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Volume 32 (1993)
- Issue 6 Pages 833-
- Issue 5 Pages 651-
- Issue 4 Pages 481-
- Issue 3 Pages 365-
- Issue 2 Pages 157-
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Volume 32, Issue 3
Displaying 1-23 of 23 articles from this issue
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Iwao EMURA, Mika SHIRAHAMA, Tooru WATANABE1993 Volume 32 Issue 3 Pages 365-372
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSNearly all of the keratotic and parakeratotic cells examined in this study showed birefringence under polarized light. Other kinds of cells, such as bronchial epithelia, tumor cells from adenocarcinomas, small cell carcinomas and non-keratinizing squamous cell carcinomas, showed no birefrin-gence under polarized light, and were therefore easily differ-entiated from most of the keratoric and parakeratotic cells. Therefore, it was concluded that polarizing microscopy is quite useful for recognition of keratotic and parakeratotic cells. Parakeratotic carcinoma cells showing birefringence were classified into two subgroups; cells with pyknotic nu-clei (K, P-CELL), and cells with non-pyknotic nuclei (K, NP-CELL). The nuclei of K, P-CELLs and K, NP-CELLs were smaller than those of non-karatotic cells. We considerthe following three criteria to be important in making a cytological diagnosis of keratinizing squamous cell carcinoma.
1) Existence of both K, P-CELLs and K, NP-CELLs.
2) K, P-CELLs have nuclei ranging from 24μ2 to 70μE2in size.
3) K, NP-CELLs have degenerated nuclei (vacuolated or aggregated chromatin pattern) larger than 45 μ2 in size.View full abstractDownload PDF (7366K) -
A new process and review of 426 cases with statistical evaluationYoshinori KOYAMA, Osamu MATSUZAKI, Akira SAKUMA, Isamu SUGANO, Tohru N ...1993 Volume 32 Issue 3 Pages 373-377
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSFine needle aspiration (FNA) of the prostate was perfor-med using the concentration of physiological saline solution (PSS) method and accuracy was assessed according to the correlation between its results and those of histology based on core needle biopsy or prostatectomy. A total of 426 FNA prostate specimens from the same number of patients was obtained and all had histological diagnoses.,
The aspirated materials in needles were jeted into the PSS. The insides of syringes and needles were washed with the same PSS. The PSS was centrifuged at 2000 rpm for ten minutes and smears were made in a routine manner from the sediments obtained by centrifugation. Four of the six slides fixed in 95% ethanol were stained by the modified Papanicolaou method. The materials were available for staining even after preservation in a refrigerator for up to twelve hours. The concentration method for PSS was an easy process and yielded a higher collection rate of cells than the usual jet method into a glass. A few cases with negative results by the latter method turned out to be positive when examined by the former method.
The histological diagnoser of the 426 prostate tumors included 75 adenocarcinoma, 345 benign lesions and 4 urinary bladder carcinomas. The accuracy rate (AR) of FNA, the correspondence between malignancy on histological and cytological diagnosis, was 66.4%. There were 27 well, 23 moderately and 23 poorly differentiated adenocarcinomas and their ARs were 11.1%, 43.5% and 82.6%, respectively. As to clinical stage, there were 20, 9, 13 and 33 cases in stages A, B, C and D and their ARs were 10%, 11%, 46% and 73%, respectively. The greater the degree of histological differentiation and the lower the clinical stages were, the lower the ARs were. The most significant challerge in applying FNA is to enhance the ARs of cases with highly differentiated lower stage carcinomas.View full abstractDownload PDF (5788K) -
Masao KOZUKA, Hitoshi HACHIYA, Katsuhisa SASOU, Taeko HAYASE, Takayuki ...1993 Volume 32 Issue 3 Pages 378-385
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThe diagnosis of hepatic, biliary and pancreatic malig-nancies by fine needle aspiration cytology under ultrasound guidance was studied using aspirates obtained from 409 patients with histological or clinical confirmation.
