Upon cytological diagnosis, Giemsa's, May-Griinwald Giemsa and Wright's stain come next to the Papanicolaou's stain. An original report of Giemsa's stain (1904), May-Grünwald-Giemsa stain (1908) and Wright's stain (1902) were cited.
Also the original method was compared with the recent modified one by using the same blood smears. The Giemsa's stain solution diluted with phosphate buffer stained better than the solution diluted with distilled water. The original May-Grünwald-Giemsa method had the same quality of staining as the variated one. The variated Wright's stain was better than the original.
With respect to the history of these three staining methods, the method began by the simple mixture of methylen blue and eosin then it was developed into the Romanowsky effect by adition of methylen azur. Then its stability was increased by the use of phosphate buffer.
Studies on simplification of these staining methods are under investigation though now three staining methods are used widely throughout the world.

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Cytologic studies of giant cell lesions of the bone containing varying degrees of osteoclast-like giant cells were carried out in order to clarify differential diagnostic characteristics. The lesions included giant cell tumor (2 cases), chondroblastoma (3), non-ossifying fibroma (2), osteoblastoma (1), and giant cell-rich osteosarcoma (2). Needle aspiration materials or smear preparations of open biopsy were stained with Pap. stain, and some with Giemsa and PAS stains. Immunohistochemical stain by the avidin-biotin-peroxidase complex method (ABC method) was also performed with antisera of S-100 protein, blood coagulation factor XIII a and alkaline phosphatase. Tumor cells other than multinucleated giant cells, such as stromal cells in giant cell tumor, chondroblasts in chondroblastoma, osteoblasts in osteoblastoma were stressed as cytologic characteristics. S-100 protein for cartilage cells, alkaline phosphatase for osteoblasts and factor XTEE a for fibroblastic cells were also helpful Diagrams of numbers and the frequency of nuclei in multinucleated giant cells revealed some differences among these tumors.

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An attempt was made to elucidate the cytological characteristics of chondrogenic tumors of bone for the purpose of differential diagnosis. Materials were obtained by needle biopsy aspiration, curettage, resected specimens or pleural effusion of enchondroma (four cases), osteochondroma, chondroblastoma, conventional chondrosarcoma, chondroblastic osteosarcoma (three respectively) and one dedifferentiated chondrosarcoma. Cartilage matrix closely associated with tumor cells wase recognized to varying degrees in all cases. Nuclear features such as enlarged nuclei, double or multiple nuclei, bizarre nuclei and high N/C ratio, in addition to the abundance of cells obtained appeared useful for the cytologic interpretation of chondrosarcoma. Chondroblastomas revealed characteristic cytology features different from those of giant cell tumor and the immunohistochemical demonstration of S-100 protein, which is not seen in the latter was especially useful. Measurement of average cell and nuclear diameters exhibited different characteristic histograms between benign and malignant chondrogenic tumors.

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In gastriculcer and gastric cancer, the endonuclear DNA content of biopsy samples obtained by direct vision endoscopy were determined by Feulgen-DNA-cytofiuorometry. The mean value of DNA content was higher in ulcer gastric mucosa, especially in the healing stage, than in normal mucosa. From analysis of histograms obtained, active mucosal healing in ulcers after polypectomy and an irreguler cell cycle in recurrent ulcers were suggested. Both the mean value of DNA content and the standard deviation in gastric cancer lesions were significantry higher than in other lesions, and the rate of appearance of polyploidy in histograms was also high. These histograms were classified into three patterns on the basis of mode and variance, and were also compared with the degree of infiltration, the degree of lymphovascular invasion and the histological type. Mucosal cancer represented much of type I, while with depth invaded of serosa tended to represent much of type III was related with few exceptions, to the degree of lymphovascular invation. There was no definite relationship between histogram pattern and the degree of histological differentiation. The DNA content in adenoma lay between that of normal mucosa and that of cancer, but when the rates of appearance of polyploidy over 3c or 4c were compared, a false positive or false negative relationship was found between some of the lesions and cancer. The quantitative method of determing the DNA content of the endonucleus seems to provide effective information not only with regard to differences between benign lesions and malignant lesions of the stomach, but also the healing tendency (ability of healing) of an ulcer, developing forms of gastric cancer, clinical diagnosis of adenoma and so on.

