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Tadashi TAKEMURA, Tadatoshi OGASAWARA, Morihiro TAKEDA, Kunio UEMATSU, ...
1988 Volume 27 Issue 6 Pages
829-834
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A review of 61 cases of endometrial carcinoma treated at the Department of Gynecology and Obstetrics of Hyogo Medical College between 1977 and 1987 revealed 4 cases of serous adenocarcinoma of the endometrium. This subtype histologically showed a complex papillary structure with irregular stratification, which was reflected in endometrial and cervicovaginal smears.
The hyaline corpuscles recognized in histological and cytological specimens suggested a diagnosis of serous adenocarcinoma.
Between serous adenocarcinoma and clear cell carcinoma of the endometrium, a common histogenesis is suggested, because overlap of these two subtypes was observed in histological specimens.
From our experiences, the clinical course of serous adenocarcinoma of the endometrium is very serious, so it is very important to differentiate this subtype from Grade I adenocarcinoma accurately. In addition, it is recommended that omentectomy be added to the surgical treatment.
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Koichi FUKUDA, Tsuyoshi IWASAKA, Tooru HACHISUGA, Yoshinobu HAYASHI, H ...
1988 Volume 27 Issue 6 Pages
835-841
Published: November 22, 1988
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Bromodeoxyuridine (BrdU) is a thymidine analogue that is also incorporated into nuclear DNA. Since Gratzner (1982) first developed a monoclonal antibody for identification of BrdU-containing nuclei, its use in immunohistochemical studies on the cellular proliferative activity of neoplastic tissue has been reported to be valuable in various tumors, especially brain tumors. DNA-synthesizing cells (S-phase cells) in seventeen patients (15 with cervical carcinoma, 1 with vaginal carcinoma, 1 with endometrial carcinoma) who had undergone radiotherapy were detected by the immunoperoxidase technique using anti-BrdU monoclonal antibody to evaluate their radiosensitivity. All patients received a local injection of BrdU into the cervix before radiotherapy or during the course of irradiation. Biopsied tissue specimens and smears were taken from the injected site in the cervix and indirect immunoperoxidase staining was used to visualizem BrdU-containing nuclei in the tissue samples. In cases showing a good response to irradiation, the BrdU labeling index (LI) decreased during the course of irradiation and only one case of poor response to irradiation showed a high LI during the course of radiotherapy. Immunocytochemical detection of S-phase cells may thus be useful for evaluating the radiosensitivity of cervical carcinoma.
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Shigemi SATO, Ikuyo TAKAMURA, Atsushi SAKURABA, Maromi MUNAKATA
1988 Volume 27 Issue 6 Pages
842-848
Published: November 22, 1988
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In a 10-year period from 1976 to 1985 inclusive, 463, 484 cervical smears were evaluated in the Aomori Cancer Detection Center. Among these smears, 43 cases of extrauterine cancer were detected and investigated, both clinically and cytologically.
1. The frequency of extrauterine cancer was 43 (or 0.0093%) of 463, 484 cervical smears.
2. Of these 43 cases, the primary was located in the intragenitalia in 21 (ovary in 19, fallopian tube in 2), and in the extragenitalia in 21 (stomach in 8, colon in 6, urinary tract in 4, breast in 13). In the remaining 1 case, there was diffuse carcinomatosis involving the peritoneal cavity and the primary site could not be determined. Twenty-three cases were associated with uterine metastasis, 9 cases were not, and in the remaining in 10 cases it was unclear whether uterine metastasis was present.
3. In the cell samples that contained malignant cells of extrauterine origin there was no tumor diathesis in 13 (30%) of the 43 cases, while tumor diathesis was observed in 30 (70%) of cases. For this reason, we think that there were many patients with uterine metastasis among those we examined.
4. Usually, it is difficult to distinguish malignant cells of extrauterine origin from those of uterine origin, by cytological findings of tumor cells in cervical smears. However, it is relatively easier to determine the suspected primary site in cases without uterine metastasis, since the cells are similar to the tissue of the primary site.
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Isao SEKIGUCHI, Mitsuaki SUZUKI, Taro TAMADA
1988 Volume 27 Issue 6 Pages
849-854
Published: November 22, 1988
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Using a monoclonal antibody to human keratin, KL 1, the localization of human keratin protein (keratin) was investigated immunohistochemically in cervical adenocarcinoma (19 cases), cervical squamous cell carcinoma (9 cases) and, as a control, in normal cervical epithelium (12 samples).
In normal endocervical glands, keratin showed uniform staining and was localized in the basal and basolateral cytoplasm but not in the apical region. On the other hand, in adenocarcinoma, the immunoreactivity of keratin varied from one gland to another or from one cell to another even in a single gland, and keratin was localized throughout the entire cytoplasm. In normal squamous epithelium, keratin was intensely positive in the upper and intermediate cell layers, but negative in some of the parabasal cells and basal layer. In squamous cell carcinoma, the immunoreactivity of keratin was weaker than that in normal squamous epithelium on the whole. Upon comparison of histological types, the keratinizing type presented relatively intense staining, although the nonkeratinizing types presented only weak staining.
These findings regarding keratin localization were recognized in cytological materials and are suggested to be useful for the cytological diagnosis of cervical carcinoma, especially adenocarcinoma. The results also indicated that a change in the localization of the cytoskeleton might take place during malignant transformation of the cervical epithelium.
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Miho FUJII, Ryuichi KUDO, Osamu MORIWAKA, Toshimitsu TAKASHINA, Shigek ...
1988 Volume 27 Issue 6 Pages
855-859
Published: November 22, 1988
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Second look operations were performed in 29 of 37 patients with ovarian cancer who had treated with anticancer agents. The association of cytologic findings on abdominal washings with their 5-year survival rates was assessed to evaluate their diagnostic value.
