It is sometimes difficult to make a diagnosis on vaginal smears obtained from postmenopausal women because of severe senile changes. And such changes often lead us to a false-negative and/or false-positive diagnosis.
We examined 43 cases of these smears which were definitely diagnosed by an estrogen proliferative test (EPT) and histology. The forty-three included nine false-positive cases, seven false-negative cases, and, as controls, sixteen negative and eleven positive cases.
Results of this study are as follows: malignant findings; severe anisonucleosis, irregularity of peripheral cellular arrangement, scanty cytoplasm and many altered bare nuclei of varying size. benign findings; less anisonucleosis, smooth cellular arrangement on the same level, abundant cytoplasm and less varying cellular size. Findings of 10-15 micron in nuclear diameter and slightly enlarged nucleolei were found in both findings.
After we reexamined the smears according to the results, in false-positive 6 out of 9 cases turned to negative and in false-negative 5 out of 7 cases turned to positive.
We think our criteria will improve the accuracy of the diagnoses on postmenopausal smears.

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The ultrastructural immunocytochemical technique using peroxidase-labeled CEA antibody was applied for the localization of carcinoembryonic antigen (CEA) on PLP fixed tissue specimens and imprinted smears taken from surgically removed uterus. Tissues were obtained from 5 cases of cervical squamous cell carcinoma, five were from cervical adenocarcinoma and four were from endometrial adenocarcinoma. Smears were also taken from 8 cases of cervical squamous cell carcinoma, three were from cervical adenocarcinoma and six were from endometrial adenocarcinoma.
Cervical adenocarcinoma had different staining pattern for CEA from endometrial adenocarcinoma in cytological specimens ultrastructually. The former showed CEA localization not only at apical portion but also at baso-lateral membrane of the cell, but the latter showed it only at apical portion of the cell. That suggested the possibility of the differential diagnosis between cervical adenocarcinoma and endometrial adenocarcinoma using immunocytochemical technique.
Cervical squamous cell carcinoma had different CEA distribution from adenocarcinoma of the cervix and the endometrium, that showed CEA localization at perinuclear space (PS) and entire cytoplasmic membrane of the cell.

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The origin of the mucus in the ovarian mesonephroid tumour was studied morphlogically with contrast to the mucinous tumour.
Both cytologically and histologically the PAS and AB positive mucus are demonstrable both extracellularly and intracellularly in the mucinous tumour. The presence of those histochemically developped mucus are clearly supported by the transmission electromicroscopy in the cytoplasma as the secretory granules.
On the other hand, the cytoplasma of the mesonephroid tumour contains abundant diastase digestive and PAS positive glycogen granules instead of the mucus, and the AB positive mucus like material is guaranteed only on the luminal suface and in the lumina. Cytologically, the AB positive mucus like material is also demonstrable only on the cytoplasmic border.
The transmision analyses of fhe mesonephroid tumour reveals numerous microvilli and many longitudinal cutts of the microvilli sorrounded by a lot of finely granular materials. Some microvilli are found to have filamentous materials on their surfaces. Those findings by the transmission electromicroscopy correspond to the scanning electromicroscopical findings about the microvilli as three dimensional projections of the cell surface and as bundles of network of the luminal content.
From above findings, the origin of the mucus in the mesonephroid tumour is inferred from the glycocalyx (Bennet, H.S., 1963) on the microvillus of the luminal surface. The term “extracellular mucin of the epithelial tumour” adopted in the WHO's “Histological Classification of the Ovarian Tumours” is vague terminology, for the luminal (extracellular) mucus is both AB and PAS positive, so the distinction between the intracytoplasmic mucus after secreted in the lumina and the glycocalyx of the luminal surface become obscure. The epithelial mucus should be divided into two categories including the ordinary secretory cell mucus and glycocalyceal mucus of the luminal surface.