In 45 of 56 patients with hepatic malignancies, malignant cells were demonstrated by hepatic aspiration cytology. In four of five patients who underwent radical surgery, the hepatic aspirate was positive, while the other case was suspicious for the hepato-carcinoma.
Malignant cells in bile of the bile duct, which were obtained though percutaneous transhepatic choleangiography, were demonstrated in 71 of 120 malignant cases. In five cases of bile duct cancer and three cases of gall bladder cancer, the bile cytology was positive in all cases. In pancreatic cancer, four of twelve cases showed positive cytological findings, while four cases of ampula cancer were negative.
Carcinoma cells in bile of the gall bladder were detected in 18 of 28 malignant cases. Six cases of gall bladder cencer were treated by radical resection, and five of those six cases showed positive findings in the cytological examination.
Fine needle aspiration cytology was performed in 17 cases of malignant pancreatic tumor. Twelve of the 17 cases showed positive cytological findings in the materials obtained by pancreatic puncture. Three patients with pan-creatic head cancer underwent surgery, including pancreato-duodenal resection, and all showed positive cytological find-ings.
Puncture of the pancreatic duct was done in two patients with pancreatic head cancer, both of whom showed positive findings in the pancreatic juice of the duct. One of these patients underwent radical surgery for pancreatic head can-cer.
There were no false positive cytological diagnosis of carcinoma cells in 179 benign cases.
Thus, fine needle aspiration cytology of the liver, biliary system and pancreas was proved to be a useful and accurate technique for diagnosing cancer.View full abstractDownload PDF (12797K) -
Yuki SATO, Akiyoshi MATSUI, Tatsuko KONNO, Keiko ITO, Hisashi HIGASHII ...1993 Volume 32 Issue 3 Pages 386-391
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA cytologic evaluation was made of 75 mammary samples collected from 69 cases during pregnancy or lactation.
Ductal cell clusters were detected in 22 of 29 aspirates. These were classified into spherical clusters and plane clusters. Enlarged nucleoli were observed in 16 of 29 aspirates. Nucleoli were usually more prominent in plane cell clusters.
Erythrocytes were detected in 31 of 46 nipple discharges. Papillary clusters of epithelial cells were noted in 8 of 46 samples.
Five of 69 cases were diagnosed as cancer histological-ly;cytology was positive in one of 2 aspirates and in one of 4 nipple discharges.View full abstractDownload PDF (8341K) -
Etsuo HORINAKA, Masato SUZUKI, Masaki OSHIDA, Atsushi ONOKI, Naoto YAM ...1993 Volume 32 Issue 3 Pages 392-398
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThe authors studied the usefulness of aspiration biopsy cytology in 266 outpatients with breast diseases examined by the First Department of Surgery, School of Medicine, University of Chiba, and compared the diagnostic results with those obtained by mammography, ultrasonography and palpation. The histological diagnoses in 103 patients with benign diseases were fibroadenoma in 52, mastopathy in 36, intraductal papilloma in 6, and others in 9 cases. In 163 patients with malignant diseases, the histological diagnoses were scirrhous carcinoma in 57, papillotubular carcinoma in 48, solid tubular carcinoma in 44, and others in 14 cases. The cytodiagnoses in the benign patients revealed classes I and II in 92 (89%), class III in 7 (7%), class IV in 2 (2%), and insufficient specimens in 2 cases (2%). The cytodiagnoses in patients with malignant diseases included class II in 2 (1%), class III in 6 (4%), class IV and V in 154 (94%), and insufficient specimens in 2 cases (1%). Aspiration biopsy cytology was thus found to have an accuracy of 92%, a specificity of 89% and a sensitivity of 94%. These values were higher than those obtained by mammography, ultrasonography and palpation. The above results indicate that aspiration biopsy cytology has a high sensitivity and consistent reliability even for small tumors of 5-10 mm provided that biopsy specimens are properly obtanined.View full abstractDownload PDF (7550K) -
Michiko UCHIYAMA, Toru HACHISUGA, Kouichi FUKUDA, Norihito MATSUO, Tsu ...1993 Volume 32 Issue 3 Pages 399-403