The exploratory operations revealed remaining tumors in 18 (62.1%) of the 29 cases. Their 5-year survival rate was 5.5%(1/18). In the rest or 11 (37.9%) patients, any cancerous tissue was not demonstrated grossly or histologically. Cytology of the intraperitoneal washings was negative in 9 of the 11 patients, and positive in 2. The 5-year survival rate was 77.7%(719) with negative cytology, while 2 with positive cytology both died within 5 years.
In patients who responded well to cancer chemotherapy with intraperitoneal cis-platinum, pretherapeutic cytologic examination had revealed about 130 clusters of tumor cells per field. After treatment, the cell clusters markedly decreased both in number and size, and flattened, indicating that tumor cells were losing the tendency to cluster together. In addition, the tumor cells revealed morphologic changes suggestive of degeneration. Second look operations revealed no tumors in their peritoneal cavity, nor did intraperitoneal washings obtained for cytology contain cancer cells. Their clinical outcomes were excellent.
An early decrease in number of cancer cells in the ascitic fluid is the important index of a response to cancer chemotherapy and an excellent prognosis. The absence of cancer cells in intraperitoneal washings coupled with the absence of tumors in the peritoneal cavity is a sign of excellent prognoses.
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Norio CHIWATA, Tadashi SUGISHITA, Norikoto ISHIDA, Hiroshi IMAI, Nobuk ...
1988 Volume 27 Issue 6 Pages
860-867
Published: November 22, 1988
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In the present study, cytological examination was performed in 3 cases of cervical papillomavirus (HPV) infection with CIS during the follow-up period.
For comparison, 4 cases of HPV infection with severe dysplasia were observed simultaneously.
1) CIS complicated cases: The age of patients with CIS complicated cervical HPV infection ranged from 42 to 46 years old averaged 44 years old, and the observation was continued for 4 months at shortest to 2 years and 2 months at longest, averaged 1 year and 4 months. After the diagnosis of moderate to severe dysplasia had been established by histological examination, CIS was diagnosed within 4 months at shortest to 1 year and 8 months at longest, 11 months on the average, by histological examination.
Severe dysplasia complicated cases: The age of these patients ranged from 36 to 38 years, averaged 37.3 years old, and the duration elapsed from mild to severe dysplasia was 4 months to 2 years and 3 months, averaged 1 year and 5 months.
2) Koilocytes appeared inconstantly, while dyskeratocyte appeared constantly during the follow-up course. There was no invariable finding during the observation period with regards to amphophilia eosinophilic background, binucleation and giant cell.
3) In CIS complicated cases, relatively identifiable findings which characteristically and frequently appeared in patients with HPV infection alone or those with mild dysplasia complicated HPV infection were no longer observed distinctly. Nuclear atypism (morphological change of nuclei to malignancy) was extremely remarkable, indicating that some signifi cant and intrincical change must have occurred in such cells as bearing cervical HPV infection. Nuclear atypism was observed mainly in those cells of intermediate type, parabasal type or immature metaplastic type.
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Nobutaka NAGAI, Hiromasa KIOKA, Yasuhiro KATSUBE, Yoshimi UEBABA, Atsu ...
1988 Volume 27 Issue 6 Pages
868-874
Published: November 22, 1988
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The detection of human papillomavirus (HPV) DNA was examined in the cytological specimens and tissue sections of condyloma acuminatum in vulva with the in situ hybridization's technique using the biotinylated HPV 6, 11, 16 and 18 DNA probes.
The cytological manifestation showes that dyskeratotic cell was frequently observed and koilocytotic atypia (koilocytosis) was not always detected in Papanicolaou staining specimens. The results of in situ hybridization's analysis revealed that HPV DNA sequences was chiefly localized in the nuclei of koilocytosis in cytology and histology of condyloma acuminatum. The positive rate of HPV 6 and/or 11 was 93.8%(15/16). Three cases were positive for HPV 6, 11 and 16 DNAs and one case contained HPV 6, 11 and 18 DNAs.
We suggest that the identification of HPV DNA types in the cytology and histology of condyloma acuminatum by in situ hybridization might be of diagnostic value in the follow up study.
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Hiroshi NAKABAYASHI, Hideki TAKANARI, Ryuichi YATANI, Yasuo SAKAKURA, ...
1988 Volume 27 Issue 6 Pages
875-881
Published: November 22, 1988
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A cytological study on the histological typing and grading of 31 cases of major salivary gland tumor was performed. In cases of pleomorphic adenoma, the mesenchymal element had a metachromatic fibrillar matrix and was closely related to epithelial elements. The presence of myoepithelial cells, which tended to be interspersed with or without the fibrillar matrix, was another feature of pleomorphic adenoma. Warthin's tumor was easily diagnosed when oncocytes and a lymphoid background were recognized. Adenoid cystic carcinoma showed a characteristic picture of globular mucoid material surrounded by uniform small epithelial cells. Histologically high-grade adenoid cystic carcinoma presented anaplastic cellular features in smear preparations. Mucoepidermoid carcinoma had epidermoid cells and mucus-producing cells. In cases of more high-grade tumor, large mucus-producing cells were aggregated to form spheroid cell clusters (cell balls). Characteristic cytological findings and patterns of clusters that were suggestive of the above-mentioned features of each salivary gland tumor were helpful for tumor histological typing.
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Shosaku ABE, Isao NAKAJIMA, Shigeaki OGURA, Shiro MAKIMURA, Yoshikazu ...
1988 Volume 27 Issue 6 Pages
882-886
Published: November 22, 1988
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We studied the relationship between clinical behavior and results of immunohistochemical staining for keratin and NSE in 8 patients with poorly differentiated squamous cell carcinoma indistinguishable from small cell carcinoma of the lung. Immunohistochemical staining for NSE was positive in 5 of the 8 patients and keratin was positively stained in 5. The growth rate of the NSE-positive tumor was significantly higher than that of the keratin-positive tumor and differences in survival times could be demonstrated between the two patient groups (P<0.05).