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We report on ultramicroscopic observations of GAK cultured cells from an inguinal lymphnode metastasis which had originated from a malignant melanoma of the vulva. Approximately 2 months after GAK cells were injected into a nude mouse, a tumor was produced in the abdomen which was subsequently examined ultramicroscopically. The cells were examined ultramicroscopically, with the main emphasis on melanogenesis, employing the premelanin, dopa, and dopa-premelanin double reactions. The following results were obtained.
1. In the GAK cultured cells and the transplantation tumor cells from the mouse, melanosomes in various stages of melanogenesis were observed. Both the GAK cells and the nude mouse tumor cells were found to be in an active state of melanogenesis. An axon body-like structure was observed, indicating the tumor cells probably were derived from neurogenic tissue. Furthermore, the premelanin reaction revealed not only electron dense melanosomes but also electron dense premelanosomes, the latter of which are a product of an earlier stage of melanogenesis. The positive dopa reaction proved the activity of tyrosinase and that the tyrosinase was the melanin-producing enzyme. Tyrosinase activity was observed ultramicroscopically in the Golgi associated endoplasmic reticulum-lysosome (GERL)-like structure which had previously been proven by biochemical studies and stereostructural analysis.
2. The cells had ultramicroscopical characteristics which were unlike those of epithelial or non-epithelial cells, suggesting they were most likely derived from neural crest tissue.
3. Intranuclear vacuoles, which are very often found during cytological examination of malignant melanomas, were in this case, proven ultramicroscopically to be due to cytoplasmic intranuclear invagination. The intranuclear vacuole was readily observed due to the rough, irregular shape and deep indentation of the nuclear membrane and the plane of sectioning used.

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It has been noticed in literature for a long time that giant cells appear on cytology of the condyloma acuminatum, however systematic observation has not yet been done. This report describes observation and discussion about these giant cells in 11 condyloma acuminatum cases composed of 4 dysplasia moderate complex cases, 3 dysplasia mild complex cases and 4 cases of only condyloma acuminatum.
Giant cells seen on cytology of the condyloma acuminatum were of two obvious types. First was the giant cell which had slight nuclear abnormality and only the cytoplasm became large. These were mostly superficial cells. This cytoplasm was eosinophilic or amphophilic and usually was normal in shape, but sometimes became a bizarre shape. The nuclei were mononucleated, binucleated and multinucleated. The second was giant cells which nuclei became as large as the cytoplasm. Most of these cells were intermediate and parabasal cells. The nuclei were mononucleated, binucleated and multinucleated. They showed atypism and the chromatin was frequently metamorphosed and unclear.
The giant cells in which only cytoplasm became large were seen among condyloma acuminatum cases and dysplasia complex cases. The giant cells which became as large as nuclei were seen more often among dysplasia moderate complex cases than among cases of only condyloma acuminatum.
We have tested five cases about human papillomavirus antigens by peroxidase-antiperoxidase technigue. 1 case of 1 dysplasia moderate complex and 3 cases of 3 dysplasia mild complex were positive and 1 case of 1 condyloma acuminatum was negative.
It is considered that giant cells mean the important auxiliary finding on cytology when condyloma acuminatum of the uterine cervix is diagnosed.

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We studied the cytologic patterns of the cervical dysplasia in which papillomavirus antigen was demonstrated by immunoperoxidase technique.
Biopsies were obtained from 80 cases of dysplasia with papillomavirus antigen. Routine Papanicolaou smears were screened for the presence of three characteristic condyloma cell types; the koilocyte, the dyskeratocyte and the condylomatous parabasal cell.
Results obtained were as follows.
1) The koilocytes were observed in 58% of the cases, the dyskeratocytes in 36% and the condylomatous parabasal cells in 70%.
2) The cases were divided into three groups with regard to the cytologic patterns;
i) almost all abnormal cells were condylomatous.
ii) condylomatous cells were dominant in mixture with dyskaryotic cells.
iii) dyskaryotic cells were dominant in mixture with condylomatous cells.
The number of the cases in each group was almost same.
3) Binucleated cells were observed in 63% of the cases.

