Carcinoembryonic antigen (CEA) was studied by the indirect immunoperoxidase technique in 10% formalinfi xed paraffin-embedded tissue specimens from 61 patients and 95% ethanolfixed smears from 26 patients with gynecologic malignancies. The tissue specimens included cervical adenocarcinoma (26 cases), cervical adenosquamous cell carcinoma (10 cases), cervical squamous cell carcinoma (7 cases), endometrial adenocarcinoma (16cases) and ovarian adenocarcinoma (2 cases). The cytological specimens included corvical adenocarcinoma (5cases), cervical adenosquamous cell carcinoma (2 cases), cervical squamous cell carcinoma (7 cases), endometrial adenocarcinoma (10 cases) and ovarian adenocarcinoma (2 cases). In tissue specimens, positive CEA staining was seen 7 of 7 squamous cell carcinomas (100%), 9 of 10 adenosquamous cell carcinomas (90%), 21 of 26 cervical adenocarcinomas (80. 8%), 2 of 2 ovarian adenocarcinomas (100%) and 8 of 16 endometrial adenocarcinomas (50%). In cytological specimens, positive CEA staining was seen all of smears except one of the endometrial adenocarcinoma.
In tissue specimens, positive area was diffuse in cervical carcinomas. Cytoplasmic membrane or secretory granules were stained diffusely. As for endometrial carcinomas positive area was localized in acanthomatous or metaplastic portion. Cytological specimens of cervical carcinomas were positive CEA staining, and 9 of 10 positive CEA staining were observed in endometrial carcinomas as same as cervical carcinomas.

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To re-evaluate the work of P.D. Gard et al., we analyzed the smear patterns of squamous carcinoma in situ of the uterine cervix in 10 aged women.
All the materials had been histologically diagnosed as carcinoma in situ of the uterine cervix after hysterectomy and we reviewed the preoperative smears of the same materials.
The age of the older group was over 60 years (the average 67.2 years) and the age of the younger group was under 59 years (the average 42.7 years).
Besides aforementioned study, we searched for the relationship between the smear pattern and the histological findings such as the histological type and the mode of extension of the lesion in each case.
The cell type of carcinoma in situ of the cervix was classified as parabasal cancer cell, clustered cancer cell, keratinizing cancer cell, fiber cell, large cell (nonkeratinizing), small cancer cell, tadpole cell and undifferentiated cancer cell according to the modified Gard's classification.
The results are as follows;
1) The average percentage distribution of malignant cells for both groups is shown below.
in older groupg in younger group
parabasal cancer cell 49.7% 75.0%
clustered cancer cell 8.4 2.0
keratinizing cancer cell 10.4 6.9
fiber cell 2.7 0.6
large cell nonkeratinizing 2.8 2.7
small cancer cell 25.7 12.3
tadpole cell 0.3 0.3
undifferentiated cancer cell 0.1 0.2
2) The background of smears from the aged was a dirty one stained with erythrocytes, necrotic cell debris, naked nuclei and ghost cells.
3) 6 out of 10 older patients had been preoperatively diagnosed as “invasive” instead of in situ carcinoma of the uterine cervix on cytology but none out of 10 younger patients.
4) In the aged group, histological characteristics of carcinoma in situ of the cervix was mostly keratinizing cell type.
5) The circular extension of the lesion reached threefourths of the circumference of the cervix in 5 out of 10 older women and in only one out of 10 younger women.
6) The moderate and severe glandular involvement of the lesion was seen in 6 out of 10 older women and in 2 out of 10 younger women.
7) In the aged group, the wider the lesion, the more pleomorphic the cytologic pattern.

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We investigated the cytological features of three kinds of cervico-vaginal smears (vaginal, ectocervical, and endocervical) in 21 endometrial carcinoma cases, in correlation with the histopathological findings of the extirpated uteri.
The results were as follows.
1) The detection rate of atypical cells was 67%, even though three cervico-vaginal smears were combined. The detection rate by endometrial smear was 88%.
2) In the poorly differentiated cases, the detection rate was high, and the endocervical smear was the most useful to detect endometrial carcinoma in these cases.
3) In the cases without myometrial infiltration, the detection rate was 60%. On the other hand, the rate was 73%, in the cases with myometrial infiltration, that is, 27% of the cases were false negative.
4) In the cases in which the carcinoma occupied less than half of the uterine cavity, the detection rate was only 55%.
5) In the postmenopausal cases, the detection rate was as high as 82%. On the other hand, the rate was 50% in the premenopausal cases.

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Needle biopsy and aspiration biopsy cytology specimens obtained from 16 prostatic adenocarcinoma cases (3 well differentiated, 3 moderately differentiated, and 10 poorly differentiated) were histologically and cytologically analized to observe a relation of histologic differentiation and cytological characteristics of cancer. All the cases were cytologically divided into 3 groups according to clusterization ; namely 8, 7, and 1 cases of compact-type, mixed compact and isolated type, and isolated-type, respectively. In addition, these were separated into 2 categories by cell atypia, comprising of 8 and 8 cases with mild and high atypia, respectively. In conclusion, the cases with mixed or isolated-type on cytology indicates that the cancer might be poorly differentiated. However, the cases with compact-type reveal various degrees of histologic differentiation of adenocarcinoma. Further cytological analysis should be nessesary as to cell atypia of the cases with compact-type.