These results suggest that the NSE-positive cells in squamous cell carcinoma cytologically indistinguishable from small cell carcinoma may differentiate toward small cell carcinoma.
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Tatsunari SATAKE, Ritsuko IMAI, Sonoko NATSUME, Masato SHINFUKU, Mie H ...
1988 Volume 27 Issue 6 Pages
887-893
Published: November 22, 1988
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Bile and direct stamp smears of 184 gallbladders, which had been excised because of gallstones (173 cases), cholecystitis without gallstones (2 cases), adenomyomatosis (7 cases), and dilatation of the choledochus (2 cases), were made. The quick Papanicolaou staining method was used in order to screen for early gallbladder cancer during surgery, as this is difficult to diagnose preoperatively. Smears from 142 patients were considered adequate for cytologic analysis.
Histologically, 149 gallbladders were considered to show no atypical epithelium. Thirty-one showed dysplasia (slight 28, moderate 2, severe 1), three showed carcinoma
in situ and one invasive cancer, respectively. In two cases of carcinoma
in situ, bile smears did not contain cancer cells, but stamp smears did. The remaining case was not examined. In invasive cancer, cancer cells were found in stamp smears and no bile smear was made. Many more epithelial cells were observed in stamp smears than in bile. Accordingly, cytologic examinations using stamp smears are thought to be more useful than those using bile smears for the diagnosis of early gallbladder cancer.
When cancer cells were observed in quickly made stamp or bile smears from gallbladders showing no gross remarkable changes, a frozen tissue study of the gallbladder was necessary in order to examine both the depth and width of the tumorous lesion.
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Soji KURITA, Takahiko SUGIURA, Kiyoko FUSE, Katsuko OKUDA, Sadayuki KA ...
1988 Volume 27 Issue 6 Pages
894-897
Published: November 22, 1988
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Diffuse pleomorphic lymphoma are proved to be associated with ATL virus in many cases. Tumor cells are usually derived from helper T cells and express surface antigens CD 3, 4. But in some cases ATL virus is not associated and CD 3, 8 are expressed indicating nature of suppressor T cells. On Papanicolaou stained imprints of lymph nodes obtained from 15 cases, diameters, areas, perimeters, and circularities of the nuclei of 200 lymphoid cells in each cases were measured on a image analyzer, Magiscan 2. The nuclear morphometry was analyzed in relation to ATLA antibody and surface antigens CD 3, 4, 8 and HLA-DR. ATLA antibody-negative cases had higher nuclear circularity than ATLA antibody-positive cases. CD 8-positive cases had larger nuclear size and lower nuclear circularity than CD 4-positive cases. CD 3-negative cases had larger nuclear size and lower nuclear circularity than CD 3-positive cases. Nuclear size and circularity were not different between HLA-DR-positive and -negative cases. These findings suggest that the nuclear morphometry might be different by association of ATL virus and the origin of tumor cells.
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Differential diagnosis of adenocarcinoma and hyperplasia
Sunayo IRIE, Fritz Lin, Marilee Means, Marilyn Davis, Susan Cook, Maur ...
1988 Volume 27 Issue 6 Pages
898-903
Published: November 22, 1988
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We studied the cytological features of 94 cases by transrectal fine needle aspiration of the prostate. There were 29 cases of adenocarcinoma (4 cases which were well-differentiated, 20 moderately-differentiated, 5 poorly-differentiated) and 65 benign cases (51 cases of prostatic hyperplasia and 14 cases of prostatitis).
Cytologically, the nuclei in prostatic hyperplasia are smaller than those in prostatic adenocarcinoma and the nucleoli are rare in numbers, small and irregular in shape. We sometimes saw atypical cells in prostatic hyperplasia accompanied by inflammation.
The three degrees of differentiation in prostatic adenocarcinoma are poorly-differentiated, moderately-differentiated and well-differentiated. The nuclear diameter is largest in the poorly-differentiated adenocarcinoma cases and smallest in the well-differentiated cases.
The nucleoli often observed were oval in shape. They were more than 1 icm in 85% of the all carcinoma cases and more than 2 μm in 61.7% of the poorly-differentiated adenocarcinomas. We conclude that in cases where the nucleoli are oval in shape and about 2 μm in diameter the diagnosis is carcinoma.
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Yoshio UEI, Tamae NAKAJIMA, Yoshitaro SAKAI, Norio MATSUOKA
1988 Volume 27 Issue 6 Pages
904-909
Published: November 22, 1988
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If a diagnostic criterion whereby cases with small numbers of cancer cells, less than 30, in a cervical smear will be excluded is used, those cases will inevitably be identified as false negative. With this in mind, this study was performed to check and see how many such cases are actually involved in mass screenings for uterine cancers.
One slide scraped from the ectocervix with a cotton ball was made for each case. Cancer cells and cells more atypical than mild dysplasia (“cancer, atypical” cells), either isolated or arranged in sheets, and “cancer, atypical” cell clusters were counted.
Cancers were detected in 138 (137 with cervical squamous carcinoma, including 54 in Stage 0, 64 in Stage I, 11 in StageII, 2 in Stage III and 6 in unknown stages ; and 1 with endometrial carcinoma) in the mass screenings of 157, 903 examinees performed by the Kanagawa Prefectural Society for the Prevention of Diseases. There were 14 cases (10.2%) (6 in Stage 0, 6 in Stage I, 1 in Stage II and 1 in an unknown stage) which contained less than 30 “cancer, atypical” cells. Of them, 10 cases (7.3%), (6 in Stage 0, 2 in Stage I, 1 in Stage II and 1 in an unknown stage) contained no “cancer, atypical” cell clusters.
