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Volume 31, Issue 1
Displaying 1-18 of 18 articles from this issue
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Atsuhiko SAKAMOTO1992 Volume 31 Issue 1 Pages 2-5
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA concept of borderline lesion of the tumours was briefly described. Three different categories were included in borderline lesion. The first was the “genuine” borderline lesion whose atypia fell just in the border between benign and malignant. Dysplasia of the uterine cervix was a typical example of this type. The second was a benign tumour which was classified as a borderline lesion. Adenoma of the stomach was, for example, dealt as Group III (borderline) in gastric biopsy diagnosis. The last one was a non-invasive carcinoma. Among the endometrial diseases, atypical hyperplasia was composed of “genuine” borderline lesion and non-invasive adenocarcinoma. We should, therefore, pay an attention to the differences of the definition of borderline lesion at every organ and site.View full abstractDownload PDF (487K) -
cervix from dysplasia infected with human papillomavirusShinji SATO, Akira YAJIMA, Ryo KONNO1992 Volume 31 Issue 1 Pages 6-10
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSHuman papillomavirus (HPV) has been shown to be associated with squamous cell carcinoma and dysplasia of the uterine cervix. We attempted to investigate natural history of cervical dysplasia infected with HPV, which progressed to carcinoma, and document long persistence of HPV infection using in situ hybridization (ISH) and polymerase chain reaction (PCR). HPV DNA was detected in 57%(45/79) of formalin-fixed, paraffin-embedded hysterectomy specimens of 25 moderate dysplasia, 20 severe dysplania, 12 carcinoma in situ, 15 microinvasive carcinoma and 7 invasive carcinoma. HPV 16/18 and 31/33/35 were detected in 28% and 28%. Nine cases positive for HPV DNA in their hysterectomy specimens, of which lesions had been under follow-up for more than 6 months, were examined for the presence of HPV in their sequential biopsy samples by ISH and PCR. In 8 of 9 cases, HPV 16 was constantly demonstrated in all biopsies throughout the course from early dysplastic changes to carcinoma. This retrospective study showed that longtime persistance of HPV infection in the cervical lesions was necessary in natural course of progrssion to carcinoma.View full abstractDownload PDF (600K) -
Toshiko JOBO, Satoshi OHKAWARA, Takayuki MORISAWA, Hiroyuki KURAMOTO, ...1992 Volume 31 Issue 1 Pages 11-20
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThe pathological specimens of extirpated uteri with endometrial carcinoma were analyzed, and 180 cases were divided into two groups according to the presence of hyperplasia (100 cases) or normal endometrium without hyperplasia (63 cases). The group with associated hyperplasia was characterized by better differentiation, less myometrial invasion and positive ER and PR. The other group was characterized by poor differentiation, deep myometrial invasion and negative ER and PR. The average age of the former group was 49.3 years and that of the latter was 57.4 years. In 63% of the cases with hyperplasia, 2 or 3 types of hyperplasia were present with atypical hyperplasia and adenomatous hyperplasia being found in 69 cases and cystic hyperplasia in 44 cases. Adenocarcinoma adjoined with hyperplasia in 66 cases (47 with atypical hyperplasia, 22 with adenomatous hyperplasia and 17 with cystic hyperplasia). These findings suggest that there are 2 groups of endometrial carcinoma with different carcinogeneses, and that tumors associated with hyperplasia are likely to progress through atypical hyperplasia. Atypical hyperplasia and stage IA carcinoma by the new FIGO criteria are identified as borderline lesions of invasive endometrial cancer. Histopathological analysis of these conditions has clarified that they are usually associated with normal endometrium (92.9% in atypical hyperplasia and 57.1% in stage IA cancer) and that the surface of normal endometrium extended widely. Adenocarcinoma exceeding 25% of the surface of the endometrial cavity was observed in only 20.8% of the cases with stage IA cancer. Cytological findings of these borderline lesions were characterized by the presence of abundant normal endometrial cells and atypical cells originating from adenomatous hyperplasia. In the cytological diagnosis of these 2 lesions, it is important to recognize mildly atypical cells suggesting adenomatous hyperplasia.View full abstractDownload PDF (7831K) -
Masami SATO, Yasuki SAITO, Noriyoshi NAGAMOTO, Chiaki ENDO, Katuo USUD ...1992 Volume 31 Issue 1 Pages 21-27
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSRecently we diagnosed 51 borderline lesions of the bronchus in 45 cases in our department. In these cases, bronchoscopic examinations were performed to brush all the branches of the bronchi respectively. Seven of the 51 lesions were diagnosed by biopsy only, and 14 were diagnosed by brushing only. Thirty lesions were diagnosed by both brushing and biopsy. Brushings revealed borderline lesions in 44 of 51 lesions (86.3%). Biopsy revealed borderline lesions in 23 of 51 (45.1%).
