Abnormal cells in the sputum of in situ and of early invasive squamous cell carcinomas were studied quantitatively and compared with borderline cases and frankly invasive squamous cell carcinomas with abnormal roentgenographic findings.
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, i.e. lemon yellow, were frequently seen.
Most Class III cases were either borderline cases or CIS cases. Most Class IV cases were roentgenographically occult lung cancer cases, and most Class V cases were advanced cancer. But it is still difficult to correctly ascertain the depth of cancer invasion in each case.

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Abnormal cells in brush specimens of in situ and early invasive squamous cell carcinomas were studied quantitatively and were compared with both borderline cases and frankly invasive squamous cell carcinomas with abnormal roentgenogram. In brush 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 brush specimens in situ carcinoma, early invasive carcinoma, frankly invasive carcinom and borderline lesions are quantitatively distinguishable from one another.

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The results of aspiration biopsy cytology (ABC) for 917 women with benign breast disease who visited the Nagano Cancer Center on an outpatient basis, during the past 7 years and 3 months, were analyzed retrospectively.
The true negative (class I·II) rate of ABC for mammary cyst (94.4%) was the highest, the subsequent order of this rate being inflammatory pseudotumor (92.3%) benign pyllodes tumor (87.5%), mastitis (85.7%), fibroadenoma (80.3%) and mastopathy (79.9%), while the rate of intraductal papilloma (50.0%) was the lowest in all benign diseases.
The undetermined rate of ABC in miscellaneous benign tumors (25.0%) was the highest of all benign mammary disorders, the subsequent order of this rate was mastopathy (13.1%), intraductal papilloma (6.3%) and fibroadenoma (5.2%).
The false positive (over class IIIb) rate of all benign breast diseases was 2.9%. Among these, that of intaductal papilloma was the highest (25.0%), the subsequent order being benign phyllodes tumor (8.3%), mastopathy (3.7%) and fibroadenoma (3.5%).
Sixteen of 27 false positive cases were diagnosed by subsequent surgical biopsy and 9 others by clinical follow up, but the remaining 2 cases necessitated radical mastectomy.
ABC is a useful diagnostic method for benign breast diseases, but false positive diognoses carry the risk of leading to excessive surgery. Therefore, handling of the patient with breast disease after ABC must be chosen carefully, in view of the feeling of needle insertion into tumorous tissues.

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The purpose of this study is to demonstrate the cytological localization of antigen CA 15-3 by using monoclonal antibodies 115 D 8 and DF 3 on benign and malignant cells of human breast lesions.
On benign cells the antibodies were localized at the apical border, whereas, on malignant cells they were in the cytoplasm. In the latter, both types of antibodies stained strongly showing granular and small lump-like forms.
The differences in localization of the reaction were statistically significant according to x² test and therefore it is possible to differentiate benign and malignant cells by this staining technique.
False negatives and false positives resulting from Pap. staining were stained immunologically. The results were malignant and benign, respectively. These findings suggest that immunostaining is a significant study.
In both early and advanced breast cancer, the cytoplasm was diffusely stained.
It is concluded that this immunostaining technique may be a useful adjunct to early diagnosis of breast cancer.

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Cytological features of medullary cai'cinomas of the breast were analyzed using imprint preparations.
Imprint specimens were made from materials obtained at intraoperative diagnosis of breast tumors. Four cases of medullary carcinomas and 2 of solid-tubular carcinomas were studied.
Cytological features of the medullary carcinomas were as follows. 1) lymphocytic background infiltration. 2) sheet-like clusters with inconspicuous overlapping. 3) large and pale staining cytoplasm. 4) centrally located, large and irregular-shaped nuclei, coarse and reticular chromatin, prominent nucleoli. These characteristics reflect histological features. Medullary carcinomas can be diagnosed by cytological appearances.