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26 cases (0.18%) of koilocytotic atypia were cytologically detected out of 14, 445 women mass-screening for uterine cancer. They belong to 16 class II b and 10 class ilia. 10 of them were examined by smear, biopsy and colposcopy. Some of them were cytochemically subjected to peroxidase antiperoxidase technique (PAP method) for immunocytochemical detection of capsid antigen of papilloma virus.
Comparative occurrences by age are 20th. 1.6%, 30 th. 0.18%, 40th. 0.19%, 50th. 0.073%, and over 60th. 0.46%.
Only 4 cases (40%) demonstrated koilocytotic atypia by repeated smear for further investigation, suggesting inaccuracy of smear for the diagnosis of HPV infection.
5 out of 10 exhibited the finding of white epithelia by colposcopy. They consist of 2 mild dysplasia and 3 squamous metaplasia.
Histological diagnosis of 10 cases are 8 squamous metaplasia, 1 mild dysplasia and 1 moderate dysplasia. 7 cases of 10, proved histological koilocytosis indicated positive in biopsy specimen. 3 (43%) out of 7, koilocytosis indicated positive reaction by PAP method.
Above-mentioned data show that target biopsy under colposcopy and PAP method are useful for koilocytotic atypia of the uterine cervix.

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Nuclear features of the cell were studied by a transmission electron microscopy in bronchial carcinoma in situ and atypical squamous metaplasia induced in dogs by means of bronchial submucous injections of 20-Methylcholanthrene.
In carcinoma in situ, many population of the cell showed an increased complexity of nuclear form and an enlargement of the nucleoli. An abundance of perichromatin granule was also seen around nuclear membrane. In atypical squamous metaplasia the cells in superficial layers showed an increased complexity of nuclear form. On the other hand, the cells in middle and basal layers revealed slightly irregular in nuclear form. Perichromatin granules were less in atypical metaplasia than these in carcinoma in situ. Enlargement of the nucleoli was also inconspicuous.
These results indicate that there are differences, although some similarities exist, between bronchial carcinoma in situ and atypical squamous metaplasia in nuclear form, number of perichromatin granules and enlargement of the nucleoli.

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For early detection of lung cancer associated with pneumoconiosis, we carried out sputum cytology in patients with pneumoconiosis who visited Iwamizawa Rosai Hospital from July, 1975 to December, 1982.
We detected 54 cases of lung cancer out of 12, 000 man year patients with pneumoconiosis. 42 (77.8%) out of 54 cases of lung cancer were detected by sputum cytology. The positivity of sputum cytology was 87.1% in patients with squamous cell carcinoma and 89.5% particularly in those with squamous cell carcinoma of hilar type.
With respect to squamous cell carcinoma, sputum cytology was detectable even in the early stage (Stage I, II). However, early diagnosis by sputum cytology was unable in patients with adenocarcinoma, small cell carcinoma and large cell carcinoma.
The results above suggest that sputum cytology taken several times a year regularly and yearly is effective as early diagnosis of lung cancer for those who have chronic lung diseases such as pneumoconiosis and pulmonary tuberculosis and for those who have high risk of occupational lung cancer.

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Direct imprint smears were obtained from surgically resected specimens of 74 human lung carcinomas and cytochemical staining for alkaline phosphatase was carried out by a modified Burstone's azo dye method.
All 33 adenocarcinomas of the lung had alkaline phosphatase activity more than usual bronchial and alveolar cells. However, only six cases out of 29 epidermoid carcinomas showed more than moderate activity of the enzyme.
The staining for alkaline phosphatase would be very useful in cytological examination to distinguish the character of glandular epithelial neoplasms in the lung.

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Authors devised an abrasive technique by esophageal sonde with sponge as the cytologic screening method for detection of esophageal cancer at the time of upper gastro-intestinal endoscopic examination in Endoscopic Center of Dokkyo University Hospital and Tochigi Cancer Detection Center.
Guiding tube is placed at the lower pharynx and endoscopic equipment is intubated through this tube. After removing gastroendoscope, esophageal sonde with sponge at the tip of it is inserted through this tube. Size of sponge attached at the tip of esophageal sonde is 15×20mm and it might be enough to abrase the all mucosa of the esophagus.
Five cases of early cancer and one of advanced of the esophagus were detected by cytology using this technique among 2, 787 cases during the period of 1974 to 1984.
Localisation of early esophageal cancer was as follows; one at Ce, 3 at Im and one at Ea.
Among these early cancer cases, 4 were m type (cancer in situ) and one was submucosal type. The smallest size of early cancer cases was 10×13mm in size.
False negative case was not found in the present series.
If these cases being performed sponge cytology is considered as high risk group because they visited both clinic with any symptoms and complaints, the incidence of early cancer detected by this technique was 0.18%. As the incidence of esophageal cancer by screening of X-ray is about 0.005-0.013%, this technique of cytologic screening using esophageal sponge must be very effective and valuable because of incidence of more than 10 times compared with the X-ray screening.

