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Problems in cytological method of localization
Masami SATO, Yasuki SAITO, Tadashi IMAI, Noriyoshi NAGAMOTO, Katsuo US ...
1987 Volume 26 Issue 6 Pages
903-913
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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By April 1986, we had 5 cases (7.9% of resected radiographically occult lung cancers) of TX lung cancers located peripherally beyond the range of optimal bronchoscopic visibility. Minute tumor shadows were excluded using tomograms and CT. In order to localize these TX lung cancers, we analyzed the cytological findings of brushing and washing specimens.
After determining which side had more cancer cells in the bronchial secretion differential brushing cytology specimens were most useful in localizing these tumors. And when we encountered the tumor, many cancer cells which had strong cell-to-cell connections with basophilic cytoplasms were found on the slide. These cells are thought to originate from relatively deep layers of the tumor directly scraped off by brushing. We conclude that these findings have the most important diagnostic values. The differential brushing cytologies must be repeated until these findings are observed.
On the other hand, when we observred slides with crosscontaminations, the numbers of cancer cells were few, and cell-to-cell connections were weak. Most of these contamination cells had eosinophilic cytoplasms, which means that they were desquamated from the superficial layer of the tumor. By evaluating these cytological findings we can not only exclude the cross-contamination specimens but also detect the tumor location according to the brushing cytology specimens.
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Correlation with cellular subtypes
Hiroko KITAOKA, Hajime FUKUI, Yutaka HIROTA, Nanshin HARAGUCHI, Manabu ...
1987 Volume 26 Issue 6 Pages
914-919
Published: November 22, 1987
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Twenty-six resected cases of moderately and well differentiated lung adenocarcinoma, diagnosed cytologically as lung cancer pre-operatively, were classified into cellular subtypes based on light microscopic observation of H-E stained specimens of the resected tumors, to determine the correlation between cellular subtypes and agreement of histologic typing in cytology.
There were seven cases of bronchial surface epithelial cell type, thirteen Clara cell type, six mixed cell type, and no other types. All cases of Clara cell type were judged to be adenocarcinoma. Three cases of bronchial surface epithelial cell type were judged to be adenocarcinoma, and the other four cases were judged to be squamous cell carcinoma. Five cases of mixed cell type were judged to be adenocarcinoma, and another one was judged to be large cell carcinoma.
Misjudged cases were all judged by brushing cytology, and all cases judged by sputum cytology were judged to be adenocarcinoma. Stratified arrangement of spindle shaped cells and necrotic findings were found in brushing cytology of the bronchial surface epithelial cell type.
Cellular subtypes should be considered in judging histologic typing in brushing cytology of lung adenocarcinoma.
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Kinya SAWADA, Kimito MATSUMURA, Hideo IKEDA, Tetusi HIRATA, Hiroyuki M ...
1987 Volume 26 Issue 6 Pages
920-925
Published: November 22, 1987
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Cytological diagnosis was studied on twelve cases of bronchial carcinoid tumors.
1. Sputum cytology was of low diagnostic value.
2. Brushing cytology done immediatedly after bronchial forceps biopsy or transbronchial aspiration cytology (TBAC) ensured adequate diagnostic techniques in the evaluation of the biopsy specimen.
These reliable techniques yielded positive in 6 out of the 12 cases (50 percent).
In the other 6 cases, diagnosis was confirmed by direct smear performed during operation.
3. Differential diagnosis among small cell carcinoma of the lung, malignant lymphoma (non-Hodgkin type) and adenocarcinoma of the lung proved enough to be possible cytomorphologically.
Differential diagnosis between typical and atypical carcinoid relied upon cellular atypism, nuclear chromatin, N/C ratio, nuclear mitosis, and necrotic finding on background.
4. Further investigations suggested that recognition of histologic pattern (Soga classification) was possible by cellular arrangement in the evaluation of cytomorphology.
5. Specimens obtained from bronchial carcinoid developed in the periphery of the lung on 5 cases showed characteristic of spindle cell form.
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Shinichirou OTA, Yasuki SAITOU, Tadashi IMAI, Syunichi SUDA, Noriyoshi ...
1987 Volume 26 Issue 6 Pages
926-931
Published: November 22, 1987
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The DNA contents of 25 operated lung cancers (14 adenocarcinomas, 9 squamous cell carcinomas, and 2 large cell carcinomas) were analyzed using flow cytometry. The DNA Index was not correlated with tumor size.
In adenocarcinoma, the DNA Index was significantly lower (p<0.005) in stages I and II (mean=1.18±0.17) than in stages III and IV (mean=1.61±0.30), and the DNA Index was significantly higher (p<0.005) in the cases with mediastinal lymphnodal metastasis (mean=1.52±0.41) than in the cases without mediastinal lymphnodal metastasis (mean=1.18±0.17).
In squamous cell carcinoma, the DNA Index was significantly lower (p<0.025) in stages I and II (mean=1.05±0.09) than in stages III and IV (mean=1.49±0.34), and the DNA Index was significantly higher (p<0.025) in the cases with mediastinal lymphnodal metastasis (mean=1.49±0.34) than in the cases without mediastinal lymphnodal metastasis (mean=1.05±0.09).
In non-small cell carcinoma, the DNA Index was significantly lower (p<0.005) in stages I and II (mean=1.15±0.20) than in stages III and IV (mean=1.56±0.30), and the DNA Index was significantly higher (p<0.005) in the cases with mediastinal lymphnodal metastasis (mean=1.50±0.34) than in the cases without mediastinal lymphnodal metastasis (mean=1.15±0.20).
There was a significant correlation between the DNA Index and the p-TNM stage, especially the N-factor.
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Hisami YAMAKAWA, Mitsutoshi SHIBA, Masayuki BABA, Takehiko FUJISAWA, Y ...
1987 Volume 26 Issue 6 Pages
932-938
Published: November 22, 1987
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Fourteen cases of lung metastasis of colorectal cancer were studied cytologically to demonstrate the diagnostic value of the cytology. Cytological examination was performed on specimens of brushing, transbronchial needle aspiration, transbronchial forceps biopsy, percutaneous fine needle biopsy and operatively resected tumors.
The specific cytological features of these metastatic tumors were as follows: massive necrotic background, palisading appearance of the tumor cells, elongated tumor cell nuclei and multiple irregularly shaped tumor cell nucleoli.
