Journal of Yeungnam Medical Science

Case Reports

Glandular papilloma of the lung with malignant transformation: Woo Jung Sung; Yeungnam Univ J Med. 2017;34(2):298-302. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.298

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Glandular papilloma of the lung is one of three histologic types of solitary endobronchial papillomas. It is known as an uncommon benign neoplasm. No malignant glandular papillomas have been reported. Herein, the first case of granular papilloma with malignant transformation is reported. A 74-year-old man with huge right lung mass extended upper and lower lobe was admitted to the hospital complaining of progressive cough and dyspnea. An open lung biopsy was performed. Microscopically, the tumor showed papillary growth pattern with thick fibrovascular cores. The stroma of the fibrovascular cores shown the infiltration of lymphoplasmacytic cells and proliferation of capillaries. The epithelial cells surrounding the papillary fronds were cilliated columnar cells with focal cellar atypia, and frequent mitoses. Suspicious pleural invasion foci were identified. The Ki-67 labeling index was about 24.3% and p53 labeling index was about 31.7%. Glandular papilloma is known as a benign neoplasm, which is lack of atypia and mitosis. In present case, there were several indications of malignant transformation, such as cellular atypia, frequent mitosis, architectural distortion, and pleural invasion. Pathologists must be aware that glandular papilloma can have a changes of malignant transformation. Further studies about disease behavior and molecular characteristics are needed.

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Adenocarcinoma-Papillary Cystic Pattern Arising in a Mixed Squamous and Glandular Papilloma of the Lung
Ae Ri An, Seung Yong Park, Jong Hun Kim, Kum Ju Chae, Myoung Ja Chung
International Journal of Surgical Pathology.2020; 28(6): 658. CrossRef

A Case of Biliary Papillomatosis with Cystic Dilatation of Bile Duct.: Yoo Mi Park, Kwangwon Rhee, Sun Och Yoon, Ji Yoon Ha, So Young Park, Jung Ho Lee, Sung Ill Jang; Yeungnam Univ J Med. 2012;29(2):136-140. Published online December 31, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.2.136

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Abstract PDF: A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.

Original Article

Evaluation of Computed Tomography and Magnetic Resonance Imaging of Sinonasal Inverted Papilloma.: Chang Hoon Bai, Young Jung Seo, Seok Choon Lee, Seung Min Chen, Un Hoi Baek, Eun Chae Jung, Si Youn Song, Yong Dae Kim; Yeungnam Univ J Med. 2005;22(2):191-198. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.191

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Abstract PDF: BACKGROUND
Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. MATERIALS AND METHODS: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. RESULTS: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. CONCLUSION: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.

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