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThe immunocytochemical staining pattern of the 36-kd proliferating cell nuclear antigen (PCNA) in gynecological cytology was studied. Using three commercially availabl mouse monoclonal antibodies (MAbs 19 A 2, 19 A 4 and samples PC 10), 80 cytologic samples of gynecologic tumors were fixed and stained by different methods. Of the three monoclonal antibodies, 19 A 2 showed maximum reactivity in cytologic materials treated with 100% methanol fixation for 24 hours. Normal superficial and intermediate squamous cells were not stained with MAb 19 A 2. Koilocytosis and the cells derived from mild to moderate dysplasia showed mainly cytoplasmic staining, but no or faint nuclear staining. Cells derived from severe dysplasia and carcinoma in situ showed both cytoplasmic and nuclear staining. Invasive squamous cell carcinoma showed predominantly nuclear staining. Nuclear staining of normal endometrial cells was evident in the proliferative phase, but not in the secretory phase. Endometrial carcinoma showed nuclear staining. When we counted only nuclei with a granular staining pattern, the PCNA-positive rates of mild to moderate dysplasia, carcinoma in situ and invasive carcinoma were 8.5±3.5, 15.5 ± 8.9 and 35.8 ± 12.2, respectively. These results suggest that the immunocytochemical method using MAb 19 A 2 may be useful for evaluating gynecologic tumor cells in S phase if the cells show a granular staining pattern.View full abstractDownload PDF (3783K) -
A study of fixation and processing methodsKatsunari KINA, Kazuhisa ISHI, Reiko KAZAMA, Junichi KOYATSU, Toru KAW ...1993 Volume 32 Issue 3 Pages 404-408
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSUsing the ISH method with the objective of detecting HPV DNA in cytodiagnosis of the uterine cervix, we studied methods fixation and processing (proteopeptic response and their combinations) and obtained the following results.
1) When ISH operational techniques were used in normal tissue specimens, staining was better with 15% neutral buffered formalin fixation than 95% ethanol, acetone fixation.
2) When 95% ethanol fixation was used, it was possible to omit the proteopeptic reaction included in the ISH operational techniques, and favorable staining results were obtained. This indicates that, during normal cytodiagnosis it is not necessary to prepare a special fixation solution.
3) From Papanicolaou staining with restaining specimens, HPV-DNA positive results were obtained. Given the above results, it is comsidered possible to conduct retrospective studies of HPV from Papanicolaou staining with restaining specimens in cytodiagnosis of the uterine cervix.View full abstractDownload PDF (8306K) -
Masako FURIHATA, Shojiroh MORINAGA, Makoto TAKAGI1993 Volume 32 Issue 3 Pages 409-413
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA 56-year-old Japanese housewife presented with headache and visual disturbance. Intracranial hypertension was detected, but no tumor was found in the brain or other organs on clinical examination. V-P shunt operation was performed under a diagnosis of pseudotumor cerebri. In the cerebrospinal fluid cytology specimen, several incohesive atypical large cells with prominent nucleoli were seen. However, these cells were erroneously judged to be ependymal cells or choroid plexus cells irritated by V-P shunt. After that, an abnormal shadow was found in a chest X-ray, and transbronchial lung biopsy and brush cytology revealed a pulmonary adenocarcinoma. Cerebrospinal CEA was elevated, and atypical cells in the cerebrospinal fluid were positive for CEA and keratin by an immunoperoxidase method. The cytologic diagnosis was corrected to leptomeningeal carcinomatosis.Autopsy disclosed a papillary adenocarcinoma, measuring 2.2 ×1.8 cm, in the upper lobe of the right lung. Diffuse metastasis of poorly differentiated adenocarcinoma was confirmed in the leptomeninges, but no nodular carcinomatous deposits were found in the brain.View full abstractDownload PDF (5833K) -
Tohru NAKAJIMA, Yasuo TAJIMA, Isamu SUGANO, Koichi NAGAO, Akira SAKUMA ...1993 Volume 32 Issue 3 Pages 414-417
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA 55-year-old woman was referred to our hospital complaining plaining of dyspnea and cough of three months' duration. Radiologic examination revealed obliterated pericardium with pericardial fluid. Malignant cells which consisted of small tumor cell clusters and dispersed single giant cells were observed in the liquid obtained by pericardial catheterization. Despite anti-cancer chemotherapy, she died due to cardiac failure. The definitive diagnosis of malignant pericardial mesothelioma was made at autopsy. To obtain an accurate diagnosis, an overall assessment of fluid cytology with the application of immunohistochemical procedures and sufficient clinical as well as radiographic information would be necessary.View full abstractDownload PDF (9179K) -