A massive necrotic background was observed in all cases and the palisading appearance of the tumor cells was detected in 10 of 14 cases. Morphometrical analysis showed that the major-minor axis ratio of the metastatic cancer cell nuclei was 1.61 and was significantly larger than that of the adeno carcinoma of the lung. Multiple nucleoli were easily identifiable in most cases and the average number of nucleoli was 3.15 per cell.
These cytological findings strongly indicate lung tumor metastatisized from colorectal cancer.
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Takashi YAMADA, Kosuke HARA, Toyohiko SATOU, Fumiko KOIKE, Shigemitsu ...
1987 Volume 26 Issue 6 Pages
939-951
Published: November 22, 1987
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A new cellular criteria for cytologic diagnosis was settled to identify the small type of mammary cancer cells reasonably, based mainly on the following characteristics; This type of cancer cells are less atypical in morphology, but the intercellular adhesiveness was loose. The cells are usually collected by aspiration in freely separated conditions.
Base on the new criteria, after usual aspiration by the thin-needle apparatus from mammary glands, morphologic identification of the mammary cancer cells was carried out for cytologic diagnosis. Consequently, the accurate diagnostic rate of the mammary carcinoma increased from 70.9% to 85.4% in frequency, whereas a total of false positive and suspicious positive was never decreased.
The morphologies of the non-cancerous cells to be misjudged and their histopathologic backgrounds were demonstrated and discussed.
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Masahiko FUJII, Yasuyoshi ISHII, Koji CHYODO, Ichiro SAKUMA, Midori NA ...
1987 Volume 26 Issue 6 Pages
952-957
Published: November 22, 1987
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Cytologic findings such as nuclear size, nucleolar features and nuclear DNA content were analized in imprint smears taken from 8 intracystic papillary carcinomas and 16 intraductal papillomas of the human breast.
The mean size of the longer axis of nuclei was 9.86, um in 8 papillary carcinomas and 9.50 pm in 16 papillomas. We could not find a significant difference in nuclear size between the carcinomas and the papillomas. Larger nuclei than 15μm in axis were detected in 6 cases (75.0%) of the carcinomas and 3 cases (18.8%) of the papillomas.
The detection rates of cells with larger nucleoli than 2.5μm in diameter and cells with more nucleoli than 5 were 1.86 % and 1.18% in the malignant cells respectively, though 0.41% and 0.10% in the papilloma cells.
DNA histograms of the papillomas were classified into 5 DNA diploid and 11 hyperdiploid tumors with a few cells with DNA content up to hexaploid. In contrast, the papillary carcinomas showed broad DNA distribution between diploid and octaploid with hyperdiploid mode and they had many cells (11.38%, mean) with DNA content over tetraploid as compared with benign cases (3.34%, mean).
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Yasuyoshi ISHII, Masahiko FUJII, Tomie WAKABAYASHI, Koji CHYODO, Akiko ...
1987 Volume 26 Issue 6 Pages
958-962
Published: November 22, 1987
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During the past two years, breast secretion smears were obtained from 120 patients examined for nipple discharge by the concentration method at Tokyo Metropolitan Cancer Detection Center. Procedure of this method was as follows Nipple secretion collected by a series of three or five days was stored in a glass tube containing YM solution. The solution was then centrifuged at 1, 500rpm for five minutes, and the sediment was smeared on the clean glass slides thinly coated with 0.1% poly-L-lysine. After air drying, smears were re-fixed in 95% ethyl alcohol and stained by the modified Papanicolaou's method.
Of 13 histologically confirmed mammary carcinomas, 8 (61.5%) were correctly diagnosed as cancer, 1 (7.7%) was diagnosed as suspicious and 4 (30.8%) were false negative by this method. Whereas the cytologic diagnosis of the conventional method by which secretion was smeared directly were positive in 3 (23.1%), suspected in 3 (23.1%) and negative in 7 (53.8%). In five cancer cases without any palpable mass (TO), all were positive in the smears made by the concentration method, while only 3 were successfully diagnosed by the direct method.
These results clearly show that this procedure is a simple and reliable method for cytology of nipple discharge and is useful not only in hospital but also in mass survey examination.
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Motomu SAKAI, Kunio TAMURA, Sakae MURAKAMI, Jun TAKEUCHI, Motoo TAJIMA
1987 Volume 26 Issue 6 Pages
963-967
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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Using imprint smears of carcinoma cells appeared in urine of 31 patients with urothelial cell carcinoma, and frozen sections of surgically resected tissues in some cases, the localization and distribution of alkaline phosphatase were observed by enzyme histochemical methods. Alkaline phosphatase activity could be observed in the imprint smears in 9 cases of transitional cell carcinoma (TCC) which showed a significant morphological atypia (high grade) and/or the invasive growth to deep submucosal layer (high stage). In the frozen sections, alkaline phosphatase activities were frequently observed on the basal surface of TCC cells, and on the cell in the extreme portions of invasive growth.
The present results seemed to show that the appearance of alkaline phosphatase-positive carcinoma cells in urine indicates a poor prognosis of the patients with urothelial cell carcinoma.
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Yoko MIURA, Kuniharu ISHIOKA, Noriko KIMURA, Tai SATO, Akemi TOGASHI, ...
1987 Volume 26 Issue 6 Pages
968-973
Published: November 22, 1987
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From 1982 to 1985, transabdominal retroperitoneal lymphnode lymphnode aspiration cytology was performed 808 times in 70 cases mainly for urologic cancer cases. Of these 140 cases, 72 were bladder cancer, 24 were testicular tumor, 22 were prostatic cancer, 16 were renal tumor, 5 were ureteral tumor, 5 were tumor of penis and 5 were other tumors. Histological examination was performed in 45 cases and discrepancy with cytological result was found in 13 cases.
The result of cytologically positive and histologically negative may be caused by 1) cytologically false positive, 2) micrometastasis to lymph nodes and 3) insufficient lymphadenectomy.
In cytologically negative-histologically positive case, most probable cause was cell-sampling error. In our results, appropriate aspiration of sampling rate was 30-50%.
This method is now useful not only for selection of therapy in urologic cancer such as bladder cancer, prostatic cancer and others, but also for evaluation of therapy and diagnosis of cancer recurrence. More utility will be aquired by skillfull aspiration and bed side judgement on the adequacy of the aspirated sample.
