We attemped successively to use specific stains in smear specimens such as phosphotungustic acid-hematoxylin (PTAH), Van-Gieson (VG) and Heidenhain Mallory azan, and were able to diagnose a uterine carcinosarcoma (undifferentiated adenocarcinoma plus leiomyosarcoma). The myofibrils in cytoplasm were stained blue by PTAH, yellow by VG and red by azan. We also cultured this tumor and established 2 different types of clonal strains. The histogenesis of carcinosarcoma is obscure. Indeed, in the past, opinions have varied as follows, collision tumor, composition tumor, combination tumor and others. In vitro culture of carcinosarcoma, we could separated two distinct cell types. One cell type had characteristics of carcinoma, the other, of sarcoma. The two typed cells were also distinguished by chromosomal analysis. The results from cell culture support the combination tumor theory that carcinosarcomas development from multipotential stem cell and diffusely intermix carcinomatous and sarcomatous elements, rather than composition tumor theory that the exudation and inflammation accompaning of undifferentiated carcinomas of the endometrium favor the growth of atypical cells resulted in the histologic appearance of sarcoma. As far as we are aware, establishment of clonal strains from human carcinosarcoma has never been reported.
A case of mesothelioma of the peritoneum with asbestosis of the lung was reported. Cytological examination of the peritoneal effusion was performed in this case, which was histologically diagnosed to have malignant mesothelioma. Characteristic findings of malignant cells are as follows: Tumor cells appeared singly or as groups consisting of a few-many cells. Some of these cells were overlapping each other. The cytoplasm was abundant and its perinuclear area was staind lightly pale or sometimes appeared to be eosinophilic, with a gradual transition to a deep stain at the periphery. Cytoplasmic rims were distinct and sometimes blister-like protrusions appeared after application of the Giemsa' stain. Nuclei were round or oval and mainly central in location. Their borders were smooth. The chromatin content was increased and chromatin was finely granular with occasional prominent clumps of chromatin. There could be seen 1-4 small nucleoli and, sometimes, 1-2 large irregular-shaped nucleoli. Single tumor cells were large and often multinucleated. Mitoses occured in a small number of tumor cells. Thick strand-like, dark clumping or finely granular PAS-positive substances were irregularly distributed in the cytoplasm, sometimes the whole of the cytoplasm was stained as a ring. Vacuolated cytoplasm gave a negative reaction to staining. Vacuolated cytoplasm and a part of the cytoplasmic border were stained positive by alcian blue staining.
We have experienced two cases of the retroperitoneal liposarcoma, which are relatively rare and scarcely experienced at daily clinical practice. At its diagnosis, though a qualitative diagnosis was impossible preoperatively, the peroperative aspiration cytology was very useful. Histologically, one was predominantly pleomorphic (poorly differentiated) type and the other was pledominantly myxoid (well differentiated) type (by WHO classification). This paper emphasized that the peroperative aspiration cytology was a very useful procedure for diagnoses of tumorous lesions of which especially preoperative diagnoses were uncertain.
A 80-year-old female, who had a diagnosis of hepatoma with cirrhosis and showed gradually increasing level of α-Fetoprotein, was investigated cytologically, histopathologically and electron microscopically. Tumor imprint cytology disclosed adenocarcinoma-like appearance, that is, overlapped cells, cytoplasmic vacuoles and large, round nucleolei. Histopathological findings of tumor were consisted with glandular formation and PAS positive material in their lumens. And epitherial junctional complexes and glycogen granules revealed by electron microscope. We made a diagnosis of this case as a mucin-producing hepatoma and discussed differential diagnosis between adenocarcinoma such as cholangiocellular carcinoma or hepatocellular carcinoma especially from the point of cytological details.
For the purpose of obtaining the specific findings in cell features of early invasive squamous cell carcinoma of uterine cervix, 12 cases with squamous carcinoma in situ, 3 cases with possible invasive squamous cell carcinoma, 11 cases with early invasive squamous cell carcinoma and 9 cases with invasive squamous cell carcinoma were subjected to this study, and the smears taken by cotten swab from cervix or endocervix of these 35 cases were used as materials. According to this study, it was concluded that, even in case the features of these malignant cells observed in early invasive squamous cell carcinoma may resemble those found in squamous carcinoma in situ, the cases where found were the findings such as a tendency of increasing of formation of cancer cell-cluster, existence of several tight and large clusters composed of over thirty malignant cells and other findings such as unevenly nuclear chromatin distribution of coarse granules, presence of distinct nucleoli, bleeding and tumor diathesis, may be strongly suggestive of early invasive squamous cell carcinoma of the uterine cervix.