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Intraoperative washing ascitic cytology was studied in 349 cases of gastric cancer.
(1) he 62 cytology positive cases (17.8%) were contrasted with pathological stages of infiltration ssy 1 case (1.8%), se 42 cases (52.5%) and sei 6 cases (66.7%).
(2) Positive cases increased with macroscopic tumor size, and comprised 53.3% of cases with average tumor diameters of 11-14 cm.
(3) Dissemination was positive in 33 cases (10.5%) in P 0 stage, and 16 cases (100.0%) in P 3 stage.
(4) Rates of positive cytology cases to Borrmann types, were 66.7% for IV 25.0% for III and 18.8% for II.
(5) The majority of positive cases, 35 (28.5%), were pathologically poorly differentiated adenocarcinomas.
(6) nfiltrative growth (INF) of the tela subserosa showed γ type in 58%, β type in 40% and α type in 2% of cytologically positive cases.
(7) Cytomorphology of gastric cancer cells in the peritoneal cavity showed small cluster type in 54%, scatter type in 38% and moderate cluster type in 8%.
The results of washing ascitic cytology related closely with tumor size, histological type and infiltrative growth of gastric cancer, and hence constitute a significant indicator of prognosis.

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Utilizing immunoperoxidase techniques, we evaluated “cell ball” -like clusters (“cell balls”), the origin of which is sometimes difficult to determine. This paper presents the cytological features of “cell balls” detected in 32 (18.4%) of 174 peritoneal washings. The cellular configuration consisted of oval cell clusters forming solid masses surrounded by squamoid cells. The interior of the “cell balls” stained deep blue with Papanicolaou's stain, which demonstrated the presence of homogeneous and amorphous materials, and sometimes showed a fingerprint-like staining pattern. Immuno-cytochemically, almost all “cell balls” were positive for cytokeratin and vimentin. However, the inner material stained positive with antibodies against collagen types I and III. Therefore, these “cell balls” are apparently serous membrane fragments composed of mesothelial cells and fibrous tissue. These findings suggest that immunocytochemical study is a useful method of characterizing “cell balls” in peritoneal washings, which exhibit features similar to those of primary and metastatic tumors and may thus complicate cytodiagnosis.

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Cytopathological observation was performed in three cases of uterine carcinoma in situ (CIS) treated with intravaginal administration of Carboplatin (CBDCA). Case 1: Perinuclear cytoplasmic vacuoles were observed after 6 hours of intravaginal administration of 50 mg CBDCA. Case 2: Ulceration with desquamated epithelium and prominent inflammatory cells were seen after intravaginal administration of 250 mg CBDCA. Cytologically, CIS cells disappeared and metachromasic degenerated cells were observed. Case 3: Most atypical epithelial cells were desquamated but CIS epithelium remained in the orea of glandular involvement after intravaginal administration of 500 mg CBDCA. In brief, several typical changes were subsequently found in this study; 1) cellular balooning, 2) cytoplasmic vacuoles, 3) nuclear degeneration, 4) cytoplasmic degeneration, 5) picnotic nucleus, 6) disappearance of CIS cells, 7) repair cells. These cytological observations were similar to the study of cisplatin (CDDP) intravaginal administration. The cytoplasmic vacuoles were the most common and most important cytological changes. In case 3, the CBDCA concentration seemed to be too low to penetrate to the deep cervical canal cells. No side effects were observed with this treatment.

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Among 2016 cases of total hysterectomy, 58 cases of glandular abnormalities of the uterine cervix, including 27 cases of endocervical glandular dysplasia (EGD), 9 cases of adenocarcinoma in situ (AIS), 4 cases of microinvasive adenocarcinoma (MI), and 18 cases of invasive adenocarcinoma (AD), have been histologically indentified in our department over the last seven years. Preoperative smears were examined for the following cytologic features: background, crowding, palisading pattern, feathering, balls of cells, and cytoplasmic vacuolation under low-power and the nuclear/cytoplasmic (N/C) ratio, chromatin distribution, irregularity in the distances between nuclei and prominent nucleoli under high-power.
The distinction between EGD and normal endocervical cells was made most clearly based on differences in the N/C ratio and the presence of prominent nucleoli. EGD was distinguished from AIS based on the presence of balls of cells and feathering. AIS could be differentiated from MI by noting variability in the distance between nuclei and observing coarse chromatin. The presence of a palisading pattern and feathering helped distinguish MI from AD.