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From 1982 to 1984, percutaneous fine-needle aspiration biopsy of the liver was performed under ultrasonic guidance in 52 patients with primary of the liver. Of 29 resectable malignant hepatic tumors, 14 were well differentiated type of HCC, 4 were moderately differentiated type, 5 were poorly differentiated type, 3 were cholangiocellular carcinoma, and 2 were combined hepatocellular-cholangiocellular carcinoma. Cytologically, in the well differentiated and moderately differentiated type of HCC and cholangiocellular carcinoma, a correct diagnosis was easily made. Although in the poorly differentiated types of HCC and combined hepatocellular-cholangiocellular carcinomas, a correct diagnosis for malignancy was easily made, differential diagnosis between these two types of HCC was difficult, because tumor cells of combined hepatocellular-cholangiocellular carcinomas had negative PAS, Alcian-blue staining and the morphological features similar to the poorly differentiated types of HCC. But in tumor cells of combined hepatocellularcholangiocellular carcinomas, chromatin patterns were more coarse and yellow-brown granules were more frequent than in those of poorly differentiated types of HCC. Electron microscopic examinations show that the individual tumor cells of combined hepatocellular-cholangiocellular carcinomas contined both elements of hepatocellular and cholangiocellular origin.

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We studied Intracytoplasmic lumina (ICLs) of breast carcinoma cells on histological and cytological preparations by light microscopy.
The ICLs were divided into two types, one was characterized by the presence of secretions in ICLs (A-type), and another was by no secretions in them (B-type).
And further, A-type was subdivided into two types (A-I & A-II type) according to characteristic of these secretions. The A-I type contained distinct round to oval shape secretions, and the A-II type secretions were not only indistinct in shape, but pale in colour.
In cases with common type of breast carcinoma, the A-type ICLs were found in 49.1% of the cytological cases.
We should consider the detection of ICLs by cytological examination in cytological diagnosis of malignant breast tumors.

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To elucidate the characteristics and origin of the bipolar nuclei of breast cytology, aspiration and touch smears of fifteen cases of fibroadenomas were studied by enzyme histochemistry (adenosine triphosphatase, ATPase reaction) and electron microscopy. There were two types of bipolar nuclei which were oval and spindle shaped appearance. ATPase reaction was rarely positive in all bipolar nuclei. Ultrastructually, these bipolar nuclei posessed thin cytoplasm and the organella (well developed rough surfaced endoplasmic reticulum and Golgi complex), but cytoplasmic filament with dense body was not demonstrated. In general, origin of the bipolar nuclei was presume as mainly myoepithelium. The authors demonstrated that bipolar nuclei were fibroblasts, and small amount of myoepithelium and duct cells. Cytological frequency of bipolar nuclei was extremely higher in fibroadenomas, against breast carcinoma and mastopathy.

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In the cases of Krukenberg tumor, positive cytology was rarely found in the vaginal or endometrial aspiration smear. In the present study, we report three cases with positive cytology out of ten Krukenberg tumors which were diagnosed during ten years. And the cytological features were discussed.
1) The cases with positive cytology had cervical or endometrial metastasis combined ascites. The back ground of the cytological smear was clear without the tumor diathesis. The atypical cells consisted with some cells having a large mucus in cytoplasma. The size of grouped cells was trend to be small and many single or isolated cells were observed.
2) The average long axis and short axis of nuclei of Krukenberg tumor cells was 10.36±1.86μ and 7.44±1.39μ. They were smaller than that of nuclei of primary cervical adenocarcinoma.

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Cytomorphologic study on recent 6 cases of malignant Müllerian mixed tumors of the uterus was performed in our laboratory by Masubuchi's aspiration cytology. These malignant tumors were composed of a single of mixed components, stromal sarcomas, leiomyosarcomas, and rhabdomyosarcomas. Non-epithelial abnormal cells were classified into 7 types due to their cellular configurations.
The following results were obtained: 1) In 6 cases, we found the define small abnormal cells exhibiting free nuclei of undifferentiated non-epithelial origin in addition to the abnormal cells with spindle, round cellular type. The small abnormal cells with free nuclei have identical findings in both nuclear size and structure. 2) By making a classification of the so-called tadpole cell into three types, cytomorphologic findings presume their histologic types. First, the detection of small abnormal cells with free nuclei presumes the presence of non-epithelial malignant tumor. Second, the recognition of cytomorphologic characteristics of spindle, round, and tadpole cell presumes the single histologic type of stromal sarcoma, leiomyosarcoma, and rhabdomyosarcoma. Third, the recognition of cytomorphologic characteristics of tadpole cell presumes tne mixed histologic types consisting of stromal sarcoma, leiomyosarcoma, and rhabdomyosarcoma, Furthermore, these cytomorphologic findings will be established by study more cases.