Abnormal cells in the sputum and in the brushing specimens of borderline cases were studied quantitatively and compared with in situ and early invasive squamous cell carcinomas. Cells in the sputum of borderline cases and in carcinoma in situ, had mean cellular areas and mean nuclear areas which were smaller than cells from the sputum of invasive cases. In some cases, it was very difficult to diagnose cancer, but in such cases, multinucleated cells and cells with acidophilic staining like a lemon yellow were frequently seen. In brushing specimens, increasing depth of invasion resulted in larger nuclear areas, more irregular nuclear shape, more nucleoli and looser connections between atypical cells.
The results indicate that in sputum cytology, the cytological differentiation between in situ and borderline lesions is still insufficient, but in brushing specimens in situ carcinoma, early invasive carcinoma, frankly invasive carcinoma and borderline lesions are distinguishable from one another quantitatively.View full abstractDownload PDF (7535K) -
Makoto MOTOI, Kohichi MANDAI, Keitaro YAMAGAMI, Shosuke MORIWAKI, Hiro ...1992 Volume 31 Issue 1 Pages 28-35
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThe concept of borderline lesions of the breast (BLB) remains controversial, both on conceptual and practical levels. We defined the BLB in cytology as lesions which could not be judged to be malignant by aspiration biopsy cytology (ABC), and examined a total of 681 aspirates from 409 malignant lesions and 272 benign lesions in which the diagnosis was histologically confirmed with excisional biopsy or mastectomy. The BLBs which were interpreted as possibly malignant by ABC included benign lesions which were atypical in morphology and malignant lesions which were less atypical in morphology. Of the 272 benign lesions, 46 (16.9%) were interpreted as possibly malignant or malignant, and 63% of these misdiagnoses were from aspirates of fibroadenoma, 24% from mastopathy and 13% from intraductal papilloma. Of the 409 malignant lesions, 44 (10.8%) were interpreted as possibly malignant. Most of these errors were based on specimens that fulfilled only a portion of the criteria for malignancy. Unfortunately, none of the special techniques that have been employed to date in an attempt to archieve precise and more reproducible separation between the benign and malignant lesions has yet fulfilled this purpose. Over all, excisional biopsy or intraoperative frozen-section diagnosis were recommended. As the presence of myoepithelial cells in breast lesions is interpreted as benign, the morphological recognition of cells in ABC specimens would promote the accuracy of cytological diagnosis of benign lesions.View full abstractDownload PDF (17058K) -
Ken-ichi KAKUDO, Nariaki MATSUURA, Emiko TANIGUCHI, Yoshiyuki ISE, Hit ...1992 Volume 31 Issue 1 Pages 36-40
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThe diagnosis of a borderline lesion is applied to a variety of lesions, in various organs, which can not be clearly classified as either malignant or benign histologically. This diagnosis is not frequently used in cytological samples, because most lesions which are borderline histologically are classified as malignant cytologically. Furthermore, cytologically suspicious (class III) lesions are not compatible with histologically borderline lesions. We propose here that cytologically borderline lesions are those which are cytologically malignant but clinically or histologically undetermined.View full abstractDownload PDF (6970K) -
Fumiaki TEZUKA, Ryoji CHIBA, Hiroyasu JUEN, Kazuko OIKAWA, Kazuo IWABU ...1992 Volume 31 Issue 1 Pages 41-46
