The cytologic characteristics of 133 nonepithe ilal tumors were analysed for the cytologic diag nosis. While the nonepithelial tumors were class fied into five groups, fibroangiogenic, osteogenic, myogenic, lipogenic, and neurogenic groups, the cell component generally consisted of the two types of cells; the fibrous mesenchymal cells and differentiated cells specified to every tumor group. The most common feature of the cellular morpho logy was observed in the nuclear characteristics such as thinsmooth nuclear membrane and fine granular chromatins and less frequently abnormal indentation of nuclear membrane and round hunge nucleolus. Cells were freely separated in the most cases, whereas the epitheloid arrangement was also observed in some of the myogenic and neurogenic tumors. The differences of cytogenetic and clinicopatho logic bases for the diagnosis between epithelial and nonepithelial tumors were discussed.
The cell pattern of fibroadenoma was observed by aspiration and operation smears obtained from 13 cases.All these were diagnosed histologically as fibroadenhma.The preparations were stained by M-G-G method. Usually, each cell from fibroadenoma case was round or oval in shape and small in size.It was rare to find nuclei over 20μ. Regular piling of cells was commonly found in these cases. Sometimes, the smears of fibroadenoma with remarkable epithelial proliferation had abundant cell materials and mild loose cohesion similar to the smears of cancer cases. Large and variable size of nuclei, irregular piling of cells, fusion of cell border and cell inclusion were common observations in cancer cases. But these findings were scarcely observed in fibroadenoma cases.
The purpose of this subject is the correlation between the clinical effect and the cancer cell damage of the anticancer drugs injected into the pleural and peritoneal cavity of the patients. Anticancer drugs, such as MMC and Endoxan, were directly injected into the pleural and perito neal cavity of 17 patients with cancerous pleuritis or peritonitis more than three times. The cells in pleuroperitoneal fluid were compared to the clinical effect. The injections of the anticancer drugs were clinically effective in five cases. The number of cancer cells per volume unit decreased remarkably in four of them, though the other case didn't reveal a noticeable change of cell count. However, in five of 12 cases clinically ine ffective, the number of cancer cells per volume unit decreased as in the effective cases. But no remarkable decrease of cell count was observed in the other 7 cases. In most cases of the group whose cancer cell count decreased, the cell number began to drop after giving small doses of anticancer drugs. The morphological changes of the cancer cells, by anticancer drug infusion, are mostly changes of nuclear chromatin pattern, especially nuclear pycnosis and vacuolation of the cytoplasma.In four of the five cases of the clinically effective group, more than half of cancer cells revealed morpholo gical damages by anticancer drug. In 12 cases of the clinically ineffective group, there were five cases with noticeable morphological cell changes (more than half of the cancer cells), five cases with poor cell changes (less than 20% of the cancer cells) and two cases that showed moderate cell changes. On the relationship between the clinical findings and the increase and decrease of lymphocytes by anticancer drugs infusion, three of the five cases of the clinically effective group revealed increases of lymphocytes though the other two didn't show prominent changes of lymphocytes. In 12 of the clinically noneffective cases, there were no noticeable changes of lymphocytes except for one case. Moreover, five clinically effective cases showed decreases of the number of cancer cells per volume unit, and an increase of morphologically changed cancer cells and an increase of lymphocytes was observed in three of them. In more than half of 12 cases, no notable changes were observed in number of cancer cells, and the ratio of the morphologically stable cancer cells to damaged ones was not influenced. However, some cases showed similar findings to the cells of the effective cases, in the decrease of the number of cancer cells, and the increase of the damaged cancer cells and lymphocytes. In these cases, we would have expected greater improvement of the clinical condition of the patients, if their condition had permitted us to administer a larger dose of the anticancer drugs.