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In order to investigate the cell kinetics of the human chorionic tissue distribution of the DNA, the content of denucleated nuclei from human chorionic tissue was measured by flow cytometry.
In the present paper, the distribution of the DNA content of nuclei derived from the normal chorionic tissue was compared with that of an “abnormal” one in the case of abortion or hydatidiform mole etc.
The materials used were obtained by means of D & C or delivery. Satisfactory preparations of nuclei were obtained by using the citric acid method. For the staining of nuclei, propidium iodide was used, and the analysis was performed by Cytofluorograf 50H (Ortho, U.S.A.).
It was observed that all samples in the third trimester showed diploid patterns in DNA distribution, but those in the first trimester showed high level patterns in both S phase and G₂+M phase.
On the other hand, clearly different patterns were found in the “abnormal” samples derived from the abortion or dydatidiform mole etc. Obvious aneuploidy was seen in the case of blighted ovum. The double peaks pattern was specific in the case of hydatidiform mole in comparison with the normal condition.
In conclusion,
1. We have established a method of denucleation of cells derived form chorionic tissues for the flow cytometry.
2. It was revealed that proliferation of chorionic cells from the first trimester are more active than those from the third trimester.
3. Moreover it was found that proliferation of the abnormal chorionic cells is quite different from that of the normal ones.

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Cytologic and immunocytochemical studies were carried out on the Papanicolaou preparations obtained from the genital tracts of the patients, cytologically diagnosed to be herpes simplex virus (HSV) infection. The cells (365) examined, consist of 250 cells cytologically diagnosed, and 115 cells suspected of HSV infection. Then, they were stained by the indirect immunoperoxidase method using anti-HSV type II rabbit immunoglobulins after destaining Papanicolaou preparations.
Immunoperoxidase positive reactions were detected in 223 (89.2%) out of 250 cells diagnosed as HSV infection and in 93 (80.9%) out of 115 cells suspected of HSVinfection. The application of immunoperoxidase method to destained Papanicolaou preparation was very useful technique for diagnosing HSV infection in cytologically suspected case. However, HSV infected cells with eosinophilic cytoplasm due to cytologic degeneration showed marked decrease in the specific immunoreaction.
Besides well-known findings pointed out by foregoing studies, ground-glass appearance of nuclei, multinucleation, molding, thickening of nuclear membrane and intranuclear inclusion bodies, the author detected intranuclear vacuoles with small basophilic granules, as important features of HSV infection. In addition, not typical findings of HSV were identified by combination immunoperoxidase staining, such as nuclear overlapping pyknotic nuclei.

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Abnormal colposcopic findings such as white epithelium (W) and/or punctation (P) and/or mosaic (M) were noted in cervical lesions in all cases of this series.
Histologic diagnoses in these 24 women were metaplasia in 9 cases, CIN 1 in 10 cases, CIN 2 in 2 cases, CIN 3 in 3 cases and CIN detection rate was 63%.
Histologic evidence of HPV infection were detected in 19 of 24 cervical biopsies (79%). But HPV structural antigens with immunoperoxidase technique were detected in only 5 of 24 cervical biopsies (21%).
Penile condylomata were detected in 12 of 21 (58%) male sexual partners of women with vulvar condyloma. Penile condylomata were more frequently found in the male sexual partners of the women with CIN than those without CIN, significantly (p<0.005).

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To try to apply to the immunohistochemical staining methods to scanning electron microscopy (SEM), the procedure which was used for observing the free cells stained by the immunohistochemical method with light microscope and moreover the same cells with scanning electron microscope were examined.
(1) We used the lymphocytes as the material for observation and anti Leu 1, Leu 2a, Leu 3a as antibodies which were the surface markers of the lymphocytes for immunohistochemical staining method.
(2) The best fixative was 0.25% glutaraldehyde for SEM. And it also satisfied the reaction of immunohistochemical staining.
(3) The effect of methylgreen nucleal staining was not recognized on the surface structure.
(4) Both Streefkerk's and Isobe et al's method which were used for the blocking of innerperoxidase reaction did not undergo the effect on the cell surface.
(5) The products from the DAB reaction did not prevent the observation of the fine structures like microvilli by 10, 000 magnification at least.
(6) Although the fixative had to be selected according to the antigen for this purpose, the observation by SEM of the surface structure of the cells which were positive or negative on immunohistochemical staining become possible. Thus it was suggested that this method could be one of the application of the immunohistchemical method to SEM.

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The authors confirmed the secretion of insulin and somatostatin from the primary culture of resected human insulinoma during the last 9 months. The cell clumps consisted of Langerhans's island-like and fibroblast-like cells. The fibroblast-like cells were proliferated during the first one to two months in the early period of culture, but the number of Langerhans's island-like cells was the same and morphological changes were not observed. However insulin secretion was maintained at about 500 μU/ml for 9 months. Moreover, somatostatin was secreted at about 100 pg/ml during these period.
Insulin secretory granules were noted in cell clumps by Peroxidase-antiperoxidase staining method. It is interesting to note that insulin and somatostatin were highly secreted in the cultivation over this period.