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To ascertain the usefulness of the cytological method for clinical diagnosis of herpes simplex virus (HSV) infection in the female genital tract, we performed morphological, clinical and virological studies, and the following results wereobtained:
1. Typical cytologic changes in infected cells were found in their nuclei, namely ground glass appearance and multinucleation with nuclear molding. Only one-third of our cases showed nuclear inclusion bodies.
2. Infected cells could be found in almost all cases with primary vulvar infection within 7 days after the onset of symptoms (vulvar itching or pain). For sample collection, scraping with the edge of a slide glass was superior to that with cotton swab.
3. Cytologically, 23 (77%) of 30 cases confirmed by HSV isolation could be diagnosed. The microtrak method was less sensitive than cytodiagnosis.
4. There was no morphological differentiation among the cells infected with HSV type 1, type 2 and varicella-zoster virus.

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Four cases of Müllerian mixed tumor including two each of mesodermal mixed tumor (MMT) and carcinosarcoma (CS), allof which we initially diagnosed as G 3 adenocarcinoma, are evaluated for the present retrospective study. Cellular findings which appear in cytological specimens are divided into two groups; piled-up clusters and scattered solitary portions. Nuclear findings differ singnificontly between the two groups, and those in the latter appear to be more atypical. Large, naked nuclei in the scattered area are stro king as the key point in diagnosing this neoplasia. This impression is confirmed by doing karyometrical analysis using IBAS-I revealing the nuclear area of the cells. Those derived from Müllerian mixed tumors are much larger, both in clusters and in scattered areas, than those from G 3 adenocarcinomas. This tendency is quite obvious in the latter group. It is concluded that the existence of markedly enlarged atypical cells, especially in the scatterd area, as well as in cluster is a specific feature of Müllerian mixed tumors.

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A new human cancer cell line, OVISE, derived from a clear cell carcinoma of the ovary has been raised successfully in cell culture for two years and eight months. The cell line was established on October 26, 1988 from a metastatic tumor of ovarian origin from a 40-year-old woman who had been treated with six courses of CAP chemotherapy. The cell line grew well without interruption and was subcultivated more than 70 times. The cells are characteristically epithelioid with spindle or polygonal shapes, do not show contact inhibition and exibit a strong tendency to pile up. The cell has a log phase doubling time of about 60 hours. The chromosome number varied widely and showed triploidy and tetraploidy. Approximately 1×10⁷ cells were transplanted into the subcutis of five-week-old BALB/C nude mice and produced tumors 1.5 cm in diameter two months after transplantation. Histological examination of the tumor revealed a clear cell carcinoma which was similar to that of the original ovarian tumor. The cells secrete tumor markers, CA-125, CA 19-9, and TPA, into the culture medium. The cell line showed drug sensitivity to ETOPOSIDE, THP and 5-FU. The OVISE cell line may provide a useful in vitro system for the investigation of ovarian clear cell carcinoma.

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We examined clinical and cytological findings in 11 cases of primary fallopian tube carcinoma treated at the Obstetric & Gynecologic Department of Fukui Prefectural Hospital during the 26-year period from 1964 to 1990.
1. We compared positive cytodiagnostic rates among preoperative cervical and endometrial cytodiagnoses, chief complaints and other specific findings under preoperative cytological examinations.
1) Two cases who had watery discharge were positive on cytodiagnosis, and 3 cases out of 4 who had genital hemorrhage were also positive.
2) The positive rate on cytodiagnosis is higher in the first phase rather than in the third progressive phase.
3) Adenocarcinomatous lesions of the oviduct were found in the ampulla and fimbria in 9 out of 11 cases.
4) Regardless of the amount of ascites, about a half of the cases were positive.
2. All 7 cases which underwent midoperative cytodiagnosis of ascites were positive, and the rate of positive results from cytodiagnoses of the peritoneum and ascites was high due to progressive carcinoma.
3. The origins of carcinomas were examined by comparing the results of preoperative cervical and endometrial cytodiagnoses, and the images of histological types of primary carcinomas. Many papillary cell clusters were found in tissues of the papillary type, and many clusters resembling bunches of grapes were observed in tissues of the alveolar type. Some clusters of acinar and spherical cells were also recognized. Sheet type cells were very few in number, and there were no arborescent structural images. By means of touch smear cytodiagnosis, not only arborescent image cell clusters but also various other kinds of image cell clusters, were observed.
4. 1) Six out of 11 cases (54.4%) were positive on preoperative cervical and endometrial cytodiagnoses.
2) Findings from the results of cytodiagnoses are:
(1) Clean backgound.
(2) A small number of malignant cells emerge.
(3) Cell clusters emerge in a round shape with mild degeneration of papillary, acinar, spherical and bunch of grape types.
(4) Cells have an intussusceptive property and there are some cytoplasma in which vacuoles are observable.
(5) The nuclei are round or slightly oval, and aggregation of chromatin and nucleoli is also observed.

