Journal of Yeungnam Medical Science

Original Article

Pathology and Forensic Medicine
Diagnostic performance of immunohistochemistry and rapid urease test in detecting Helicobacter pylori, emphasizing bacterial localization and mucosal changes: a retrospective cross-sectional study: Kongsak Loharamtaweethong, Chalermpak Supakatitham; J Yeungnam Med Sci. 2025;42:41. Published online July 13, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.41

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Background
Accurate detection of Helicobacter pylori is essential for diagnosing and managing gastritis and related gastrointestinal disorders. This study evaluated the diagnostic performance of the rapid urease test (RUT) and immunohistochemistry (IHC) using four antibodies (BioGenex, MBL, Cell Marque, and Dako), focusing on bacterial localization (surface vs. subepithelial) and associated mucosal changes.
Methods
Gastric biopsy specimens from patients undergoing upper endoscopy at Vajira Hospital (June–December 2022) were retrospectively analyzed. Histological evaluations included hematoxylin and eosin staining, RUT, and IHC. Sensitivity of each antibody for detecting H. pylori was compared, emphasizing subepithelial colonization and histopathological patterns.
Results
The BioGenex antibody exhibited the highest sensitivity, followed by MBL, Cell Marque, and Dako antibodies. RUT demonstrated the lowest sensitivity, particularly in cases of chronic nonactive gastritis or minimal mucosal changes. BioGenex detected the greatest number of subepithelial H. pylori cases, many of which were missed by the other antibodies and RUT. Subepithelial colonization appeared as dot-like signals indicative of coccoid forms or bacterial remnants. The BioGenex antibody identified all subepithelial cases detected by the TMDU antibody, highlighting the former’s superior sensitivity. Statistical analysis confirmed the significantly higher diagnostic accuracy of the BioGenex antibody across multiple histological subgroups (p<0.05).
Conclusion
Subepithelial H. pylori colonization is clinically important but often missed by RUT and less sensitive IHC antibodies. The BioGenex antibody showed superior detection of both surface and subepithelial bacteria. Patients suspected of subepithelial infection without surface bacteria should undergo urea breath or stool antigen testing per guidelines.

Citations

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COMPARISON OF RAPID UREASE TEST WITH IMMUNOHISTOCHEMICAL EXAMINATION OF GASTRIC MUCOSA SPECIMEN IN THE DIAGNOSTICS OF HELICOBACTER PYLORI INFECTION AMONG OUTPATIENTS
Anna Bryczkowska, Tomasz Arłukowicz, Leszek Paweł Gromadziński
Polish Journal of Natural Sciences.2025; 40(3): 181. CrossRef

Case Report

Pathology and Forensic Medicine
Mammary Paget’s disease without underlying malignancy of the breast: Nuri Jang, Suhwan Kang, Young Kyung Bae; Yeungnam Univ J Med. 2018;35(1):99-103. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.99

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Abstract PDF

Mammary Paget’s disease (MPD) is usually accompanied by underlying breast malignancy; however, a few cases have been reported as only skin lesions without any evidence of malignancy of the breast on imaging tests and microscopic examination of surgical specimen. Here, we describe a 47-year-old woman who visited our hospital who had an eczematous lesion on right nipple and areola for over 10 years. The lesion was diagnosed as Paget’s disease by punch biopsy; however, imaging studies demonstrated no breast malignancy or lymph node metastasis. The patient underwent surgery of on the nipple and areola including underlying breast tissue. No underlying malignancy was found upon microscopic examination, except for Paget’s disease. Immunohistochemical stains revealed that the tumor cells were positive for cytokeratin 7, and negativity for p63, cytokeratin 5/6, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. We report a case of MPD without underlying malignancy. To the best of our knowledge, this is the third case reported in Korea.