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In order to differentiate whether a malignant bone tumor was osteosarcoma or a malignant giant cell tumor, enzyme cytochemistry and immunocytochemistry for alkaline phosphatase and acid phosphatase were performed on cell materials.
Tumor cells obtained by pleural aspiration showed mostly a spindle-shape. Small numbers of osteoclastelike cells or pleomorphic multinuclear giant cells were also found. Although a diagnosis of malignant bone tumor was possible, it was difficult to differentiate osteosarcoma from malignant giant cell tumor by usual cytological examinations. Using enzyme and immunocytochemical procedures, alkaline phosphatase activity was revealed along the plasma membrane or in the cytoplasma of the tumor cells, while acid phosphatase activity was not found. These results were coincident in the histochemical results of the tissue materials and a diagnosis of osteosarcoma was confirmed.
Enzyme and immunocytochemistry of alkaline phosphatase and acid phosphatase are effective in differentiating osteosarcoma from malignant giant cell tumor in the field of cytological diagnosis as they are in histochemical diagnosis.

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A case of histiocytosis X in a fifty-five year ole male is described.
He had a palpable mass in the left inguinal region for two months and destruction of pelvic bones had been first noticed seven years previously. On cytological and histological examination the inguinal tumor consisted of histiocytic cells, xanthoma cells, Touton type and foreign body type giant cells and the other. Histiocytic cells have lobulated nucleus and small amounts of cytoplasm. Immunohistochemically, histiocytic cells showed a positive reaction for S-100 protein, but were negative in reactions to lysozyme and α1-antitrypsin. On electron microscopic examination Langerhans cell granules (Birbeck granules) were demonstrated in a part of histiocytic cells. Cytophotometric study of nuclear DNA content disclosed that histiocytic cells showed aneuploidy and increased number of cells in G2 and S phase, suggesting that histiocytic cells are neoplastic.

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A 60 years-old male was operated for a spinal tumor. An imprint specimen prepared from the removed tissue exhibited numerous signet ring-like cells, suggesting metastasis of the carcinoma. The tumor cells themselves, however, showed rather mild cellular atypism. The histological examination revealed that the tumor tissue consisted of two components, diffusely proliferated signet ring-like cells and cuboidal cells lining cystic tubules. Transitional features between both types were also observed. Histopathological diagnosis was spinal ependymoma. The signet ring-like structures of the tumor cells were ultrastructurally lined by microvilli, indicating their propery of “intracytoplasmic lumen (ICL) ”. Glycosaminoglycan was demonstrated in the suf ace coat of the ICL.

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We had an opportunity to study the cytologic findings on the pericardial effusion of a malignant neurogenic tumor, which occurred in the pericardium of a 54-year-old woman, and was diagnosed by histology and peroxidase-antiperoxidase method.
The initial signs of the patient were dyspnea and orthopnea. Chest X-ray film showed pleural effusion and marked cardiomegaly. CT scan led us to suggest an mediastinal tumor involving the pericardium. Upon operation, the tumor appeared to be a whitish, soft, and hemorrhagic one, and located in the pericardium. The Hemorrhagic pericardial effusion contained numerous large atypical cells, which had a maldistributed nucleus with dispersed fine chromatin and/or without one or two small nucleoli, and ample cytoplasm. There were a few atypical cells showing spindle or polygonal shape. Histologically, the tumor was composed of fusiformcells accompanying numerous mitotic figures. There were focal myxoid changes in the stroma and nuclear palisading in one part. By the peroxidase-antiperoxidase method, several tumor cells were positive for S-100 protein, but negative for myoglobin, keratin, and myosin. These findings corresponded to the malignant neurogenic tumor.
It appears that the cytological findings may be distinct from malignant mesothelioma and/or other epithelial tumors, but a neurogenic origin cannot be supposed by the cytological features alone.

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A case of chordoma at the blumenbach's clivus was reported. The patient was a 20-year-old Japanese woman complaining of double vision. An autopsy showed a good egg size whitisch tumor in the clivus.
Histologically, the tumor is composed of large polyhedral cells disposed in lobules or cords surrounded by a myxomatous matrix.
Cytologically, it consists of large cells which contain intracellular mucin. In some instances, the individual cells (physaliphorus cells) are demarcated with a high vacuolization. We think that the presence of mucin and vacuolization together with the specific cells found in these tumors are the most cytologic features of chordoma.

