 5 min for free discussion). Equipments are available for presentation by Windows power Point.
09:20~09:40 Opening Ceremony
1) Opening Remarks: Sun Hee Chang, MD, PhD. Ilsan Paik Hospital, Inje University, College of Medicine, Goyang, Korea 2) Opening Address from Japan : Osamu Matsubara, MD, PhD. Vice President, International Academy of Pathology Hiratsuka Kyosai Hospital, Hiratsuka, Japan 3) Opening Address from Korea : Geon Kook Lee, MD, PhD. Department of Pathology, National Cancer Center, Korea 4) Introduction of the Japanese Participants: Takeshi Fujii, MD, PhD. Department of Pathology, Toranomon Hospital Kajigaya, Kanagawa, Japan 5) Introduction of the Korean Participants: Geon Kook Lee, MD, PhD. Department of Pathology, National Cancer Center, Korea
17 09:40~10:40 Case Presentation (1) 09:40~10:00 Case K-2 Moderator: Se Jin Jang, MD, PhD. Department of Pathology, Asan Center of Cancer Genome Discovery, Asan Medical Center, Seoul, Korea Submitter: Hye Seung Lee, Wan Seop Kim, MD, PhD. Department of Pathology, Korea Clinical Laboratory, Seoul, Korea; 1Department of Pathology, Konkuk University Medical Center, Seoul, Korea Discussant: Takuo Hayashi, MD, PhD. Department of Pathology, Juntendo University School of Medicine, Tokyo, Japan
10:00~10:20 Case J-1 Moderator: Noriko Motoi, MD, PhD. Department of Pathology, National Cancer Center Hospital, Tokyo, Japan Submitter: Yuma Fukumoto, MD1, Shunichi Watanabe, MD, PhD1, Noriko Motoi, MD, PhD.2 Department of Thoracic 1Surgery and 2Pathology, National Cancer Center, Tokyo, Japan Discussant: Hwa Jin Cho, MD, PhD. Department of Pathology, Inje University Busan Paik Hospital, Busan, Korea
10:20~10:40 Case K-1 Moderator: Geon Kook Lee, MD, PhD. Department of Pathology, National Cancer Center, Korea Submitter: Heae Surng Park, MD, PhD Min-sun Cho, MD, PhD. Department of Pathology, Ewha Womans University Seoul Hospital, Ewha Womans college of Medicine, Seoul, Korea Discussant: Hiroshi Minato, MD, PhD. Department of Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
10:40~11:00 Coffee Break
18 11:00~12:00 Case Presentation (2) 11:00~11:20 Case J-2 Moderator: Takeshi Fujii, MD, PhD. Department of Pathology, Toranomon Hospital Kajigaya, Kanagawa, Japan Submitter: Mari Kirishima, Takako Tanaka, Kazumasa Hamada, Hirotsugu Noguchi, Ikumi Kitazono, Michiko Horinouchi, Tsubasa Hiraki, Michiyo Higashi, Akihide Tanimoto Department of Pathology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University Discussant: Yu-Deok Choi, MD, PhD. Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
11:20~11:40 Case K-3 Moderator: Mee Sook Rho, MD, PhD. Department of Pathology, Dong-A University Hospital, Busan, Korea Submitter: Hyeon Jeong Oh, Geon Kook Lee, MD, PhD. Department of Pathology, National Cancer Center, Korea Discussant: Yumiko Yasuhara, MD, PhD. Department of Diagnostic Pathology, Kinki Central Hospital, Itami, Japan
11:40~12:00 Case J-3 Moderator: Osamu Matsubara, MD, PhD. Department of Pathology, Hiratsuka kyosai Hospital, Hiratsuka, Japan Submitter: Masashi Kawamoto1, Yoshinori Kawabata2, Yutaka Tsuchiya3 1Department of Diagnostic Pathology, Teikyo University Hospital, Mizonokuchi, Kanagawa, Japan 2Division of Diagnostic Pathology, Saitama Cardiovascular Respiratory Center, Saitama, Japan 3Internal Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan Discussant: Jung Wook Yang, MD, PhD. Department of Pathology, Gyengsang National University Hospital, Jinju, Korea
12:00~12:10 Photo time
12:10~13:00 Lunch Onsaemiro (1st Floor) Commodore Hotel
19 The 4th Korea-Japan Joint Slide Conference of Endocrine Pathology
Day 2: 2019. 11. 30. (Saturday) Haemaru hall III, Commodore Hotel, Busan, Korea
Slide Conference Program
08:30~09:00 Registration
Session 09:00~12:00 Photo 09:15~09:20
General information Presentation time：20 min/each case (8 min for discussant, 7 min for submitter, and 5 min for free discussion). Equipments are available for presentation by Windows Power Point.
Slide Images for Cases http://sktc.codns.com/collibio/CollibioWorkspace.html?wid=IAP-2019-4&uid=guest
09:00~09:15 Opening Ceremony 1) Opening Remarks: Soon Won Hong, MD, PhD. Gangnam Severance Hospital, Yonsei University College of Medicine, Korea Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan 2) Introduction round: all participants introduce themselves
09:15~09:20 Photo
09:20~10:20 Case Presentation (1)
09:20~09:40 Case E-K-1 Thyroid Moderator: Young Lyun Oh, MD, PhD. Samsung Medical Center, Sungkyunkwan University, Korea Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan
20 Submitter: Yoon Ah Cho, MD, PhD., Young Lyun Oh, M.D. PhD. Sungkyunkwan University, Korea Discussant: Yuto Yamazaki, MD, PhD. Tohoku University Hospital, Japan
09:40~ 10:00 Case E-K-2 Thyroid Moderator: Young Lyun Oh, MD, PhD. Samsung Medical Center, Sungkyunkwan University, Korea Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan Submitter: Hee Young Na, MD, PhD., So Yeon Park, M.D., PhD. Seoul National University Hospital, Korea Discussant: Hirofumi Watanabe, MD Tohoku University Hospital, Japan
10:00~10:20 Case E-K-3 Thyroid Moderator: Young Lyun Oh, MD, PhD. Samsung Medical Center, Sungkyunkwan University, Korea Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan Submitter: Sue Youn Kim, MD, Chan Kwon Jung, M.D., PhD. The Catholic University of Korea, Seoul St. Mary’s Hospital, Korea Discussant: Toru Odate, MD. Yamanashi University Hospital, Japan
10:20~10:40 Coffee Break
10:40~11:40 Case Presentation (2)
10:40~11:00 Case E-J-1 Adrenal Moderator: Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan Young Lyun Oh, MD, PhD. Samsung Medical Center, Sungkyunkwan University, Korea Submitter: Yuto Yamazaki, MD, PhD., Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan Discussant: Seung Eun Lee, MD, PhD. Konkuk University Hospital, Korea
21 11:00~11:20 Case E-J-2 Thyroid Moderator: Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan Young Lyun Oh, MD, PhD. Samsung Medical Center, Sungkyunkwan University, Korea Submitter: Hirofumi Watanabe, MD, Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan Discussant: Hee Young Na, MD, PhD. Seoul National University Hospital, Korea
11:20~11:40 Case E-J-3 Thyroid Moderator: Hironobu Sasano, MD, PhD. Tohoku University Hospital, Japan Young Lyun Oh, MD, PhD. Samsung Medical Center, Sungkyunkwan University, Korea Submitter: Toru Odate, MD1, Tetsuo Kondo, MD, PhD.1, Ryohei Katoh, MD, PhD.2 1Yamanashi University Hospital, Japan; 2Ito Hospital, Japan Discussant: Ju Yeon Pyo, MD, PhD. Catholic Kwandong University Hospital, Korea
11:40~11:50 Discussion
11:50~12:00 Closing Remark
12:10~13:00 Lunch
Onsaemiro (1st Floor) Commodore Hotel
22 The 3rd Korea-Japan Joint Slide Conference of Genitourinary Pathology
Day 2: 2019. 11. 30. (Saturday) Huirak hall I, Commodore Hotel, Busan, Korea
Slide Conference Program
08:00~08:20 Registration
Session 08:20~11:50 Photo 11:50~12:00
General information Presentation time：30 min/each lecture (including Q&A ) 20 min/each case (8 min for discussant, 7 min for submitter, and 5 min for free discussion). Equipments are available for presentation by Windows Power Point.