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Our present studies were aim at:(1) exploration of the applicability of the light and electron microscopic immunoperoxidase procedure to diagnostic cytology of the breast, (2) investigation of the possibility of differentiating benign from malignant mammary cells on aspiration biopsy smears by studying their localization of immunoreactive patterns of carcinoembryonic antigen (CEA), (3) establishment of mammary specific tumor markers.
Methodologically, we utilized indirect peroxidaselabeled antibody method (Nakane) at both light and electron microscopic levels. Specimens were:(1) imprinted smears from various mammary lesions, (2) tissue specimens from same lesions where imprints were taken.
CEA was found histologically in all studied cases, but its localization in malignant ducts was dramatically different from that in benign ones. That is CEA was found on the apical surfaces of the non-neoplastic mammary glands, but in adenocarcinomas, this polar distribution was absent and, in general, immunoreaction of anti-CEA was increased around the indivisual malignant cells. And these staining tendency and intensity in tissue preparation were reflected to imprinted smears. In nonneoplastic mammary cells, CEA was localized on the entire cell membrane of indivisual cells with uniform staining intensity. However in malignant mammary cells, CEA was localized on the cell membrane with their immunoreactive pattern different from that of benign cells. That is, in malignant cells, the intensity of immunocytochemical staining and localization of CEA varied among indivisual neoplastic cells even within the same clusters. These observations suggested that neoplastic transformation of the mammary epithelial cells may be recognized as a loss of the normal polar distribution of CEA. Therefore, the staining of CEA on aspiration biopsy smears would be helpful in differential diagnosis of atypical cells.
Among “mammary tumor marker”, Pregnancyassociated α-2 glycoprotein (PAG) was found in all of mammary carcinomas, but not in adenocarcinomas of other primary sites. Therefore, this marker appeares to be most specific for neoplastic cells originating from the breast.

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We have been employing echo-guided aspiration biopsy cytology for thyroid cancer in mass screening during September 1983 to December 1984.
In this survey 8, 976 samples (male: 6, 229, female: 2, 747) were examined, and 496 persons (male: 253, female: 243) were performed by echo-guided aspiration biopsy cytology. Thirty-three cases of thyroid carcinoma were detected, and the detection rate was 0.22% in male and 0, 69% in female.
The largest diameters of the operated carcinomas were as large as 11.9±4.2 mm, and more than the half of the cases were small carcinomas less than 10 mm in largest diameter.

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Sputum cytologic findings of twenty-five cases of resected early squamous cell carcinoma were analyzed quantitatively. All the cases were radiographically occult. Four cases were in situ carcinoma and twenty-one cases showed limited invasion within the bronchial wall. Cytomorphological findings of in situ and early invasive squamous cell carcinoma were compared with those of frankly invasive carcinoma and borderline cases (i.e. sputum in which cancer was cytologically suspected, but for which no cancer was detected after intensive examinations).
Cytomorphological differences among these groups were demonstrated to some extent. Cellular atypism of early squamous cell carcinoma was generally less bizarre than those of frankly invasive carcinoma, and it was sometimes difficult to discriminate these abnormal cells from severe atypical squamous metaplastic cells. These abnormal squamous cells were characterized by the predominant feature of keratinization ranging from small round or oval orangeophilic cells with relatively high N/C ratio to large polygonal slightly orangeophilic cells. Multinucleations were frequently observed.
The essential factors affecting these findings are various degrees of cellular differentiation toward the bronchial surface, surface maturation and abnormal mitoses.