At the times of routine on the cytologic diagno sis in the field of gynecology we may sometimes encounter with difficulties in discrimination of cells from severe dysplasia and carcinoma in situ. In other words parabasal dysplastic cells and malignant basal cells are several times hardly distinguishable from each other. Resently the classification of parabasal dysplastic cells into three types (A, B, and C type) was proposed by Tenjin and coworkers. By investigating of frequency of these cells appe ared in cervical smears from above epithelial lesions, they made an attempt to find out the correlation of these cells with histologic typing. The purpose of the present study is to investigate and to analyze more objectively their theories. One of the four populations used in this study was reserve cells, as representative of normal cells. The other populations consist of finely granular as well as coarsely granular dysplastic cells and epidermoid carcinoma cells. All measurements were carried out by means of APAMOS version 2 on Zeiss's SMP-05 scanning microscopephotometer connected on line to small laboratory computer (PDP 12). A measuring spot size of 1.0×1.0 micron was used, and all measure ments were taken at a wavelength 550 nm. At first, digitized mirrorimages of individual cells were printed out and a cut-off point was established on the histogram of extinction values. In these mirror images the boundary between nucleus and cytoplsm was on the cut-off point methode drawn. These models fitting with boundary are statistically and mathematically analyzed and investigated. The results may be summaried as follow: 1) Statistical assessment of the anti-smoothness measure of optical density in nucleus (Anti-Smoo thness Variance Measure and Anti-Smoothness Standard Deviation Measure) shows, that no significant differences between each cell population were recognized. 2) Assessment of complexity measure of chromatin contour: At first, the contour of different extinction levels was drawn. Let H denote the height of extinction level, S denote the area surrounded by contour and L denote the length of contour, then L2/S values of each extinction level (H) were obtained. Investigating L2/S values in a given cell, the value on height (H) of most complicated contour is appoximately at maximum of L2/S. It can be considered, that it is possible to predict the histologic type of epithelial lesion whichis present, when the distribution of the value H which maximizes L2/S and the Max.L2/S values of individual cells are investegated. 3) In the process of calculation for complexity measure of nucleus it may be possible to recognize mathematically shape and number of chromatin granules.
Exfoliative Cytology of the herpes simplex infe ction of female genital tract shows characteristic morphologic changes. Between July 1, 1970, and October 31, 1973, a total of 18, 224 women were screened cytologically for female genital carcinoma in Shizuoka prefecture and 3 Patients (0, 016 Percent) had cytologic evidence of an active genital herpetic infection. The ages of the 3 patients ranged from 32 to 52 years, and they were none Pregnant at the time of the cytologic detection of the herpetic infect ion.these patients were found from summer to the beginning of fall.The clinical features showed only acute, none specific, slight inflammatory reac tion of cervix and vagina. Biopsy and cytology of these patients after seven and fourteen days showed within normal limits.
The cytologic features of 49 cases with dyspla sia, carcinoma in situ and early invasive carcinoma of the uterine cervix were precisely examined in correlation with histopathologic findings. 1. The histologic diagnsis of biopsy specimen was not always the same with final diagnosis based on the serial or step section of conization or resec ted uterus. 2. In general the narrower area of atypical epithelium, as determined by serial sections, were associated with fewer atypical cells in cellular samples while with the wider area of lesions the abnormal cell count was higher.And also the area of atypical epithelium in dysplasia was usually narrower than those in carcinoma in situ or invasive cancer. 3. In order of dysplasia, carcinoma in situ and invasive cancer mean nuclear diameter and mean cell diameter less and less reduced in size and nuclear cytoplasmic ratio increased more and more. 4.As for the chromatin pattern, nuclear membrane and cell configuration cellular samples from dysplasia showed rather different characteristics than samples from carcinoma in situ and invasive cancer. But there was no deffinite difference between the last two entities. 5.Though the cytologic specimens from dysplasia, carcinoma in situ and invasive cancer have each characteristic feature in general, it must bekept in mind that there remain certain indistingui shable cases. 6.The cytologic features in carcinoma in situ and invasive cancer are occasionally affected by the coexisting dysplasia. The consideration to such coexisting lesion must be important in diagnostic cytology of these borderline lesions.