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Acinic cell tumor (ACT) from minor salivary gland is very uncommon. Only twentyfour cases of the ACTs from the buccal salivary glands had been ever reported, as far as we could find from the literature. In this paper, a case of ACT arising from the buccal salivary gland of 58-year-old female was reported with some clinical and cytological references of the ACT. An aspiration biopsy before the operation helped in the judgement of the foretelling diagnosis in this case.
The Papanicolaou-stained cytology revealed prominently single-isolated and or aggregated tumor cells among the blood corpuscles in the smear. The off-centered round or oval nuclei were characteristic. In green-stained cytoplasmas, there were observed many fine-vacuolar structures, probably secretory granules. The N/C ratio was low. Most of these tumor cells were oval and quite similar each other in shape.

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A case of extrahepatic pedunculated anaplastic hepatoma occuring in a 52-year-old male was reported. The patient was admitted to the hospital with the chief complaint of a gradually increasing epigastric mass. The preoperative physical examination and imaging procedure failed to show the accurate nature of the tumor. An ultrasonically guided aspiration cytology performed prior to the operation was diagnosed as leiomyosarcoma based on the findings of a remarkable variation, both in size and shape, of the tumor cells with occasional intracytoplasmic thin filaments. Many tumor cells had multiple or bizarre nuclei. Mitotic figures were frequently seen.
Surgery revealed a pedunculated tumor, 23×15×10 cm in size and 1, 800g in weight, underneath the right lobe of the liver connected with cord-like fibrous tissue. The liver showed cirrhotic change, however, no tumorous nodules were observed.
Histology of the resected tumor showed sarcoma-like appearance in a large portion of the tumor. However, the silver impregnation method used for the tumor preserved the architecture of an alveolar pattern. In a small portion of the tumor adjacent to the peduncle there appeared hepatocellular carcinoma with trabecular pattern. Electron microscopic findings also suggested hepatocellular carcinoma because of the findings of numerous microvilli on the surfaces of the tumor cells with the formation, though incomplete, of bile canaliculus-like spaces. The patient has been in good health for the past 3 years since the surgery.

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The hitherto reported number of studies on the cytology of the glucagonoma is extremely rare. Recently we have succeeded in making an identification of the glucagonoma through having performed a peroxidase anti-peroxidase (PAP) method immunocyto-chemical stain on an ascites of a glucagonoma patient by using an antiglucagon (monoclonal antibody). Here follows the report on the above diagnostic record.
The patient was a 71 year old Japanese woman who complained an abdominal tumor with a showing of an abnormally high blood sugar level who was then hospitalized. The tumor biopsy and ascites specimens had been collected while observing the process by use of an ultrasonic wave multiscanner. With the ascites smear specimen obtained through a Papanicolaou (Pap.) stain,
numerous papillary cell clusters were observed mixing with a large quantity of blood cells and mesothelial cells. Pleomorphic and neoplastic findings were observed with the nuclei, such as a marked anisonucleosis, coarse granular chromatin, and/or a prominent nucleoli etc. It was observed that there were existing materials (glucagon) in the lace-like shaped cytoplasms that could be stained by the anti-glucagon, and eventually the patient was diagnosed as suffering from a glucagonoma. The patient died on the tenth day after her hospitalization, and the autopsy was duly conducted. The tumor was a moderately differentiated tubular adenocarcinoma, and this could be stained by using an antiglucagon to eventually be diagnosed as a glucagonoma.
We cultured this pancreatic tumor and measured the glucagon levels in conditioned media. The cultures were characterized as produced glucagon in vitro.
As has been evidenced by the above example, we now can state positively that the immunocyto-chemical stain through the use of a monoclonal anti-glucagon is useful for making an identification of a glucagonoma in conducting a cytological and histological diagnosis.

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A 64-year-old man with pseudosarcoma of the esophagus is described. Morphological examinations were made and the tumor showed a polypoid macroscopic appearance. Imprint cytology revealed that many fusiform bizarre tumor cells occurring in clusters. These cells each contained a large nucleus with some prominent nucleoli and a granular chromatin pattern. We reported for the first time that the cytological findings for the sarcoma-like cells of the esophageal pseudosarcoma. These cystological findings and polypoid growth appearance of the esophageal carcinoma suggest the carcinoma may be a pseudosarcoma.

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We report a case of gastric teratoma diagnosed by aspiration cytology. The patient was 2-month-old male infant. A large mass showing extragastric growth was located on the grater curvature of body region and measured 12×9×9cm. Cytologically the tumor was composed of the elements derived from three germ layers including squamous, cuboidal and high collumnar epithelium with or without cilia, fat tissue, cartilage and neural tissue.
The majority of these cells appeared to be predominant mature but some of the neural cell cluster showed primitive immature structures.
The patient is presently doing well 6 months of the surgery, and there is no evidence of recurrent tumor.