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The nebular inclusions (NI), which are characteristic of chlamydial infection, are often overlooked in the routine screening work because of poor morphological characteristics of the inclusions. Which a view to making up for the weak points, morphological analysis of the nuclei of the chlamydia-infected cells were performed to compare with the nuclei of the noninfected cervical cells.
It was confirmed by the immunoperoxidase method (PAP) that all of 461 infected cells collected from the uterine cervices of 30 patients contained the chlamydial inclusions.
The results are as follows:
1) The nuclear diameter and the irregularity of nuclear rim of the infected cells showed intermediate values between those of the noninfected cells and the dyskaryotic cells.
2) The most remarkable nuclar atypia was observed in the tissue repair cells infected with chlamydia, while the atypical nuclei resembling those of the dyskaryotic cells derived from dysplasia were detected in only one case out of 30 cases of chlamydial infection.
These findings suggest that if a lot of atypical metaplastic cells with slightly enlarged nuclei, hyperchromasia and irregular nuclear rim are encountered in screening, the preparation should be examined for NI with the utmost care, because the case is strongly suspected to be chlamydial infection.

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Malignant granular cell tumor is a rare malignant tumor of the soft tissue. A case of primary malignant granular cell tumor of the uterine body observed in a 53 year-old woman with complaints of lumbago and lower abdominal pain was reported. The case was diagnosed as having a tumor of the uterus and underwent abdominal simple hysterectomy with bilateral adnexe. Many semispherical dark red to red-brown tumors were observed at the rear wall of the removed uterus and a section of the tumor was colored pale yellow. Histological examination revealed pleomorphic tumor tissue, abundant cytoplasm with diastase resistant PAS positive granules, swollen nuclei and nucleoli, a great amount of mitosis and multinucleated giant cells, strong infiltration and proliferation in vascular canals around the tumor, which all suggested an unfavorable prognosis. Imprinted smears revealed a somewhat dirty background due to necrosis, dispersed tumor cells, irregular polygonal cells with obscure boundary, cytoplasm with granules, nuclei of irregular size, many swollen nucleoli and outstandingly large nucleoli in the multinucleated giant cells. Differential diagnosis from clear cell carcinoma or uterine sarcoma was considered to be necessary for this tumor. Many theories have been presented as to the histogenesis of this tumor but none is considered to be determinant.

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Cytological features of a 47-year-old patient with clear cell carcinoma of the ovary are reported here. The characteristic amorphous PAS-positive, diastase-resistant body surrounded by tumor cells was found in the vaginal pool smear and ascitic fluid. The origin of the amorphous body was discussed from the cytological and histological points of view. The existence of a characteristic body may be useful in diagnosings clear cell carcinoma.

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Clear cell carcinoma occurs most frequently in the ovary, but vary rarely in the endometrium. This is a case report of a primary clear cell carcinoma of the latter origin. A 75-year-old woman, para 1, was hospitalized with the chief complaint of postmenopausal bleeding. In the specimen of endometrial cytology taken by Endocyte, tumor cells were revealed to have apparently clear and abundant cytoplasm with occasional vacuoles. PAS-positive glanules were found in it. The honey-comb pattern of cellular arrangement was obvious and a tubular pattern was also observed in part. The nuclei, round and oval, were hyperchromatic in which one or two nucleoli were observed. Solid and tubular patterns of clear cells were characteristic in the histopathological specimen of the case.

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Primary adenocarcinoma of the vagina is a extremely rare disease, and only a few cases have been reported except for clear cell carcinoma which seems to be related to non-steroidal estrogens such as diethylstilbestrol.
A vaginal tumor was found in a 47 year-old female and diagnosed histologically as a moderately differentiated endometrioid adenocarcinoma. The vaginal scraping smear showed a tumor diathesis and contained a small number of malignant cells. Tumor cells were relatively small, but varied in size with a high N/C ratio. The nuclei contained prominent nucleoli, but hyperchromasia was not conspicuous. In the imprint smear, the adenocarcinoma cells showed a remarkable resemblance to those obtained by the vaginal scraping smear.