Citations

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Isolated Extensive Paget’s Disease Without Underlying Breast Carcinoma
Shivani Moudgil, Cherry Bansal, Gurupriya Anand, Gomty Mahajan
Indian Journal of Surgery.2025;[Epub] CrossRef
‘Eczematous’ dermatitis of the nipple: clinical and histopathological differential diagnosis of Paget disease
Hatice B. Zengin, Puay Hoon Tan, Regina Liu, Bruce R. Smoller
Pathology.2024; 56(3): 300. CrossRef
An unusual case of longstanding mammary Paget disease presenting with reticulated skin changes
S. K. Dhariwal, E. Rytina, J. C. Sterling
Clinical and Experimental Dermatology.2021; 46(4): 748. CrossRef
Histopathological patterns of skin adnexal tumours in Ibadan, South-West Nigeria
OmoladeO Adegoke, MustaphaAkanji Ajani
Hamdan Medical Journal.2021; 14(4): 168. CrossRef
Clinicopathological characteristics of mammary Paget’s disease: A single‐center 25‐year experience in Korea
Young J. Kim, Keon H. Lee, Woo J. Lee, Chong H. Won, Sung E. Chang, Jee H. Choi, Mi W. Lee
The Breast Journal.2020; 26(4): 806. CrossRef

Review

Pathology and Forensic Medicine
Combined Hepatocellular-Cholangiocarcinoma: Recent Progress in Pathology and Classification.: Joon Hyuk Choi; Yeungnam Univ J Med. 2011;28(1):1-12. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.1

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Abstract PDF

Primary liver carcinomas have been classified into hepatocellular carcinoma, cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma (CHC). CHC is a tumor containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma. It forms a small but significant proportion of primary liver carcinomas. The origin and pathogenesis of CHC have not been well established. According to the 2010 WHO classification, CHCs are categorized into 2 groups: the classical type and a subtype with stem cell features. This review describes recent progress in pathology and classification of CHC.

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Synchronous Double Primary Hepatic Cancer: Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma
Jin Ok Kim, Dae Won Jun, Kiseok Jang
The Korean Journal of Gastroenterology.2013; 62(2): 135. CrossRef

Case Reports

Pathology and Forensic Medicine
Angiomatoid Fibrous Histiocytoma: A Case Report.: Joon Hyuk Choi, Woo Jung Sung, Nam Hyuk Lee; Yeungnam Univ J Med. 2007;24(2):315-321. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.315

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Abstract PDF

Angiomatoid fibrous histiocytoma is a rare soft tissue tumor that generally affects children and young adults. We report a case of angiomatoid fibrous histiocytoma in an 11-year-old boy who complained of a back mass for 3 years. Surgical excision was performed. The excised specimen showed a 4.0 x 3.6 x 3.0 cm, well circumscribed, grayish white tumor, with multicystic changes. Histological examination showed proliferation of spindle or round shaped tumor cells. There was a dense fibrous pseudocapsule with prominent chronic inflammatory cell infiltrates.

Citations

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Imaging of childhood angiomatoid fibrous histiocytoma with pathological correlation
Ali Yikilmaz, Bo-Yee Ngan, Oscar M. Navarro
Pediatric Radiology.2015; 45(12): 1796. CrossRef

Pathology and Forensic Medicine
Calcifying Aponeurotic Fibroma: A Case Report.: Joon Hyuk Choi, Jae Sung Seo, Kil Ho Cho; Yeungnam Univ J Med. 2003;20(2):223-228. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.223

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Abstract PDF

Calcifying aponeurotic fibroma is a rare benign soft tissue tumor that usually involves distal extremities in children and adolescents, especially the hands and feet. We report a case of calcifying aponeurotic fibroma arising in a 14-year-old boy who complained of right thumb mass. Surgical excision was performed. The resected specimen showed a 2.0x1.5 cm grayish white, fibrotic tissue. Histologic examination showed proliferation of fibroblastic cells with infiltrative growth pattern. Foci of calcification and chondroid differentiation were present.

Citations

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Calcifying Aponeurotic Fibroma of Leg Masquerading as Hemangioma in an Adolescent Male along with Review of Literature
Akriti Jindal, Gargi Kapatia, Manjit Kaur Rana, Rahul Sharma
Indian Journal of Surgical Oncology.2024; 15(1): 136. CrossRef
Calcifying Aponeurotic Fibroma of the Elbow - A Case Report -
Mee-Hye Oh, Eun Ah Jung, Ji Hye Lee, Hyun Deuk Cho, Jong Kyu Han, Yong-Koo Park
The Korean Journal of Pathology.2009; 43(1): 75. CrossRef

Oncology and Cancer Research
Chordoma: A Clinicopathologic Review of 4 Cases.: Joon Hyuk Choi, Young Kyung Bae, Mi Jin Kim, Duk Seop Shin, Kil Ho Cho; Yeungnam Univ J Med. 1999;16(2):369-375. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.369