08:20~08:30 Opening Ceremony
1) Opening Remarks: Gheeyoung Choe, MD, PhD. Representative, Korean Study Group of Urological Pathology 2) Introduction of the Japanese Participants: Yoji Nagashima, MD, PhD. Representative, Japan Study Group of Urological Pathology 3) Introduction of the Korean Participants: Gheeyoung Choe, MD, PhD. Representative, Korean Study Group of Urological Pathology
08:30~10:10 Lecture and Case Presentation (1)
08:30~09:00 Lecture J-1 Moderator: Yoji Nagashima, MD, PhD. Tokyo Women's Medical University Hospital, Japan Lecture Speaker: Toyonori Tsuzuki, MD, PhD. Aichi Medical University Hospital, Japan Intraductal carcinoma of the prostate
23 09:00~ 09:30 Lecture K-1 Moderator: Gheeyoung Choe, MD, PhD. Chair, Dept. of Pathology, Seoul National University College of Medicine, Korea Lecture Speaker: Yong Mee Cho, MD, PhD. Asan Medical Center, Korea Genomic landscape of young-onset bladder cancer and it's prognostic implication on adult bladder cancer
09:30~09:50 Case G-J-1 Moderator: Hiroyuki Yanai, MD, PhD. Okayama University, Japan Submitter: Kosuke Miyai, MD, PhD. National Defense Medical College, Japan Discussant: Su-Jin Shin, MD, PhD. Gangnam Severance Hospital, Yonsei University College of Medicine, Korea
09:50~10:10 Case G-K-1 Moderator: Chan Choi, MD, PhD. Chonnam National University Hwasun Hospital, Chonnam National University, Korea Submitter: Ghee Young Kwon, MD, PhD. Samsung Medical Center, Korea Discussant: Akira Sato, MD, PhD. Aichi Medical University, Japan
10:10~10:20 Coffee Break
10:20~11:40 Case Presentation (2)
10:20~10:40 Case G-J-2 Moderator: Toyonori Tsuzuki, MD, PhD. Aichi Medical University Hospital, Japan Submitter: Hiroyuki Hayashi, Fukuoka University, Japan Discussant: Hyun Jung Lee, MD, PhD. Pusan National University Yangsan Hospital, Korea
10:40~11:00 Case G-K-2 Moderator: Yeong Jin Choi, MD, PhD. Seoul St. Mary's Hospital, The Catholic University of Korea, Korea
24 Submitter: Kyu Sang Lee, MD. PhD. Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea Discussant: Yoji Nagashima, MD, PhD. Tokyo Women's Medical University Hospital, Japan
11:00~11:20 Case G-J-3 Moderator: Yoji Nagashima, MD, PhD. Tokyo Women's Medical University Hospital, Japan Submitter: Fumiyoshi Kojima, Wakayama Medical University, Japan Discussant: Kyung Chul Moon, MD, PhD. Seoul National University College of Medicine, Korea
11:20~11:40 Case G-K-3 Moderator: Nam Hoon Cho, MD, PhD. College of Medicine, Yonsei University, Korea Submitter: Young Sub Lee, MD. Seoul St. Mary's Hospital, The Catholic University of Korea, Korea Discussant: Hiroyuki Yanai, MD, PhD. Okayama University, Japan
11:40~11:50 Concluding remark
11:50~12:00 Photo time
12:10~13:00 Lunch
Onsaemiro (1st Floor) Commodore Hotel
25 The 1st Korea-Japan Joint Slide Conference of Pancreatobiliary Pathology
Day 2: 2019. 11. 30. (Saturday) Huirak hall II, Commodore Hotel, Busan, Korea
Slide Conference Program
08:45~12:00 Case discussion and Mini-lectures
Opening remark 08:45 ~ 09:00 Case Discussion 09:00 ~ 10:30 Photo & Coffee Break 10:30 ~ 11:00 Mini-lectures 11:00 ~ 12:00
General information Case discussions: 3 cases from Japan, 3 Cases from Korea 15 min/each case (10 ~ 12 min. for presentation, 3 ~ 5 min. for discussion). Mini-lectures: 30 minutes by Korea (Seung-Mo Hong) & Japan (Yoko Matsuda).
08:45~09:00 Opening Remark and introduction of participants
1) Opening Remarks: Kee-Taek Jang, Representative, Pancreatobiliary Pathology Club of KSP Toru Furukawa, Chair of Japanese Pancreatobiliary Pathology Club 2) Introduction of the Japanese Participants: Noriyoshi Fukushima, Vice-chair, Japanese Pancreatobiliary Pathology Club 3) Introduction of the Korean Participants: Kee-Taek Jang, Representative, Pancreatobiliary Pathology Club of KSP
09:00~10:30 Moderator: Seoung-Mo Hong, Noriyoshi Fukushima
09:30~09:15 PB-K-1 Submitter: Kee-Taek Jang Department of Pathology, Samsung Medical Center Unusual cystic lesion of the pancreas tail
26 09:15~09:30 PB-J-1 Submitter: Yoko Omori Tohoku University Hospital A case of pancreatic head tumor with rare histology in an old male
09:30~09:45 PB-K-2 Submitter: Hye Jung Choi Ulsan University Hospital, Ulsan, Korea Unusual liver mass
09:45~10:00 PB-J-2 Submitter: Toshihiro Haga Hirosaki University Graduate School of Medicine A rare case of tumor-forming pancreatitis
10:00~10:15 PB-K-3 Submitter: Haeryoung Kim Department of Pathology, Seoul National University Hospital, Seoul A case of a pancreatic head tumor with ambiguous histology
10:15~ 10:30 PB-J-3 Submitter: Kenji Notohara Kurashiki Central Hospital Gallbladder polyp of a teenager
10:30~11:00 Photo time & Coffee Break
11:00~12:00 Mini-Lectures (Moderator: Kee-Taek Jang / Toru Furukawa)
11:00~11:30 Seoung-Mo Hong Asan Medical Center, Seoul, Vascular invasion in pancreatic cancer
11:30~12:00 Yoko Matsuda Depart. of Pathology and Host-Defense, Faculty of Medicine, Kagawa University, Japan Pancreatic Relationships with Aging, Cancer and Tissue Stem Cells
12:00~12:10 Closing remark
12:10~13:00 Lunch
Onsaemiro (1st Floor) Commodore Hotel
27
The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP)
Day 1: 2019. 11. 29. (Friday) Haemaru hall, Commodore Hotel, Busan, Korea The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP)
Day 1: 2019. 11. 29. (Friday) Haemaru hall, Commodore Hotel, Busan, Korea
J-1 Pancreas, 63 year old female
Submitter: Takeo Yamamoto1), Yutaka Koga1), Yoshinao Oda1) Institution: 1)Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University Organ: Pancreatic tumor Clinical history: Sixty-three year-old female patient was admitted to our hospital for examination of a pancreatic tumor, which was found during a checkup on abdominal ultrasonography. Abdominal computed tomography revealed a 20 mm pancreatic mass located in the pancreatic body. Based on preoperative examinations, we diagnosed the tumor as a pancreatic neuroendocrine tumor, and then performed a laparoscopic spleen-preserving distal pancreatectomy. The resected pancreas was containing a well-circumscribed and solid mass, and its cut surface was white.
30 K-1 Lung and pleura mass, 49 year old Male
Submitter: Yoon-La Choi, Joungho Han Institution: Department of Pathology and Translational Genomics, Samsung Medical Center, Seoul Tumor organ: lung History: A man 49 years of age who smoked with 10 pack-year presented with dyspnea and right flank pain. He was treated on the provisional diagnosis of pneumothorax but symptom was not relieved. The computed tomography (CT) of his chest showed a malignant right pleural effusion with multiloculation as the manifestation of malignant pleural effusion. A presumed primary tumor in the superior segment of the right lower lobe with atelectasis was also found. The emergency palliative chemotherapy was started due to rapid progression. The primary debulking surgery of pleural mass was performed. The submitted slide was taken from pleural excision specimen.
31 J-2 Pancreas, 50 year old female
Submitter: Hiroshi Yamaguchi Institution: Division of Diagnostic Pathology, Tokyo Medical University Case Subspecialty: Digestive system Organ and Specimen Type: Pancreas (head) and bile duct, Surgical specimen Clinical History: A 50-year old Japanese woman visited our hospital because of right upper abdominal pain. Although serum tumor markers were within normal range, pancreatic-head mass and multiple lymph-node metastases were detected by imaging studies (such as computed tomography, magnetic resonance image and ultrasonography). Endoscopic ultrasound-guided fine needle biopsy both from a pancreatic head mass and a lymph node revealed malignancy. She underwent pylorus preserving pancreatoduodenectomy. Two representative slides will be demonstrated.
32 K-2 Duodenum tumor, 49 year old Male
Submitter: Haeryoung Kim Institution: Department of Pathology, Seoul National University Hospital Tumor organ: Duodenum History: A 49 year old male without previous surgico-medical illness visited the outpatient clinic complaining of abdominal pain and melena. An abdominal CT revealed thickening of the duodenal wall. He underwent a Whipple operation under the impression of a malignant duodenal neoplasm. Submitted slide is a representative section from the duodenal mass.
33
J-3 Soft tissue tumor, 79 year old male
Submitter: Waki Hosoda, Eiichi Sasaki, Katsutoshi Seto, Masataka Haneda, Yoshiko Murakami, Seiichi Kato, Shiro Fujita, Katsuhiro Masago, and Yasushi Yatabe Institution: Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Cancer type: soft tissue tumor Clinical history & histologic findings: Patient is a man aged 79 who had been well until 3 months before the visit to our hospital when a persistent shoulder pain developed. He had had a history of hitting his shoulder hard in his 30s, and since then he had noticed a lump in his shoulder. He was seen by his orthopedic surgeon at another clinic where X ray of the shoulder revealed a calcified mass near the shoulder joint. He was referred to our orthopedic surgery for further evaluation and treatment. CT of the shoulder revealed a well-circumscribed solid tumor in the trapezoid muscle, measuring 68mm in greatest dimension, characterized by numerous fine calcifications in the periphery of the tumor. Biopsy was performed, and the tumor was diagnosed as atypical spindle cell proliferation, suspicious for sarcoma. Wide resection of the shoulder tumor was performed. Histologically, the tumor consisted of homogeneous, short spindled neoplastic cells with round to oval nuclei, growing in a trabecular or fascicular fashion. Tumor cells were accompanied by hyalinized and partly calcified collagenous stroma. Mitotic activity was low (0-1/ 10HPF), and no tumor necrosis was seen. Immunohistochemically, tumor cells were all negative for cytokeratin, p63, S100, Desmin, CD34, HMB45, MITF, SOX10, TTF1, SATB2, TFE3, TLE1, ERG, EMA, MUC4, and beta-catenin. Ki67 LI was 1%.
34
K-3 Pancreas, 52 year old female
Submitter: Kee-Taek Jang1), Sanghyun Shin2) Institution: 1)Department of Pathology and Translational Genomics, Samsung Medical Center, Seoul 2)Department of Surgery, Samsung Medical Center, Seoul Tumor organ: Pancreas History: A female patient with 52 years old age admitted hospital with chief complain of abdominal pain. Her past medical history was unremarkable and laboratory finding were within normal range except for increased CEA level (10.54 ng/ml). The abdominal computed tomography revealed a large solid and cystic mass in pancreas tail portion, measuring 5 cm. She underwent laparoscopic RAMPs operation under the impression of malignant solid pseudopapillary tumor or mucinous cystic neoplasm. The submitted slide was taken from resected specimen.