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Rare cases of adenosquamous carcinoma of the liver and biliary cystadenocarcinoma, each of which was diagnosed by aspiration cytology and biopsy of cystic lesions of the liver.
A case of adenosquamous carcinoma of the liver was discovered in a 72-year-old man complaining of anorexia and abdominal fullness. Abdominal CT, ultrasonography and angiography revealed hepatic cystic lesions. As a result of aspiration cytology and biopsy adenosquamous carcinoma was suspected. The patient died after a six month course of the disease. Upon autopsy the liver was partially replaced by a solid tumor. Histologically the tumor demonstrated both malignant squamous and glandular components.
A case of biliary cystadenocarcinoma was discovered in a 51-year-old female having a complaint of left upper abdominal tumor. Abdominal CT and ultrasonography revealed hepatic cystic lesions. As a result of aspiration cytology and needle biopsy low grade cystadenocarcinoma was suspected. After that the patient developed ascites and right pleural effusions, from which adenocarcinoma was found in the cytology. However the patient is still alive two and half years after the diagnosis.
In the present cases aspiration cytology and biopsy specimens taken from cystic lesions of the liver yielded unequivocal evidence of malignancy, indicating that aspiration cytology can be quite helpful in determing the nature of the liver lesions.

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A case of granular cell tumor of the breast has been studied by cytology, histology and electron-microscopy. In cytological samples, granular cells with coarsely granular, ill defined cytoplasm were seen in clusters or in single. Angulated body cells with angular inclusion bodies were seen around or in the clusters of the granular cells. These inclusion bodies were unstained and slightly birefringent by Papanicoloau stain, pale blue by Giemsa stain and strongly PAS positive. Histologically, granular cells with weakly eosinophilic and coarsely granular cytoplasm were lobulated in cell nests by fine fibrovascular tissue. Spindle cells with strongly PAS-positive and angulated inclusion bodies (angulated body cells) were seen in thefibrovascular stromal tissue. By electron-microscopy, angulated body cells looked-like fibroblasts contained eliptical or round inclusion bodies. These inclusion bodies were composed of parallel stacks of filaments or segmented bimolecular structures.
In the cytological and histological diagnosis of granular cell tumor, it is an important criterion to identify the angulated body cells in addition to the granular cells.

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Cytological investigations of primary signet-ring cell carcinoma of the breast were reported.
The patient, a 74 year-old woman, had noted the tumor of the left breast few days before admission. A radical mastectomy was performed, followed by chemotherapy and the patient, after 3 years and 3 months, is apparently well.
The tumor, measuring 1.5 by 1.3 cm in greatest dimensions, histologically consisted of sheets and clusters of signet-ring cells with a moderate amount of fibrous stroma. Serial sections revealed the presence of foci of intraductal carcinoma.
Cytologically, the tumor cells, with abundant granular and/or foamy cytoplasm which was faintly pinkish with the Pap. stain, showed scattered distribution. Round and kidney-shaped nuclei, containing granular chromatin and a small round nucleoli, were usually displaced to one side of the cells. There was no any amounts of extracellular mucin.
The results of mucin stains showed that signet-ring cell carcinomas contained both sialo-and sulfomucins in cytoplasm.
A malignant tumor was not encountered radiologically in the gastrointestinal tract of the patient.

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The presence of psammoma body is an aid in the diagnosis of thyroid cancer. In this case, there were numerous psammoma bodies with characteristic laminations in the aspirated smear of the thyroid tumor. Despite the lack of malignant cells, positive diagnosis was made in the original cytological report.
After the operation, the histologic diagnosis was adenomatous goiter. So, a reobservation of the smear and comparison with the bodies in this case and the true psammoma bodies associated with thyroid cancer were performed by using oil immersion. The central area of the bodies in this case were thin and showed a foamy apperance. PAS reaction was negative. Therefore, the bodies in this case were considered to be a kind of calcific deposits.
To avoid a false positive diagnosis, detection of malignant cells and confirmation of true psammoma body in the aspirated smear are important for the cytology of thyroid cancer.