From the above finding, it is evident that cases with less than 30 “cancer, atypical” cells and clusters must be taken into consideration in the automated cytology using image processing techniques.
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Hiroshi ISHIKAWA
1988 Volume 27 Issue 6 Pages
910-918
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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The reliability of measurement of cellular DNA content from paraffin embedded tissue using a flow cytometer (FCM) was studied. After fixation in formalin, both the DNA-derived fl uorescence intensity of cancer cells and that of lymphocytes were found to be reduced in parallel, but the DNA index (DI) of cancer cells was higher than that of lymphocytes due to non-specific cytoplasmic fluorescence in the former. Trypsinization abolished the non-specific cytoplasmic fluorescence, and subsequently the DI of formalin-fixed cells was found to be closely correlated with the DI obtained with fresh cells or ethanol-fixed cells. Using tumor-infiltrating lymphocytes as an internal standard, we found that trypsinization was a necessary process in order to carry out reliable DI determination. DI values obtained from colorectal cancers were not influenced by the interval of fixation in formalin for 1-9 days. When tumor-infiltrating lymphocytes were used as an internal standard, there was a close relationship (r=0.957) between DI values from fresh non-fixed cancer cells and formalin-fixed ones in 42 cases of colorectal cancer. On the basis of these results, in order to clarify the influence of cellular DNA content on survival, this parameter was measured by FCM using paraffin embedded materials from 236 cases of colorectal cancer. In Dukes' B, C and D cases, the survival of patients with diploid DNA patterns was significantly longer than that of patients with DNA aneuploidy.
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Kimie YAMAGISHI
1988 Volume 27 Issue 6 Pages
919-925
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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Four different cytological specimens were screened by 60 certified cytotechnologists at the workshop which was provided the Japanese Society of Clinical Cytology.
They had to screen one glass-slide within three minutes and were divided into three groups to screen the specimens through 50 by 24 mm
2, 40 by 24 mm
2 and 30 by 24 mm
2 scope separately.
Four cases contained a few cancer cells.
Three minutes per one slide for screening made a lot of false negative.
It is recommended, average screening time for observation area of 50 by 24 mm
2 requires more than six minutes per slide.
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Yasuhiko KIYOZUKA, Shunsuke IMAI, Tsuneo NODA, Junji MORIMOTO, Ikuko M ...
1988 Volume 27 Issue 6 Pages
926-935
Published: November 22, 1988
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Human ovarian serous cystadenocarcinoma cell line was newly established after long term culture
in vitro, respectively. SHIN-3 was succesively subcultured 62 times in about 23 months. The cells were found to form a monolayer jig-saw puzzuled and pavement like pattern showing no contact inhibition. The population doubling time was calculated to be about 48.3 hours and 26.7 hours at the 12 th and 20 th passage of culture, respectively. At the 12th passage, saturation density was 9.3 × 10
4/cm
2 and mitotic index was 3.2%. Karyotype analysis showed triploidy and model number of 61 with 8 kinds of trisomies.
After 1 × 10
5 cells were cultivated for 7 days, the supernatant contained 1, 500 U of CA 125 and 37.5 U of TPA. After subcutaneous transplantation into nude mice, the cells grew into poorly differentiated serous cystadenocarcinoma, which closely resembled to that of primary tumor in human. Although CA 125 expression varied following suit to total number of SHIN-3 cells
in vitro, its maximum peak of CA 125 expression was seen rather just before the logarithmic phase than during logarithmic phase of cell growth. TPA expression was also started just before cells' logarithmic growth but continued during logarithmic phase. CA 125 and TPA were also demonstrated immunohistochemically in cultured cells. SHIN-3 cells will be a useful material to investigate two kinds of tumor markers, CA 125 and TPA, cytobiologically.
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Raj K. Gupta, Sarla Naran, Robert Fauck, Tadao K. Kobayashi, Andrew Bu ...
1988 Volume 27 Issue 6 Pages
936-937
Published: November 22, 1988
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The accompanying report further emphasises the value of cytobrush washing in the detection of unsuspected infectious in this case, caused by
Enterobius vermicularis in a Melanesian women.
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Masashi MORIYAMA, Osamu IWANARI, Jinya MIYAKO, Satoshi KIJIMA, Yoshie ...
1988 Volume 27 Issue 6 Pages
938-942
Published: November 22, 1988
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In Shimane prefecture, 178, 768 women over 30 years of age underwent mass-screening for uterine cervical cancer between 1981 and 1986, and two cases of carcinosarcoma of the uterus and three cases of endometrial cancer were found.
The two patients with carcinosarcoma of the uterus were postmenopausal women, a 56-year-old woman who underwent massscreening without any sign of genital bleeding, and a 64-year-old woman who had suffered from vaginal discharge for one month. Both were examined cytologically (both endocervical smears). The most commonly encountered cellular components were malignant epithelial cells, which bore a close semblance to those derived from endometrial adenocarcinoma. Another infrequent cellular component was fibrogenic sarcomatous cells, which had an illdefined and lacy cytoplasm and a single nucleus containing rather finely granular chromatin.
For these two patients, modified radical hysterectomy and radical hysterectomy were performed, respectively. The pathologic diagnosis was carcinosarcoma in both cases.
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Toshio OYAMA, Koichi SUDA, Masako MITSUMATA, Tsutomu YUMINAMOCHI, Yosh ...