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In an attempt to obtain information about the peritoneal mesothelium, we applied the monolayer technique to the aortic endothelium in order to prepare single-layer specimens of mesothelium. Mesothelial single-layers, free from connective tissues, were easily obtained with this method. This technique is thought to be very useful for observing a large number of mesothelial cells.
We also attempted immunohistochemical and enzyme histochemical studies of the peritoneal mesothelial and aortic endothelial cells. The results obtained are as follows:
1. Bromo-deoxyuridine (BrdU), cytokeratin (CK) and vimentin (V): No BrdU, CK or V was detected immunohistochemically in whole tissue specimens before single-layer preparation. In contrast marked BrdU-positive reactions were observed in the nuclei of mesothelial and endothelial cells, and some mesothelial cells also showed CK and V positive reactions in the cytoplasm after single-layer preparation.
2. Acid phosphatase (AP): AP activities were observed as red granular precipitates in the perinuclear cytoplasm of mesothelial and endothelial cells using whole tissue specimens before single-layer preparation.
These findings indicate that it is preferable to perform immunohistochemical studies using single-layer specimens, whereas it seems better to perform enzyme histochemical studies with whole tissue specimens before single-layer preparation.

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A case of cryptococcal granuloma in a healthy person and a case of cryptococcal pneumonia in an end stage bronchioloalveolar carcinoma case are reported. The former case was diagnosed by TBLB and bronchial brush cytology, which revealed macrophages and giant cells engulfing yeast-like orgamisms with thin capsules. On the other hand, sputum of the latter case showed many free organisms with thick capsules. Although cryptococcosis, especially the granulomatous type, is often difficult to diagnose, cytology has been shown to be useful. In the former case, the orgamnisms has thin capsules and there was an intense inflammatory response, while the latter had thick capsules and the inflammatory response was mild. This contrast is of interest in considering pathogenesis and its relation to host immunity.

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A case of pulmonary sclerosing hemangioma in a 75-year-old woman was diagnosed preoperatively by fine needle aspiration cytology.
This patient was noted to have a coin lesion in the left upper lung. On cytological examination of the lesion, the clusters of tumor cells revealed several characteristic findings as follows:
1) Papillary or frondlike clusters were lined by cuboidal cells which formed a ribbon-like arrangement and showed a positive reaction for anti-surfactant apoprotein antibody.
2) Round-to-polygonal cells, which had pale cytoplasm and coarse nuclear chromatin, were arranged in close proximity.
3) Spindle-like nuclei were observed among papillary arrangements and sclerotic areas.
4) Many histiocytes, containing hemosiderin, were scattered among the tumor cell clusters.
5) Background with marked hemorrhage.
Based on the above characteristic features, it was possible to make a preoperative diagnosis of pulmonary sclerosing hemangioma on cytological grounds. In conclusion, we believe that fine needle aspiration cytology is a suitable procedure for precise diagnosis of this tumor.

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Adenoid cystic carcinoma of the lung occurs commonly in the trachea and main bronchi and rarely occurs as a peripheral lung mass. A case of peripheral adenoid cystic carcinoma of the lung is reported. The patient was a 67-year-old Japanese female who had the complaint of cough for one and half months. On admission to the hospital, she was found to have a left abnormal lung mass. She was transferred to the Surgical Department of Kanazawa University Hospital for further examination and surgery. A tumor was located in the left superior lingula segment (S-4 b), and was resected. The cut surface of the tumor was yellow-white and measured 2.3×3.0×2.6 cm with a well-defined margin. There was no relationship between the tumor and the trachea or main bronchus. Histologic and electron microscopic examination revealed the tumor to be an adenoid cystic carcinoma. Histologically, there was no involvement of the main bronchi in the tumor, but bronchi without cartilage were found at the periphery of the tumor, which indicated that the tumor might arise from the fifth or sixth order bronchus.