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An unusual anaplastic thyroid carcinoma with osteoclast-like giant cells is reported in a 72-year-old woman. The inprint smears from the thyroid tumor were highly cellular. Two cell types, mononuclear cells and multinucleated giant cells, were clearly recognizable. The mononuclear cells having round or oval nuclei showed variety in size but not in shape. Most nuclei had prominent nucleoli. The multinucleated giant cells contained from several to 100 or more round nuclei. The nuclei are located centrally and showed overlapping. The nuclear shape of some giant cells are similar to those of tumor cells. Histologically, monotonous proliferation of various sized mononuclear tumor cells were accompanied by numerous osteoclast-like multinucleated giant cells. A small area of papillary carcinoma merging with anaplastic area was disclosed. Electron-microscopically, the anaplastic carcinoma cells displayed prominent mitochondria, rough endoplasmic reticulum and intermediate cell junctions. The cell clusters formed irregular lumen into which numerous microvilli were extended and contained colloid-like material. Occasionally incomplete basal lamina were present. Existence of cell clusters showing a transitional picture from cell cluster to multinucleated giant cell and engulfing mononuclear tumor cell in multinucleated giant cell was observed by either light and electron microscopy. Findings from this report support the conclusion that anaplastic tumor cells probably arise in preexisting differentiated thyroid cancer and associated multinucleated giant cells are formed by the fusion of carcinoma cells.

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Sputum cytology has been introduced into several mass surveys because of its simplicity and ease of repetition. It is generally considered important for the detection of cases of central type lung cancer, especially radiologically occult squamous cell carcinoma in situ.
Most radiologically occult lung cancer cases, detected by sputum cytology, are squamous cell carcinoma. The two cases of peripheral type adenocarcinoma reported here, were negative on the P-A view, and they were detected by mass survey sputum cytology. Lateral X-ray revealed the lesions to be in S⁸ and S⁶, and they were 3.0 × 3.0 cm and 2.7 × 3.0 cm in size, respectively. On the P-A view the abnormal shadows were hidden by the right diaphragm or the right hilar shadow. Re-examination of sputum after admission also revealed malignant appearance, strongly suspicious of adenocarcinoma. Clinically both cases were stage I and lobectomy was successfully performed in both. The fact that a sputum cytology survey resulted in detection of 2 peripheral type adenocarcinomas not visible on routine P-A view X-ray, reaffirms the importance of mass sputum cytology survey in certain populations for the detection of lung cancer at a surgically treatable stage.

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A 76-year-old male complained of right upper abdominal pain. Because cholecystolithiasis was suspected, but malignant tumor could not be overlooked he was admitted to Isahaya Health Insurance General Hospital. He took a swift down-hill course with respiratory and cardiac failure and died on the sixth day in hospital. Although pleural effusion (1t. 350ml; rt. 640ml) and bloody pericardial effusion (500ml) were noticed, there was no detectable neoplasm, macroscopically. Cytological observation of the pericardial effusion at necropsy revealed numerous atypical cells. It was very difficult to differentiate among reactive mesothelial cells and neoplastic cells using Papanicolaou's stain. Because the PAP methods for CEA and keratin showed strong positivity, carcinoma was suspected. Semiserial cutting of the left lung showed tiny pulmonary carcinoma in the upper portion.
It is very effective to employ the immunocytochemical study of cavity-fluid for finding undetectable tumor at autopsy.

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Because of an interesting cytological feature, a case of endometrial hyperplasia showing marked squamous metaplasia is presented.
In the cytologic picture of the uterine cervix from a 52-year-old menopausal patient, abnormal keratinized cells were noted among the cervical cells without abnormal characteristics. On the endometrial cytology, numbers of irregular shaped keratin bodies were observed among numeraous squamous metaplastic cells and endometrial cells with slight anaplasity suggesting atypical endometrial hyperplasia.
This characteristic cytological feature was assumed to be caused from: 1) development of endometrial polyp, 2) atypical endometrial hyperplasia confirmed by postoperative histologic examination, 3) significant sub-mucosal inflammation and bleeding of the endometrium.
In addition, obesity and diabetes mellitus of the patient might have helped to make this an interesting pathologic picture showing remarkable keratinization of the endometrium.

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Malignant cells were found in the female urethra discharge of a 52-year-old woman.
The characteristic cytological finding were as follows:
1) Two types of cell were found, mostly in cluster or in papillary found.
2) The cells had abundant cytoplasm fain polygonal and dense.
3) The chromatin was finely granular.
4) The nucleoli were prominent and cetrally located and were present in the majority of the cells.
This tumor was very similar to clear cell adenocarcinoma in the female genital tract. We suggested a possible Müllerian origin of this tumor.
The patient is presently doing well 6 month after surgery, and there is no evidence of recurrent tumor.