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSMorphometry and multivariate cluster analysis (Ward's method) was applied in endometrial cytology to determine the classifiability of endometrial epithelial cells in different conditions. From samples obtained from 29 cases of adenocarcinoma, hyperplasia and normal controls, 69 clumps of cells were randomly selected and, in each clump, 5 parameters of its constituent cells were morphometrically estimated:(1) nuclear size (mean area), (2) anisokaryosis (covariance of areas), (3) nuclear form (meanform index), (4) nuclear pleomorphism (covariance of form indices) and (5) regularity of arrangement (DP index). All 69 clumps could be divided by the 5 dimensional cluster analysis into 3 groups, the first consisting of 34 clumps, the second of 9 and the third of 26. When compared with microscopical diagnoses made by 15 experienced cytotechnologists and Cytopathologists, all the clumps included in the first and second groups corresponded to “non-positive for malignancy” and the majority of clumps of the third group to “positive for malignancy”. However, the clumps diagnosed as “suspicious of malignancy” did not constitute a single group.View full abstractDownload PDF (3545K) -
For detecting glandular cells and stromal cellsYoshie KOHNO, Osamu IWANARI, Jinya MIYAKO, Kanji RYUKO, Masayuki MORIY ...1992 Volume 31 Issue 1 Pages 47-51
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThis study was undertaken to evaluate the usefulness of immunocytochemical staining of keratin (KL-1) and vimentin (V9) for detecting adenocytes and stromal cells in endometrial cytology. Immunohistochemical staining was performed on paraffin sections obtained from 22 individuals with normal endometrium, 5 individuals with endometrial hyperplasia and 10 patients with endometrial cancer. For adenocytes, the rate of positive KL-1 staining was 100%(37/37), and that of positive V 9 staining 70.3%. For stromal cells, the rate of positive KL-1 staining was 0% and that of positive V 9 staining 100%. Immunocytochemical staining was performed on smears of uterine endometrium obtained from 11 individuals with normal endoterium, 1 person with endometrial hyperplasia and 4 patients with endometrial cancer. KL-1 staining was positive in adenocytes and V 9 was negative in all stromal cells for each smear. These findings suggest that immunocytochemical staining of KL-1 is useful for differentiating adenocytes from stromal cells in endometrial cytology.View full abstractDownload PDF (4284K) -
clinical and cyto-pathological studies of eleven casesKen SHIMIZU, Nobuhide MASAWA, Kei SAIGUSA, Takashi YAMADA, Mikio ANZAI ...1992 Volume 31 Issue 1 Pages 52-59
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSFifteen cases of breast carcinoma with osteoclast-like giant cells (OCGC) were analyzed clinico-cytopathologically. Cytological and pathological specimens were obtained from young and elderly women with a mean age of 45.6 years. The specimens from 11 cases obtained by preoperative aspiration biopsy cytology were moderately cellular with mild inflammatory cells and blood. Necrotic debris was scarce. There was a dimorphic pattern of cells a large number of cancer cells and scattered OCGC. The cancer cells overlapped, forming clusters with dyshesiveness. They possessed ill-defined cytoplasm and irregularly-contoured round nuclei with hyperchromatism and mild anisonucleosis. OCGC, varying from 30 to 180 pm in size, had abundant well-delineated cytoplasm in which up to 80 central, vesicular nuclei with a few prominent nucleoli were present. Macroscopically, the tumor, measuring less than 2 cm in nine cases, was a well-demarcated, dark brown mass. Histological examination revealed an invasive ductal carcinoma showing tubular, solid and scirrhous growth, and reaching the extramammary adipose tissue in 12 cases. OCGC were observed among the tumor cell nests associated with a marked increase in capillaries. In immunohistochemical examinations, KP-1, an excellent marker for monocyte/macraphages, was positive in 75% of the cases examined. One patient died of the disease 4 years and 8 months after surgery and signs of recurrence are evident in another case.View full abstractDownload PDF (10988K) -
Kuni AMAKO, Kiyoko UEDA, Toshitaka MATSUYAMA1992 Volume 31 Issue 1 Pages 60-64
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSAfter a histological examination of the uterine cervical polypectomy, a polyp was diagnosed as that of epitheloid granulomas. The result of the endometrial culture of tuberculosis bassilli was positive.