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A case of mediastinal seminoma with positive aspiration cytology of pleural fluid and sputum is reported. The patient was a 20-year-old male who had complained of excessive sputum production. An abnormal shadow was noted on chest X-P examination. Fine needle aspiration showed a characteristic two cell pattern composed of large tumor cells and lymphocytes. The tumor cells were present singly and were uniformly scattered. They were round cells with central or sometimes peripheraly located nuclei which had fine chromatin and prominent nucleoli. The cytoplasm was PAS-positive in the pleural fluid specimen. The sputum cytology revealed similar tumor cells with a background of scattered lymphocytes. Preoperative chemotherapy includeing cisplatinum was administered. The histologic examination of the resected specimen showed a massive necrosis of relatively uniform coagulative necrotic cells. No viable tumor tissue nor other teratomatous elements were detected.

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The Rosen report states that the Mucocele-like Lesion (MLL) of the mammary gland is a benign little known condition analogous to mucocele of a minor salivary gland. Recently we had an opportunity to investigate and report on the cytological structure of MLL in a 27-year-old female patient. As a result we found that it is relatively difficult to distinguish MLL from mucinous carcinoma using breast aspiration cytology and, in the early stage of mucinous carcinoma, we came to believe that it would be relatively difficult to make an unequivocal diagnosis using histological examination. Though it has often been reported that mucinous background with relatively bland cells is an aid to the diagnosis of mucinous carcinoma, we believe that the cytologist must bear in mind the existence of benign MLL and use extreme caution when observing the cytological evidence. Clinically speaking, MLL tends to occur in pre-menopausal women younger than the age with which the occurance of mucinous carcinoma is usually associated. This clinical factor may be helpful in the actual diagnosis and subseqent treatment of MLL.

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A 32-year-old male was found to have lesions in the left adrenal gland, liver and bilateral kidneys on computed tomography and ultrasonography. These lesions were suspected to be metastases of islet cell carcinoma from his history.
Seven years previously he had undergone pancreaticoduodenectomy under the clinical diagnosis of cancer of the pancreas head, which tuened out to be islet cell carcinoma by histological diagnosis.
Left adrenalectomy and resection of hepatic and bilateral renal tumors were performed. Imprint cytology obtained from the left adrenal tumor for frozen section suggested pheochromocytoma, because cell variability in size, form and structure were characteristic of pheochromocytoma, and because intranuclear inclusion bosies were also seen in some tumor cells.
The postoperative histological diagnosis was pheochromocytoma of the left adrenal gland, liver metastasis of the islet cell carcinoma and renal cell carcinoma of the bilateral kidneys.
Electron microscopic observation revealed neurosecretory granules in the cell cytoplasma of the pheochromocytoma and islet cell carcinoma.
Immunohistochemically, the pheochromocytoma was positive for S-100 protein in the sustentacular cells and positive for Neuron specific enolase and chromogranin inchromaffin type cells. S-100 protein staining of the pheochromocytoma was differnt from that of the islet cell carcinoma.
Although this patient did not show classical multiple endocrine neoplasia type I nor type II, the presentation of the tumors in this patient may suggest an overlapping form of type I and type II. This patient had an additional third tumor: renal cell carcinoma. Altough familial occurrence has not been documented, this patient and his family should be closely followed up.

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A case of pericardial mesothelioma is reported. A 28 year-old male was admitted to Chukyo Hospital under a diagnosis of cardiac tamponade due to pericardial tumor. Cytological examination of the pericardial effusion revealed the presence of atypical cells, but definite diagnosis was not obtained. At autopsy the tumor was considered to have arisen from the pericardium, and histological, histochemical and ultrastructural study revealed the mesothelial charactor of the tumor cells. Immunohistochemically, the tumor cell was positive for CEA, although this tumor was diagnosed as a case of pericardial mesothelioma.

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We report case of congenital monocytic leukemia with skin involvement, who underwent spontaneous remission.
The patient is an 18-month-old girl. She was born at full term, after an uneventful pregnancy, to healthy parents. Hepatosplenomegaly and generalized purplish nodules, up to 15 mm in diameter, were evident at the birth. Marked leukocytosis and elevated serum LDH level were also noted.
The skin biopsy specimen from the lesion exhibited diffuse infiltrates of atypical cells through the dermis with sparing of the papillary dermis with scattered nuclear debri and a few erythrocytes. Peripheral blood and bone marrow analyses revealed that more than 90 percent of cells were atypical and had characteristics of the monocytic lineage on morphological and cytochemical grounds. Chromosomal examination revealed normal karyotype. There was no evidence of leukemoid reaction. These findings indicated monocytic leukemia of M 5 b according to the FAB classification, and were thought to fulfill Pierce's criteria for congenital leukemia.
During hospitalization her peripheral white cell count and serum LDH dramatically decreased to normal levels. By the age of forty days, leukemic cells had disappeared from peripheral blood and bone marrow. The skin lesion also disappeared. At this point, we considered her to have undergone spontaneous remission.

