The nuclear DNA content was measured in twentythree cases with nodular goiter, four cases with follicular adenoma and nineteen cases with papillary adenocarcinoma. Two hundreds cell nuclei were measured in each case. Most of the cases with nodular goiters and follicular adenomas had a nuclear DNA distribution ranging hypodiploid to hypotriploid. In papillary adenocarinomas, the modal value in majority of the cases was from hypodiploid to hypotetraploid. There was a widely spread aneuploid DNA distributions in four cases. It is indicated that nuclear DNA determinations proved useful in differential diagnosis only for occasional special cases.

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Cytological differentiation by aspiration biopsy between benign adenoma and carcinoma of thyroid is difficult morphologically. We investigated the utility of micro-spectrophotometric measurement of nuclear DNA contents in differential diagnosis of these diseases. Of 24 cases, 6 cases were histologically diagnosed to have carcinoma, 8 cases, benign adenoma, 6 cases, thyroditis and 4 cases, cystic formation.
Nuclear Feulgen-DNA contents were measured with multi-micro-spectrophotometer (Olympus) at wave length of 550nm.
The nuclear Feulgen-DNA contents of all benign cases (adenoma, thyroiditis and cyst) were distributed mainly in diploid area, except one case of benign adenoma (follicular adenoma) showing increased nuclear DNA contents.
The nuclear Feulgen-DNA contents of carcinoma cases showed DNA histogram pattern, and major peaks of all cases were observed beyond 3 C region.From this study, it is concluded that micro-spectrophotometric measurement of nuclear DNA contents of aspirated cells could be helpful to differentiate benign nature from malignant one in patients with thyroid involvement.

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In 32 cases with thyroid carcinoma, breast carcinoma and ovarian carcinoma, -of which the cells are morphologically similar one to another-, cancer cells taken from primary foci or from metastasized foci were stained with 6 different hydrolytic enzymes (non-specific esterases, alkaline phosphatase, acid phosphatase, β-glucuronidase and aminopeptidase), and the following results were obtained:
1) Enzyme patterns in cells from metastasized cancer were the same as those in cells from primary tumor.
2) Enzyme activity determined in this study was not helpful to differentiate benignancy from malignancy for cells from serous effusion.
3) To differentiate whether mammary gland cell is benign or malignant, ALP staining was useful. The result of ALP staining of cells from breast carcinoma was negative in most of the cases.
4) ALP activity and AMP activity varied obviously according to locations of primary tumor; ALP (-) and AMP (-) for thyroid cancer, ALP (-) and AMP (+/-) for breast cancer, and ALP (+) and AMP (+/-) for ovarian cancer.
5) It was suggested that, in thyroid cancer, brea. st cancer and ovarian cancer which are morphologically similar one to another, determination of ALP activity and AMP activity in cells from metastasized foci permits assuming the site where primary tumor is located.

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It is well known that small cell carcinoma of the lung has been the most chemosensitive histologic type among all lung cancers. There is a direct correlation between the duration of survival and the response to chemotherapy. It may become an essential part in individual treatment planning to predict the degree of response to chemotherapeutic agents prior to the initial treatment.
We investigated whether or certain cytologic characteristic of small cell carcinoma could be correlated with response to chemotherapy. We observed cellular features of tumor cells obtained by brushing under bronchoscopy from two groups ofpatients: one group had achieved a response to cyclophosphamide (good response group) and the other had not (no response group).
Chromatin patterns of the tumor cells from small cell carcinoma were various in individual patient, and there were some differences between the good response group and the no response group.
The tumor cells in the good response group more frequently showed finely granular chromatin evenly distributed throughout the nuclei. The tumor cells in the no response group predominantly showed deeply stained nuclei with coarsely granular chromatin distributed evenly or pale nuclei with unevenly distributed chromatin. The nuclear chromatin patterns from small cell carcinoma of the lung may be an indicator to predict the degree of response to chemotherapy.