Hiroko KUWABARA, Hirotsugu UDA, Kohji KOHNO, Fujio KISHIDA, Yasunobu F ...1993 Volume 32 Issue 3 Pages 418-421
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSCytologic studies of cerebrospinal fluid (CSF) in infiltrating lobular carcinoma of both breasts with carcinomatous meningitis is reported. The patient, a 32-year-old woman, complained of mass lesions in both breasts and abdominal fullness. CT scanning revealed swelling of both ovaries, ascites and pleural effusion. The patient underwent ovariectomy and biopsy of both breasts. These lesions were diagnosed histo pathologically as invasive lobular carcinoma. Seven months later, she had headache, nausea an vomiting, and was readmitted. Meningeal carcinomatosis was diagnosed by cytological examination of the CSF. The examination revealed the following cytological characteristics. Cancer cells were scattered, solitary or arranged in sheets. There were also some paired cells. Autopsy revealed carcinoma cells around small vessels in the subarachnoid space.View full abstractDownload PDF (6593K) -
Takao SATOU, Motohiro IMANO, Shigetoshi UNO, Kazunori NISHI, Kazuhiro ...1993 Volume 32 Issue 3 Pages 422-428
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSApocrine carcinoma of the breast is occurring with increased frequency in Japan. We report a 72-year-old woman who was admitted for a painless tumor in the left breast. An excisional biopsy was performed, and histological examination of the tumor specimen revealed as breast apocrine carcinoma. In the imprint specimen, cell clusters with slight overlapping or flattened sheets and individually scattered atypical cells around the clusters were observed. Atypical cells showed striking pleomorphism and large nuclei with increased chromatin and one or two distinct nucleoli. The cytoplasm was abundant and had very fine eosinophilic granules. Multivacuolated (globoid) cells were mixed. Immunohistochemical staining for and-gross cystic disease fluid protein 15 (GCDFP-15), carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), macrophages, αl-antitrypsin, α1-antichymotrypsin and lysozyme was performed. Tumor cells showed distinct differentiation of apocrine epithelium because of mosaic positive staining for anti-GCDFP-15. Multivacuolated cells showed positive staining for anti-GCDFP-15, CEA and EMA and negative staining for anti-macrophage and lysozyme. Therefore, the results of immunohistochemical staining suggested that multivacuolated cells did not originate from the macrophages, but from the epithelium.View full abstractDownload PDF (13501K) -
Kenzo ONO, Mariko OSHIRO, Yuji KAMIYA1993 Volume 32 Issue 3 Pages 429-434
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThis report describes a 5-month-old boy with melanotic neuroectodermal tumor of infancy. The tumor originated from the maxilla, and computed axial tomographic scan showed swelling of the lesion and destruction of the maxilla. The lesion was surgically removed and the specimen obtained from the lesion was examined cytologically, histologically, histochemically and ultrastructually. The tumor consisted of two different kinds of cells: large epithelial cell-like cells with obvious cytoplasm and melanin granules, and small cells with scant cytoplasm that were similar to neuroblastic cells. The larger cells reacted with both anti-S-100 antibody and anti-NSE antibody, while the small cells showed a positive reaction only with the latter antibody. All evidence from the histological studies suggested that these cells were differentiated from the neural crest. Although the disease is extremely rare and generally recognized as benign, it is important to keep in mind that the disease might sometimes be difficult to differentiate from other malignant diseases like malignant melanoma without sufficient information.View full abstractDownload PDF (8896K) -
Tomoko MORIWAKI, Mamoru TADOKORO, Sakiko HOSHIKAWA, Eiko TAKEUCHI, Mit ...1993 Volume 32 Issue 3 Pages 435-442
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of prolactin-producing pituitary adenoma diagnosed by aspiration cytology from the sphenoid sinus.