35
J-4 Mediastinum mass, 63 year old male
Submitter: Masafumi Ito ([email protected]) Institution: Department of Pathology, Japanese Red Cross, Nagoya 1st. Hospital Organ: A case of large cystic mediastinal tumor Clinical history: Sixty-three year-old male patient consulted internal medicine by bloody sputum 2 weeks continued, and large mediastinal mass was pointed out. He was introduced our Department of Respiratory Surgery. Chest CT-graph demonstrated large cystic mass (12x12x16cm) in right lower middle mediastinum from bifurcation of trachea to right lower lobe. PET examination revealed high integrated FDG signal on partial cyst wall. He was treated by cyst drainage. Bloody fluid was aspirated and cytology examination was negative and no infectious agent was found out. Mediastinal tumor resection and right lower lobectomy was done. Macroscopic findings: Mediastinal tumor was large monocytic lesion with 16cm diameter. Fibrous thicken cyst wall was adhered to RLL. Necrotic bloody fluid was contained in cyst. Cyst wall was irregular thickened fibrous tissue with focally whitish tumor lesion. Lung had no evidence of focal lesion.
What is the pathological diagnosis?
36 K-4 Skin, 20 year old Male
Submitter: Kee-Taek Jang1), Kiwoong Sung2) Institution: 1)Department of Pathology and Translational Genomics, Samsung Medical Center, Seoul 2)Department of Pediatrics, Samsung Medical Center, Seoul Tumor organ: Skin History: A 20-year-old male patient had a past medical history of brain tumor of pilocytic astrocytoma in cerebellum 3 years ago. He underwent a surgical tumor removal and received a chemoradiation therapy. Recently, targeted therapy of vemurafenib was administered. Several small cutaneous pigmented lesions, measuring less than 1 cm, were developed in scalp and fifth toe after vemurafenib treatment. Submitted slide was taken from pigmented lesion of fifth toe skin, measuring 4 mm.
37
The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP)
- Special Lecture - Special Lecture I
Pathologic Diagnosis for Breast Cancer on Therapeutic Perspectives
Minjung Jung, M.D., Ph.D.
Department of Pathology, Gospel Hospital, Kosin University, Busan, Korea
Treatment for breast cancer are determined on basis of its stage and some special clinical and histopathologic findings. By the most recent AJCC system, breast cancer can be assigned by traditional anatomic stage groups as well as pathological prognostic stages based on the additional pathologic and genomic findings, such as tumor grade, results of three biomarkers of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) and genomic profiles using multigene assay. In addition to the stage, various histopathological findings and results of biomarkers are used to make decision of treatment strategies in terms of locoregional treatment and systemic treatment. The criteria of pathologic assessment may be different according to disease or type of treatment. For example, an adequacy of surgical margin for invasive carcinoma and associated ductal carcinoma in situ (DCIS) is “no ink on tumor” in contrast to “at least 2 mm width” for DCIS. However, if the size of the invasive carcinoma does not exceed 1 mm, the criteria for adequate margin is “at least 2 mm width” instead of “no ink on tumor”. In addition, when applying radiation therapy, invasive breast cancer (T1-2N0M0) adopts different criteria, “1 mm width”. For another example, the application of chemotherapy may vary depending on histologic type and results of multigene assay, even in breast cancer with same results of biomarker and same stage. Here I present the key pathologic findings used as selection criteria for each treatment and new changes of treatment approach.
Keywords: Breast, Cancer, Histopathologic, Stage, Treatment
40 Special Lecture II
Overview of Placental Pathology
Bomi Kim, M.D.
Department of Pathology, Inje University Haeundae Paik Hospital, Busan, South Korea
Contents: The placenta is a unique temporary organ that is connected with the maternal and fetal origin. This organ delivers nutrition and oxygen from mother to fetus, excretes waste products from fetus to mother, prevents rejection of the fetal allograft and secretes hormones for maternal metabolism and fetal development. During the pregnancy period, the placenta develops and shows various histologies for the gestational age. Although the placenta is not a rare specimen in the pathologist's work field, placental pathology is not familiar to us. Here, I am going to review placental histology and development briefly and introduce general placental pathology and clinical significance based on Amsterdam Placental Workshop Group Consensus statement. Amsterdam Placental Workshop Group reported sampling and definition of placental lesions in 2016 to standardize placental pathology. They suggested placental lesions should be classified as maternal vascular malperfusion, fetal vascular malperfusion, delayed villous maturation and villitis of unknown etiology.
Keywords: Placenta, Surgical Pathology, Chorionic villi, Perfusion, Growth and Development
41
The 13th Korea-Japan-Taiwan Joint Slide Conference of Bone and Soft Tissue Pathology
Day 2: 2019. 11. 30. (Saturday) Haemaru hall I, Commodore Hotel, Busan, Korea The 13th Korea-Japan-Taiwan Joint Slide Conference of Bone and Soft Tissue Pathology
Day 2: 2019. 11. 30. (Saturday) Haemaru hall I, Commodore Hotel, Busan, Korea
B-J-1 Tumor of lower leg, 17 years old female
Taro Mori, Yuichi Yamada, Yoshinao Oda
Department of Diagnostic Pathology, Kyushu University Hospital, Japan
[Clinical history] When she was 8 years old, she suffered from bilateral ankle and knee pain. Refractory hypophosphatemic osteomalacia with high level of serum FGF23 was pointed out from 11 years old. Small mass in left back was resected at 13 years old. When she was 14 years old, right thigh and left lower leg, left lung tumors were resected. At this time, she was affected by 15cm-sized left lower leg tumor. The tumor was suspected to be a recurrence of primary lesion, and amputation was carried out.
[Family history] Normal serum phosphorus level, No consanguineous marriage
[Physical examination] Reddish brown mass (15x9cm) in the exterior of the left lower leg With heat, internal hemorrhage and focal disintegration Hypesthesia, paralysis and pain of tibial nerve region
[Laboratory data (17 y.o.)] IP 0.8 mg/dL, FGF23 1,300 pg/mL
[Imaging findings] - 11 y.o.: Plain radiography revealed widened growth plate with fuzzy, irregularly mineralized metaphyseal interface zones in bilateral knee and ankle joint. - 13 y.o.: MRI showed T1 iso, T2 high intensity mass in the left trapezius muscle. - 14 y.o.: MRT revealed T1 iso, T2 high small nodules in the right thigh and left lower leg. PET-CT showed bright nodule in the same areas. Chest CT demonstrated multiple 44 small nodules in bilateral lungs. - 17 y.o.: Plain radiography showed huge soft tissue mass with bone erosion in the left lower leg. MRI T1 and T2 fat suppression reveals huge soft tissue tumor involving tibia and fibula, as well as neurovascular bundles. PET-CT reveals extremely bright mass.
[Discussion point] Pathological diagnosis
Plain X-P : Bilateral Knee (11 y/o) and MRI: Back, left (13 y/o) T1 (middle), T2 (right)
MRI : Thigh, right (14 y/o), T1 (left) and T2 (right)
MRI, PET/T : Lower leg, left (14 y/o), T1 (left) and T2 (right)
45 Xp and MRI : Lower leg, left (17 y/o), T1 FS (middle), T2 FS (right)
46 B-K-1 Femur Bone Mass, 61 years old Male
Sang Kyum Kim
Department of Pathology, Yonsei University Severance Hospital, Korea
He had no specific medical history. Recently, he has visited the hospital due to a generalized myalgia and a weight loss. He had a pelvic pain when he walked. MRI imaging studies revealed an approximately 2.2 x 1.4 cm sized lobulated enhancing subcortical mass at anterior aspect of right femur neck. A brief summary of the results of initial evaluation is provided below. Next, bone curettage from the right femur neck was performed.
[MRI both hip]
[PET-CT Ga-68 DOTATOC] Multiple sites of increased Ga-68 DOTATOC uptake are noted in the bilateral bony ribs, left proximal femora, both proximal fibulae, right distal tibia and right calcaneus, suggestive of insufficiency fractures. Most intense Ga-68 DOTATOC accumulation is seen in the right femoral neck.
[Blood chemistry]
47 B-T-1 Left kidney tumor, 31-year-old male
Jen-Wei Tsai1, Hsuan-Ying Huang2
1Department of Anatomical Pathology EDA Hospital/EDA University, Kaohsiung, Taiwan 2Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
This 31-year-old male is a patient of ankylosing spondylitis treated by COX 2 inhibitor for about ten years. He sought for medical assistance for dull and sharp pain over left lower quadrant off and on since four months ago. CT scan revealed a 7.8 cm infiltrative tumor arising from left kidney with renal vein tumor thrombosis and paraaortic retroperitoneal lymphadenopathy. Under the impression of renal cell carcinoma, he was admitted for surgical resection.
48 B-J-2 Lower leg tumor, 55 years old female
Yu Toda, Yuichi Yamada, Kenichi Kohashi, Yoshinao Oda
Department of anatomic pathology, Kyushu University Graduate School, Japan
Chief complaint: Rt. Lower leg mass
History of present illness: Soft tissue mass was accidentally found in rt. lower leg. Tumor had been grown up for 5-6 months. The result of magnetic resonance imaging suggested the possibility of neoplastic lesion. Past medical history: Moderate mental retardation Physical examination: Soft tissue mass (10cm) in the medial aspect of the right lower leg was elastic hard and showed no mobility. No pain.
Imaging findings: - Plain radiography: Radiolucent soft tissue mass in the medial site of the right lower leg. Scalloping of the external surface of the cortex of the diaphysis was observed in the right tibia. - Magnetic resonance imaging (MRI): Soft tissue mass was homogenous and of low signal on T1 weighted images, whereas on STIR it showed iso to muscle and high signals. The signal changes in the intraosseous findings were not evident. - Position emission tomography/computer tomography scan (PET-CT): 18-F-fluorodeoxyglucose was mildly up-taken (SUV-MAX: 2.93).
Clinical outcome: Open biopsy was performed. Biopsy specimen revealed the feature of malignant small round cell tumor with prominent desmoplasia. She underwent wide resection under general anesthesia. Four months after the surgery, multiple lung metastases were found. Palliative care was selected based on the result of conference with her family.