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Syoji OHKI, Toshiyuki OKADA, Fumio HORIUCHI, Bin TAKEDA
1987 Volume 26 Issue 6 Pages
974-979
Published: November 22, 1987
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C. trachomatis is known to be dorminant as causative microorganism of male nongonococcal urethritis, but cytomorphological studies of Chlamydial urethritis are inadequate and Papanicolaou-stained preparations were considered to give no diagnostic findings
Cytological preparation, obtained by small cotton swab from 99 cases of urethritis were stained by PAP method for immunocytochemical demonstration of Chlamydia. Positive smears were decolored and restained by Papanicolaou-stain. 10.1% of them was PAP positive for C. trachomatis. PAP findings were classified to deffusely positive (D-type)(31.2%), marginally positive (M-type)(22.8%), and localized positive (L-type)(46.0%). Papanicolaou findings were divided to densely light-green positive (A-type)(45.6%), lightly light-green positive (B-type)(43.5%) and blot-like hematoxylin positive (C-type)(10.9%).
Such typical inclusions as observed in smear of uterine cervix, were not detected in urethral cytology of Papanicolaou-stain, but above-mentioned C-type is a remarkable detection and the author named blot inclusion of C. trachomatis.
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Naoki YOSHIMI, Masayoshi TAKAHASHI
1987 Volume 26 Issue 6 Pages
980-990
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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Computer-assisted image analysis entered the biomedical area, including cytology and histopathology, in the 1960s. We had developed the rapid image sensor analytical system (RISAS) with a linear type CCD (charge coupled device) for the quantitative analysis of biological activities of neoplastic and non-neoplastic cells. Recently, great advancements and refinements in electronic technology have enabled us to improve the RISAS. The new RISAS is based on a microcomputer. In the present study, the accuracy test, particularl on the absorbance microphotometry in the new RISAS was carried out in comparison with that in the flow cytometry (FCM). Also, the potential application of this system in the quantitative cytology and histopathology was evaluated by the experimental data using cytological and paraffin-embedded specimens. The results obtained in this study are as follows:
1) Varieties of image analysis by means of diologic system were easily handled with a microcomputer.
2) There were no quantitative differences between the resolution of image analysis scanned at intervals of 1μm and 1/4μm on the slides, although 1/4μm scanning was more reflective in character display than 1μm scanning.
3) Quantitative DNA analysis of over 1, 000 nuclei oparaffin-embedded sections was enough to show the changes of DNA pattern and to determine the DNA stemline. The data of DNA analysis using this system were similar to those obtained by FCM.
4) Analysis of cell cycle in a thousand isolated and smeared cells could be rapidly measured by this system and the data were similar to those by FCM.
5) The above findings indicate that the image analysis using the new RISAS is available not only to cell cycle analysis and/or DNA measurement but also to the observations of cell morphological characterizations.
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Pitfall for aspiration biopsy cytology of the subcutaneous tumors
Takashi YAMADA, Kosuke HARA, Toyohiko SATOU, Masahiko KAKIHANA, Masahi ...
1987 Volume 26 Issue 6 Pages
991-999
Published: November 22, 1987
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Eight cases of subcutaneous lesions associated with benign atypical cells of mesenchymal origin were studied. The findings confirmed cytologically accepted view of the morphology of these lesions, and also revealed the previous undescribed fact that the benign atypical cells of mesenchymal origin were not exclusively collected for cytologic diagnosis from so-called pseudosarcomatous lesions such as nodular fasciitis, proliferative myositis etc. From degenerated and/or regenerated lesions of the striated muscle and fibrous tissue, they were also found. Many of the latter lesions were induced by expansive and/or invasive growthes of neoplasms into the mesenchymal tissues.
It should be emphasized that some of the benign atypical cells described here may be not rarely mistaken for sarcoma cells.
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Toshihiko TOKI, Masayuki HORIGUCHI, Yuichi WADA, Akira YAJIMA, Makiko ...
1987 Volume 26 Issue 6 Pages
1000-1004
Published: November 22, 1987
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Patients with abnormal PAP tests of class III cytology were screened for Chlamydial infection, and the cytologic features of the Chlamydia-positive cases were examined.
The results obtained were as follows:
1) According to the enzyme immunoassay (EIA) method, 18 (4.7%) out of 380 cases with class III cytology were Chlamydia-positive.
2) In any one of these positive cases, cytologic examination revealed no findings characteristic of Chlamydial infection, such as central target formation, nebular inclusion and the like, indicating the difficulty in diagnosing Chlamydial infection via cytologic examination alone.
3) Cytologically, and/or histologically, 56% of the Chlamydia-positive cases showed signs of human papillomavirus (HPV) infection.
4) Atypical cells of all the 13 treated cases disappeared in 6 cases and persisted in 7 cases. Disappeared atypia in these 6 cases were mainly slight metaplastic atypia, while 6 out of 7 cases with persistant atypia showed signs of HPV infection. Cell atypia due to HPV infection persisted regardless of the treatment, i. e., cell atypia seems to become a problem especially when Chlamydial infection is complicated with HPV infection.
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Taiichiro AKAHORI, Masato KINUGASA, Azusa KIMURA, Youichi TOKIWA, Yasu ...
1987 Volume 26 Issue 6 Pages
1005-1013
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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In 12 cases of uterine nonepithelial tumors treated at Hyogo Medical Center for Adults, cytological features were studied by comparing the histological finding and the cytological finding. The cytological characteristics of uterine sarcoma were a relatively scattered occurrence of sarcoma cells, fibrous or quasicircular shape cells, and thin nuclearrim and clear nucleoli in the nuclear structures. In the sarcoma cells of carcinosarcoma cases, as compared to pure uterine sarcoma, various forms of cells were evident, and the incidence of a coarsely granular chromatin pattern was high, and the finding of nucleoli were more obvious. Furthermore, in the carcinosarcoma, cells hard to distinguish from cancer cells tended to appear in mass, even in the cells derived from sarcoma.
When the correct diagnostic rate was retrospectively compared between outpatient histodiagnosis and cytodiagnosis of outpatient, the histodiagnosis estimated sarcomas at 60% and carcinosarcomas at 71.5%, while the cytodiagnostic results were very poor, being 20% and 28.5%, respectively. But it was interesting in cytodiagnosis that the presence of malignant tumors could be predicted in all carcinosarcoma cases, although only benign lesions or borderline lesions could be estimated in 60% of the sarcoma cases.