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Small-cell bronchial carcinoma cells obtained from 18 patients by brushing under the fiberbronchoscope were examined to determine whether the morphological features of the cells could be related to the prognosis. A combination of features, that is to say, small (less than 10μ) or large (over 11μ), round or polygonal, irregular shaped, and darkly-or lightly-stained nuclei was seen in many small-cell carcinomas.
In small-cell carcinoma of which the prognosis was extremely poor (patients died within 4 months) the incidence of small, round and darkly-stained nuclei was much higher and many coarse or pyknotic chromatin patterns were more seen in comparison with small-cell carcinoma of which prognosis was better (patients survived more than 2 years). In small-cell carcinoma of which prognosis was good, the incidence of large, polygonal or irregular shaped and lightly stained nuclei was much higher and many fine chromatin patterns were more seen in comparison with that in which the prognosis was extremely poor.The morphological features of cells are thought to be related to the prognosis.

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Sputum cytologic examinations were performed in 312 patients. They have lived in air pollution area in the southern part of Nagoya city and suffered from chronic obstructive lung diseases.
We investigated the correlation between the incidence of sputum components (squamous metaplastic cells, dust cells, Curshmann's spirals, eosinophils, bronchial epithelial cells) and the 7 clinical data, and the inter relationship of these components by use of electronic computer.
1. Correlation between eosinophils in blood and sputum was significant.
2. As the incidence of dust cells was correlated with that of metaplastic cells, Curshmann's spirals and bronchial epithelial cells, it was supposed that air prollution was related with the incidence of these components.
3. 5 patients of lung cancer were discoverd and the age of each patient was over 68 years. This incidence was very high compared with that of this age bracket in Japan, 1975.
It is necessary to follow up this group for a long time especially by cytological observations of sputum.

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Intracytoplasmic lumina (ICLs) of breast carcinoma cells are dominantly noted as rather specific structures in various organella of carcinoma cells. The present study deals with the characteristic patterns of ICLs in the ultrastructural and cytological features of breast carcinomas. Ultrastructural analysis of benign and malignant breast lesions for ICLs revealed a high occurrence of such lumina in the carcinomas. Especially frequent lumina were noted in cells of scirrhous carcinomas.
In 33.3% of the cytological cases with scirrhous carcinoma, the tumor cells showed ICLs, however such lumina were found very few in benign lesions. These results demonstrate that the detection of ICLs by cytological examination can be useful in establishment of a diagnosis of malignant breast tumors (especially scirrhous ca.), and in the decision on a breast origin for metastatic tumors.

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The utility and reliability of aspiration biopsy were proved in the cytodiagnosis of liver tumors. A retrospective analysis was made for 157 cytologic specimens (144 of fine-needle aspirates and 13 of touch preparations from the livr) taken at the Cytodiagnostic Unit of the Central Laboratory in the Nagasaki University Hospital, during the period from 1970 to 1979. The series comprised 35 cases with liver cell carcinoma (hepatoma), one with hepatoblastoma, six with cholangioma, 47 with metastatic carcinoma, three of malignant lymphoma, 19 with liver cirrhosis and 28 with others lesions.The cases whose slides showed neither liver cells nor tumor cells and whose diagnoses were established neither clinically nor histologically, were excluded f rom this study.
Out of 35 cases with liver cell carcinoma, 30 cases were cytologically diagnosed as hepatoma, four were suspected of malignancy and one was negative. Cholangioma was confirmed only in one out of six cases; one was negative and the remaining cases had hepatoma or metastatic carcinoma. Of the 47 cases with metastatic carcinoma, 42 were positive, however, the determination of the origin of the tumor was difficult. A false positive was f ound among the 19 cases with liver cirrhosis.A cytologic diagnosis of malignant tumor was made in 80 cases (87%) out of the 92 cases.
The cytomorphologic features of hepatoma were as follows; 1) the presence of well-developed, granular and ill-defined cytoplasm, 2) variation in nuclear size with giant nuclei (anisonucleosis), 3) enlarged nucleoli, 4) intracytoplasmic bile pigment, 5) eosinophilic cytoplasmic inclusions. The N/C ratio was small.As either cholangioma or metastatic carcinoma of the liver demonstrated no morphological details contributing these diagnoses, it's difficult to give a specific diagnosis just based on the cytological criteria alone. A cytological preparation from liver cirrhosis revealed a picture of benign proliferative hepatic cells resembling that of hepatoma.Consequently, difficulty arose in differentiation of cirrhosis f rom carcinoma. The cytomorphological differentiation of primary live carcinoma could be of especial importance from two points of view. It is well-known that carcinoma of the liver most often occurs in cirrhotic liver. Today, surgical treatment is technically possible in some cases. The study herein reported demonstrated the value of fine-needle aspiration biopsy of the liver for the cytological diagnosis of liver tumors.