49 Discussion point: Diagnosis
T1W1 (left) STIR (right)
50 B-K-2 Axillary masses, 25 years old Male
Kyung Un Choi
Department of Pathology, Pusan National University Hospital, Korea
A 25-year-old woman found a mass at the right axilla about two months ago. She had no other notable symptoms and visited a hospital for an evaluation. There wasn't any specific information relevant to this matter in her past history, family history or laboratory examination. A MRI finding showed four mases (3.8x3.8x1.2 cm, 4.2x3.4x2.7 cm, 3.1x1.9x1.4 cm, 1.6x1.2x0.9 cm) at right axillary area. T1WI and T2WI showed homogeneous low SI and heterogenous high SI. Strong high SI was seen on T2 FS image. Clinical impression was neurogenic tumor, such as neurofibroma. Three masses were surgically removed. The cut surface was yellowish white with foci of hemorrhage, necrosis and cystic change.
51 B-T-2 Bone tumor of left mandible, 30-year-old man
Shih-Chiang Huang1, Jen-Chieh Lee2
1Department of Anatomic Pathology, Chang Gung Memorial Hospital, Chang Gung Medical University, College of Medicine, Taoyuan, Taiwan 2Department of Pathology, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan
A 30-year-old man had complained of painless swelling at left chin for several months. The computed tomography revealed an expansile intra-osseous soft tissue mass in left mandible, measuring 7.8x4.8x3.5 cm in size. Segmental mandibulectomy was performed.
without contrast with contrast
bone window
52 B-K-3 Uterus mass,58 years old female
Yoon-La Choi
Department of Pathology, Samsung Medical Center Sungkyunkwan University School of Medicine Hospital, Korea
A 58-year-old female patient visited the hospital as a symptom of vaginal bleeding. In D/C/B, the histologic findings suggested undifferentiated carcinoma. The pelvic MRI showed a huge uterine malignant solid mass. The patient had TAH with BSO surgery. The slide was taken from the uterine mass.
53 B-T-3 Tumor of cervical spine, 1-year-11-month-old girl
Yen-Wei Chien MD1, Hsuan-Ying Huang MD2, Yu-Chien Kao MD3
1Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan 2Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan 3Department of Pathology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
A 1-year-11-month-old girl presented with limited range of motion of the neck for 3 months, weakness of right arm and leg for 2 weeks, and neck pain and sleep disturbance for 3 days. Magnetic resonance imaging revealed a heterogeneous, ill-defined mass, measuring 4.0 x 3.3 x 2.7 cm in size, in the posterior C1-C2 region with foramen magnum extension. C1 laminectomy and partial resection were performed for histological diagnosis.
54 The 8th Korea-Japan Joint Slide Conference of Pulmonary Pathology Korean Cardiopulmonary Pathology Study Group (KCPSG) Japanese Pulmonary Pathology Society (JPPS)
Day 2: 2019. 11. 30. (Saturday) Haemaru hall II, Commodore Hotel, Busan, Korea The 8th Korea-Japan Joint Slide Conference of Pulmonary Pathology Korean Cardiopulmonary Pathology Study Group (KCPSG) Japanese Pulmonary Pathology Society (JPPS)
Day 2: 2019. 11. 30. (Saturday) Haemaru hall II, Commodore Hotel, Busan, Korea
L-J-１: 56-year-old male, lung (left S10, segmentectomy)
Submitter: Yuma Fukumoto, MD1), Shunichi Watanabe, MD, PhD1), Noriko Motoi, MD, PhD2) Department of Thoracic Surgery1) and Pathology2) National Cancer Center, Tokyo, Japan
A 56-year-old male, manufacturing engineer Chief complaint: No symptoms (incidental pulmonary shadow detected on CT images.) Past history: hypertension, urinary calculi Smoking history: Past smoker (10 cigarettes per day×8 years, Brinkman’s index 80) Present history: Chest CT scan showed a part-solid ground glass opacity in the left S10, 11 mm in the maximal diameter, with low uptake of PET-CT scan (SUV max =1). There was no change in size between 3 months. Diagnosis: Lung cancer, suspect of adenocarcinoma Operation: left S10 segmentectomy by VATs
CT MRI
Cut surface of resected lung specimen showed a congestive indistinct lesion.
56 L-K-1 : 53-year-old male, lung (right lower lobe, wedge resection)
Submitter: Heae Surng Park, Min-sun Cho Department of Pathology, Ewha Womans University Seoul Hospital, Ewha Womans College of Medicine, Seoul, Korea
History: A 45-year-old male was referred due to multiple lung nodules which were incidentally found during health check-up. He recently diagnosed adenocarcinoma in situ of ascending colon after endoscopic polypectomy. He manages horses in the racetrack and is a current smoker (35 pack year). Chest CT showed multiple variable-sized nodules as well as pulmonary emphysema and nonspecific subpleural fibrosis in both lungs. Wedge resections of right upper and lower lobe of the lung were performed. On gross examination, black, ovoid solid nodules were identified and the surrounding lung parenchyma was slightly fibrotic. After histopathological examination, the nodules turned out benign intrapulmonary lymph nodes. A representative section of the surrounding lung parenchyma of right lower lobe was submitted.
57 L-J-2: An endobronchial tumor of the right inferior lobar bronchus in a 39-year-old woman
Submitter: Mari Kirishima, Takako Tanaka, Kazumasa Hamada, Hirotsugu Noguchi, Ikumi Kitazono, Michiko Horinouchi, Tsubasa Hiraki, Michiyo Higashi, Akihide Tanimoto Department of Pathology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University
A 39-year-old woman who had persistent productive cough after being treated with antibiotics for 2 months was presented for examination. Chest radiograph showed atelectasis in the right lower lobe, and an endobronchial tumorous lesion was suspected on the computed tomography (CT) scan. Bronchoscopy was conducted, and a biopsy was performed on the endobronchial tumor of the right inferior lobar bronchus. After the pathological diagnosis was confirmed, right middle and lower lobectomy was performed. Macroscopically, on the cut surface of the resected lobe, a whitish polypoid tumor measuring 18x16x12 mm protruded into the right inferior lobar bronchus, causing atelectasis in the peripheral lobe. Hematoxylin and eosin (H&E)-stained section of the tumor was submitted for histopathological analysis.
58 L-K-2: 36-year-old female, lung (left upper lobe, wedge resection)
Submitter: Hye Seung Lee, Wan Seop Kim1 Department of Pathology, Korea Clinical Laboratory, Seoul, Korea; 1Department of Pathology, Konkuk University Medical Center, Seoul, Korea
She was a 36-year-old woman who had a sore throat a month ago from March 2011. She visited the hospital with a cough that did not improve, yellow phlegm, and difficulty breathing that worsened during exercise. There was no specific past, social, drug, or family history, and there were no specific findings on blood tests. Chest computed tomography showed diffuse miliary nodules, patchy consolidation, ground-glass opacities in both lung, as well as pneumomediastinum. There was no pleural effusion or enlarged lymph nodes. In May 2011, the patient performed a thoracoscopic biopsy to diagnose the condition that did not improve well with antibiotics and steroids.
59 L-J-3: 77-Year-Old Male
Submitter: Masashi Kawamoto1), Yoshinori Kawabata2), Yutaka Tsuchiya3) 1)Department of Diagnostic Pathology, Teikyo University Hospital, Mizonokuchi, Kanagawa, Japan 2)Division of Diagnostic Pathology, Saitama Cardiovascular Respiratory Center, Saitama, Japan 3)Internal Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
A 77-Year-Old Male was admitted to B hospital because of reducing food intake and developing lethargy. Medical check-up revealed fever less than 38 ℃, C-reactive protein: 10.7mg/dL, and multiple nodular shadows in bilateral lungs. He received antibiotics therapy (Ceftriaxone:2g/day、 Clarithromycin:400mg/day), but pulmonary shadow was getting worse. Thirty seven days after hospitalization, the patient was transferred to C hospital. Twelve years before, he suffered from cerebral hemorrhage, followed by higher brain dysfunction and symptomatic (secondary) epilepsy. Since then, he had been in a wheelchair for life having right side hemiparesis. He was ex-smoker (50 pack-years) and no drinking history. On presentation to C hospital, the temperature was 35.8℃, the heart rate 78 beats per minute, the blood pressure 97/63 mmHg, and the respiratory rate 20 breaths per minute. The oxygen saturation (SpO2) was 97% while he was receiving oxygen through a nasal cannula at a rate of 2 liters per minute. No apparent abnormality was heard on auscultation of chest and heart.
[Laboratory Data (abnormal datum is underlined)] White-cell count: 8,690/μL (Neutro 51.1%, Eosino 5.6%, Lymph 32.3%, Mono 10.8%), Hemoglobin: 12.1g/dL, Platelet count: 201,000/μL, Total protein: 6.3g/dL, Albumin: 2.5g/dL, AST(GOT):22U/L, ALT(GPT): 8U/L, Lactate dehydrogenase: 161U/L, Urea nitrogen:7.4mg/dL, Creatinine:0.52mg/dL, Sodium: 134mEq/L, Potassium: 4.8mEq/L, Chroride: 99mEq/L, Calcium: 8.3mEq/L, C-reactive protein: 3.75mg/dL, Rheumatoid factor: 4 IU/mL, Antinuclear antibody<40, Anti cyclic citrullinated peptide antibody (-), Proteinase 3- antineutrophil cytoplasmic antibody(ANCA) (-), Myeloperoxidase-ANCA(-), Angiotensin converting enzyme:13.2 U/L, Carcinoembryonic antigen: 8.4ng/ml, Prostate specific antigen: 7.2 ng/mL, β-D glucan: 56.9pg/ml, Aspergillus galactomannan antibody: 3.3, Cytomegaloviral antibody(-), Cryptococcus neoformans antibody(-), Candida antibody(-), Procalcitonin :0.07ng/mL, Anti-Mycobacterium avium complex antibody(-), QuantiFeron (-), Sputum culture: normal flora, Mycobacteria culture: sputa(-), peripheral blood(-), Tuberculin reaction(-)
Clinical symptom and data suggested malignancy and/or pulmonary fungal infection. Nine days later, bronchoscopic examination was performed, but neither malignancy, nor infective microorganism was found. Computed tomographic images taken 2 days before bronchoscopy are shown below. To reach diagnosis, video assisted thoracoscopic lung biopsy (submitted specimen) was performed (1 month after hospitalization in C hospital).