The patient was a 50-year-old, unmarried, non-pregnant woman (menopause at the age of 48). This case was discovered by a public periodic cancer examination. At first the patient desired to have her uterine cervical polyp treated. Her chest X-ray marked no special finding, but the tuberculin reaction was strongly positive.
Cytologically in the endometrial smear test, the cells that had originated in the tubercle were epitheloid cells which were oval-and spindle-shaped, relatively large cells having oval-or spindle-shaped nuclei, Langhans' giant cells whose nuclei were arranged within the circumference in shapes of rosettes and horseshoes, lymphocytes, and multi-nuclear histiocytes.
Histologically in the uterine-cervical polyp there were tuberculosis granulomas which consisted of many epitheloid cells, Langhans' giant cells and lymphocytes. In the endometrial stroma there were epitheloid cells, Langhans' giant cells and some caseatious necrosis. The lymphocytes infiltrated in the surroundings of the granulomas.
The endometrial smear test was effective in making the diagnosis and in judging the drug effects. The coexistence of genital tuberculosis and genital cancer was found in 13.3% in Japanese reports, so we had to take caution in making the diagnosis and treating the case.View full abstractDownload PDF (4372K) -
Ikuo SATO, Rie TAKEUCHI, Etsuko NOZUE, Hideyo FURUSHIMA, Kyoko SHINPO, ...1992 Volume 31 Issue 1 Pages 65-69
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSFor five years from March, 1984 to February, 1989, 5 cases were suspected of endometrial tuberculosis by the endometrial and cervical cytodiagnosis, later a definite diagnosis was made by the culture of tubercle bacillus. The cases were 5 postmenopausal females 56-70 years of age. 3 of them had a history of tuberculosis and 4 cases wee sterile. Chief complaints were vaginal discharge and genital bleeding, but 2 cases were discovered by medical examination. The intrauterine cavity was 6 cm to more than 10 cm long. 2 cases had retention of intrauterine fluid. Cytodiagnostic findings revealed, in addition to the inflammatory background, (neutrophiles and lymphocytes), many epitheloid cell clusters, Langhans giant cells, and mononuclear and polynuclear histiocytes. Except for 1 case which discontinued chemotherapy, 4 cases recovered after chemotherapy.
Sterile females who complain of postmenopausal vaginal discharge and genital bleeding must be suspected of having endometrial tuberculosis as well as cancer of the uterine body, and cytodiagnosis seems useful for its diagnosis.View full abstractDownload PDF (3951K) -
Yasuhisa IWAOKI, Yasuhiro KATSUBE, Koji NANBA1992 Volume 31 Issue 1 Pages 70-73
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA case of clear cell carcinoma of the endometrium following squamous cell carcinoma of the cervix is reported.
The patient had had a previous cervical biopsy which revealed squamous cell carcinoma (large cell non-keratinizing type), classified clinically as a stage fib lesion. She was treated with external pelvic irradiation delivering an estimated tumor dose of approximately 7, 000 rads and intracavital radium application delivering 4, 995 mg. hr. radiation when she was 51 years old. She complained of postmenopausal bleeding at age 66 and was diagnosed by endometrial cytology as having clear cell carcinoma of the endometrium. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. The clinical stage of the endometrial cancer was lb, She is alive after 2 years with no evidence of disease.
Endometrial cytology revealed several adenocarcinoma cells in small clusters. The shape of the nuclei was somewhat irregular, the chromatin pattern was fine granular, and single or multiple nucleoli were seen. The diameter of these nuclei ranged from 10 to 30μm. The cytoplasm was pale green or vacuolated. The volume of the cytoplasm varied from scanty to abundant. These findings suggested clear cell carcinoma.