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The cytologic changes in cancer cells in the pleural and peritoneal fluid caused by direct injection of anticancer drugs were studied. Observations were performed in 53 cases with cancerous pleuritis or peritonitis. There was a remarkable decrease in the number of cells composing the cancer clusters. Marked enlargement of cancer cells was also noticed. Pyknosis, vacuolation or abnormal staining of cancer cellswere occasionally found, too.The cytologic changes appeared on the third day after injection. Anthcancer drugs seemed effective for two weeks. The efficacy of injected anti-cancer drugs tended to be related rather to accumulated dosage than to a single dose. Combination of anti-cancer drugs and steroids was especially effective to decrease the number of cells composing the cancer cluster.

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By our preceeding studies, inclusion body bearing cells were scarcely encountered in the urinary cytology of the adult free from lesions.
This time, continuous examinations were performed on 50ml (larger amount than before) initial morning urine of healthy adult (3) and children (4).
1) By this condensed method, inclusion body bearing cells were detected in numbers with 0-10 per one slide.
2) Remarkable increase is noticed in case of virus infection, in accordance with clinical severity.
3) No changes of inclusion body bearing cells were observed either by exaustion of overworking or by disturbances of gastrointestinal tract due to overdrinking.
4) In cold syndrome, these cells appeared in the urine, at least 12 hours before the onset of clinical symptoms.
5) No seasonal variations were noticed in the healthy adult.But in winter season, some increase of above-mentioned cells were observed in low occurrence, in symptomless cases of recovering common cold.
More studies are required on a large numbers of healthy adults and on follow-up examination, if possible, of the newborn, before we can draw some conclusion concerning relations between these cells and virus infection.

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1, 863 cervicovaginal cytologic smears were obtained from 236 women who had been treated with radiotherapy for cervical cancer during five-year follow-up examinations.
113 cases (47.9%) presented suspicious or positive cytology during the follow-up examinations. 74 (65.5%) of these cases had persistent or recurrent carcinoma during the period of observation. The majority of these suspicious or positive smears were obtained within 6 months after radiotherapy.
72 (63.7%) patients with positive and suspicious cytology died of cancer, while in the group with negative cytology only 59 (48.0%) died of the disease. From our experience, it can be safely said that the cytologic examination, when the result is positive or suspicious, will be a valuable prognostic index which assures that the tumor has not been sterilized.
In our series of 236 cases, local recurrence was found in 18 cases who were cytologically normal, so in the future, other cytologic technique, for example, aspiration cytology should be used in addition to the usual technique of collecting vaginocervical smears.

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Out of postmenopausal women, the cases where the result of the first cytological diagnosis was found false positive (especially 40 cases where diagnosis was. difficult), were treated with estrogen (premarin tablets 1.25mg/day) for successively 14 days. 3 days after the last tablets given, we performed the cytological diagnosis once more.
Out of these 40 cases, the result was benign in 21 cases, false positive, in 2 cases, and malignant, in 17 cases. We obtained a 100% correct diagnosis. However, the period of treatment must be long, and there are still some point to improve. But the method is a practical and useful to make a diagnosis correctly.

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We performed pseudopregnancy therapy with EP mixture or danazol therapy for dysplasia and carcinoma in situ of the cervix complicated by endometriosis and studied cytologically the biological behaviors of lesions according to hormone reactions.
After initiation of pseudopregnancy therapy, it was found for nuclear chromatin structure of dyskaryotic cells and malignant cells that fine reticular structure and fine granular structure were remarkably decreased, in contrast, coarse reticular structure and coarse granular structure, as well as unstructural changes such as opacity, karyorrhexis, e tc., were increased. In addition, analysing the appearance rate of these cells, it was confirmed that lesions on and below moderate dysplasia and a part of severe dysplasia were decreased, most of severe dysplasia and CIS were not remarkably changed and only CIS was partly increased.
Under danazol therapy, it was confirmed that nuclear chromatin structure of dyskaryotic cells and malignant cells were not changed as remarkably as seen under pseudopregnancy therapy, but in similar manner as tendency. However, there were no noticeable changes in incidence of these cells in comparison between their incidence before the therapy and that after it.
From the above results, it was suggested that dysplasia and CIS changed morphologically by influences of steroid hormones. Especially under pseudopregnancy therapy, it was found that lesions on and below moderate dysplasia and a part of severe dysplasia tendedto regress, most of severe dysplasia and CIS, to be stable, and a part of CIS, to progress.
As mentioned above, cytological examination by pseudopregnancy therapy permits differentiating the biological behaviors of borderline lesions which are difficult to diagnose histologically for a short period. This examination will be useful in clinical differential diagnosis specially for dysplasia, and will be also possible to utilize as a therapentic method.