Additional information: We performed Ziehl-Neelsen staining and Methenamine silver-nitrate staining, but no apparent infective microorganism was found.
60 Acknowledgments: We are grateful to Dr. Takuo Hayashi and Dr. Syu Hiai, (Department of Pathology, Juntendo University) for generously providing us with the specimens.
61 L-K-3: A solid mass in right lower lobe, a solid nodule in left lower lobe and multiple subsolid nodules in both lungs in a 71-year-old female
Submitter: Hyeon Jeong Oh, Geon Kook Lee Department of Pathology, National Cancer Center, Korea
A 71-year-old female, who had abnormal chest X-ray findings in regular health check in Dec 2018, showed a 3.4 cm solid mass in right lower lobe, a solid nodule in left lower lobe, and multiple sub-solid nodules in both lungs in chest CT scan of Feb 2019. The lesions had not changed until May 2019. Transbronchial EBUS biopsy of RLL bronchus showed nonspecific inflammatory changes. The patient is a non-smoker and has no familiar history of cancer. Lobectomy of right lower lobe was performed in May 2019. The representative CT images and a gross photo of cut surface of the lesion are as follows, and a representative HE section of the tumor has been submitted.
62 The 4th Korea-Japan Joint Slide Conference of Endocrine Pathology
Day 2: 2019. 11. 30. (Saturday) Haemaru hall III, Commodore Hotel, Busan, Korea The 4th Korea-Japan Joint Slide Conference of Endocrine Pathology
Day 2: 2019. 11. 30. (Saturday) Haemaru hall III, Commodore Hotel, Busan, Korea
Slide Images for Cases http://sktc.codns.com/collibio/CollibioWorkspace.html?wid=IAP-2019-4&uid=guest
Endocrine Cases
Case Organ Institution Submitter Discussant
E-K-1 Thyroid Samsung Yoon Ah Cho, MD and Yuto Yamazaki, MD, medical center Young Lyun Oh, MD Tohoku U
E-K-2 Thyroid Seoul National Hee Young Na, MD and Hirofumi Watanabe, MD, University So Yeon Park MD Tohoku U Bundang Hospital
E-K-3 Thyroid Seoul St. Sue Youn Kim, MD and Toru Odate, MD, Mary’s Hospital Chan Kwon Jung, MD U of Yamanashi
E-J-1 Adrenal Tohoku Yuto Yamazaki, MD and Seung Eun Lee, MD university Hironobu Sasano, MD Konkuk U hospital
E-J-2 Thyroid Tohoku Hirofumi Watanabe, MD Hee Young Na, MD university and Hironobu Sasano, Seoul National U hospital MD
E-J-3 Thyroid University of Toru Odate, MD, Tetsuo Ju Yeon Pyo, MD Yamanashi, Kondo, MD and Ryohei Catholic Kwandong U ItoHospital Katoh, MD
64 E-K-1: A 36-year-old man presenting with thyroid nodule
Yoon Ah Cho, M.D. and Young Lyun Oh, M.D.
Department of Pathology and Translational genomics, Samsung medical center, Sungkyunkwan University, Seoul, Korea
A 36-year-old man was incidentally discovered with right thyroid nodule on the chest computed tomography (CT) scan for a previous rib fracture. He has not received radiation on the head and neck before. No known family history of endocrine disease was detected. Nor did he have medical or surgical history. Chest CT showed 16.9 mm infiltrative non-enhancing nodule on the right thyroid lobe. Serum levels of free triiodothyronine, free thyroxine, and thyroglobulin were within normal ranges. A pre-operative serum calcitonin was elevated up to 392.0 pg/mL (normal range of 1.9-9.6 pg/ml). The patient underwent total thyroidectomy with selective cervical lymph node dissection.
Virtual slides 1. https://nagasaki.pathpresenter.net/publicDisplay/DisplayCase/cf37ef95-f559-476b-9f76-692263547228 2. https://nagasaki.pathpresenter.net/publicDisplay/DisplayCase/b0d56769-58d1-4281-b903-634fece4a929
65 E-K-2: A 45-year-old woman presenting with neck swelling and cough
Hee Young Na, M.D. and So Yeon Park, M.D.
Department of Pathology, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea
A 45 year-old previously healthy woman presented with neck swelling and cough. The symptoms started 5 days before her visit. Neck Computed tomography (CT) revealed a 7.7 cm-sized mass in right thyroid lobe, and bilateral neck and mediastinal lymph node enlargement suggesting thyroid cancer metastasis. The patient underwent total thyroidectomy, central neck dissection and bilateral modified neck dissection. Gross examination revealed a huge whitish mass replacing the right lobe of the thyroid. The mass was invading to trachea.
Virtual slides 1. https://nagasaki.pathpresenter.net/publicDisplay/DisplayCase/57a67a72-0630-40b8-a605-e185b44024ec 2. https://nagasaki.pathpresenter.net/publicDisplay/DisplayCase/d13d99f7-8aa2-4b3c-99b9-257957f2d207
66 E-K-3: A 28-year-old man presenting with thyroid nodule
Sue Youn Kim, M.D. and Chan Kwon Jung, M.D.
Department of Pathology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
A 28-year-old man with no significant past medical history presented with a thyroid nodule incidentally discovered on neck ultrasound imaging. Thyroid ultrasonography showed a 6.1 x 3.9 x 3.4 cm well circumscribed nodule with mild hypoechogenicity in the left thyroid. Serum levels of thyroid-stimulating hormone (TSH), triiodothyronine (T3), free thyroxine (T4), and calcitonin were within normal ranges. The patient underwent left lobectomy and left central lymph node dissection.
Virtual slides https://nagasaki.pathpresenter.net/publicDisplay/DisplayCase/831d5475-fb1f-472f-abdc-daa9906b40fc
67 E-J-1: A 62-year-old female harboring adrenal mass
Yuto Yamazaki, M.D and Hironobu Sasano, M.D
Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
A 62-year-old previously healthy woman was pointed out her hypertension (SBP: 180mmHg) and diabetes mellitus and presented headache. She was started to be medicated with anti-hypertensive agents. Based on the result of computed tomography (CT) scan, left adrenal mass (greatest dimension: 10cm) was detected. The tumor invaded into left renal vein and multiple nodules were detected in bilateral lung and liver. The patient underwent left adrenalectomy as a debulking surgery.
10cm
Virtual slide: https://nagasaki.pathpresenter.net/publicDisplay/DisplayCase/fa7d1252-9805-425c-88c4-ad08cbe57374
68 E-J-2: An 83-year-old man presenting with thyroid nodule
Hirofumi Watanabe, M.D. and Hironobu Sasano, M.D.
Department of Pathology, Tohoku University Hospital, Sendai, Japan
A left thyroid nodule was detected in the 83-year-old man by ultrasound imaging. His past medical history was unremarkable except for hypertension. Ultrasound imaging revealed a 60 x35 x31 mm well circumscribed nodule with calcification displaying iso- and hypoechogenicity. Foci of extraglandular invasion or swelling of lymph nodes were not identified. CT revealed the presence of 63 mm nodule on the left thyroid lobe. Infiltration was suspected but no apparent distortion or destruction of thyroid cartilage or cricoid cartilage. Serum levels of free triiodothyronine, free thyroxine, and thyroglobulin were all within normal ranges, but serum TgAb, CEA and SCC were elevated up to 326.6 IU/ml, 5.4 ng/ml and 2.0 ng/ml each other (normal range of 0-28 IU/ml, 0-5 ng/ml and 0-1.5ng/ml each other). Core needle biopsy indicated the histopathological diagnosis of thymoma, type B3 but not conclusive. Therefore, the patient underwent left thyroidectomy with selective cervical lymph node dissection.
Virtual slide: https://nagasaki.pathpresenter.net/publicDisplay/DisplayCase/e56fbae8-62c8-45ca-afe8-c22954b8e5bf
69 E-J-3: A slowly enlarging neck mass in a 73-year-old man
Toru Odate1, Tetsuo Kondo1 and Ryohei Katoh2
1Department of Pathology, University of Yamanashi, Yamanashi, Japan 2Department of Pathology, Ito Hospital, Tokyo, Japan
A 73-year-old Japanese man was presented with a slowly enlarging neck mass. He was diagnosed with Graves’ disease 12 years ago. The euthyroid status has been maintained by an administration of methimazole (5mg, eow). Two years before admission, he noticed a neck mass. The mass has been growing gradually, then he consulted a doctor. There was an egg-sized, elastic-hard tumor with smooth-surface in palpation. Ultrasound scan and computed tomography (CT) of the neck showed the well-demarcated mass, about 5cm in diameter, in the left lobe of the thyroid. Serum levels of FT3, FT4, TSH, and thyroglobulin were within normal ranges. TRAb (ECLIA), TgAb and TPOAb were elevated: 4.0 IU/mL (normal range: under 2.0), 22228.0 IU/ml (normal range: less than 40) and 230.6 IU/ml (normal range: less than 28), respectively. Fine needle aspiration showed scattered spindle cells with nuclear atypia and categorized as “suspicious for malignancy” The patient underwent left thyroid lobectomy with s central neck dissection.
Virtual slides: https://new-nagasaki.pathpresenter.net/#/public/display?token=5b7e7e3b
70 The 3rd Korea-Japan Joint Slide Conference of Genitourinary Pathology
Day 2: 2019. 11. 30. (Saturday) Huirak hall I, Commodore Hotel, Busan, Korea The 3rd Korea-Japan Joint Slide Conference of Genitourinary Pathology
Day 2: 2019. 11. 30. (Saturday) Huirak hall I, Commodore Hotel, Busan, Korea
Case G-J-01 Kosuke Miyai (National Defense Medical College, Japan) A 59-year-old Japanese male without any notable past or familial history was admitted to our hospital because of a painless mass of the right testis. Abdominal and pelvic CT revealed a 4.5 cm-sized mass in the right testis with no evidence of ascites, nodal or distant metastasis. Serum levels of LDH, AFP, and hCG were within normal limits. Right radical orchiectomy was performed with a clinical diagnosis of germ cell tumor or malignant lymphoma. Grossly, a poorly circumscribed white yellow solid mass measuring 5.0 x 4.0 x 2.9 cm was found in the testicular parenchyma.