1988 Volume 27 Issue 6 Pages
943-948
Published: November 22, 1988
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Two cases of malignant melanoma, originating from the vagina and uterine cervix, respectively, are presented. The first case, in a 73-year-old patient, showed typical cytological findings. However, the second case in on 80-year-old was unusual case. The specimen taken from the uterine cervix was diagnosed as squamous cell carcinoma initially, and radiation therapy was carried out. Subsequently, however, a specimen taken from the vagina was diagnosed as malignant melanoma, because of the presence of melanin granules in the cytoplasm, nuclear invagination and large eosinophilic nucleoli in the tumor cells. S-100 protein was stained immunohistochemically.
The diagnostic availability of immunohistochemistry with S-100 protein antibody for malignant melanoma was discussed.
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Mariko MATSUMURA, Toshitaka MATSUYAMA, Toshiaki SAITO, Tsunehisa KAKU, ...
1988 Volume 27 Issue 6 Pages
949-952
Published: November 22, 1988
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Atypical glandular cells were detected in a cervical smear of 27 years old infertile patient which a right adnexal mass. The mass was diagnosed histologically to be a serous cystadenoma of low potential malignancy by subsequent laparotomy. Cervical cytology revealed only a few clusters of atypical glandular cells in a clear back ground and showed such clusters to be of three dimensions. The atypical cells were smaller in size than ovarian adenocarcinoma cells. The cytoplasms were narrow and thick, and a few of them had vacuoles. The nuclei of these cells were round or oval and had thick nuclear membranes. Pleomorphism of these cells was not marked. The N/C ratio was increased, however, the nucleoli of these cells were not prominant.
These findings were consistent with those in previous reports about atypical cells at the cervical cytology from serous cystadenoma of low potential malignancy of the ovary. They were different from those of cervical or endometrial adenocarcinoma cells.
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A case report with cytologic, immunocytochemical and electronmicroscopic studies
Masahiro FUJITA, Hideo MATSUI, Shizuo KATOH, Yutaka TOMODA, Eiichi SAK ...
1988 Volume 27 Issue 6 Pages
953-958
Published: November 22, 1988
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A rare case of olfactory neuroblastoma is reported with reference to the cytologic features revealed by immunocytohistochemical and ultrastructural studies. A 35-year-old Japanese male underwent surgical excision of a polypoid tumorous mass in the right nasal cavity, attached at the superior turbinate. Imprint cytology showed small, loose denuded round cells with fine chromatic nuclei and focal, vacuolated, fibrillary cytoplasm. We thought that these features were those of small round cell tumor and suggestive of a neurogenic origin, but it was very difficult to clarify the nature of the tumor cells on the basis of cytology alone. Immunostaining for both NSE and S-100 protein by the PAP method was positive in the imprint cells. Also in histologic sections, NSE was diffusely positive and S-100 protein was positive at the tumor periphery. Light microscopic histology revealed that the tumor cells, uniform in size with oval nuclei, were arranged in nests. No rosettes or fibrillar stromal materials were recognized. By electron microscopy, the tumor cells had abundant cytoplasmic processes with focal intermediate attachments. There were many intracytoplasmic dense core vesicles. These morphological features were in accord with those of olfactory neuroblastoma. Cytology, electronmicroscopy and immunocytohistochemistry were all considered to be important for the pathological diagnosis of this disease.
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Atsuhiro NAKAMURA, Emiko SHIMONAKA, Mitsuo ISHIHARA, Nobuyuki KANAI, N ...
1988 Volume 27 Issue 6 Pages
959-962
Published: November 22, 1988
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A rare case of simultaneous occurrence of medullary and follicular carcinomas in the left thyroid lobe of a 51-year-old woman is reported. The diagnosis was made upon the cytological findings of fine-needle aspiration cytology. This was confirmed by the histopathological findings after the resection of the tumor. This case represents that two malignant epithelial neoplasms of different origin could occur in the same lobe of the thyroid, as a rare event.
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Gen TAMURA, Takuya IWASAKI, Jun-ichi SAITO, Hitoshi IIJIMA, Takao KAWA ...
1988 Volume 27 Issue 6 Pages
963-967
Published: November 22, 1988
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Clinging carcinoma (Azzopardi, J. G., 1979) of the breast in a 32-year-old female is reported. The patient was in lactation and had bilateral primary breast carcinomas. Clinging carcinoma was found in the left breast and invasive ductal carcinoma in the right. The cytological and histological characteristics of tumor cells of clinging carcinoma were as follows: 1) rather small clusters of tumor cells in aspiration cytology; 2) plane arrangement of tumor cells without pileup in a three dimensional arrangement; 3) loose cellular adhesion of tumor cells suggesting easy desquamation into the ductular lumina; and 4) positive immunohistochemical staining for CEA.
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Diagnosis of localization from analysis of cytological findings
Motoyasu SAGAWA, Yasuki SAITO, Masami SATO, Noriyoshi NAGAMOTO, Tasuku ...
1988 Volume 27 Issue 6 Pages
968-973
Published: November 22, 1988
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We report a case of lung cancer showing no abnormal chest shadow, which was located peripherally beyond the range of optimal bronchoscopic visibility. A 60-year-old man suspected to have lung cancer by mass-screening sputum cytology was admitted to our hospital for determination of the cancer localization. No abnormal shadow was found on chest X-ray, tomography and CT, and no abnormal bronchofi berscopic findings were apparent. We attempted to obtain cytologic specimens by differential brushing from each segmental and sub-segmental bronchus, and found many clusters of cancer cells with basophilic cytoplasm in specimens from the right-B
8 bronchus. He subsequently underwent right lower lobectomy. Histological findings showed microinvasive squamous cell carcinoma located in the right S
8 segment.
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a case report
Hideaki MIYAMOTO, Toshiki HIROSE, Miharu TSUCHIYA, Kimiko MAEKAWARA, H ...