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Nobuzo IWA, Yoshitaka TABARU, Chikao YUTANI, Hatue UEDA, Kazuyoshi MAS ...
1987 Volume 26 Issue 6 Pages
1014-1018
Published: November 22, 1987
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Destained-cervical smears from 14 patients with condylomatous atypia are demonstrated by means of an avidinbiotin-peroxidase complex (ABC) method with antisera to human papillomavirus (HPV) to demonstrate the presence of HPV antigen.
The staining for HPV antigen was present in 11 cases of cellular samples with condylomatous atypia while 3 cases of condylomatous atypia and 2 cases of non-infected cellular samples failed to show HPV antigen. Specific antigen for HPV was intensely presented in the nuclei of cells having a single or binucleated koilocytotic cells. The percentages of HPV antigen in koilocytes were ranged 0% to 57.2%.
The immunocytochemical technique of HPV antigen provides further confirmation to the HPV etiology of cervica condylomatous lesions.
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Ikuno FUJIMOTO, Katsuhiko HASUMI, Kazumasa MASUBUCHI, Yoshiyuki OSAMUR ...
1987 Volume 26 Issue 6 Pages
1019-1026
Published: November 22, 1987
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Using indirect immunoperoxidase technique on histological sections and cytologic smears of peritoneal fluid from ovarian epithelial tumors, we have evaluated the role of Epithelial Membrane Antigen (EMA) and its association with histopathologic types and staining pattern related to histologic grade.
Sections from 72 tissues (serous cystadenocarcinomas 37, mucinous cystadenocarcinomas 18, serous cystadenomas (LPM) 2, mucinous cystadenomas (LPM) 4, serous and mucinous cystadenomas 8 and normal ovaries 3) and the peritoneal smears from 18 serous cystadenocarcinomas and 10 mucinous cystadenocarcinomas were examined by immunohistochemical staining for EMA.
The following results were obtained:
1. In serous and mucinous tumors, the highest positive rate of EMA staining was observed in malignant groups, the second positive rate was in “LPM” groups, and lowest in benign groups.
2. All of 37 serous cystadenocarcinomas was stained for EMA (100%), and of 18 mucinous cystadenocarcinomas 14 cases were stained for EMA (77.8%).
3. In tissue specimens, EMA positive area was localized at luminal membranes in well differentiated adenocarcinomas, and in poorly differentiated, positive area was in diffuse cytoplasm.
4. Comparing EMA-positive rate with CEA, hkp and CAl25 in serous cystadenocarcinomas, the higher positive rate of EMA and CAl25 was obtained than that of CEA and hkp. In contrast the positive rate of CEA in mucinous cystadenocarcinomas was higher than that of EMA.
5. In cytological specimens, EMA staining was seenstrongly on entire cell membrane or diffuse cytoplasm. These findings were well correlated with those of histologic sections.
These results suggest that immunocytochemical staining for EMA could be of value not only for the diagnosis of malignant ovarian tumors but also for the automated screening of peritoneal smears.
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Yuji KANDA, Mitsuharu OHNO, Toshimitsu TAKASHINA, Eiki ITO, Osamu YAMA ...
1987 Volume 26 Issue 6 Pages
1027-1029
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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Of 6 cases with no endometrial invasion and positive cytology in ascitic fluid with ovarian cancer, 3 were positive on intratubal cytologic examination. Therefore it was concluded that cancer cells may appear in the cervix and/or vagina by passing through the uterine tube, particularly if ascites is present. In cases with endometrial invasion by ovarian cancer, cancer cells may appear in cervicovaginal smears as a result of a combination of passage through the uterine tube and discharged from the metastatic deposits.
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Mathilde E. Boon, Alons-van Kordelaar
1987 Volume 26 Issue 6 Pages
1030-1033
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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With the introduction of the combined spatula-Cytobrush sampling method, the percentage of representative smears (containing endocervical cells) rose from 68 to 99%, and the rate of cytologic positive cases increased significantly.
Both effects can be explained by the efficient endocervical sampling of the Cytobrush: first, it reaches higher parts of the endocervical canal, and, second the bristles of the brush dislodge atypical epithelium lining the endocervical clefts.
In the current paper is shown that the increase in detection rate depends on the type of cervical lesion. For slight dysplasia (mainly located on the ectocervix) the increase was nil, whilst in the more severe preneoplastic lesions (mainly situated in the endocervix) the increase was 1.5 till 2.4.
So Cytobrush sampling is essential for the efficacy of detection the more severe preneoplastic lesions.
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IInd report on intraepithelial neoplasia of cervical uteri
Fumio HORIUCHI, Syoji OHKI, Toshiyuki OKADA, Bin TAKEDA, Hideaki IWASA ...
1987 Volume 26 Issue 6 Pages
1034-1037
Published: November 22, 1987
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218 biopsies of uterine cervix with histological diagnosis of intraepithelial neoplasia (CIN) were immunohistochemically studied on paraffin section to analyse relation of concomitant infection of Chlamydia trachomatis and HPV.
1) Occurrence rate of positive Chlamydia trachomatis antigen in CIN was 27.0%, while that of HPV was 10.6%.
2) Chlamydia trachomatis antigen was detected in 21.7% of HPV positive CIN.
3) 15.3% of koilocytosis was found in Chlamydia trachomatis positive CIN.
4) Occurence rate of koilocytosis in CIN decreased with progresion of nuclear atypia of CIN.
Above-mentioned data seem to indicate possible mixed infection of STD of these two kinds.
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Keiko ITO, Hiroe OIKAWA, Taeko KONNO, Kazuo IWABUCHI, Naotake KANETA, ...
1987 Volume 26 Issue 6 Pages
1038-1045
Published: November 22, 1987
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The following results were obtained by examining the results of the mass screening for cervical cancer performed at the Cytology Center of Miyagi Cancer Society:(1) Investigations into 5-year changes in the ratio of adenocarcinoma cases to the invasive cancer of the cervix cases discovered since 1966 revealed a trend of increase in the ratio in recent years.(2) The ratio of cases having atypical columnar cells not satisfying cytological criteria as adenocarcinoma and subclassified into III Ad to the total cases screened was 0.06%.(3) Columnar malignancy including glandular dysplasia was detected in about 20% of the III Ad cases.(4) Cellular findings in the glandular dysplasia cases were characterized by the palisade arrangement and the nuclear hyperchromasia. Nuclear enlargement and coasely pattern of chromatin were minor.(5) Follow-ups of 93 glandular dysplasia cases revealed progression to adenocarcinoma in situ in 2 cases, to adenocarcinoma in 1 case, and to adenosquamous carcinoma in 1 case.
