The Journal of the Japanese Society of Clinical Cytology
Online ISSN : 1882-7233
Print ISSN : 0387-1193
ISSN-L : 0387-1193
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Volume 47, Issue 5
Displaying 1-10 of 10 articles from this issue
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Original Article
  • Analysis of orangeophilic cells in effusion cytology
    Nobuo SAKUMA, Hiroshi OKAMURA, Hidemi SHIBUTA, Yoshimi IMAI, Toshiaki ...
    2008 Volume 47 Issue 5 Pages 351-354
    Published: 2008
    Released on J-STAGE: January 09, 2009
    DOIhttps://doi.org/10.5795/jjscc.47.351
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    Objective: Cells with orange-colored cytoplasm (orangeophilic cells) are sometimes found in Papanicolaou-stained smears of serous effusions. We studied the frequency of their occurrence in effusions of various origins.
    Study Design: We retrospectively studied cytocentrifuged cell smears stained by Papanicolaou, i. e., 24 malignant mesotheliomas (MM), 53 reactive mesothelia (RM), 25 pulmonary adenocarcinomas (PAC), and 13 ovarian serous papillary adenocarcinomas (OSPAC). The numbers of orangeophilic cells were counted in each specimen.
    Results: Orangeophilic cells were observed in 18 (75.0%) MM, 2 (3.8%) RM, 2 (8.0%) PAC, and 3 (23.1%) OSPAC. Twelve (50.0%) MM, 1 (1.9%) RM, 1 (4.0%) PAC, and 1 (7.7%) OSPAC contained 5 or more orangeophilic cells in each specimen. The frequency in MM was statistically higher than in RM, PAC, or OSPAC (p<0.001).
    Conclusions: Orangeophilic cells are very often found in effusions of MM, and are useful findings to differ MM from others. When we find orangeophilic cells in a specimen, we must carefully examine for MM. The presence of orangeophilic cells, especially 5 or more, is thus useful for diagnosing MM in serous effusions.
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Clinical Articles
  • Two cases of atypical teratoid/rhabdoid tumor in the brain
    Naoki SHIMADA, Yasuko WADA, Reiko YASUDA, Hirotaka KOIZUMI, Shigeko OH ...
    2008 Volume 47 Issue 5 Pages 355-361
    Published: 2008
    Released on J-STAGE: October 28, 2010
    DOIhttps://doi.org/10.5795/jjscc.47.355
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    Background : Atypical teratoid/rhabdoid tumor (AT/RT), a newly included entity in the latest WHO classification, is a rare brain tumor occurring in infants and children. We encountered 2 cases of AT/RT and report the cytologic and histologic findings.
    Cases : Case 1 was a 11-month-old boy. Imprint cytology showed papillary growth of small atypical cells, some of which had eccentric nuclei, with thick cytoplasm. Histologically, the tumor had initially been diagnosed as a choroid plexus carcinoma, but re-examination revealed it to be an AT/RT because of the presence of rhabdoid cells and negative immunostaining for INI1. Case 2 was a 16-month-old girl. Imprint cytology exhibited scattering or gathering small atypical cells having the appearance of peculiar rhabdoid cells. The diagnosis of AT/RT was made histologically on the basis of the papillary epithelioid structure, primitive neuroectodermal tumor-like appearance, presence of rhabdoid cells, and the absence of INI1 expression.
    Conclusion : Cytologic diagnosis of AT/RT is possible based on identification of the peculiar epithelioid clusters and rhabdoid cells, in combination with immunocyotological demonstration of the absence of INI1 expression.
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  • A case of central giant cell lesion
    Kyuichi KADOTA, Reiji HABA, Yoshio KUSHIDA, Naomi KATSUKI, Yumi MIYAI, ...
    2008 Volume 47 Issue 5 Pages 362-366
    Published: 2008
    Released on J-STAGE: October 28, 2010
    DOIhttps://doi.org/10.5795/jjscc.47.362
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    Background : Central giant cell lesion (CGCL) is an uncommon tumor-like lesion, and most commonly affects the gnathic bone. We enconstered a case of CGCL of the mandible in an infant, and report the cytological features.