1988 Volume 27 Issue 6 Pages
974-977
Published: November 22, 1988
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A few case reports on clinical cytologic studies of alveolar soft part sarcoma can be found. These reports are based on a search of touch imprints using extracted samples, and only one report based on fine needle aspiration cytology before an operation can be found in Nieberg's case report in 1984. We speculated that it was pulmonary metastasis of alveolar soft part sarcoma, from the shape and the beads-like arrangement of cells observed during percutaneous transthoracic fine needle aspiration. After that, a clinical search for a primary tumor was carried out and both a primary lesion and two pulmonary metastases were resected. In a case of alveolar soft part sarcoma, hematogenous metastasis, particularly pulmonary metastasis often occur. In many cases, pulmonary metastasis have already occurred before it is found. Therefore, it can be considered that a pulmonary metastasis may be found before a primary tumor is found like our case. In such a case, diagnostic approach based on percutaneous transthoracic fine needle aspiration cytology is very useful.
According to the findings from our aspiration cytology, PAS-positive granules and nuclear inclusion bodies could not be seen in the cytoplasm of tumor cells. However obscure cytoplasm dyed on light green, spheroidal nucleuses in large and small sizes, granular chromatin, acidphilic large spheroidal nucleoli, and beads-like arrangement tumor cells were observed. Therefore, there was a suspicion of alveolar soft part sarcoma. It is probably justified to consider that the existence of beads-like arrangement of tumor cells shows alveolar soft part sarcoma.
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Koichi MANDAI, Shosuke MORIWAKI, Hiroyoshi DOIHARA, Kyoko HARA, Yoshin ...
1988 Volume 27 Issue 6 Pages
978-983
Published: November 22, 1988
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A 42-year-old woman, who had been suffering from dysphagia, was admitted to hospital. She was diagnosed as having lymphocyte-predominant thymoma from needle aspiration biopsy of a lower mediastinal tumor. During the clinical course, pure red cell aplasia was noticed and liver metastasis was suspected on the basis of the results of roentgenography and ultrasonography. She died five years and seven months after admission due to severe generalized infection. Autopsy revealed an epithelioid cell-predominant malignant thymoma in the anterior mediastinum, but no liver involvement was noted.
Intranuclear inclusions and cytomegaly were noted in the lungs, uterus-vagina, rectum, urinary bladder, tongue and tonsils. The spleen weighed 7 g and showed the features of hypoplasia histologically, which seemed to have played a part in the patient's immunocompromised state.
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Hiroko KOTANI, Yuuko KOORITANI, Katsutoshi MIHARA, Masami NISHIDA, Sei ...
1988 Volume 27 Issue 6 Pages
984-987
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A case of adult T-cell leukemia with enlarged lymph nodes and pulmonary infiltration was diagnosed in smears taken from the lymph node, sputum, bronchial brushing and bronchial washing. The smears showed many malignant cells.
Cytologically, in the Papanicolaou-stained smears, malignant cells in lymph node showed anisocytosis. Large-or medium-sized cells had plenty of cytoplasm, oval nuclei and predominant nucleoli. Small-sized cells had scanty cytoplasm and irregularly-shaped nuclei with nuclear convolution or lobulation. Otherwise, malignant cells in the sputum, or obtained by bronchial brushing or bronchial washing were composed of relatively small-sized nuclei without variation in size. The cytoplasm was usually scanty, and faintly basophilic. The nuclei showed convolution or lobulation with coarsely distributed chromatin. Nucleolus was almost indistinct.
The autopsy revealed that many malignant cells had infiltrated into enlarged lymph nodes and most of the whole organs including the lung.
T cell subset analysis was performed with monoclonal antibodies; both malignant cells of peripheral blood and lymph node had phenotype of helper/inducer.
Cytologic examinations of sputum, bronchial brushing and bronchial washing were valuable in the differential diagnosis of pulmonary complications.
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Tsutomu ITOH, Yuko KOGA, Naomi NARAHASHI, Mariko NAGAO, Toshihiko KOGA ...
1988 Volume 27 Issue 6 Pages
988-993
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A 23-year-old male was found to have a nodular shadow in the lingular area of the left upper lobe by chest X-ray examination.
The patient was diagnosed as having coccidioidomycosis by frozen histology and imprint cytology of an open lung biopsy on the basis of the preserce of immature spherules and hyphae, and spherules filled with endospores.
Histological examination revealed primary coccidioidomycosis forming a granuloma (coccidioidoma) in the lung.
The patient had a history of agricultural training for twoyears in California.
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Yoshimune HORIBE, Masao KASAHARA, Yoichiro HOSODA, Tsuyoshi HIRANO, Mo ...
1988 Volume 27 Issue 6 Pages
994-1000
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A rare case of angiomyolipoma with extramedullary hematopoiesis in the liver (hepatic angiomyo-myelolipoma) is reported with special reference to the findings of imprint cytology.
The patient, a 48-year-old male, complained of upper abdominal pain and was found to have hepatic dysfunction. Abdominal CT showed a low-density area in the caudate lobe and selective hepatic arteriography demonstrated it to be a hypervascular tumor.
The removed tumor was solid in consistency, fairly well demarcated and 5.7×7.0×4.0 cm in size. The liver itself showed no evidence of cirrhosis.
Histologically, the tumor consisted of abundant blood vessels with various calibers, oval or spindle-shaped smooth muscle cells and mature fat cells. Hematopoietic cells such as megakaryocytes, erythroblasts and granulocytes were also present in the interstitium and intravascular spaces. The histological findings were almost the same as those of imprint cytology: the exfoliated cells were mainly composed of oval or spindle-shaped smooth muscle cells, which appeared in either planar cell clusters or groups of scattered cells. The vascular endothelial cells showed tubular or fibrous structures, and were intermingled with the smooth muscle cell clusters. Scattered fat cells, foamy cells, erythroblasts and megakaryocytes were also seen. In some of the smooth muscle cells, there were signs of cellular atypia such as nuclei with various sizes and irregular shapes and swollen nucleoli. The findings are indicative of hepatocellular carcinoma and other malignant non-epithelial tumors.