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The uterine mixed mesodermal tumor (MMT) is a highly malignant and rare lesion. Most recently, we encountered a case wherein the patient was diagnosed as suffering a uterine MMT that revealed findings of a rhabdomyosarcoma as well as an adenocarcinoma in it as a result of an autopsy. The patient's peripheral blood and bone marrow fluid may be indicating a sarcoma of unknown origin, poorly differentiated carcinoma, or leukemia. In conducting the above diagnosis, we employed immunohistochemical staining for myoglobin and studied the case immuno-enzymehistochemically to obtain the following conclusion through discussion of the resulting histology, peripheral blood smear, bone marrow smear as well as tumor stamping smear.
1. Though it is, in most cases, difficult to make an identification histologically with either an adenocarcinoma or an alveolar type rhabdomyosarcoma with H-E stained specimen, this becomes relatively easy if we employ an anti-myoglobin stain.
2. If atypical cells with striation can be observed in a smear specimen, a rhabdomyosarcoma can be easily diagnosed. However, with only rhabdomyoblast appearing in the specimen, it could be anything but an easy task to identify a rhabdomyosarcoma from other types of tumors or cancer. It is easy to diagnose a rhabdomyosarcoma using anti-myoglobin staining techniques.

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According to Herting, adenoacanthoma is defined as an adenocarcinoma with focal a benign appearing squamous metaplasia and few cases of primary uterine cervical adenoacanthoma have been reported. One case of cervical adenoacanthoma is presented here.
A 46 year old patient, para 2, had minimal cervical associated with contact staining of one month duration.
The cytology of a cervical smear showed malignant cells either in isolation, side by side grouping, or in overlapping conglomeration in a relatively clean background. Cell contour was hazy and cytoplasm was rich, lacy and cyanophilic. The large ovoid or round nucleus contained fine granular chromatin and prominent nucleoli pseudocannibalism of cells was noticed. Many loose sheets of abnormal cells indicating squamous metaplasia frequently arranged in stone wall fashion were rather conspicuous.
The conglomeration of cells may suggest endometrial origin, although the clean background and broad cytoplasm were considered contradictory.
A histology of operative specimens revealed highly differentiated adenocarcinoma of endometrioid type with focal squamous differentiation confined within the uterine cervix at stage Ib.

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Numerous mature squamous cells are not found in the ascites. There have been no reported cases in which mature squamous cells were found in the ascites at laparotomy. We have experienced a case of immature teratoma associated with endodermal sinus tumor of the ovary which had numerous mature squamous cells in the ascites.
The patient, a 14 year-old girl, was admitted to our hospital because of abdominal distension. Upon opening the abdomen, intraperitoneal cavity was filled with a giant left ovarian tumor and 300ml of yellowish ascitic fluid was aspirated. Cytological examination of the ascitic fluid disclosed numerous superficial, intermediate and parabasal squamous cells which had no atypia among small numbers of neutrophils in a clean background. There were no other tumor cells. Histologically, most of the mass was mature teratoma but partially immature neural tissue and endodermal sinus tumor. After chemotherapy for nine months, a second look operation was performed. Gliomatosis peritonei was only found in the peritoneal cavity. There was no evidence of recurrence and no squamous cells in the washing cytology.
We concluded that the numerous mature squamous cells were derived from the ruptured immature teratoma, in particular parts of mature squamous tissue. These cells were not found at the second look operation.

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A case of alveolar rhabdomyosarcoma of the vulva was studied by histological and cytological examinations. Histologically, alveolar structures which consisted of round and oval cells with scant cytoplasm and fibrous trabecula were found. These findings were compatible with those of alveolar rhabdomyosarcoma regardless of absence of clear cross striations.
Imprint smears showed the following findings; uniformity of tumor cells, isolated cells, finely granular chromatin pattern, presence of macronucleoli and presence of multinucleated cells.
Among these, uniformity of the tumor cells might be of importance to differentiated this tumor from other sarcomas.
Considering a poor prognosis of this disease, it is of much interest that a combination chemotherapy used was effective transiently.

