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Recently, as the use of ultrasonographic examination has increased, the possibility of incidental findings of thyroid nodules has also increased. In Korea, the prevalence of thyroid nodules detected by an ultrasonogram is approximately 19-67%.1,2 The fine needle aspiration cytology (FNAC) of the thyroid gland is an important and definitive method for the diagnosis of thyroid nodules.3,4 Follicular neoplasm (FN) and Hurthle cell neoplasm (HCN) are relatively rare diseases and their cytologic diagnosis is difficult when compared with papillary carcinoma (PC) which shows a cytologic accuracy of more than 90%. In addition, cytologic differentiation between benign and malignant tumors is not possible in FN and HCN cases. When the histologic correlation is made, the diagnostic accuracy and predictive malignancy rate of FN and HCN are much lower compared with PC. According to the guidelines for the treatment of thyroid nodules provided by the Korean Thyroid Association, surgery is recommended for patients when FN or HCN is diagnosed by FNAC because the possibility of malignancy in this case is not known until the histologic diagnosis is made from the lobectomy or total thyroidectomy specimen.1,3 In contrast, guidelines for the treatment of PCs are relatively well established according to the categories of cytologic diagnosis. FN and HCN are still rare FNAC findings. Follicular carcinoma (FC) comprises approximately 5% of thyroid cancers,5 and because the number of FN cases is limited and FC cannot be distinguished from benign follicular adenoma (FA) on the basis of cytologic findings, describing FN cytologically in an ambiguous manner may be inevitable. Therefore, more cytologic information regarding FN and HCN are required not only for the cytologic diagnosis but also for the development of appropriate treatment guidelines. In this study we evaluated the FNAC accuracy in FN cases based on the histologic diagnosis and investigated the cytologic findings to increase the probability of a correct cytologic FN diagnosis.

The hedgehog (Hh) signaling pathway was first discovered as a primary regulator of embryonic development.1 Mammalian Hh signal transduction involves three Hh homologues: sonic (Shh), Indian, and Desert. The Hh signaling cascade is initiated as the Hh binds to the twelve transmembrane proteins patched 1 (Ptch). This internalizes the Ptch and relieves the suppression of the smoothened (Smo), which allows for the activation of the glioma-associated oncogene (Gli) transcription factor. The Gli transcription factor exists in three forms, Gli-1, Gli-2, and Gli-3.2,3 Although the detailed mechanism of this pathway is yet to be understood, a full-length Gli-3 is transported into the nucleus in order to activate the Hh target genes.4 Gli-1, one of the Hh target genes that functions only as a transactivator, is considered to be a marker of the Hh pathway activation.4,5 Recent studies have demonstrated that carcinomas of various organs, such as the skin, cerebellum, lungs, stomach, pancreas, prostate, uterine cervix, and breasts, harbor the ligand-dependent activation of the Hh signaling pathway.2,6,7 Shh, Ptch, and Gli-1 have been reported to be overexpressed in breast carcinomas.2 In addition, a positive correlation between the estrogen receptor (ER) status and Gli-1 nuclear translocation has been reported and further studies indicated that estrogen-induced Shh expression activated the Hh pathway and increased cell proliferation.2,8 Breast cancer is one of the most heterogeneous types of tumor with various histology, phenotype, and clinical behavior. In general, systemic therapy recommendations follow the subtype classification, which is determined by hormone receptor status, human epidermal growth factor receptor 2 (HER2) expression and Ki-67 labeling index. The purpose of this study was to evaluate Hh signaling protein expression in breast carcinoma according to immunohistochemical subtypes, correlate the expression with known clinicopathologic parameters, and compare the overall survival rates.

Background: The microtubule-associated protein Tau binds to both inner and outer surfaces of microtubules, leading to tubulin assembly and microtubule stabilization. The aim of this study was to evaluate the significance of Tau, α-tubulin, and βIII-tubulin expression in breast carcinoma and to assess their relationships with disease progression in the context of taxane treatment. Methods: Immunohistochemical expressions of Tau, α-tubulin, and βIII-tubulin were assessed in 183 breast cancer cases. Expression was correlated with clinicopathologic parameters, disease progression and overall survival. Results: Tau expression was correlated with lymph node metastasis and estrogen receptor (ER) positivity (p = .003 and p < .001, respectively). Loss of α-tubulin was significantly correlated with distant metastasis (p = .034). Loss of βIII-tubulin was correlated with lymph node metastasis and ER positivity (p = .004 and p < .001, respectively). In taxanetreated cases, Tau expression and loss of α-tubulin and βIII-tubulin expression were related to disease progression (p = .001, p = .028, and p = .030, respectively). Tau expression was associated with a worse survival rate in taxane-treated patients (p = .049). Conclusions: Tau expression and loss of α-tubulin and βIII-tubulin expression were correlated with aggressive behavior in taxane-treated breast cancer. Further evaluation of Tau, α-tubulin and βIII-tubulin may be useful in predicting clinical behavior and seeking therapeutic measures in taxane-based chemotherapy for breast cancer.

Primary endometrial squamous cell carcinoma (PESCC) is an extremely rare tumor with unclear pathogenesis. A 54-year-old postmenopausal woman presented with a 6-month history of vaginal bleeding. The patient was provisionally diagnosed with uterine submucosal leiomyoma. This was followed by total hysterectomy with a bilateral salpingo-oophorectomy under the laparoscopic guidance. Histopathologically, the tumor was PESCC which was accompanied by a lack of the tumor in the uterine cervix. The tumor showed positive immunoreactivity for p(16INK4a). But there was no evidence of human papillomavirus (HPV) on in situ hybridization and HPV DNA chip analysis. We also present a review of the relevant literature on Korean women.