The submitted specimen is taken from the tumor.
Case G-K-01 Ghee Young Kwon (Samsung Medical Center, Korea) A 69-year-old male patient presented with hematuria and was found to have a large prostate mass on imaging studies. Serum PSA level was 50.21ng/ml and biopsy was performed with subsequent radical prostatectomy. Gross examination revealed a light brown well-circumscribed mass measuring 8.2X7.0X6.0cm with focal necrosis. Submitted slide is a representative section of the mass from the radical operation.
Case G-J-02 Hiroyuki Hayashi (Fukuoka University School of Medicine, Japan) The patient was a 73-year-old man, who had urinary tract management for neurogenic bladder caused by trauma. Five months before, mild thickening of anterior wall of the bladder was detected by CT examination. He was admitted to the hospital with hematuria, one month before, and CT examination showed a large bladder tumor with pelvic nodal enlargement. Transurethral resection of the tumor was performed.
72 The submitted specimen is the resected tumor. Abdominal CT
Case G-K-02 Kyu Sang Lee (Seoul National University Bundang Hospital, Korea) A 33-year-old female patient with unremarkable history was found to have a right renal mass on routine examination. The mass was a solid nodule on CT scan. Robotic partial nephrectomy was performed with a presumptive diagnosis of renal cell carcinoma. Grossly the mass had yellow brown cut surface with areas of focal hemorrhage and dark pigmented areas. The submitted slide is from a representative section of the tumor.
Case G-J-03 Fumiyoshi Kojima (Wakayama Medical University, Japan) The patient was a 50-year-old man. A left renal tumor was detected by medical check-up. Enhanced computed tomography (CT) revealed a hypervascular tumor in the mid portion of left kidney. No metastasis was found by additional images. Left renal tumor was diagnosed as renal cell carcinoma clinically and partial nephrectomy for left renal tumor was performed. Macroscopic findings are not available. The tumor was well-demarcated without fibrous capsule. The submitted specimen is taken from the tumor.
Case G-K-03 Young Sub Lee (Seoul St. Mary's Hospital, The Catholic University of Korea, Korea) A 42-year-old male was consulted to our hospital for further work-up after radical orchiectomy for seminoma. Abdominopelvic CT revealed a 9.5 cm-sized mass in left retroperitoneum. Serum AFP level was mildly increased (37.9 ng/mL). Serum b-hCG was within normal limit. After 4 cycle of chemotherapy, he received retroperitoneal mass excision. Grossly, the mass was 9.7 x 7.0 x 6.8 cm sized, well demarcated, whitish pink, and showed multinodular and chondroid cut surface with multiple yellow chalky foci. The submitted specimen is taken from the retroperitoneal tumor. 73
The 1st Korea-Japan Joint Slide Conference of Pancreatobiliary Pathology
Day 2: 2019. 11. 30. (Saturday) Huirak hall II, Commodore Hotel, Busan, Korea The 1st Korea-Japan Joint Slide Conference of Pancreatobiliary Pathology
Day 2: 2019. 11. 30. (Saturday) Huirak hall II, Commodore Hotel, Busan, Korea
PB-K-1 Unusual cystic and solid lesion of pancreas tail
Kee-Taek Jang, Yoonah Cho
Department of Pathology, Samsung Medical Center, Seoul, Korea
A 25-year-old woman who had no previous medical history was diagnosed with abdominal peritoneal tumor of 6.6cm on her abdominal ultrasonography. Abdominal computed tomography (CT) and abdominal MRI showed that the solid and cystic mass, measuring 7.8 cm, in the pancreas tail. Surgical procedure of spleen preserving left side pancreatectomy was performed under the impression of lymphangioma, and it was described that serous fluid flowed from the cystic mass at the time of surgery. The resected specimen showed multi-locular cystic lesion with surrounding well-demarcated red color soft tissue lesion. The slide from a representative cross section of cystic tumor was submitted.
76 PB-J-1 A case of a pancreatic head tumor with rare histology in an old male
Yuko Omori1, Michio Kuroki2, Hiroya Ohtake3, Toru Furukawa1 1Department of Investigative Pathology, Tohoku University, Graduate School of Medicine 2Department of Gastroenterology, Yamagata City Hospital Saiseikan 3Department of Pathology, Yamagata City Hospital Saiseikan
We report a case of a 65-year-old male with a mass in the pancreatic head, who had difficulty in preoperative histological diagnosis. He presented with abdominal pain and he was diagnosed as cholecystitis. CT scan also revealed a mass with calcification in the pancreatic head incidentally. EUS-FNA was performed and nests of neoplastic cells comprising anisokaryotic nuclei with hyperchromasia and clear foamy cytoplasms had obtained sufficiently. Immunohistochemically, neoplastic cells were positive for p53, CD56, synaptophysin, CD10, and vimentin, and negative for CK, chromogranin A,β-catenin, S-100, desmin, CD34, and c-kit. Ki-67 labeling index was less than 1%. Some low-grade malignant neoplasm was suspected, but it did not reach any definite pathological diagnosis preoperatively. Pancreatoduodenectomy was performed. In the resected specimen, the mass was composed of solid-pseudopapillary and pleomorphic components. Immunohistochemical examination showed heterogenous nuclear accumulation of ß-catenin in the entire neoplasm and overexpression of p53 in the pleomorphic component. Perineural invasion and extra-pancreatic invasion was observed. We made the final diagnosis of a pleomorphic solid pseudopapillary neoplasm. The pleomorphic variant of solid pseudopapillary neoplasm has been reported scarcely. Detailed histopathological features will be presented.
PB-K-2 Unusual liver mass
Hye Jung Choi Department of Pathology, Ulsan University Hospital
A 70-year-old male patient was referred for liver masses on ultrasonography in medical checkup at another hospital. He had a history of intracerebral hemorrhage, and coronary stent insertion due to myocardial infarction. Physical examination showed no abnormalities. The laboratory test results were within normal limits. The level of aspartate transaminase was 27 IU/L, alanine transaminase was 24 IU/L, total bilirubin was 0.9 mg/dl, alkaline phosphatase was 96 IU/L and gamma glutamyl transferase was 34 IU/L. The Further image study including computed tomography (CT), magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT were done. The MRI revealed two arterial enhancing masses
77 measuring 3.6cm and 3.3cm in the left lateral segment of liver suggesting HCC and another smaller arterial enhancing nodular lesion in S4 segment probable of HCC. The PET/CT revealed two masses in the left lateral segment of liver were hypermetabolic (the maximum standardized uptake value [SUVmax] was 4.4, and a nodule in segment IV was isometabolic. He underwent left hemihepatectomy
PB-J-2 A rare case of tumor-forming pancreatitis
Toshihiro Haga Hirosaki University Graduate School of Medicine
PB-K-3 "A case of a pancreatic head tumor with ambiguous histology"
Haeryoung Kim Department of Pathology, Seoul National University Hospital, Seoul, Korea
Brief patient history This 67 year-old female was referred to general surgery for surgical treatment of a pancreatic head mass. She was diagnosed with diabetes mellitus 3 years ago, which was aggravated from 4 months ago. An abdomino-pelvic CT scan was performed to investigate the possibility of a pancreatic tumor, and it revealed a 4.2cm-sized heterogeneous mass in the pancreatic head with atrophy of the pancreatic tail. Under the clinicoradiologic impression of a mixed type intraductal papillary mucinous neoplasm with suspicious malignancy, she underwent a total pancreatectomy.
PB-J-3 A polypoid lesion of the gallbladder in a teenager
Kenji Notohara, M.D., Ph.D. Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Japan
A teenaged boy visited the hospital because of vomiting and abdominal pain. On admission,
78 serum levels of hepatobiliary enzymes were markedly elevated. An ultrasonographic examination and a CT scan revealed dilatation of the gallbladder and intra- and extrahepatic bile ducts. Endoscopically, blood clots were observed in the stomach, and hemorrhage was detected from the duodenal papilla. Filling defects that were consistent with blood clots were also demonstrated with cholangiography. A diagnosis of biliary hemorrhage was rendered, and due to uncontrollable hemorrhage, an emergency operation was carried out. An intraoperative cholangioscopic examination depicted a polypoid lesion in the gallbladder, which seemed to be a malignant neoplasm. Cholecystectomy and choledochectomy were performed.
79 Mini-Lecture I A ‘Clearer’ View of Vascular Invasion of Pancreatic Cancer
Seung-Mo Hong Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Venous invasion is three times more common in pancreatic cancer than it is in other major cancers of the gastrointestinal tract, and venous invasion may explain why pancreatic cancer is so deadly. To characterize the patterns of venous invasion in pancreatic cancer, 52 thick slabs (up to 5 mm) of tissue were harvested from 52 surgically resected human ductal adenocarcinomas, cleared with a modified iDISCO method, and labeled with fluorescent-conjugated antibodies to cytokeratin 19, desmin, CD31, p53 and/or e-cadherin. Labeled three-dimensional (3D) pancreas cancer tissues were visualized with confocal laser scanning or light sheet microscopy. Multiple foci of venous and even arterial invasion were visualized. Venous invasion was detected more often in 3D (88%, 30/34 cases) than in conventional 2D slide evaluation (75%, 25/34 cases, P < 0.001). 3D visualization revealed pancreatic cancer cells crossing the walls of veins at multiple points, often at points where preexisting capillary structures bridge the blood vessels. The neoplastic cells often retained a ductal morphology (cohesive cells forming tubes) as they progressed from a stromal to intravenous location. Although immunolabeling with antibodies to e-cadherin revealed focal loss of expression at the leading edges of the cancers, the neoplastic cells within veins expressed e-cadherin and formed well-oriented glands. We conclude that venous invasion is almost universal in pancreatic cancer, suggesting that even surgically resectable PDAC has access to the venous spaces and thus the ability to disseminate widely. Furthermore, we observe that sustained epithelial –mesenchymal transition is not required for venous invasion in pancreatic cancer.