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1.7% was the incidence of intraepithelial carcinoma operated under the condition that colposcopic findingsare negative, findings of punch biopsy are negative and findings of cytodiagnosis are positive. The lesion showed endocervical glandular type and was relatively small in many cases. As result of the cytodiagnosis, the following characteristics were observed:
(1) The follow-up of smears revealed wide variation between classes I and V.
(2) The cytodiagnostic findings seen in smears, which were interpreted as class V at the final stage of the follow-up, were characterized by the presence of the degenerated malignant cells with chromatolytic nuclei.
(3) The cytodiagnostic findings obtained from the endocervical smears were more positive than those from the vaginal smears and occasionally the cytodiagnostic findings from the vaginal smears were quite normal.
(4) Glandular appearance was remarkable, and malignant cells were observed around it.

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In a period of 11 years from 1969 to 1979, 1, 077 patients with leiomyoma were treated by simple total hysterectomy in the department of Gynecology, Kyoundou Hospital. 64 of them (5.9%) were those who had submucous myoma, 12 of these 64 cases had pedunculated myoma, and further 8 cases had myoma exposed in the vagina.
Cytological findings in all of these 8 patients showed abnormal cells that could easily be misdiagnosed for malignant cells. On the other hand, two of patients with serious Trichomonas colpitis who visited our hospital in a period of 2 years from 1976 to 1978 had cytologically similar abnormal cells that looked like malignant cells.
As a matter of fact, all of the abnormal cells were resulted from tissue repair cells by degeneration. The results of cytological observation and analysis in these cases are reported in this paper. The present report gives warning against misdiagnosis in cases having pedunculated myoma with myoma in the vagina and in cases having extremely serious Trichomonas colpitis, where abnormal cells is very apt to be cytologically misdiagnosed for malignant cells.

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Saccomanno's cell concentration method was applied to 602 cytologicl specimens of body fluid. In order to keep cell degeneration to minimum, cells were immediately fixed in Saccomanno's solution (50% etha nol+2% carbowax). As the specific gravity of the fixed cells ranged from 1.24 to 1.28, slight centrifuge yielded sufficient sediments. Air-dried specimens on slide glass could be preserved for a long period and stained at any time with various types of stain.This logical procedure, which needs no transfer of specimens from one container to another, gave a high diagnostic value in all 602 fluid specimens.

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In A 64-year-old female who was clinically diagnosed to have constrictive pericarditio cerebral infarct which caused death occurred. Autopsy was carried out. We confirmed the primary malignant mesothelioma of pericardium and discussed the tumor imprint cytology.
Characteristic findings of tumor imprint cytology were as follow: 1) Adenocarcinoma-like round cells and spindle-like malignant tumor cells coexisted.
2) Intercellular combination was dense.
3) Average diameter of tumor cells was 20μ to 300μ.
4) Blister-like cytoplasm was pale and fine vesicular.
5) Nucleolei were 3μto 4μin size and were small and round.
6) Glycogen granules, fibrilles, desmosomes and microvilli were revealed under electron microscope.
We diagnosed this case as a primary pericardial malignant mesothelioma.