    Case : A male infant presented with swelling of the cheek and fever. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a mass lesion in the left mandible. Positron emission tomography (PET) demonstrated 18F-fluoro-2-deoxyglucose (FDG) uptake in the left mandible. Malignant tumor of the mandible was suspected, and a lesion biopsy was performed under general anesthesia. Intraoperative stamp smear of the biopsy specimen showed tissue fragments and dispersed cells against a hemorrhagic and necrotic background. The tumor was composed of mononuclear cells, multinucleated giant cells and spindle-shaped fibroblastic cells admixed with collagen fibers and inflammatory cells, such as lymphocytes and neutrophils. CGCL was suspected cytologically, and surgical curettage of the lesion was performed. Finally, the diagnosis of CGCL was confirmed histopathologically.
    Conclusion : It was possible to diagnose CGCL cytologically, and stamp cytology during surgery was useful in the present case.
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  • Oncocytic myoepithelioma of the parotid gland: A case report
    Mari NARITOMI, Sakae HATA, Shuji HAMAZAKI, Nobuhisa IWACHIDOU, Minako ...
    2008 Volume 47 Issue 5 Pages 367-371
    Published: 2008
    Released on J-STAGE: October 28, 2010
    DOIhttps://doi.org/10.5795/jjscc.47.367
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    Background : We report a case of oncocytic myoepithelioma of the parotid gland, and discuss its cytology and diagnosis differentiating it from other salivary tumors with oncocytic or eosinophilic cells.
    Case : A 60-year-old woman seen for a mass in the left neck was found in computed tomography (CT) and magnetic resonance imaging (MRI) to have a 2.5×2.0 cm tumor of the left parotid gland. Aspiration cytology showed a large number of clustered and isolated cells with voluminous eosinophilic cytoplasm and round nuclei. Smaller cells forming tightly cohesive clusters were also seen, as was the transition between eosinophilic and smaller cells. Based on histological and immunohistochemical findings, the tumor was definitively diagnosed as oncocytic myoepithelioma.
    Conclusions : Oncocytic myoepithelioma is a rare neoplasm of the salivary gland that should be included in the differential diagnosis of salivary gland aspiration when smears contain oncocytic or eosinophilic cells.
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  • Primary retroperitoneal mucinous cystic tumor of low malignant potential—A case report—
    Noriko ABE, Syouichiro SANADA, Tomoko HARADA, Tatsunari SATAKE, Nobuo ...
    2008 Volume 47 Issue 5 Pages 372-376
    Published: 2008
    Released on J-STAGE: October 28, 2010
    DOIhttps://doi.org/10.5795/jjscc.47.372
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    Background : Primary retroperitoneal mucinous cystic tumors are rare. We report the cytology and histology of a case and discuss its differential diagnostics points.
    Case : A woman in her twenties reporting right abdominal pain and found in ultrasonograms and computer tomography to have a cystic tumor beneath the right kidney had no epithelial cells aspirated in percutaneous fine needle aspiration cytology done three times and yielding only sticky fluid. Cytological preparations from the fluid in a surgically resected cyst yielded many tall columnar cells forming numerous clusters arranged in sheets or papillary patterns. Nuclear atypia were insufficient for carcinoma diagnosis. The resected cystic 5×5 cm tumor contained dark brown mucinous fluid. Microscopically, it was diagnosed as a primary retroperitoneal mucinous tumor of low malignant potential. Immunohistochemical examination revealed ovarian stroma cells in tumor stroma.
    Conclusion : It is important to suspect a primary retroperitoneal mucinous tumor when an aspiration biopsy cytology specimen from a retroperitoneal cystic lesion contains mucinous material, even if no epithelial cells are seen.
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  • Intraoperative cytological findings from peritoneal fluid of desmoplastic small cell tumor—A case report—
    Shigeru TSUCHIDA, Masaru KOJIMA, Harumi KAMIYAMA, Ryota TANAKA, Yoshim ...
    2008 Volume 47 Issue 5 Pages 377-380
    Published: 2008
    Released on J-STAGE: October 28, 2010
    DOIhttps://doi.org/10.5795/jjscc.47.377
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    Background : Desmoplastic small cell tumor (DSCT) is recently recognized to mainly affect serous surfaces of young males and to show an aggressive clinical course. We report intraoperative cytological findings from peritoneal fluid in a case of DSCT, and discuss the differential diagnosis.