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Two cases of mixed mesodermal tumor and one case of rhabdomyosarcoma of the uterine body were investigated.
Case 1; A 68-year-old female, gravida 6, para 6, was admitted to our hospital complaining of postmenopausal bleeding. Pelvic examination revealed an enlargement of the uterus and a polypoid tumor which was protruding from the cervical os. A scratch smear from the tumor showed many malignant nonepitherial cells which exhibited large nuclei and scanty cytoplasm. In additin to this a few malignant epitherial cells were found, and they were suspected to be adenocarcinoma. Histopathologically the tumor was composed of adenocarcinoma and sarcoma including the chondroid structure. This case was diagnosed as mixed mesodermal tumor.
Case 2; A 78-year-old female, gravida 4, para 4, was admitted complaining of bloody discharge. Pelvic examination showed a fistsized uterus. A vaginal smear taken at the first examination was negative. An imprint smear taken during the operation revealed the cytologic feature of squamous cell carconoma and adenocarconoma. In addtion to this a few malignant nonepitherial cells with large nuclei and scanty cytoplasm were found. These did not have the special features of the heterologous elements. Histological examination showed that this tumor consisted of adenocarcinoma with squamous metaplasia and rhabdomyosarcoma. This case was diagnosed as mixed mesodermal tumor.
Case 3; A 77-year-old female, gravida 9, para 9, was admitted complaining of abdominal pain and bloody discharge. Pelvic examination showed a polypoid tumor which protruded from the cervical os. The fundus and adnexa could not be palable. A scratch smear from the tumor showed malignant nonepitherial cells, which exhibited pleomorphism with enlarged nuclei, prominent nucleoli and scanty cytoplasm. In some of these cells we found intracytoplasmic cross striations. Histopathologically this tumor was diagnosed as pure rhabdomyosarcoma (Pleomorphic type).

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A case of so colled carcinoid tumor of the uterine cervix is reported. The patient was a 44-year-old woman having a complaint of vaginal bleeding and lumbar discomfort. She was clinically diagnosed as stage IVa carcinoma of the uterine cervix and received radiation treatment. During the treatment, she developed brain metastasis and expired 2.5 months after diagnosis. The cytohystological features are summarized as the following.
I) Histologic findings: Light microscopically, the predominant cells were small, possessing round to oval hyperchromatic nuclei with nucleoli and a scanty illdefined eosinophilic cytoplasm. Mitotic figures were easily observed. These cells were arranged in a solid nest with a trabecular pattern and a rosset liked structure. Grimelius stain of these cells was positive. At the ultrastructural level, cytoplasm of the tumor cells contained neurosecretory granules.
II) Cytologic findings: The arrangement of tumor cells was a loose or sheet-like grouping. The small round and oval cells had a scanty, illdefined basophilic cytoplasm. The nuclei had a variety of shapes, including those which were round, oval, or spindle-like. These nuclei with their thin nuclear borders had fine granular chromatin and predominant nucleoli. In these cells, mitotic figures were found.

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Process of progress of cell collection technics in the field of gastric cytology was described at first. Author started the study of gastric cytology by abrasive balloon technique in 1955 and biopsy with flexible gastroscope by author's own idea in 1958. Since 1963, gastrofiberscope was introduced for endoscopic examination and author deviced some equipments for cytologic examination under direct vision by gastrofiberscope.
Since 1974, author moved to new surgical clinic in Dokkyo University Hospital, and studied cytological examination for several organs in digestive tract.
1) Sponge cytology was performed as the screening of esophageal cancer for almost 3, 000 cases after gastroendoscopic examination. 7 cases of cancer of the esophagus were positive in cytology and among them 6 were in its early stage with rather smaller size. Some of them were very difficult to point out the lesion by x-ray or endoscopic examinations. This technique should be performed more widely for early detection of esophageal cancer.
2) Endoscopic biopsy and brushing cytology were used at the same time of examination in my clinic. Positive result of biopsy and cytology in each was almost 90% in cases of early gastric cancer at the first trial. However by using both technics at the same time the positive result was going up to almost 95%. Particulary, combined use of both technics for diagnosis of small early gastric cancer is essential.
Also cytology is the most benefitable technique for the diagnosis of the malignant lymphoma of the stomach. In my clinic, correct diagnosis of this malignancy was given in 90% of cases.
3) Cytological examination is also used for the diagnosis of cancer in the liver, biliary passage and pancreas by technics of endoscopic washing, brushing and aspiration under guiding of ultrasound. Aspiration technique under guiding ultrasound should be used for the diagnosis of liver, gall bladder and pancreas. Endoscopic washing and brushing should be performed for common bile duct and pancreas. PTC-cytology might be benefitable for cancer of the common bile duct and the head of pancreas. Combined use of these technics should be significant for the diagnosis of cancer in smaller size in these organs.
4) Technics of immuno-cyto-chemistry should be used for the analysis of function of cells. In my clinic Microtubule Associated Antigen-1 (MAP-1) antibody deviced by Dr. Chikako Sato (Aichi Cancer Center) is used for staining of cytological smear in the stomach. Cells with proliferative potential may be stained positively by this technique. These kinds of procedure should be performed with the combination of morphological study for analyzing the function of cells.

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