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A case of primary malignant mesothelioma arising in the pericardium of a 48-year-old female is reported.
Two types of cells, epithelial and nonepithelial form, were detected in the imprinted smears of the tumor tissue. They were arranged in cell clusters and in sheetlike formation. Epithelial cells were composed of roundshaped cytoplasms and centrally located nuclei. Each nucleus had somewhat thickened nuclear rim, evenly scattered fine granular chromatins and 1 or 2 small nucleoli. Nonepithelial cells possessed long elliptical or spindle-shaped cytoplasms and nuclei with fine and coarse chromatins, but the nucleolus was not prominent. The cytoplasms of both cellular types were stained light-green with Papanicolaou stain and showed lace-like fassion. A great majority of these cells had well-defined cellular boundary.
Histologically, the tumor which was composed of cuboidal or polygonal cells in most areas revealed tubulopapillary pattern. Some areas comprising not only round or polygonal cells but also spindle cells assumed solid pavement-like arrangement. These cells were vacuolated and had intercellular spaces with formation of cleft-like or even glandular structures. No fibrosarcomatous pattern was seen.
The tumor cells showed positive staining reaction for colloidal iron and alcian blue, but the reaction was reduced or disappeared by digestion with hyaluronidase. The staining with PAS was weakly positive in the minority of cells, but negative following diastase digestion. The staining with mucicarmine was negative. In cytology, keratin staining exhibited more strongly positive reaction in epithelial cells than nonepithelial cells. In paraffin sections, keratin staining in epithelial cells varied from strongly to weakly positive reaction. Nonepithelial cells, however, displayed negative reaction for keratin in most parts.
Ultrastructurally, the tumor cells were characterized by numerous microvilli, abundant tonofibrils and tonofilaments associated with desmosome, and the presence of basal lamina.

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A case report of needle aspiration cytology on sacrococcygeal chordoma is described here. The patient, an 80-year-old man, appeared at the first Surgery of Kurume University Hospital because of a pelvic tumor and an aspiration cytology was performed.
Cytologically, tumor cells were arranged in cords and sheets in a mucinous background. The tumor-cell cytoplasmic features were distinctive and some of the tumor cells (so-called physaliferous cells) contained one too many clear vacuoles-about 2 to 20 micron in diameter. Multiple small vacuoles were arranged around a nucleus and signet ring cell-like large vacuoles were also seen.
The electron microscopic observation revealed physaliferous cells, nonvacuolated stellate cells and transitional forms. The tumor cells were locked together by interdigitating cellular processes and desmosomes were present. These cells had many organelles including rough ER, bundles of microfilaments and clusters of glycogen.
The plasma membrane exhibited a large number of pinocytotic vesicles and occasionally the cytoplasmic intrusions appeared as intranuclear pseudoinclusion. The cytoplasmic vacuoles were of three types: distended rough ER, cytoplasmic vacuole and intercellular space. The signet ring cell-like large vacuoles were cytoplasmic vacuoles delimited by a single membrane and some of them contained a variable amount of amorphous granular materials.

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Here we report chiefly about cytologic features in neoplastic cardiac tamponade from a patient with mediastinal embryonal carcinoma.
The patient was a 55-year-old female who had complained of hoarseness and coughing for a few months. Later, cardiac tamponade suddenly occurred. Although many atypical cells suggested of adenocarcinoma were seen in the aspirated pericardial effusions, the primary focus was not made clear.
The tumor cells generally appeared in clusters of glandular or papillary arrangement. They had cytoplasms stained well with light green and ovoid-shaped nuclei with slight anisonucleosis. The nuclear membrane was clear and one or two prominent nucleoli were recognized. Some tumor cells had markedly indented nuclei.
A definite diagnosis was confirmed by autopsy. Macroscopically, a mass, 6×4×4.5 cm in size, was detected in the anterior superior mediastinum and had invaded directly to the pericardium. Histopathologically, the tumor was diagnosed as embryonal carcinoma which proliferated in glandular, papillary or medullary fashion. The tumor cells were negative for PAS reaction, and also negative for alpha-fetoprotein, human chorionic gonadotropin and placental alkaline phosphatase in immunohistochemical staining using the peroxidase antiperoxidase technique. Neoplastic changes or scar fibrosis were not recognized in bilateral ovarian tissues.

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A case of mixed types of squamous cell carcinoma and transitional cell carcinoma of the urinary-bladder is reported here. The patient was a 60-year-old Japanese man who complained of hematuria.
Cytological diagnosis of the urine showed mixed types of transitional cell carcinoma and squamous cell carcinoma.
The biopsy showed transitional cell carcinoma with squamous metaplasia during hospitalization.
Cytological diagnosis of the touch smear from the tumor at autopsy showed keratinizing squamous cell carcinoma, which had the following features cytologically:
1) Oval or polygonal shapes,
2) Parabasal and superficial cell size,
3) Dense opaque orangephilic cytoplasma with laminar structure,
4) Nucler pyknosis and karyolysis.

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