Mini-Lecture II Pancreatic Relationships with Aging, Cancer and Tissue Stem Cells
Yoko Matsuda
Age-related pancreatic dysfunction is associated with atrophy of the pancreas and a decreased number of pancreatic exocrine and endocrine cells. Aging induces various diseases such as diabetes mellitus and pancreatic cancer; therefore, age-related pancreatic changes are important for healthy life expectancy. We have analyzed age-related pathological changes using elderly Japanese autopsied samples. The aging pancreas showed various pathological changes such as pancreatic fatty replacement, lobulocentric pancreatic atrophy, pancreatic duct ectasia, and metaplasia of pancreatic exocrine cells, as well as changes in islet cells (Pathol Int, 2019). Furthermore, the aging
80 pancreas often harbors precancerous lesions such as pancreatic intraepithelial neoplasia (PanIN) and cysts. The incidence of PanIN increased according to age and approximately 80% of elderly samples had PanINs. Carcinoma in situ (PanIN-3) was more frequently identified in patients with diabetes mellitus and/or older age (Pancreas, 2017). Pancreatic cysts with high-grade dysplasia arose in the pancreata of older patients with larger numbers of cysts (Pancreas, 2019). The incidence of pancreatic cancer in autopsy cases was 2%. Approximately 8% of pancreatic invasive ductal adenocarcinomas progressed asymptomatically and were discovered incidentally at autopsy. Occult cancer incidence increased with age (pancreas, 2016). To clarify the molecular mechanisms of age-related changes of the pancreas, I analyzed telomere length by fluorescence in situ hybridization (FISH). The rate of decline in telomere length due to age was greater in duct and centroacinar cells than in acinar cells. The fact that the maximum regression of telomeres was found in duct and centroacinar cells suggests that the number of tissue stem cells with the longest telomeres decreases with age. Telomere length was the shortest in carcinomas, followed by PanIN-3, PanIN-2, PanIN-1, and duct epithelium (PLoS One, 2015). The telomere length in centroacinar cells and duct epithelium was shorter in cases of carcinomas or PanINs than in age-matched controls, suggesting that telomere shortening occurs despite the absence of histological changes. The incidence of abnormal mitosis, which is a pathological marker of chromosomal instability, showed a negative correlation with telomere length (Pancreatology, 2016). Analysis of single nucleotide polymorphisms (SNPs) revealed that six SNPs that were correlated with blood lipid levels were associated with the risk for pancreatic cancer (Genes Chromosomes Cancer, 2018). It suggests that different clinicopathological characteristics and predispositions may affect pancreatic carcinogenesis in elderly Japanese patients. In conclusion, age-related pathological changes play a key role in pancreatic carcinogenesis via telomere dysfunction in pancreatic stem cells. Further studies are warranted to clarify the molecular mechanisms of pancreatic carcinogenesis in elderly patients.
81
Poster Abstracts [Poster J1] Histologic Appearance and Immunohistochemistry of DNA Mismatch Repair Protein and p53 in Endometrial Carcinosarcoma
Hiroyuki Yanai, M.D., Ph.D1, Masayuki Saijo, M.D.2, Keiichiro Nakamura, M.D., Ph.D2, Naoyuki Ida, M.D.2, Atsuko Nasu, C.T1, Tadashi Yoshino, M.D., Ph.D3, and Hisashi Masuyama, M.D., Ph.D2
1Department of Pathology, Okayama University Hospital and Departments of 2Obstetrics and Gynecology and 3Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Endometrial carcinosarcoma (ECS) is a rare and aggressive mixed-type epithelial and mesenchymal tumor. This study focused on the histologic appearance, loss of DNA mismatch repair (MMR) protein expression, and aberrant p53 expression in the epithelial component, and overall prognosis of 57 cases with ECS. Histologically, 21 and 36 cases exhibited low-grade (endometrioid grade 1 and 2) and high-grade (others) epithelial components, respectively. In a Kaplan-Meier analysis, patients with a high-grade epithelial component exhibited worse progression-free survival (PFS), compared with those with a low-grade component. Although the former group also exhibited worse overall survival, the difference was not significant. Thirty-six cases exhibited aberrant p53 expression. Of these, 5 cases exhibited focally aberrant p53 expression in carcinomatous components with diffuse aberrant p53 expression in mesenchymal components. Aberrant expression of p53 did not show significant association with prognosis. Six patients with MMR deficiency exhibited relatively better PFS. In conclusion, a low-grade epithelial component is a superior predictor of the PFS of ECS, compared with MMR protein and p53 expression status. In some cases of ECS, TP53 mutation may be a late event associated with histogenesis of the sarcomatous component.
Keywords : Carcinosarcoma, End ometrium, p53, MMR
84 [Poster J2] Whole-exome sequencing of high-grade fetal lung adenocarcinomas
Masaki Suzuki, MD, PhD1, Rika Kasajima, PhD2,3, Tomoyuki Yokose, MD, PhD1, Rui Yamaguchi, PhD3, Seiya Imoto, PhD3, Yoichi Furukawa, MD, PhD3, Satoru Miyano, PhD3, Emi Yoshioka, MD1, Kota Washimi, MD, PhD1, Yoichiro Okubo, MD, PhD1, Kae Kawachi, MD, PhD1, Yohei Miyagi, MD, PhD2
1Department of Pathology, Kanagawa Cancer Center, Kanagawa, Japan 2Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, Kanagawa, Japan 3The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Background: Fetal adenocarcinoma of the lung is a rare variant of lung adenocarcinoma, which is subcategorized into low-grade (L-FLAC) and high-grade (H-FLAC) forms. Our past study showed that pulmonary adenocarcinomas with H-FLAC component had a poor prognosis, but genetic abnormalities of H-FLAC are yet to be clearly defined. Methods and results: We performed whole-exome sequencing (WES) on 16 surgically resected cases of lung cancers with H-FLAC (LC with H-FLAC). DNA was extracted from formalin-fixed paraffin-embedded tissues, after macrodissection of H-FLAC component. Cancer-related gene mutations in KRAS (4 cases), TP53 (4 cases), CTNNB1 (2 cases), STK11 (2 cases), EGFR (1 case), and PTEN (1 case) were identified. Additionally, pulmonary surfactant system gene mutations in NKX2-1 (3 cases) and SFTPC (2 cases) were identified. No cases showed ALK or ROS1 mutations. Discussion: None of the major driver gene mutations known to occur in conventional lung adenocarcinomas were strongly associated with H-FLAC. But CTNNB1 mutation, which was characteristic for L-FLAC, was detected in 2 cases of LC with H-FLAC. In addition, mutation rates of LC with H-FLAC might be worth investigation, as EGFR mutations were reportedly observed in about half of lung adenocarcinoma cases in East Asian patients. The past study reported that pulmonary surfactant system genes were identified as a mutational target and as a worse prognostic factor in pulmonary adenocarcinomas with usual interstitial pneumonia, and these gene mutations were also identified in LC with H-FLAC. Conclusion: Our study demonstrated that CTNNB1 mutation was occasionally observed in LC with H-FLAC. Pulmonary surfactant system gene mutations were often detected in LC with H-FLAC.
Keywords: high-grade fetal adenocarcinoma, pulmonary adenocarcinoma, whole-exome sequencing, CTNNB1
85 [Poster J3] High-grade fetal adenocarcinoma of the lung with component of enteric features and lepidic growth pattern: a case report
Yoko Yonemori, M.D.1, Hironobu Shiota, M.D.2, Yukio Nakatani, M.D.PhD.3, Daisuke Ozaki, M.D.PhD.1
1Department of diagnostic Pathology, Japan Organization of Occupational Health and Safety, Chiba Rosai Hospital 2Department of Thoracic Surgery, Japan Organization of Occupational Health and Safety, Chiba Rosai Hospital 3Department of Pathology, Yokosuka Kyosai Hospital
High-grade fetal adenocarcinoma of the lung is a variant of the lung adenocarcinoma and has much worse prognosis than the conventional lung adenocarcinoma. We report a case of high-grade fetal adenocarcinoma of the lung with component of enteric features and lepidic growth pattern. A 70-year- old man with a heavy smoking history presented with a peripheral nodule by screening chest CT. Lung carcinoma was suspected and he underwent a right lower lobe segmentectomy. The cut surface of the surgical specimen revealed a tan to grayish white, well-circumscribed nodule measuring 13mm. Histologically, the tumor was consisted of complex glandular structures composed of glycogen-rich, non-ciliated cells and eosinophilic, tall columnar cells. Those solid part of the tumor show prominent nuclear atypia and geographical necrosis. The tumor cells were immunopositive for oncofetal markers, including α-fetoprotein and glypican-3. The cells with enteric feature were positive for CDX2. The lepidic growth pattern are seen surrounding area of solid part, and those cells display mild nuclear atypia but no morula formation.
Keywords: [High-grade fetal adenocarcinoma of the lung, enteric adenocarcinoma, lepidic growth pattern, α-fetoprotein, glypican-3]
86 [Poster J4] Japanese family with gastric adenocarcinoma and proximal polyposis of the stomach: case report
Tanaka Takehiro, M.D. Yoshino Tadashi, M.D.
Department of Pathology, Okayama University, Okayama, Japan
A 29-year-old Japanese female presented at the previous hospital with upper abdominal pain. Esophagogastroduodenoscopy revealed large polyps and carpeting polyposis, involving exclusively the gastric fundus and corpus. The patient was referred to other institution for further investigation and treatment. Serum anti-Helicobacter pylori antibody and C urea test were negative, which revealed she was not infected with Helicobacter pylori. Total colonoscopy did not reveal polyposis. Endoscopic mucosal resection was performed. Resected specimens showed high-grade dysplasia with gastric phenotype without invasive component. Her mother and two sisters had fundic gland polyposis revealed by EGD. Germline mutation analysis exhibited a point mutation in exon IB of the APC. Thus, the pedigree was diagnosed as gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS). This is very rare family with GAPPS in Asia in whom germline mutation of APC exon IB has been detected.