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It is usually very difficult to diagnose carcinoma of the gallbladder with certainty before surgery because the gallbladder is not accessible to direct investigation. Percutaneous puncture of the gallbladder is now as feasible as percutaneous transhepatic cholangiography. So that this is one of the direct approaches to the gallbladder. At present, aspiration cytology of the gallbladder through this procedure may be thought to be only one morphological diagnostic method untill the safe and accurrate biopsy will be developed. Taking this point into account, percutaneous aspiration cytology of the gallbladder has been performed for the last six years.
Aspiration cytology was carried out in sixty one cases with nonfunctional gallbladder. Following puncture and evacuation of the contents of the gallbladder, the gallbladder was washed and irrigated with saline solution through a drainage tube, and then the materials were collected and prepared for cytologic examination. Six of sixty one cases were histologically proven to have gallblader cancer. Four of these six cases with gallbladder cancer were diagnosed by aspiration cytology. In this paper, the cytological and histological features of these four cases were described and some problems concerning this cytodiagnostic method were disccused.

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A 58 year-old female was admitted to Kyushu Cancer Center because of painful rapid growing mass in the upper lateral quadrant of the left breast.The left radical mastectomy was performed in May, 1979. Macroscopically, the mass, 3.5×4 cm in size, was spherical, yellowish gray-white in colour and elastic hard in consistency.
The tumor was diagnosed as Osteoclastoma-like Giant Cell Tumor of the breast which consisted of multinucleated giant cells with benign appearing osteoclast-like nuclei and atypical “stromal cells”. The multinucleated giant cells contained many, up to 50, centrally located small nuclei with inconspicuous pleomorphism.
Post-operative course was uneventful, but she was readmitted to our Hospital because of metastasis.She expired on May, 10, 1980, and autopsy was done.Cytologic specimen obtained from pleural fluid at autopsy revealed atypical “stromal cells” composed of large pleomorphic cells, lymphocyte-like small round cells, spindle shaped cells simulating fibrosarcoma or Leiomyosarcoma with atypical nuclei, and scattered multinucleated giant cells measuring 70-170μ in size, containing many centrally located, round to oval shaped nuclei, measured about 20μ.

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In this paper a 41-year-oid woman with mucoepidermoid carcinoma arising in the left ovarian dermoid cyst was reported. From the histologic type of the tumor, it is reasonable on its histogenesis that mucoepidermoid carcinoma could originate from ciliated columnar epithelium observed in dermoid cyst which looks like bronchial epithelium. It is possible that lipid, especially cholesterol in the contents of ovarian dermoid cyst, has relation to the carcinogenesis of squamous cell carcinoma and mucoepidermoid carcinoma that are predominant in the malignant tumor arising in ovarian dermoid cyst. Gall bladder carcinoma was referred concerning to malignant transformation of ovarian dermoid cyst as the same model of carcinogenesis.

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In a 42-year-old woman with genital bleeding, “Leiomyoma” was diagnosed in the uterus, but preoperative examination revealed that she was affected by AML The uterus operatively resected was larger than henegg in size, and the tumor mainly situated in the cervix. Cut surface of the tumor colored yellowish-green. Microscopically, infiltrations of the tumor cells were seen in the corpus uteri and ovaries.
The disease was diagnosed as chloroma of the uterus. Retrospective observation of the smears from the cervix revealed relatively small-sized tumor cells. Difficulty in differential diagnosis between chloroma and RS has been commented in the literatures, but differences from the latter were observed in the nucleoli, chromatin pattern and the nature of the cytoplasms in this patient.The chloroma in the uterus as reported here is a very rare condition.

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The cytological and pathological features in a patient with carcinosarcoma of the uterus were reported. In aspiration smear from the uterine cavity, three kinds of atypical cells were detected;
1) Large fibrous and spindle-shaped cells with hyperchromatic nuclei and marked nucleoli.
2) Flatly arranged cells with broad and dense cytoplasma, which have irregular-shaped nuclei.
3) Cell cluster with large cytoplasmic mucus vacuoles, increased chromatin and prominent red nucleolus.
These cytological features were respectively compared with the corresponding elements of the histopathological specimens.The first cell group was found to be delivered from sarcomatous elements, the second was from epidermoid carcinoma and the third was supposed to be adenocarcinoma origin.

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A case with adenoma malignum, considered to be relatively rare, was encountered.
We reported on its cytologic, histologic and ultrastructural findings and discussed the histogenesis of this tumor because its lymphnode metastasis yielded adenosquamous carcinoma.
It was suggested that the radiosensitivity of this tumor was extremely low.

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