Histopathologically, an irregular shaped polypoid tumor, 3×1.5 cm in size, was located on the lower anterior wall of the uterine corpus. The tumor was a clear cell carcinoma showing a solid and papillary pattern. A hobnail pattern was not observed. The cytoplasm was clear and abundant, and PAS-positive granules digestible by diastase were seen.
These 2 cancers had different pathological features and their immunohistochemical reactivities for CEA and keratin were also different. This patient was regarded as having a rare heterochronous double cancer consisting of squamous cell carcinoma of the cervix and clear cell carcinoma of the endometrium.View full abstractDownload PDF (6403K) -
Taku KATOH, Hisao TAKAHASHI, Takashi KIYOKAWA, Takashi MATSUMOTO, Bin ...1992 Volume 31 Issue 1 Pages 74-78
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA case of juvenile granulosa cell tumor (JGCT) of the right ovary associated with rapid malignant course in 25-year-old female was presented. The tumor showed macroscopically solid and cystic tumor sized 17×11×10 cm in diameter.
Touch cytology disclosed coherent small round granulosa cells, scattered spindle theca cells, a few cells with deviated nuclei and luteinized cells with rich cytoplasma. Mitotic figures were more frequent than reported adulte granulosa cell tumor (AGCT). Cytologic findings of this case revealed less nuclear grooves, more mitotic figures and no Call-Exner body. Tumor cells was vimentin and desmin positive by immunocytochemical staining, a few cells with nuclear deviation was estradiol staining positive.
Ultrastructural features of this tumor was recognized granulosa cells, theca cells, intermediate cells of these two kinds, and fibroblast like cells.View full abstractDownload PDF (10894K) -
Minoru SHINOZAKI, Motoshige KUDO, Tadashi IDE, Masako SHIMIZU, Shiro T ...1992 Volume 31 Issue 1 Pages 79-84
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSUrinary specimens of two cases of small cell carcinoma of the primary urinary bladder were cytologically studied. For comparison, primary lung small cell carcinomas in pleural fluid (5 cases) were also examined. Although general cytologic features in the two different watery conditions were essentially the same, urinary specimens showed the following characteristics: Cell clusters, being usually made up of less than thirty small round cells with high nuclear-cytoplasmic ratio, had loose cell cohesiveness and less nuclear moldings, as compared with pleural fluid. Furthermore, cell degeneration and necrosis were more prominent in urine. As a result, urinary specimens had numerous isolated cells with pyknotic nuclei and dirty background with abundant cell debris. Since the cellular characteristics of small cell carcinoma are well retained in urine, it is not difficult to distinguish both transitional cell and squamous cell carcinomas of urinary bladder, which are much more commonly encountered in urine. Histologic, immunohistochemical and ultrastructural studies of the small cell carcinoma showed typical features in both cases, and one of them had both transitional cell carcinoma and squamous cell carcinomaView full abstractDownload PDF (14326K) -
Kumiko TANAKA, Tomoko SUGIUCHI, Goro WATANABE, Mayumi ISHII, Noriaki K ...1992 Volume 31 Issue 1 Pages 85-86
Published: 1992
Released on J-STAGE: November 08, 2011
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Hiroshi SHIMOTA, Kazuhisa ISHI, Katsunali KINA, Junichi KOYATSU, Kazuy ...1992 Volume 31 Issue 1 Pages 87-88
Published: 1992
Released on J-STAGE: November 08, 2011
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Takazo OKUYAMA, Shinya TOYOKUNI, Shigeru OKADA, Yasuaki NAKASHIMA, Hir ...1992 Volume 31 Issue 1 Pages 89-90
Published: 1992
Released on J-STAGE: November 08, 2011
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Shouichirou SANADA, Tatsunari SATAKE1992 Volume 31 Issue 1 Pages 91-92
Published: 1992
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (4622K)
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