Keywords: stomach, polyposis, APC
87 [Poster J5] Systemic sclerosis related colonic perforation: a case report
Takanori Ito, MD., Akira Satou, MD. Ph.D, Toyonori Tsuzuki, MD. Ph.D
Surgical pathology, Aichi medical university, Nagakute, Japan
Contents: Background: Systemic sclerosis is a generalized autoimmune connective tissue disorder, characterized by fibrosis and degenerative change of multiple organs, including the gastrointestinal tract. The most frequent complication of the gastrointestinal tract is reflux esophagitis, but the colonic involvement of systemic sclerosis is also not uncommon.
Case presentation: A 79-year-old female was admitted because of abdominal pain and nausea with entire abdominal tenderness. She suffered from abdominal distention of a week ago. She had no remarkable past history. She immediately underwent emergency surgery of partial resection of the colon due to perforation. Histological examination of the resected colon showed a scant smooth muscle cell density or diminishing in the muscularis propria and neurons of the Auerbach plexus was vanished or decreased and replaced by collagenous fibrosis, which is the characteristic findings of scleroderma involvement of colon. No evidence of vascular obstruction is seen. After the operation, she recovered safely and had received treatment of systemic sclerosis.
Conclusion: Perforation of the colon is one of the serious complications of systemic sclerosis. Hyalinized collagen and vanished/decreased neurons of the Auerbach plexus are unique features in systemic sclerosis-related colonic perforation.
Keywords: Systemic sclerosis, perforation, collagenous fibrosis
88 [Poster K1] Synchronous seminoma and Langerhans cell histiocytosis with a multilocular thymic cyst: A rare case
Ji Hye Kim, MD1. , Kyungbin Kim1, Misung Kim1, Hye Jeong Choi1,2, Young Min Kim1,2, Jae Hee Suh1,2, Hee Jeong Cha, MD. PhD.
1Department of pathology, Ulsan University Hospital, Ulsan, Korea 2University of Ulsan College of Medicine, Ulsan, Republic of Korea
Contents : 28-year-old man with an anterior mediastinal mass underwent total thymectomy. The surgical specimen showed multilocular cysts and nodules. On microscopic examination, the cysts were lined by squamoid epithelium, consistent with thymic cysts, and tumors showing two different histologic features were identified. One tumor component was composed of sheets of monotonous, oval-to-round nuclei with pale cytoplasm and indistinct cell borders. The other tumor component comprised sheets of Langerhans cells admixed with eosinophils. Immunohistochemical analysis revealed different staining patterns in each component: the former was positive for D2-40, c-kit, and OCT3/4; and the latter was positive for S100 protein and CD1a. Based on these histopathological and immunohistochemical findings, we diagnosed the tumor as a synchronous seminoma and Langerhans cell histiocytosis along with a thymic cyst. To the best of our knowledge, this is the first case of the coexistence of these lesions in the thymus.
A B
Keywords : Mediastinum; Multilocular thymic cyst; Seminoma; Langerhans cell histiocytosis
89 [Poster K2] Oncocytic papillary renal cell carcinoma exhibits recurrent KRAS mutation
Sung Sun Kim, MD1, Yong Mee Cho, MD2, Keun Hong Kee, MD3, Hun-Soo Kim, MD4, Kyoung Min Kim, MD5, Jo-Heon Kim, MD1, Chan Choi, MD1
1Department of Pathology, Chonnam National University Medical School, Gwangju, Korea; 2Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul; 3Departments of Pathology, College of Medicine, Chosun University, Gwangju; 4Department of Pathology, Wonkwang University College of Medicine, Iksan; 5Department of Pathology, Chonbuk National University Medical School, Jeonju, Republic of Korea
Contents : Oncocytic papillary renal cell carcinoma (OPRCC) is a recently described subtype of papillary renal cell carcinoma (PRCC) characterized by an intensely eosinophilic cytoplasm, uniform nuclei, low nuclear grade, and indolent biological behavior. However, there is an overlap in the histology of OPRCC and other PRCCs with an oncocytic cytoplasm. This study sought to compare OPRCC features with those of type 2 PRCC (PRCC2) in terms of clinicopathologic, histologic, immunohistochemical, and molecular features. A cohort of 30 OPRCC and 26 PRCC2 cases was used. Tissue microarray slides were made using 3 cores per tumor, which were stained with cytokeratin 7 (CK7), alpha-methylacyl-CoA racemase (AMACR), epithelial membrane antigen (EMA), E-cadherin, vimentin, and CD10. Targeted sequencing of 90 cancer-related genes was performed in 26 OPRCC samples using next-generation sequencing. Further, PNA-mediated clamping PCR was performed using paired normal and tumor DNA from 30 OPRCC and 26 PRCC2 cases, respectively. OPRCC exhibited distinct clinicopathologic features: small tumor size, lower pathologic T stage, and no disease-specific death during the follow-up period. Histologically, peritumoral lymphoid aggregation, prominent papillary architecture (> 80% of tumor), hyalinized papillae, inverted nuclear location, and lower nuclear grade were observed. OPRCC was usually positive for CK7, AMACR, EMA, E-cadherin, and negative for CD10. Recurrent mutations in KRAS were detected in 26 of 30 OPRCC samples. However, there were no KRAS mutations in any PRCC2 sample. OPRCC exhibited characteristic clinicopathologic profiles with an indolent behavior, distinct histologic and immunohistochemical features, and a different KRAS mutation status from the PRCC2 samples.
Keywords : Kidney; papillary renal cell carcinoma; immunohistochemistry; KRAS; prognosis
90 [Poster K3] Gene fusions in glioma detected by targeted next generation sequencing
Ha Young Woo, M.D.
Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
Contents : Gene fusions of oncogenes have been reported in gliomas and may serve as novel therapeutic targets. Using targeted next generation sequencing (NGS), we assessed clinic-pathological and molecular characteristics of gliomas with fusion gene. Gliomas (n=390) were analyzed by NGS using the TruSight Tumor 170 (TST-170) panel. Fifty-five gene targets were analyzed and fusions with preserved kinase domains were investigated. Overall, 64 gliomas (16.4%) harbored targetable gene fusions, the majority of which were found in glioblastoma (n=53, 82.8%). Fusions were significantly more frequent in receptor tyrosine kinase (RTK) pathway-altered gliomas (p=0.002). The frequency of IDH mutation was not significantly different in gliomas with or without fusion genes (p=0.162). The most frequently detected therapeutically targetable fusions were in FGFR (n=13), followed by MET (n=11), EGFR (n=11), and NTRK (n=6). When analyzed by the fusion genes, gliomas with MET fusion were significantly associated with TERT-wild, 1p loss, PTEN-wild, p53 mutation; EGFR fusion with TERT promoter mutation and PTEN mutation. In summary, targetable gene fusions are enriched in RTK-altered gliomas, which will influence enrollment in and interpretation of clinical trials of glioma patients.
FGFR MET EGFR NTRK Other fusion fusion fusion fusion fusion Genetic profiles p-value n=13, n, n=11, n, n=11, n, n=23, n, (%) (%) (%) n=6, n, (%) (%) IDH mutation 0 (0.0) 3 (27.3) 0 (0.0) 1 (16.7) 5 (21.7) 0.140 TERT promoter mutation 10 (76.9) 2 (18.2)* 11 (100.0)* 2 (33.3) 11 (47.8) <0.001 MGMT methylation 5 (38.5) 6 (54.5) 5 (45.5) 3 (50.0) 9 (39.1) 0.963 1p loss 0 (0.0) 2 (18.2)* 0 (0.0) 0 (0.0) 1 (4.3) 0.287 19q loss 0 (0.0) 0 (0.0) 1 (9.1) 1 (16.7) 4 (17.4) 0.346 ATRX loss 2 (15.4) 3 (27.3) 1 (9.1) 2 (33.3) 5 (21.7) 0.763 H3K28me3 loss 0 (0.0) 2 (18.2) 0 (0.0) 0 (0.0) 2 (8.7) 0.366 RTK pathway 5 (38.5) 8 (72.7) 11 (100.0)* 2 (33.3) 14 (60.9) 0.007 EGFR amplification 1 (7.7) 1 (9.1) 11 (100.0)* 1 (16.7) 2 (8.7) <0.001 EGFR splice variant 0 (0.0) 1 (9.1) 10 (90.9)* 0 (0.0) 2 (8.7) <0.001 PDGFRA amplification 2 (15.4) 6 (54.5) 1 (9.1) 1 (16.7) 11 (47.8) 0.043 KIT amplification 2 (15.4) 4 (36.4) 1 (9.1) 1 (16.7) 8 (34.8) 0.401 MET amplification and/or splice variant 0 (0.0) 4 (36.4)* 0 (0.0) 0 (0.0) 0 (0.0) 0.003 PI3K / PTEN pathway 8 (61.5) 1 (9.1) 9 (81.8)* 0 (0.0) 7 (30.4) <0.001 PTEN mutation 7 (53.8) 0 (0.0)* 9 (81.8)* 0 (0.0) 6 (26.1) <0.001 p53 / MDM2 / p14ARFpathway 7 (53.8) 11 (100.0)* 4 (36.4) 1 (16.7) 14 (60.9) 0.003 p53 mutation 6 (46.2) 9 (81.8)* 3 (27.3) 1 (16.7) 10 (43.5) 0.056 MDM2 amplification 0 (0.0) 2 (18.2) 1 (9.1) 0 (0.0) 3 (13.0) 0.512 *adjusted p-value<0.01
Keywords : Glioma, fusion, next generation sequencing
91 The 16th Korea-Japan Joint Slide Conference of International Academy of Pathology (IAP)
Print 2019. 11. 22 Published 2019. 11. 29
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