Cytomorphological study on tissue repair cells observed in the cytological specimens obtained from the cervix of patients (two pt.who received cryosurgical treatment for the chronic cervicitis, two pt. who received iiradiation therapy for the cervical cancer and two pt. who were suffering from heary colpitis) was carried out. The nuclear configulation was round or oval in 97.2% of analysed nuclei. Irregular nuclear borders were observed in 5.9%. The chromatin patten was recognized as finely granular in 99.6% and chromatin was equally dis tributed in 99.3% Irregular nucleolar borders were observed in 5.3% multiple macronucleoli were recognized in 4.6% macronucleoli, over 2.5μ in diameter, ware observed in 14.8%. Nuclear diameter, which was expressed as a half of long axis plus short axis, was rather small. Nuclear diameter under 10μ was investigated in 64.4% and nucleus more over 15μ in diameter was observed in 3.2%. Irregular nuclear borders and macronucleoli were observed in 8.2% and 16.6% of nuclei of postcryo surgical cases and in 8.0% and 19.0% of nuclei of inflammatory (colpitis) cases.Irregular nucleolar borders were observed in 12.0% of nucici of post cryosurgical cases. Cellular origin of these cells and differential diagnosis from cells derived from neoplastic lesion of the cervix were also dis cussed.
Studies on the histological bases of unclean back grounds of vaginal smears in the cases of cervical carcinoma were performed, and following results were obtained. 1) Unclean back grounds of vaginal smears came from hemorrhage, inflammatory cell infiltration, pleomorphism of degenerated noncancerous squa mous epithelium and presence of ghost cells or cellular fragments. 2) Hemorrhage was observed at the surface of the carcinoma tissue in the most cases of invasive carcinoma (96%). 3) Inflammatory cell infiltration into squamous epithelium were observed in 35 cases of 50 invasive carcinomas (70%), 3 cases of 20 in situ carcinomas (15%), and 5 cases of 50 myomas (12%). 4) Frequency of parakeratosis was relatively high in carcinoma in situ (30%), and only 10% in invasive carcinoma. 5) Pleomorphism of squamous epithelium was observed in 19 cases of 50 invasive carcinomas (38%), and not in 20 in situ carcinomas and 50 myomas. 6) It was suggested that ghost cells or cellular fragments observed frequently in the vaginal smears of invasive carcinoma originated mainly from dege nerated carcinoma cells themselves and partially from degenerated squamous epithelium with acido philic cytoplasm.
The following observations were made by imprint smear cytology of pelvic lymph nodes in patient with cervical cancer after lymphography and irra diation. 1. Influences of lymphography a) As regards size distribution of retictlum cells, a bimodial distribution was observed. A tendency to enlargement of reticulum cells was also observed. b) Appearance of multinuclear histiocytes. 2. Cytological changes due to Linac X-ray irra diation a) Nuclei of reticulum cells decreased in size after 2, 000 rad of Linac X-ray irradiation. b) Decrease in cell size was seen in multinu clear histiocytes. c) Enlargement and wide variation of the size of cells and nuclei were observed in plasma cells after 2, 000 rad of radiation (in those cases lymphography was performed and positive metastasis revealed). d) Many of metastatic squamous cell carcinoma cells showed the typical radiation changes.
1.Adenocarcinoma cells were observed on cellular samples by brushing Smear from the uterine cavity, which were found originated from the left tubal adenocarcinoma at the relatively earlier stage, but this case had been clinically diagnosed as adeno carcinoma of the uterine body. 2.Cytologic features of adenocarcinoma of the tubal origin were summarized as follows: 1) Tree like appearance and/or grape formation. 2) Cytoplasma, relatively scant, but with marked vacuoles observed. 3) Nucleoli, not prominent. 3. As regards adenocarcinoma of the fallopian tube, the rate of positive cytology, calculated from data, furnished by reported papers, is approximately 39.4%, which motivates us to realize the importance of cytology for the tubal carcinoma.