The patient was a 70-year-old woman with left exophthalmus and decreased visual acuity, who was admitted to the ophthalmology clinic. Imaging examination disclosed a tumor mass which showed destruction of the base of the sella turcica and invasion into the sphenoid sinus wall and left orbita. However, the pituitary gland itself was unremarkable.
For conclusive diagnosis, aspiration cytology and biopsy of the tumor were performed from the sphenoid sinus. The biopsy revealed a proliferative tumor rich in vascular channels, but the histological diagnosis was not contributory due to markedly crushed tissue. Aspiration cytology revealed tumor cells that were 20-30 micron in size and presented small vacuoles in the nuclei and cytoplasm. The cytoplasm also had scatterd eosinophilic granules. Some cells showed domed projections at one end of the cytoplasm and crowded eosinophilic granules. Indented or distorted tumor cells were observed. Immunocytochemical staining using antiprolactin antibody revealed granular and/or diffuse, and localized collecting reactions in the cytoplasm.
From the above cytological appearance, we considered the tumor to be a prolaction-producing pituitary adenoma. It was concluded to be ectopic by imaging.View full abstractDownload PDF (10944K) -
Shinya SATO, Kazuki NABESHIMA, Akinobu OHNO, Yuji HINOURA, Hajime OHTA ...1993 Volume 32 Issue 3 Pages 443-446
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA 25-year-old man had an intracranial germinoma in the thalamic region. The differential diagnosis included germinoma, glioma, malignant lymphoma and metastatic carcinoma. Sterotaxic biopsy was performed to determine the diagnosis. Frozen sections made during surgery showed hyperplastic gliosis and lymphocytic infiltration in a large portion. Although atypical cells were noted in a small portion, no definite diagnosis could be made because of extensive crush artifact. However, squash cytology revealed large tumor cells accompanied by mature lymphocytes in the background, suggesting the two-cell pattern. The tumor cells had a round or oval nucleus with fine granular chromatin, one or a few prominent nucleoli and indistinct cell borders. These findings allowed us to make a diagnosis of germinoma. The diagnosis was confirmed by the paraffin sections made after surgery. It is important to differentiate germinoma from other tumors during surgery, because radiation therapy is the first choice for germinoma. Since germinoma is sometimes difficult to detect histologically due to intense gliosis, it is useful to perform both histological and cytological (especially squash cytology) examinations. The combination of the two methods enables more tissues and cells to be examined, and increases the possibility of detecting the tumor cells. Thus, combined examination is strongly recommended for more accurate diagnosis.View full abstractDownload PDF (3877K) -
Mutsuo TAKAHASHI, Fumiko HIRAOKA, Etsuko ISE, Hiroo KAWANO, Toshikazu ...1993 Volume 32 Issue 3 Pages 447-452
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA case of clear cell adenocarcinoma of the endometrium coexisting with uterine tuberculosis is described.
Preoperative endometrial cytology revealed characteristic tumor cells which displayed overlapping clumps or fragments. Individual tumor cells had abundant clear cytoplasm and vesicular nuclei with one or two centrallysituated, distinct nucleoli.