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Hajime TAMURA, Hidemitsu MIZUUCHI, Ryuichi KUDOH, Kentoku KUMAI, Kunih ...
1987 Volume 26 Issue 6 Pages
1046-1050
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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This study was performed to identify transferrin receptors of exfoliated cells in gynecologic cytology using monoclonal antibody (anti OKT9 antibody) and the immunoperoxidasetechnique (ABC method). In normal villi, syncytio-trophoblasts showed positive staining but, cytotrophoblasts showed negative staining.
In normal cervical epithelium, though basal cells showed negative staining, parabasal cells were positive. However intermediate and superficial cells were negative for OKT9.
When the epithelium was dysplastic, basal cells showed positive staining. For example, in mild dysplasia basal, parabasal cells and part of the intermediate cells were positive. In CIS, cancer cells were positive. With respect to invasive cervical cancers, both squamous cell cancer cells and adenocarcinoma cells showed strongly positive staining, but the stroma stained negatively. Therefore there was a clear distinction between the stroma and the cancerous lesion.
Endometrial cancer showed strongly positive staining.
The anti-transferrin receptor antibody used in this study provided a useful additional method for the diagnosis of gynecological malignancies.
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Hiroyuki MIURA, Harubumi KATO, Hideki SHINOHARA, Norihiko KAWATE, Chim ...
1987 Volume 26 Issue 6 Pages
1051-1055
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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Three cases of postinflammatory pseudotumor of the lung, which were strongly suspicious of lung cancer clinically, based on the chest X-ray examination and TV-brushing cytology results, were reported.
Case 1, a 69 year-old female was diagnosed as adenocarcinoma, case 2, a 76 year-old male and case 3, a 48 year-old male were diagnosed as squamous cell carcinoma. Pathological examination of surgically resected specimens revealed postinflammatory pseudotumors with atypical hyperplasia of the bronchial epithelium in case 1 and atypical squamous metaplasia in case 3 in adjuscent bronchi. In case 2 the site of origin of the brushing materials was unclear.
On the occasion of screening, differential diagnosis between atypical hyperplasia of the bronchial epithelium and adenocarcinoma, and between severe squamous metaplasia and squamous cell carcinoma is difficult. When making diagnosis we must keep in mind the posibility of chronic infectious lesions of the lung, such as postinflammatory pseudotumors and must also consider the transition from benign epithelial cells to atypical cells and overstaining.
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Yosei KATAYAMA, Takuzo ISHIDATE, Makoto TOGASHI, Fumie SHINYA, Shin TS ...
1987 Volume 26 Issue 6 Pages
1056-1061
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A case of false-positive sputum cytology in a patient with pulmonary embolism is reported. A 63-year-old male, who had a history of thrombophlebitis of the left leg, was admitted to the Hakodate Municipal Hospital because of bloody sputum and chest pain. Chest X-ray revealed abnormal shadows in the bilateral costphrenic angle. Atypical cells with enlarged nucleus and prominent nucleoli are forming small clusters in the sputum collected on 9 to 11 days after the onset of the respiratory symptoms. Their cytological findings were thought to be indicative of adenocarcinoma. However, pulmonary arteriography revealed several emboli. Repeated sputum cytology, performed on 22 to 24 days after the onset, did not have any atypical cells, and the abnormal shadows on chest X-ray film gradually disappeared.
As mentioned above, sputum cytology in patients with pulmonary embolism may transiently show some stypical cells resembling to adenocarcinoma cells. The knowledge on this fact is important to perform sputum cytology.
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Atsuko KAWAI, Kiyoko YOSHIDA, Shinsuke IWABUCHI, Yoko MIURA
1987 Volume 26 Issue 6 Pages
1062-1065
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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The case is a 61-year-old man who presented lung metastasis 4 years after radical operation for left femoral rhabdomyosarcoma.
Lung metastasis, which generally occurs frequently in the peripheral, especially just in the subpleural region of the lung, is difficult to examine transbronchial cytologically and/or histologically.
The present case presented a subbronchomucosal metastatic focus, cytologic and histological examinations of which were possible by biopsy from the tumor surface exposed to the bronchial lumen.
Brushing cytology revealed marked irregularity, polymorphism, colorfulness, etc., in both the nucleus and the cytoplasm. No definite cytoplasmic stria were observed, but pictures characteristic of rhabdomyosarcoma appeared, such as nuclear protrusion from the cytoplasmic border of nuclear superposition on the cytoplasm. The case was regarded as lung metastasis of rhabdomyosarcoma from the biopsy results and its past history.
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Hitomi ISHIWATA, Mikio KAWAGUCHI, Masami KURIHARA, Masatoshi ASAMI, Yu ...
1987 Volume 26 Issue 6 Pages
1066-1071
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A case of malignant pleural mesothelioma was presented and mesothelioma cells in the pleural fluid were examined histochemically and electron microscopically. Thickening of the left pleura with effusion of a 62-year-old house wife was pointed out by the chest x-ray at the mass survey for the pulmonary tuberculosis.
The pleural effusion had a plenty of mesothelioma cells, which occasionally formed clusters. These clusters consisted of about 5 to 70 malignant cells and formed “balls”. The mesothelioma cells had round central nucleus with granular chromatin and a few nucleoli at the center of the cytoplasm. The rich cytoplasm had a few vacuoles stained with Alcian blue and showed blister structure by the Giemsa staining. PAS-positive granules were seen in the cytoplasm of malignant mesothelioma cells.
The perinuclear cytoplasm was stained with keratin immunohistochemically which corresponded to the deposited area of intermediate filaments and mitochondria revealed by electron microscopy.
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Hitoshi HARA, Koichi SUDA, Masahiro KIMURA, Eri ISHII, Kazuhiko TAKASO ...