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The patient was a 4-month-old female with a hemorrhagic sarcoma botryoides-like tumor which protruded from the vagina. The tumor was examined cytologically and histologically. In brush cytology specimens obtained from he surface of the tumor, many tumor cells formed clusters of various sizes; a syncytial or reticular pattern. Tumor cells had ill-defined cell borders, and the cytoplasm was pale green and foamy, and often had rounded vacuoles. Nuclei were oval to. round, irregulaly shaped without smooth nuclear membranes, had fine chromatin, and one or few nucleioli. Histologically, tumor cells with the clear cytoplasm showed proliferation of a solid or microcystic pattern. No Schiller-Duval bodies were found. Immunoperoxidase studies demonstrated that staining for AFP was positive, and confined to tumor cells.

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A case of chlamydia infection detected by cervicovaginal smears was studied by cytology and immunocytochemistry.
The patient was a 35-year-old woman.
Chlamydia-infected cells consisted of squamous metaplastic cells or parabasal type cells. These showed intracytoplasmic inclusions in cervicovaginal smears.
The intracytoplasmic inclusions had small sized, basophilic, fine granules that occupied the entire cytoplasm or showed irregular clumping within it. Needle bodies were also found in the intracytoplasmic inclusions.
The chlamydia antigen was detected by Avidin-Biotin Peroxidase Complex staining with the reaction products in the intracytoplasmic inclusions and needle bodies.

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An unusual case of postirradiated malignant fibrous histiocytoma of the vagina in a 72-year-old female is reported. The tumor occurred in the radiation field 30 years after radical hysterectomy and preoperative radiation therapy (Radium 5, 200 mgh) for squamous cell carcinoma of the uterine cervix. She had been disease free for 30 years until she noticed a large mass in the vagina.
Cytological study showed mainly two types of non-epithelial malignant cells; spindle-shaped fibroblast-like cells and histiocyte-like cells. Bizarre mono or multinucleated giant cells were often observed.
The operative specimen revealed an arrangement composed of short or long spindle cells and vacuolated mononucleated and large multinucleated cells. The diagnosis was comfirmed by immunohistological and ultrastructural study.
We have reviewed the literature on malignant fibrous histiocytoma occurring after radiation for cervical carcinoma.

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Müllerian mixed tumor (MMT) of the uterine corpus is rare and the prognosis is very poor.
In the three years from 1987 through 1989, three cases of MMT first diagnosed by cytology were diagnosed at our facility. The three patients were postmenopausal women, aged of 67, 54, and 54, who were admitted to our hospital, complaining of genital bleeding. We obtained endometrial specimens by Masubuchi's aspiration technique in one case and the endocyte scraping method in the other two cases. In all cases, the cytological features were characterized by admixture of adenocarcinoma cell clusters and sarcomatous cells showing pleomorphism on a background of bloody necrosis. In some of these cells, we found a few intracytoplasmic hyaline globules. With Masubuchi's aspiration technique it is possible to obtain a larger volume of tumor cells without degeneration than by the endocyte scraping method. Histologically, two cases were diagnosed as carcinosarcoma, and the other case as mixed mesodermal tumor.
This tumor is often difficult to diagnose correctly by cytology, because of the variety of cellular elements. Therefore, in the cytology of the uterine cavity, it is importantimportant that cytologists think about the possibility of MMT hen they recognize bizarre sarcomatous cells as well as adenocarcinoma cells in the same specimen.