    Case : A 39-year-old Japanese man admitted for upper abdominal pain was found in computed tomography to have an upper abdominal tumor requiring resection. Intraoperative peritoneal cytology specimens showed numerous loosely aggregated tumor cell nests. Tumor cells were monomorphic small round cells measuring 15∼20 μm with scant cytoplasm, round or oval nuclei, and fine granular chromatin. Histological findings for the resected tumor were compatible with DSCT. Immunohistochemically, tumor cells were positive for cytokeratin, epithelial membrane antigen, vimentin, desmin, and WT-1.
    Conclusion : DSCT tumor cells appear difficult to differentiate from cells of other small round cell sarcoma, reactive mesothelial cells and histiocytes in cytological peritoneal fluid specimens. Clinical findings and nested patterns seen in low-power examinations are suggestive of DSCT. Cytopathologists should thus be aware of this entity so that DSCT is included in the differential diagnosis of small round cell sarcoma arising at intraabdominal sites.
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  • A case of sinonasal teratocarcinosarcoma metastasis to the lung and pleura
    Motoko Yoshikawa TACHIHARA, Takashi ISHIDA, Junpei SAITO, Toshiyuki HO ...
    2008 Volume 47 Issue 5 Pages 381-385
    Published: 2008
    Released on J-STAGE: October 28, 2010
    DOIhttps://doi.org/10.5795/jjscc.47.381
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    Background : Sinonasal teratocarcinosarcoma (SNTCS) is a rare and highly malignant tumor arising from the nasal cavity and paranasal sinuses. Little is known about the characteristic cytological features of this tumor.
    Case : A 49-year-old man presenting with a large mass occupying the nasal cavities underwent biopsy. Histopathologically, the specimens revealed abundant undifferentiated neuroepithelial tissue with components of immature chondroid tissue, atypical myoid tissue, along with the features adenocarcinoma, which led to the diagnosis of SNTCS. The primary tumor almost disappeared after chemoradiotherapy, but lung and pleural metastases appeared 3 months later. Brush and imprint cytology of the lung and pleural lesions showed loosely arranged short and spindle-shaped malignant cells with hyperchromatic round nuclei and scanty cytoplasm. The presence of immature mesenchymal cells suggested the possible diagnosis of metastasis from the SNTCS.
    Conclusion : Diagnosis of SNTCS is not easy due to the mixed proliferation of various elements. Diagnosis is difficult from the cytopathological findings alone, but observation of the cell composition throughout may offer clues. Moreover, appropriate sampling of specimens from several portions is important to arrive at the correct diagnosis.
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  • Two cases of epithelioid gastrointestinal stromal tumor of the stomach
    Minako FUKUYA, Sakae HATA, Nobuhisa IWATIDOU, Hirotake NISHIMURA, Taka ...
    2008 Volume 47 Issue 5 Pages 386-390
    Published: 2008
    Released on J-STAGE: October 28, 2010
    DOIhttps://doi.org/10.5795/jjscc.47.386
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    Background : Gastrointestinal stromal tumor (GIST) growth is subclassified histologically as fusiform, epithelioid, or mixed pattern growth. Histological features of epithelioid GIST are fairly well documented, unlike its cytological features.
    Case 1 : Stamp smear preparation of a submucosal tumor in the gastric body surgically removed from a 67-year-old woman showed loose clusters of small round to ovoid tumor cells with rare rosette-like structures. Histologically, the tumor consisted of solid proliferations of round epithelioid tumor cells and rare rosette-like structures.
    Case 2 : Stamp smear preparation of a submucosal tumor of the gastric fundus removed during biopsy and partial gastrectomy done on a 70-year old man contained tumor cells with round and spindled morphology. Large cells with marked pleomorphism and multinucleated giant cells were observed. Rare tumor cells showed intranuclear cytoplasmic inclusion. Histologically, the tumor consisted of a predominant mixed epithelioid growth pattern accompanied by fusiform growth. GIST was diagnosed based on biopsy and gastrectomy. Both cases showed positive immunocytochemical staining for c-kit (CD117) and CD34.
    Conclusions : Differential diagnosis of an abdominal tumor with round cell morphology or diverse cytological appearance should include epithelioid GIST. Epithelioid GIST is difficult to diagnose by cytology alone, and an immunocytochemical evaluation of c-kit and CD34 is needed to ensure a definitive diagnosis.
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Brief Notes
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