1987 Volume 26 Issue 6 Pages
1072-1075
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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The cytological characteristics of tumor cells obtained from two cases of tumors of meningeal origin with extracranial metastasis are presented. The first case was meningothelial meningioma, Grade I with pulmonary metastasis. The primary focus showed the histologically typical whorl arrangement and the presence of psammoma bodies in the proliferating center of the tumor cells. Cytologically the nuclei of these tumor cells were devoid of all characteristics of malignancy. The second case was meningothelial meningioma, Grade m with extra-cranial metastasis to the chest. Cytologically these tumor cells were polyhedral or spindle shaped, rich in cytoplasm and the nucleo-cytoplasmic ratio was not very high, however the nuclei and nucleoli were rather large, suggestive of malignant non-epithelial tumor. This case had repeated local recurrences and generalized metastasis occurred at the final stage.
These two cases were similar meningothelial meningiomas with chest metastasis, however there were differences in their clinical course and cytological findings.
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Toshiaki FUKATSU, Nobuo NAKASHIMA, Takao SHIRAI, Kenichi YOSHIDA, Yosh ...
1987 Volume 26 Issue 6 Pages
1076-1082
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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We report a thymic tumor of a 61 year-old male with cough and dyspnea, diagnosed as carcinoid by fine needle cytology.
CT scan showed a tumor with sharp border and homogeneous density in the anteriosuperior mediastinum, measuring 5×3×8cm.
Ultrasonically guided fine needle cytology was performed. The tumor cells are small and monomorphic, with oval to round nuclei containing 1 to 3 nucleoli and fine granular chromatin. The nuclear membranes are delicate. Multinucleated cells and mitotic figures are present. The cytoplasm is granular, the nucleus being occasionally eccentrically located. The tumor cells are arranged in loose sheets, showing a trabecular pattern with rosette formation.
It was impossible to resect the tumor completely, because of its infiltrative growth into the superior vena cava and the pericardium. Thymic carcinoid is a relatively uncommon and slow-growing tumor, but it should be regarded as potentially malignant.
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Machiko HASHIMOTO, Shinichi NAKAMURA, Tamotsu TAKAHASHI, Eiji OHARA, E ...
1987 Volume 26 Issue 6 Pages
1083-1087
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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The case of a 79 year old female who complained of recurrent nasal obstruction and bleeding and diagnosed as having well differentiated adenocarcinoma of the nasal cavity was reported in this paper. Diagnosis was based on cytologic and histopathologic findings. Malignant cells of various size were observed in aggregated and scattered forms. The tumor cell nuclei were round and oval in shape and rich in chromatin. Several nucleoi were observed in the nuclei. Cytological diagnosis of well differentiated adenocarcinoma was identical to that of the histological diagnosis.
It was concluded that touch smear was useful for prompt diagnosis of the tumor.
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Minoru MATSUDA, Hiroko MOTOBAYASHI, Naomi YAMATO, Kumiko KOIKE, Sachik ...
1987 Volume 26 Issue 6 Pages
1088-1092
Published: November 22, 1987
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Cytologic examinations of two cases of male breast cancer were reported.
Case 1.
A 68-year-old male visited our hospital complaining of a discharge from the left nipple. The cytologic diagnosis of the nipple discharge was initially reported as negative. Because only one round cluster of tightly connected cells could be observed on these smears. As small tumor measured 0.5 cm in diameter was palpable, fine needle aspiration cytology was performed twice on this tumor. Aspirated smears showed rich cellularity that was loose in arrangement. But as cellular atypia was slight, we could not identify these cells as malignant.
Case 2.
A 73-year-old man visited our hospital for a check up after he became aware of breast mass. Fine needle aspiration cytology was performed on this mass. A large number of cell clusters were observed on the cytological smears. The clusters were round, oval or papillary in shape. These cell clusters were composed of cells with slightly cellular atypia that was irregularly overlapped. These cells could be diagnosed as malignant, and this was confirmed by the subsequent histologic report. In this case, during the clinical examination, a thyroid tumor was detected. This tumor was diagnosed as papillary carcinoma based on fine needle aspiration cytology. Histologically, this patient was confirmed to have a double cancer of the breast and thyroid.
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Toshiki HIROSE, Tsunehiro NISHI, Yoko KOKAI, Harumi YAMAMURA, Miharu T ...
1987 Volume 26 Issue 6 Pages
1093-1098
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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We experienced a case of noninvasive ductal carcinoma showing marked apocrine metaplasia, in a 42-year-old female.
Aspiration biopsy cytology showed papillary clusters with cells with abundunt eosinophilic fine granules. They were diagnosed as benign apocrine metaplastic cells.
Histologically, there was a 9 mm, well-demarked nodule showing mainly low papillary structures only in the mammary ducts, and atypical cells with abundant fine eosinophilic granules. Fine eosinophilic granules in the cytoplasm were PAS-stain positive and 0.5-2μsized dense secretory granules appeared on electron microscopy.
The characteristic findings of touch smear of the tumor appeared as benign apocrine metaplastic cells: larger cellular size, more cellular and nuclear atypism, slight papillary structure due to loose union, and uneven density of granules in every cell. We emphasize especially that the size of this cancer is very large, measuring 40-75μ(mean 52μ).
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Eiko TAKEUCHI, Mamoru TADOKORO, Tomoko MORIWAKI, Mieko ARIFUKU, Sakiko ...
1987 Volume 26 Issue 6 Pages
1099-1104
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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An autopsy case of primary pericardial malignant mesothelioma is reported.
A 55 year-old male was admitted to St. Marianna Univ. Hospital because of dyspea, cough and chest pain. On admission, laboratory findings showed elevated serum lactic dehydrogenase (LDH) and carcinoembryonic antigen (CEA). An X-ray examination showed marked pleural effusion and echocardiograms showed pericardial effusion. Pericardial and pleural punctures were performed and obtained bloody fluid. Cytological examination of these fluid revealed numerous malignant tumor cells. Some of these malignant cells had excentric nucleus, and cytoplasm of the cells were stained in P. A. S. stain and torelant for diastase treatment. These tumor cells were stained in alcian-blue stain (pH 2.5) and torelant for hyaluronidase treatment. Immunohistochemical stainings for keratin and CEA were positive. Autopsy was performed and revealed malignant mesothelioma cell nests limiting at the epicardium. Distant metastasis was found only in the supraclavicular lymph nodes. No other primary tumor was found. From these findings primary pericardial malignant mesothelioma was diagnosed.
