婦人科細胞診による性器外原発癌の診断

抄録

Three cases of cancer of extra-genital origin werediagnosed by gynecologic smear tests during 1973, while 3, 753 materials were examined at Kitasato universityhospital.
The occurrence rate of this diagnosis wasone in every 1, 251 cases.
Case 1. A sixty-two y. o. female complained of hema-turia and dysuria. The corpus uteri was the size ofsmall fist, including the bladder. The cytology out of the uterine cavity revealed a group of cells which hada large amount of greenish cytoplasm with cornersand placed their nucleus on one side.
Those roundnuclei appeared hyperchromatic with one or more marked nucleoli.
Bizarre solitary cells including the snakeshaped ones with enlarged eccentric nuclei were alsoscattered.
Adenomatous cell clusters were sporadi-cally seen. The findings led to a diagnosis of high-graded transitional cell carcinoma.
Case 2. A thirty-one y. o. patient was admitted with c. c. of palpitation, and noted to have anemia as well asa dark red spot on the posterior fornix and an irregularhard tumor beneath the normal uterus.Smear of the fornix showed a thick cluster of highcolumnar cells withpalisade-like arrangement.
The abundant cytoplasmspreserved vacuoles.
Their malignant nuclei retainedthe thickened membrane and a large nucleolus.
Thiscase was diagnosed as adenocarcinoma tubulare of thecaecum in addition to the detection of G-I series.Case 3. A 41 y. o. patient with c. c. of metrorrhagiahad a history of gastrectomy due to stomach cancer 2 years previously. The uterine corpus was the sizeof small fist, and movable. The right ovary was enlar-ged and of small hen-egg size.
All smears from theuterine cavity and cervix revealed scattered malignantsignet-ring cells.
Surgical specimen showed infiltratingadenocarcinoma mucocellurare onto the ovary, and theuterine cervix and corpus.
The significance of cancer of extra-genital originwhich emerged out of routine gynecologic smear sampleshas been discussed and the literature reviewed bothcytologically and statistically.