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41 year old female complained left vulvar tumor with bleeding and crater-like appearance of 5 mm in diameter. Colposcopy revealed villous papillary proliferation and erosion in crater.
Scraped smear preparation indicated sheet-like arrangement of columnar cells with no or minor nuclear atypia. In some of the cell groups, nuclei were slightly enlarged with chromatin condensation and moderately swollen nucleolei.
Histology exhibited gland proliferation with back to back arrangement, but no cellular atypia and invasive growth, and diagnosis was given to be papillary hidradenoma. Discussions with preceeding papers on hidradenoma were performed on the importance of combined diagnosis of clinical and morphological approach.

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We encountered a primary carcinoma of the fallopian tube, the most rare disease of gynecologic malignancy. The patient was 54 years old and her complaint was profuse vaginal discharge, the characteristic symptom of the disease. Pelvic mass was palpated in the left adnexal region. Carcinoma of the fallopian tube was suspected preoperatively, but the cytological diagnosis of cervical smear was false-negative due to screening error.
On laparotomic examination tumor formation was observed in the left salpinx and the involved tube was sausage-like appearance. Invasion was found in the left ovary and metastatic tumor was also recognized in the vesico-uterine cavity. Simple total hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathologically the tumor was poorly differentiated and composed of papillary adenocarcinoma, therefore it was the papillary-medullary type.
Re-examination of cervical smear was performed immediately after operation and atypical cells derived from carcinoma of the fallopian tube were identified. Thus far, cases with positive cytology in cervico-vaginal smear total 20 in Japan. The reason for false-negative diagnosis in cervical smear was discussed in this case report.

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1. When vaginal or endometrial cytology is positive and biopsy from the portio or the endometrium is negative, we should suspect the malignancy of the fallopian tube or the ovary.
2. Laparoscopy will be useful to detect the focus, even when we cannot palpate or demonstrate it by ultrasonography or computed tomography.
3. Ultramicroscopic findings, especially ultrastructual alveolar space may be aid of making diagnosis of the eartly malignant lesion of the fallopian tube.
4. The definitions of intraepithelial or early invasive carcinoma of the fallopian tube have not been established. We must be careful in making the diagnosis of intraepithelial or early invasive carcinoma of the fallopian tube, because proliferative and atypical pattern are also demonstrated in some cases of chronic or acute salpingitis and the other lesions.
5. We felt that mitotic activity, nucleolar variability, cribriform pattern and stromal invasion enabled us to make the diagnosis of early invasive carcinoma.
6. Atypical cells of the endometrial aspiration cytology have relatively rich cytoplasm and sheet like arrangement, so we needed the differentiation from repair cells. Hyperchromasia and loss of polarity may be the differential point.
Compaired with normal pattern, nuclear and nucleolar enlargement was evident in the touch smear of the operated sample.

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Thecoma is a relatively unusual disease and is characterized by its nature as a functional tumor to produce hormones. Details of a case are here described along with observations on its cytological patterns in comparison with those of granulocytoma.
Thecoma mainly occurs scattered and isolated, while granulocytoma not only occurs in a scattered and isolated manner, but also in rosette-like arrangements which correspond with call-exner bodies or in groups which are assumed to be in a laminated form. This may suggest that thecoma is cytologically of a inon-epithelial nature, whereas granulocytoma has characteristics of non-epithelial and epithelial properties. Closer observations on the cytological patterns of both diseases revealed:
1) Thecoma has two cell types: one similar to that of theca cells and the other similar to fusiform fibrous cells.
2) The nuclei of granulocytoma have a nucleous groove or a narrow part which resembles the shape of coffee beans or kidneys.
3) Chromatin of granulocytoma is in an extremely fine granular form, whereas that of thecoma is in a fine granular form.
4) Nuclear corpuscles of thecoma are usually imperceptible, whereas that of granulocytoma is occasionally perceptible.
As described above, thecoma and granulocytoma have their respective characteristic patterns of cells emergence, presence or absence of fusiform fibrous cells, nuclei shapes, nuclei diameters and chromatin. Differential diagnosis of both diseases can be claimed as feasible also on the basis of their cytological patterns.

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A 12-year-old girl admitted with the complaint of nasal bleeding. She was pointed out for the malignant tumor by the cytological examination of the nasal discharge, and the olfactory neuroblastoma was diagnosed by the histological investigation for the biopsy specimens. This tumor arises rarely in the nasal cavity resembling the histological feature of neuroblastoma arising from the adrenals and sympathetic ganglion. However, this tumor occurs relatively in the high age group of 10 to 50 compared with the high incidence within the age of 5 in the sympathetic neuroblastoma. Twenty-three cases were reported in Japan until 1982. Although the histogenesis has been unknown, the immature cells in the olfactory mucosal epithelium may be the base of this tumor. Histologically, the rosette or pseudorosette formation, neurofibril formation and alveolar pattern with fibrous stroma are found in the typical cases. The differential diagnosis may be difficult from the rhabdomyosarcoma, malignant lymphoma, malignant melanoma, plasmacytoma, undifferentiated carcinoma, etc.

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A 2 month-old child complained the hydrocele of the spermatic cord and visited our hospital. Aspiration cytology revealed various kinds of erythroblasts and myeloblasts, and megakaryocytes. Namely, orthochromatic polychromatic and basophilic erythroblasts, and metamyelocytes and myelocytes etc. were observed in the aspirated fluid. In addition, macrophages with phagocytosed foreign bodies, red blood cells and erythroblasts were also found. Examination of the blood was normal and atypical blood cells were not observed. There was neither hepatomegaly nor splenomegaly. In other words, physical examination was negative except for hydrocele. Now he is well 3 and half years after. Therefore, this case was diagnosed as extramedullary hematopoiesis in the hydrocele of the spermatic cord and we discussed this rare case.

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