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Tamiko KIMURA, Akinori ISHIHARA, Akira KAMIMORI, Hideyuki KOYAMA, Mits ...
1987 Volume 26 Issue 6 Pages
1105-1110
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A case of eosinophilic pericarditis with atypical plasma cells in pulmonary infiltration with eosinophilia (PIE) syndrome was reported.
A 61 year-old man with recurrent asthma in recent years admitted to the hospital because of dyspnea and fever. Diffuse pulmonary infiltrations appeared in the lower lobe of the left lung with a blood leukocyte count of 17, 000 per cu, mm., 20 percent eosinophil content (PIE syndrome). The sputum contained numerous eosinophils but significant bacterial pathogens. After treatment with prednisolone, his symptoms and signs of the disease disappeared promptly and clinical data returned to normal. On the 10 days after his discharge, he readmitted to the hospital because of progressive dyspnea and chest discomfort. A chest roentgenogram showed mediastinal enlargement of the cardiac shadow and cardiac echogram revealed pericardial fluid. Pericardiocentesis was performed and 200 ml of a yellow fluid were removed.
Smears of the sediment of the pericardial effusions showed numerous eosinophils (69%), lymphocytes, histiocytic cells and atypical plasma cells with irregular and multiple nuclei, predominant nucleoli and frequent mitotic figures. However, physical and laboratory data, including bone marrow aspiration etc. did not reveal any malignancy. He rapidly improved after therapy with prednisolone and is apparently well.
It has been suggested that pleomorphism of plasma cells in the pericardial effusions may be regarded as benign reactive atypia.
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Ko-ichi NAGASAKA, Masafumi ISHIKAWA, Hirosato IWASE, Hideo MOROTA, Bin ...
1987 Volume 26 Issue 6 Pages
1111-1117
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A 49 year-old male was operated for ceruminal adenoma in the external auditory canal. The case was studied cytologically, histologically, cytochemically, and electon microscopically, and discussed relative to earlier reports.
The cytological figures consisted mainly of columnar cell groups associated with squamous metaplasia cells, apocrin metaplasia cells and foamy cells. All of them lacked nuclear atypia.
The columnar cells were cytochemically positive in PAS, Alcian blue, Alkaline phosphatase (ALP), Acid phosphatase (ACP) and non-specific esterase. Some of the columnar cells were Keratin and Myoglobin positive.
Squamous metaplasia cells were also positive for PAS, ALP, ACP and Keratin. The cytoplasmic granula of the apocrin metaplasia cells were stained by PAS and the whole cytoplasma were positive for ALP, ACP and Keratin.
Electron microscopy of the columnar cells showed nuclei in various sizes and with irregular borders; cytoplasma with both glycogen and secretory granules; microvilli in the free borders; and lysosome with fatty substances. Some of the gland cells revealed tonofilament and desmosome, suggesting transition to squamous character. Myoepithelial cells were detected under the columnal cell line.
Ceruminal adenoma may be cytologically diagnosed by characteristic cellular figures, considering pathological pro portion of occurrence. Cytochemical, histological and ultrastructual findings were consistent with the kinds of cell found in the smears.
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Kisaku OHNO, Kimiyoshi SUZUKI, Tsuneko KIMURA, Akira TABAYASHI, Zenkur ...
1987 Volume 26 Issue 6 Pages
1118-1123
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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An unusual case of primary anaplastic small cell carcinoma of the esophagus is reported in a 50-year-old Japanese female. The morphological features observed are presented here and differential diagnosis among small cell carcinoma and other kind of carcinomas and histogenesis of esophageal small cell carcinoma are discussed. Grossly, the lesion showed an ulcerative tumor with a protruding portion in the middle part of the esophagus. Cytological smears revealed small mononuclear anaplastic cells occurring singly or in clusters. The tumor cells had small hyperchromatic round nuclei with no prominent or only slightly prominent nucleoli and scanty cytoplasm. The Indian-file appearance that is occasionally recognizable in the smears obtained from small cell carcinoma of the lung was also observed in the present case. Some tumor cells suggesting poorly differentiated squamous cell carcinoma were found in these smears. Histological examination of the resected esophagus showed that small tumor cell infiltration was confined to the tunica muscularis propria. The Grimelius method revealed a positive reaction in the tumor cells and NSE staining also demonstrated positive immunoreactivity in the cancer cell cytoplasm. The histopathological diagnosis was a primary small cell carcinoma of the esophagus.
Although, small cell carcinoma of the esophagus is rarely encountered, the cytological features mentioned above indicate that the tumor is a small cell carcinoma. Morphological findings suggest that this tumor originated from mucosal Kultzschisky cells or by dysdifferentiation of mucosal and/or glandular epithelial cells.
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Takashi KONDOH, Masahiko SATO, Makoto KOIDE, Hideki SAKURAI, Katujirou ...
1987 Volume 26 Issue 6 Pages
1124-1129
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A case of inflammatory pseudotumor of the liver is reported. The patient, a 56-year-old man, was admitted to our hospital because of middle grade fever. Abdominal CT, ultrasonography and angiography revealed a left hepatic hypovascular tumor, 6×7cm in size. Ultrasonically guided fine needle aspiration cytology was performed. Cytologically, the tumor cells with basophilic stained spindle or oval cytoplasm were scattered in their distribution. The round or oval nuclei were enlarged and the eosinophilic nucleoli were also enlarged. Cytologically they were diagnosed as class V. An ultrasonically guided needle biopsy was performed. Histologically, fibrous cell proliferation, small round cell infiltration and multinucliated giant cells appeared. The histological diagnosis was granuloma. The resected tumor's enclosing fibrous capsule, measured 9×7×4.5cm. It was white-yellow on the cut surface. Histologically, the fibrous tissue revealed a feature of inflammatory granuloma.
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Report of a case with cytologic findings of ascites
Hiroshi SONOBE, Shunichi MANABE, Yuhei OKADA, Katsuhiko KAWAI, Yoshihi ...