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Two cases of müllerian adenosarcoma of the uterine body are reported. Our report aims at describing the cytologic features of this rare tumor. Patient 1 was a 67-yearold woman who underwent total hysterectomy because of abnormal vaginal bleeding of three months duration. The resected specimen revealed a cauliflower-like tumor (7×7×3 cm) growing into the intrauterine cavity. Patient 2 was a 55-year-old woman with a large intravaginal tumor. The hysterectomy material showed a pedunculated tumor (12×5×6 cm) protruding from the external os of the uterus. The latter patient died of extensive lung metastasis 6 years after surgery. Both cases were histologically diagnosed as adenosarcoma. Preoperative endometrial cytology and imprinting tumor cytology revealed various types of epithelial cells such as endometrial gland-like, cervical gland-like, squamous metaplastic and tissue repair cells, and there were no definite findings of malignancy. As epithelia of müllerian origin are capable of differentiating into various morphological appearances, the possibility of adenosarcoma must be considered when these unusual epithelial cells appear on endometrial cytology in postmenopausal women. Recognition of sarcomatous atypical cells is the key diagnostic finding. Repeat of cytology and biopsy should be performed when numerous clustering interstitial cells are found, because the diagnostic sarcomatous cells may appear only rarely.

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A case of metastatic uterine carcinoma derived from the breast is reported. The patient was a 47-year-old woman who had a history of left mastectomy for breast cancer two years previously. Without any clinical symptoms, cytological examination of endometrial aspirate strongly suggested the existence of tumor cells originating from breast cancer. The endometrial biopsy revealed the metastatic site in the uterus, and CT scan showed a metastatic lesion of the left lobe of the liver. Simple hysterectomy with bilateral salpingo-oophorectomy was performed, and a catheter was inserted into the hepatic artery for chemotherapy. The metastatic site in the uterus, (1.5×0.7cm), was located in the endometrium with invasion into the myometrium. Furthermore, microscopic metastasis was disclosed on the surface of the left ovary. After surgery, the liver metastasis was wellcontrolled by chemotherapy.
Although a poor prognosis has been reported for metastatic uterine carcinoma, the case described in this communication is currently well-managed and followed up with careful observation.

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A case of granulosa cell tumor with squamous metaplasia in a 69-year old woman is described.
In the cytological examination of ascitic fluid and pleural effusion, tumor cells showed different nuclear sizes, increased numbers of mitoses and prominent nucleoli, but the origins of the tumor cells were difficult to determine.
Histological examination at autopsy revealed that tumor cells in ascites and pleural effusion fluids were intermediate in type, between granulosa cell tumor and squamous cell metaplasia.

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The cytologic findings of a case of hydrops fetalis (fetal age 25 weeks) infected with human parvovirus B 19 (B 19) were studied in body fluids at autopsy. The diagnosis of B 19 infection was established by the immunoperoxidase method and polymerase chain reaction (PCR).
During an endemic outbreak of erythema infection in 1991 in Kanagawa prefecture, Japan, a 28-year-old woman at 10 weeks of gestation acquired a mild rash on her face accompanied by slight fever and arthralgia. At 25 weeks and 2 days of gestation, the fetus died of hydrops fetalis and pregnancy was terminated.
At autopsy intranuclear inclusions were not clearly observed on ascitic fluid cytology using bluish-purple papanicolaou staining. But these infected cells were well demonstrated by the immunoperoxidase method and PCR. In paraffin-embedded tissue of the lung, heart, liver, spleen, kidney, stomach, and placenta at autopsy, the intranuclear inclusions were observed. In these cells, the B 19 antigen was also detected in cytoplasm by the immunoperoxidase method (indirect).
It is suggested that recognition of B 19 infected cells in body fluids is a useful method of diagnosing hydrops fetalis due to B 19 infection during pregnancy.

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Intraoperative pathological diagnosis of chondroid chordoma was carried out based on cytologic studies using the squash method. The patient was a 20-year-old Japanese woman who had difficulty in swallowing and complained of double vision.
Cytologically, tumor cells were arranged in clusters and isolated in a mucinous background. The tumor cell cytoplasmic features were distinctive and some of the tumor cells (so-called physaliforous cells) contained one to many clear vacuoles. Chondroid cells and stellate cells were evident. Based on these findings, we diagnosed chondroid chordoma. The tumor cell cytoplasm contained PAS positive material which was digested by diastase, indicating the presence of glycogen. Using an immunoperoxidase technique, these tumor cells were demonstrated to be positive for EMA, Keratin, S 100 protein, NSE and Vimentin.
It is important to distinguish chondroid chordoma from nonchondroid in considering the prognosis. In this case, intraoperative cytologic studies performed by the squash method were effective in diagnosing chondroid chordoma.

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