A diagnosis of hepatic angiomyo-myelolipoma can, however, be made from cytological findings elements such as smooth muscle cells, vascular endothelial cells, fat cells and additional hematopoietic cells are mainly detected in the imprint specimens.
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Hitoshi HAREYAMA, Masataka DEMISE, Kouji HIRAHATAKE, Rokei KURE, Isao ...
1988 Volume 27 Issue 6 Pages
1001-1006
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A case of pelvic fibromatosis is reported. A 30-year-old housewife was found to have tumors on the side-wall of the upper vagina during pregnancy. The tumors were situated in the area surrounded by the symphysis, bladder, urethra, vagina and rectum. These were surgically removed in the puerperium. The tumors weighed 233g and 42g and were solid and yellowish-white in color.
Imprint smears from the cut surface of the tumor showed that the cells were spindle shaped with light green-staining cytoplasm. The nuclei were oval or round in shape and the nuclear chromatin showed a finely reticular pattern with one or two prominent nucleoli. Polygonal cells with two nuclei and the striped nuclei were occasionally observed. Ultrastructurally, two types of cell were found: fibroblast-like cells and myofibroblast-like cells. The former had much rough endoplasmic reticulum and the latter had microfilaments.
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Akira TANIMURA, Hiroshi KAWAMOTO, Makoto SUGIHARA, Tatsuo KURE, Sakae ...
1988 Volume 27 Issue 6 Pages
1007-1010
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A mesenteric fibromatosis of 18 year-old young female with complaint of abdominal pain and abdominal tumor was reported.
The tumor, measuring 10cm in diameter, was located at the root of mesentery, and was compressed small intestine and was incorporated transverse colon into tumor tissue.
Imprint cytological features revealed the benign fibrous tumor. The tumor cells were spindle or polyhedral in shape, which had round nuclei with small distinct nucleoli. No abnormal mitosis was observed.
Histologically the tumor consisted of proliferation of the spindle cells in fusiform or whorl pattern.
Electron microscopically these tumor cells revealed fibroblast-like cells, which had abundant rough endoplasmic reticulum.
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Kimiyoshi SUZUKI, Tsuneko KIMURA, Kisaku OHNO, Masanobu MARUYAMA, Zenk ...
1988 Volume 27 Issue 6 Pages
1011-1015
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A 59-year-old Japanese man with adrenocortical carcinoma is reported. Laboratory date suggested that this tumor did not retain the ability to clearly sythesize steroid. Grossly, the carcinoma showed a large nodular mass, measuring 8×6cm and a dark red cut section with yellow parts. Histologically, the tumor revealed solid proliferation of relatively large carcinoma cells with frequent giant cells. Mitotic figures and venous permeation were occasionally observed in the tumor. Estradiol staining showed a positive reaction in the tumor cells. Imprint cytology demonstrated that many carcinoma cells often occurred in clusters in clear background. The tumor cells showed ill-defined cellular margin and hyperchromatic and irregular-shaped nuclei of markedly various sizes. The nuclei contained one to three prominent nucleoli. Mono-and multi-nucleated giant cells and mitotic fi gures were also noted. Markedly atypical nuclei were often observed in the tumor cells. It has been reported that it is difficult to differentiate adrenocortical carcinoma from adrenal adenoma on cytological examination. But, the present tumor showed markedly atypical cytological features, so that thetumor was easily considered to be of adrenocortical carcinoma.
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Cytodiagnostic findings
Hiroshi SEKIMOTO, Shigeru KIMURA, Takashi JOSHITA, Takashi YAMADA, Yas ...
1988 Volume 27 Issue 6 Pages
1016-1023
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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Three cases of embryonal rhabdomyosarcoma of the urinary bladder are reported with special reference to the morphologies of their exfoliated cells, Small round cells of these sarcomas were hard to distinguish morphologically from those exfoliated from other anaplastic sarcomas, whereas the following cell features were considered to be characteristic for this type of sarcoma: A nuclear configuration extending from the cytoplasm, racket form cells and striations in the cytoplasm. Occasionally, a round eccentric nucleus associated with deeply staining cyanophilic cytoplasm (rhabdomyoblast) was observed.
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Katsushige TAKEBAYASHI, Kazuo NAGASHIMA, Toshihiro SATO, Yasuhiro SUZU ...
1988 Volume 27 Issue 6 Pages
1024-1028
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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Until recently, bone metastases and urinary obstruction were thought to be the earliest manifestation of the prostate cancer. But lymph node metastases may not be infrequently in early manifestation of the prostate cancer and involvement of lymphatic system was often misdiagnosed as malignant lymphoma in clinically.
We report a case of nodal dissemination mimicking malignant lymphoma in prostate cancer without other metastases. These are thought to be relatively rare case in Japan. A 57-years-old man noticed bilateral inguinal pain and left flank pain was referred to a hospital.
Physical and laboratory findings revealed almost normal range. But computerized tomography (CT) findings showed involvement of retroperitoneal and pelvic lymph nodes and hydronephrotic change of the left kidney following compression by the tumors. Histologically, tumor cells have medullary and alveolar nesting pattern and markedly single round nucleoli.
Immunohistochemical staining for prostate specific antigen (PSA) was positive. Electronmicroscopically, desmosome, intercellular space and secretory granules were found in these tumors.