1987 Volume 26 Issue 6 Pages
1130-1134
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A case of thalamic primitive neuroectodermal tumor (PNET), metastasizing to the peritoneal cavity through the ventriculoperitoneal (V-P) shunt, is reported with special reference to the cytologic and immunocytologic findings of ascites cells. The patient was a 13 month-old male infant complaining of vomiting and disturbance of consciousness. CT revealed hydrocephalus and a cystic tumor, measuring 4cm in diameter, in the right thalamus. In spite of therapy including partial resection of the tumor, V-P shunt and Co irradiation, the patient died of cachexia with massive ascites 23 months later. At autopsy solid nodular tumors occupied the entire ventricles of the brain in association with necrotic and hemorrhagic foci, and in the peritoneal cavity, many nodular metastatic tumors in varying sizes showed similar characters. Histologically, both tumors consisted exclusively of rather small round undifferentiated cells. In the brain, small foci of spongioblastic, oligodendroblastic and ependymoblastic-type tumor cells were detected on occasion. Cytologically, the tumor cells were extremely undifferentiated, being closely similar to those of the small cell type of lung cancer. The immunocytologic results of ascites cells were the same as those observed in the tumor. Namely, antisera to S-100 protein, neurofilament and neuron specific enolase, except for glial fibrillary acidic protein, were positive in some tumor cells. These findings indicate that the PNET of our case originated from undifferentiated cells possessing multipotential ability to differentiate in the brain.
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a case report and cytomorphological characterization of T-zone histiocyte
Shu NAKAMOTO, Yoshie MORIWAKI, Shouichi HOSOYA, Yoshiaki FUKAZAWA
1987 Volume 26 Issue 6 Pages
1135-1138
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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We report a case of dermatopathic lymphadenitis (DL). Histologically, the biopsied lymph node showed typical features of DL; follicular hyperplasia, expansion of the paracortical area by proliferation of T-zone histiocytes (TZH) and the presence of brown pigment-laden macrophages. TZH was positive for S 100 proteins by the immunohistochemical analysis.
On the cyotological examination of the imprint smears from the lymph node, TZH showed characteristic cytological features on Papanicolaou's staining. The nucleus was ovoid (10×6.3μm), had fine chromatin and thin nuclear membrane, and often showed deep lobation. The cytoplasm was clear, broad and often dendritic. The lymphoid cells around TZH showed little atypism and there were a few brown pigmentladen cells. Based on these findings, a diagnosis of DL was made.
Few disease, such as DL and histiocytosis X, show TZH in lymph nodes. Thus, it is possible to diagnose these diseases only by cytological examination.
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Taku KATOH, Hisao TAKAHASHI, Mituo FUJITA, Kuniyoshi NOZUMI, Norikazu ...
1987 Volume 26 Issue 6 Pages
1139-1143
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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Most primary malignant tumors of the urinary bladder consist of transitional cell carcinoma and the occurrence of adenocarcinoma is as rare as 1-2%; that of signet ring cell carcinoma is rarer. We experienced a case of signet ring cell carcinoma of urinary bladder origin, and report it with cytological studies. A 74-year-old woman was admitted to the hospital with pollakiuria, hematuria, and pain in the lower abdomen. Urine cytology showed many signet ring carcinoma cells scattered or in clusters, with inflammatory cells and slightly mucinous background. Cystoscopy revealed a papillary tumor in the left wall of urinary bladder, surrounded by submucosal proliferation of tumor. TUR biopsy indicated signet ring cell carcinoma. Systemic examination showed no adenocarcinoma related to the origin in any part of the body, so the diagnosis of primary signet ring cell carcinoma was confirmed and an operation was undertaken. Only 17 cases of signet ring cell carcinoma of the urinary bladder have been reported in past studies. Further comparative studies of these 18 cases were performed, with some comments and discussion.
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Nobuzo IWA, Chikao YUTANI, Yoshitaka TABARU, Hatue UEDA
1987 Volume 26 Issue 6 Pages
1144-1148
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A case of human papilloma virus infection to the vaginal wall in a 58 year-old female was followed for sixteen months by both of cytology and immunocytochemistry. The characteristic cellular changes of atypical condyloma were recognized: enlarged nuclei with hyperchromasia, smudged nuclei, binucleation, multinucleation, and dyskeratotic cells. However, the perinuclear cavitation was scanty or absent for these cells. The atypical condyloma had appeared for three months and also their immunostains were positive in the nuclei. The degenerated nuclei and dyskeratotic cells had appeared thereafter, however, the immunostain was negative.
The present case provides further confirmation to the HPV etiology of cervical condylomatous lesions.
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Satoshi KIJIMA, Goshi MIURA, Osamu IWANARI, Kazuhiko YAMAMOTO, Masashi ...
1987 Volume 26 Issue 6 Pages
1149-1153
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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Primary carcinoma of the Fallopian tube is the rarest tumor among genital female cancers. The usual histologic type is papillary, alveolar and medullary adenocarcinoma. Here a case of primary clear cell adenocarcinoma of the fallopian tube with positive Papanicolaou smears is reported.
A 61-year old woman with atypical genital bleeding was seen, seven months before her admission in June 1986 to this hospital.
Pelvic examination revealed a myoma node of the uterus and mild resistance in the right adnexal region. The cervical smears and endometrial smears (Endocyte) showed apparent malignant cells, so called hobnail cells and mirror ball clusters. The endometrial biopsy, however, showed atrophic endometrium with no apparent malignancy.
On diagnosis for primary carcinoma of the fallopian tube, total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. The histologic diagnosis of those specimens were primary clear cell adenocarcinoma of the right fallopian tube.
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Megumi YOSHIDA, Yoji KUSUYAMA, Hideaki IMAI, Taro HOSOMICHI, Yoshiya M ...
1987 Volume 26 Issue 6 Pages
1154-1157
Published: November 22, 1987
Released on J-STAGE: November 08, 2011
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A case of mucinous adenocarcinoma of the endometrium was reported cytologically and histologically. A 77 year old woman was referred to our hospital because of genital bleeding. The endometrial aspiration smears showed moderate number of atypical endometrial clusters; loss of polarity and mild nuclear overlapping with sheet arrengement at the periphery of the clusters. Mild anisokaryosis, fine chromatin pattern, and a few small nucleoli with delicate and wide cytoplasm were observed. Many neoplastic cells contained positive materials for PAS stainings with and without amylase predigestion. The neoplasia was localized only at the uterine corpus, histologically, these showed villous and glandular architectural growth with much extracellular mucin and many cells containing intracytoplasmic mucin.
Although the mucinous adenocarcinoma is uncommon tumor of the endometrium, it is considered that the neoplasia may be diagnosed by cytology.
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