In the same preparation, two types of cells indicating tuberculosis were observed: 1) epithelioid cells characterized by oval to elongated nuclei and slender cytoplasm with indistinct cell borders, and 2) Langhans' giant cells characterized by thick cytoplasm with peripherally arranged nuclei.In the histologic preparations obtained from radical surgery, the uterine cavity was filled with tumor cells, and classical tuberculous lesions were also seen in the uterus. The tumor cells had clear cytoplasm containing large amounts of glycogen, and were arranged predominantly in a papillary fashion with an occasional solid or glandular pattern. A hobnail pattern was also seen in limited areas of the myometrium.View full abstractDownload PDF (10586K) -
Toshimi TAKAHASHI, Takeo NISHINO, Koichi KUBOTA, Tokuzo KASAI, Isamu S ...1993 Volume 32 Issue 3 Pages 453-458
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA 26-year-old nulliparous woman with amenorrhea but otherwise no particular complaint was found to be in the seventh week of pregnancy and to have left ovarian tumor by ultrasonography. Ovariectomy revealed an 8-cm dermoid cyst with hair, fat and a yellowish solid lesion measuring 5 cm in greatest diameter. The imprint smears showed a thyroid follicle pattern: cells with round nuclei around colloid substance with anisocytosis and stratification. Some of them had nuclear grooving and pseudo-inclusion, suggesting papillary carcinoma.
Histologically, the tumor had mature teratoid elements: skin with appendage glands, brain and cartilage. The solid lesion presented as thyroid tissue with mild nuclear anaplasia, capsular and vascular invasions compatible with follicular carcinoma but without papillary change. Grimelius and Fontana-Masson staining were negative. Immunohistochemical studies showed expression of thyroglobulin but not calcitonin. Ultrastructurally, the nuclear cleavage and pseudoinclusion were not remarkable ; however, they were unlikely for a benign lesion. Flow cytometric DNA measurement showed a poly ploid pattern, suggesting malignancy.
The final diagnosis, made with the support of ultrastructural, immunohistochemical and DNA analysis studies, was papillary carcinoma, follicular variant, of struma ovarii.View full abstractDownload PDF (11227K) -
Fumio MURAYAMA, Susumu ISHIKAWA, Tsutomu YAMAGUCHI, Sachiko KUBONO, To ...1993 Volume 32 Issue 3 Pages 459-460
Published: 1993
Released on J-STAGE: November 08, 2011
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Akinobu OHNO, Yuji HINOURA, Atsushi TSUNEYOSHI, Yujiro ASADA, Tohru HA ...1993 Volume 32 Issue 3 Pages 461-462
Published: 1993
Released on J-STAGE: November 08, 2011
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Sister Mary Joseph's noduleRaj K Gupta1993 Volume 32 Issue 3 Pages 463-464
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA case of metastatic mucus producing adenocarcinoma of the umbilicus (Sister Mary Joseph's nodule) is described. The primary tumour was an adenocarcinoma of the sigmoid colon. The cell blocks from the aspirate highlighted the histological features of the metastatic tumour with extensive mucus production which was also confirmed by alcian blue and mucicarmine stains.View full abstractDownload PDF (2603K) -
Setuko OHTA, Takuya MORIYA, Noriko OOSUGI, Yasuyuki MIYAKE, Sakae HATA ...1993 Volume 32 Issue 3 Pages 465-466
Published: 1993
Released on J-STAGE: November 08, 2011
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Kumiko NAKAZAWAI, Shigemi HOSOGAYA, Masako MITSUMATA, Koichi SUDA, Sho ...1993 Volume 32 Issue 3 Pages 467-468
Published: 1993
Released on J-STAGE: November 08, 2011
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Toshihiko TOKI, Yukie KUMAGAI, Kimio KOHSAKA, Yohsei KATAYAMA1993 Volume 32 Issue 3 Pages 469-470
Published: 1993
Released on J-STAGE: November 08, 2011
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Yoshimi INANIWA, Koyu SUZUKI, Yoshitomo SHIMIZU, Ayano HONDA, Masahiko ...1993 Volume 32 Issue 3 Pages 471-472
Published: 1993
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (2935K)
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