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A case report
Toshio TOH, Gunji TESHIMA, Mitsuru KINJO, Kazuyuki SAGIYAMA
1988 Volume 27 Issue 6 Pages
1029-1033
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A case of papillary adenocarcinoma of the prostate is reported. The patient, a 59-year-old male, was admitted to our hospital because of dysuria of 3 months duration. Serum acid phosphatase and gamma seminoprotein levels were within normal limits. In spontaneously voided urine or aspirated material from the prostate, tumor cells showing foamy, clear cytoplasm and elliptical nuclei with vague nucleoli were found. These were arranged in solid nests with irregular stratification and a trabecular pattern. The nuclear chromatin was finely granular and homogeneously distributed. Histologically, the tumor consisted of papillary adenocarcinoma, of which individual tumor cells closely resembled those in the cytological studies. Immunohistochemistry for both PAP and PSA showed no positive reaction.
Papillary adenocarcinoma of the prostate is uncommon in Japan, where only 5 cases have been reported in detail so far, to our knowledge. This prompted us to report the present case.
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Akira SATO, Hirotsugu UDA, Naotomo TAKATANI, Teruo KADOWAKI, Tokumi IS ...
1988 Volume 27 Issue 6 Pages
1034-1039
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A case of minimally malignant mesothelioma of the tunica vaginalis testis, originally suspected to be adenocarcinoma by cytologic examination of the hydrocele fluid, is reported. The patient, a 60-year-old man, complained of hydrocele and aspiration cytology was performed.
Cytologically, medium to large tumor cells 20-50μm in diameter appeared in three-dimensional clusters. Also, atypical mesothelial cell sheets containing the same medium to large tumor cells were also seen. The cytoplasm of the free round tumor cells was deeply stained with light green but only palely in the peripheral marginal zones circumferentially. Nucleoli were prominent and some tumor cells had indented or multiple nuclei. A right high orchiectomy revealed a little finger tip-sized tumor near the head of the epididymis. Histologically, it was a mixed-type malignant mesothelioma that showed both epithelial and fibrous components in close association. The epithelial cells lining the tunica vaginalis were enlarged reactively, showing abrupt transition into the tumor. Although malignant mesothelioma of the tunica vaginalis testis is an uncommon tumor, of which only thirty-one cases have been previously reported in the literature, cytologic examination of hydrocele fluid is important for preoperative diagnosis.
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Shinji KAKUMU, Koji KATSUTA, Hideki TAKANARI
1988 Volume 27 Issue 6 Pages
1040-1044
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A case of nodular fasciitis of the left thigh is reported. The patient was a 54-year-old woman. The cells appeared in large or small bundles, or as isolated cells. Intermingled with the cells were scattered neutrophilic and eosinophilic leukocytes and histiocytes. The mucoid substance also present was stained strongly reddish-violet with May-GrünwaldGiemsa.
Most of the cells were spindle-shaped with well defined cytoplasm. The nuclei of the cells were round to oval, with prominent nucleoli. The chromatin of the nuclei was evenly distributed and finely granular. Some multinucleated giant cells and mitotic figures were also present.
A diagnosis of sarcoma was unlikely because the chromatin pattern of the cell nuclei was benign.
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Junichi WAKABAYASHI, Masaaki SATOH, Yoshihiro KISHI, Atsuo HATTORI, Ma ...
1988 Volume 27 Issue 6 Pages
1045-1049
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A rare case of malignant lymphoma with multiple boneinvolvement is described.
A 21-year-old male was admitted for pathological fracture of the bilateral tibia. Bone X-ray revealed multiple osteolytic lesions on the bilateral tibia, right femur, skull and vertebrae (L 3, 4, 5 & S 1). No lymph node swelling was palpable. Ewing's sarcoma, neuroblastoma, eosinophilic granuloma or malignant lymphoma was suspected. An imprint smear obtained from a biopsy specimen of the right tibia showed that the tumor cells had a round to oval nucleus with one or two small nucleoli, and scanty, ill-defined cyanophilic cytoplasm. PAS staining of these cells was negative. Based on these cytological findings, we suspected that the patient had malignant lymphoma. Histologically, tumor cells were negative for PAS staining and MT-1 (T-cell marker)-positive. At the ultrastructural level, the cytoplasm of the tumor cells contained clustered dense bodies. Cytologically, histopathologically and ultrastructurally, this tumor was diagnosed as malignant lymphoma (non-Hodgkin, diffuse, mixed cell type) of the bone.
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Akira TANIMURA, Hironobu HASHIMOTO, Tetsuya TAKAHASHI, Seiichiro SOMEY ...
1988 Volume 27 Issue 6 Pages
1050-1053
Published: November 22, 1988
Released on J-STAGE: November 08, 2011
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A case of glioblastoma multiform of left frontal lobe, 67 year-old male with complaint of disturbance of speech and mental deficiency was reported.
Before surgery, there were many rosette-like giant cells in cerebrospinal fluid. It was suggestive of glioblastoma multiform or medulloblastoma.
Taking age and tumor location in consideration it was diagnosed of glioblastoma multiform.
Histologically tumor cells revealed pleomorphic appearance mixed with many rosette-like giant cells as seen in cerebrospinal fluid.
Immunohistochemical staining for GFAP was positive in some tumor cells, but most of tumor cells were negative.
Electron microscopically rosette-like giant cells revealed multinucleated giant cell with condensed, degenerated nuclei.
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Yoshiro KIDERA, Kazuma ONOUE
1988 Volume 27 Issue 6 Pages
1054-1055
Published: November 22, 1988
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Hiroaki TAKEUCHI, Akiko MAKINO, Takako NAGADOMI, Miyuki KAMEI, Yuko HI ...
1988 Volume 27 Issue 6 Pages
1056-1057
Published: November 22, 1988
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Naoya FUNAKOSHI, Eiichi AKAOGI, Katsumi YAMABE, Hiroshi TSUKADA, Riich ...
1988 Volume 27 Issue 6 Pages
1058-1059
Published: November 22, 1988
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