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Abstract PDF: Chordoma is a slow-growing malignant neoplasm arising from the remnants of the primitive notochord. It accounts for 1 to 4% of all malignant bone tumors. It occurs exclusively along the spinal axis. Authors experienced four cases of chordoma occurred in the sacrococcygeal region. There were two male and two female patients, with a mean age of 63.5 years(range. 57~75 years). Tissue was obtained by wide excision in two patients, by incisional biopsy in one patient and by needle biopsy in the other. Adjuvant radiation theraphy was performed on all the patients after their biopsy. The mean diameter of the tumors was 7.6cm(range, 5.5 to 13.0cm). Grossly, tumor was multilobulated, soft and myxoid gelatinous mass. Microscopically, the tumor showed lobulated feature divided by fibrous septa within it. There were physaliphorous cells with vacuolated bubbly cytoplasm. And small uniform, round, and non-vacuolated tumor cells were also present. On immunohistochemical stain, all the cases were immunoreactive for cytokeratin, epithelial membrane antigen(EMA) and vimentin, respectively. One of the 4 cases was positive for S-100 protein. All the cases were negative for CEA.

Original Articles

Oncology and Cancer Research
A Clinicopathological Study of Solid and Papillary Neoplasm of Pancreas.: Joon Hyuk Choi, Mi Jin Gu, Hong Jin Kim; Yeungnam Univ J Med. 1998;15(1):36-46. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.36

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Abstract PDF: Solid and papillary epithelial neoplasm of pancreas is a rare tumor, usually affecting young women, and its histogenesis is still controversial. This study was performed to define the clinicopathologic features and cellular origin of this tumor. Eight female cases of solid and papillary epithelial neoplasm of pancreas were studied by analyzing the clinicopathologic findings and immunohistochemical and electron-microscopic findings. The age of eight cases ranged from 21 to 54 years (mean, 34 years). The tumors developed in the tail (4 cases), body-tail (2 cases), body (1 case) and head (1 case). The mean diameter of tumors was 9.3 cm (range, 5.5 to 13 cm). Tumors showed solid, cystic and hemorrhagic areas. Histologically, the tumor cells were uniformly round or polygonal in shape, and formed solid sheets and papillary pattern. On the immunohistochemical stain, 8 cases (100%) were immunoreactive for alpha1-antitrypsin, 7 cases (87.5%) for cytokeratin, 7 cases (87.5%) for progesterone receptor, 6 cases (75%) for vimentin, and 1 case (12.5%) for synaptophysin, respectively. None of them were immunoreactive for estrogen receptor. Electron microscopic examination showed many mitochondria, annulate lamellae and canaliculi-like gap. These findings suggest that solid and papillary epithelial tumor of pancreas possibly originates from totipotential stem cells.

Oncology and Cancer Research
Expression of Oncogene Product in the Colorectal Carcinoma.: Young Ran Shim, Woo Young Jang, Kyoung Chan Choi, Joon Hyuk Choi, Won Hee Choi, Min Chul Shim; Yeungnam Univ J Med. 1995;12(2):210-225. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.210

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Abstract PDF: The expression of p62"' and p2l can be seen in many solid tumor, but the pattern and incidence of expression were different according to organ, countries, and examiners, thus it is not definitely defined. Total 67 colorectal carcinoma in paraffin sections are analysed by immunohistochemically for evaluation of the p62and p21- expression according to the age, sex, chief complaints, location, differentiation, modified Dukes stage, using the specific monoclonal antibodies. The results were summarized as follows : The age of patients ranged from 32 years to 82 years. The mean age was 57.6 years. The expression of p 62y' and p21 was not correlated with age. Male was 29 cases(43.3%) and female was 38 cases(56.7%). The male to female ratio was 1:1.31. The and 95.0% in moderately differentiated adenocarcinoma, 90.0% and 90.0% in poorly differentiated <,;, adenocarcmoma, 100.0% and 100.0% in mucinous carcinoma. The positive rate of p62!and and p2l' was 94.1% and 88.2% in Dukes stage B,, 96.0% and 96.0% in Dukes stage B,, 100.0% and 100.0% in Dukes stage C,, 100.0% and 88.9% in Dukes stage C, and 100.0% and 100. o% in Dukes stage D. The expression of p62 y' in metastatic colorectal carcinoma showed diffuse and strongly positive reaction than primary colorectal carcinoma. The expression of p21 in primary colorectal carcinoma showed diffuse and strongly positive reaction than metastatic colorectal carcinoma.

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