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Yuji ARAI, Masafumi TSUZUKU, Atsuhiko SAKAMOTO
1997 Volume 36 Issue 2 Pages
109-114
Published: March 22, 1997
Released on J-STAGE: November 08, 2011
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To clartify the grading of thyroid carcinoma on cytology, 13 poorly differentiated and 17 well differentiated papillary carcinomas were investigated in the present study.
Cytological characteristics of poorly differentiated carcinoma were as follows; 1) Presence of small clusters and dispersed cancer cells. 2) Clusters showing a piled-up irregular cell arrangement, and forming loose arrangements in some areas. 3) Large elliptic nuclei as compared to welldifferentiated types of cancer. Prominent anisokaryosis. 4) Occasional admixture of well differentiated carcinoma components.
These results were confirmed by morphometrical analysis as to nuclear size, shape and anisokaryosis. The findings obtained in this study are possible indicaters for making a diagnosis of poorly differentiated papillary carcinoma of the thyroid on routine cytological examination.
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Mitsuyoshi HIROKAWA, Sakae HATA
1997 Volume 36 Issue 2 Pages
115-118
Published: March 22, 1997
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We cytologically examined 12 non-Hodgkin's B-cell lymphomas and 10 non -neoplastic lymphoproliferative lesions (4 Hashimoto's disease and 6 chronic thyroiditis) of the thyroid. In malignant lymphomas, the prevalence of large cells exceeded 20%, while that of small cells was less than 20%. On the other hand, in non-neoplastic lymphoproliferative lesions, the large cells accounted for less than 20%, and the small cells more than 20%. The prevalences of cleaved nuclei among medium-sized and large cells were more than 10% in malignant lymphomas and less than 10% in benign lesions. Unevenly distributed nuclear chromatin, nuclear streak, and lymphoglandular bodies suggested malignant lymphoma, the presence of epithelial nests a benign lesion.
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Taku KATO, Hisao TAKAHASHI, Tomoko ANDO, Tomoko TUSHIMA, Yoshihiro IDA ...
1997 Volume 36 Issue 2 Pages
119-123
Published: March 22, 1997
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In order to perform reasonable breast conserving surgery for breast cancer, intraoperative rapid imprint cytologic examination was employed to diagnose the extent of cancer spread at the surgical margin. Thirty-three patients underwent breast conserving surgery in our hospital from April 1993 to June 1996. The following conclusions were derived:
1. Sensitivity, specificity and accuracy were 100%, 90.7% and 92.4% respectively.
2. Most true positives revealed non-invasive carcinoma, while false positives were ductal hyperplasia. The differential points in both cases were (1) Appearance types and numbers of cells in the background.(2) Cohesion of epithelial cell clusters and presence of myoepithelial cells.(3) Nuclear form and various sizes of epithelial cells and periglandular nuclear forms.(4) Hyperchromatin and prominent nucleoli.
3. The direction of intraductal cancer spread from the tumor margin was predominanthy toward the nipple side (15.3mm in average length), followed by the superior lateral side (6.4mm), inferior lateral side (6.2mm) and distal side (5.0mm).
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Mitsuyoshi HIROKAWA, Minako TAMAI
1997 Volume 36 Issue 2 Pages
124-127
Published: March 22, 1997
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We cytologically compared 4 necrotizing Warthin's tumors with 16 typical tumors in order to clarify cytologic features of necrotizing Warthin's tumor. The cytologic features were as follows, 1. abundant necrotic epithelial cells and lymphocytes, 2. minimally cohesive oncocytic cells, 3. the presence of squamous cells, 4. predominant neutrophils or histiocytes in the background, and 5. the presence of hemosiderin or hematoidin. When typical oncecytes are not seen, mast cells, inspissated proteinacious globles and granular background are useful in diagnosing Warthin's tumor.
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Mitsuyoshi HIROKAWA, Miyuki KABATA, Michio SHIMIZU
1997 Volume 36 Issue 2 Pages
128-131
Published: March 22, 1997
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To clarify the variety of morphological features of myoepithelial cells, we examined cytological smears of 30 cases histologically diagnosed as pleomorphic adenoma of the salivary gland. The epithelial cells were classified into four types, epithelioid cell type, plasmacytoid cell type, myxoid type and spindle cell type. Their incidences were 46.7%, 60.6%, 66.7% and 20.0%, respectively. In most cases, a mixture of these cell types was detected, and the morphological variety of myoepithelial cells is thought to be a characteristic feature of pleomorphic adenoma.
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Kanae ARIMITSU, Takuo KANAHARA, Mari NARITOMI, Sakae HATA, Mitsuyoshi ...
1997 Volume 36 Issue 2 Pages
132-135
Published: March 22, 1997
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A tigroid or striped background shows dense and light stripes in the background in air-dried, Wright-Giemsa stained smears, characteristic of seminoma.
We studied factors in the pathogenesis of the tigroid background in 7 patients with seminoma.
We clarified that the appearance of tigroid background was related to glycogen-rich tumor cells, cellular smears, good air-dried smears, and abundant naked nuclei.
Therefore, the tigroid background was thought to result from disruption of the cytoplasm at the time of smearing.
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Takuo KANAHARA, Mika SHIMOOKU, Kanae ARIMITSU, Noriko OSUGI, Yasuyuki ...
1997 Volume 36 Issue 2 Pages
136-140
Published: March 22, 1997
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We retrospectively rescreened cases diagnosed as false negatives on the first screening, in order to clarify the accuracy of cytology in our department. Of 44, 962 cases negative on the first screening, 133 were judged as suspicious or positive on the second screening. The false negative rate was 0.29%. Among false negative factors, screening on Monday, samples of urine, pleural and peritoneal fluid and bile, screening experience less than three years, a small number of atypical cells on a preparation and an inflammatory or degenerative smear were associated with high false negative rates. In order to reduce misevaluation in screening, we must be aware of the above results and promote the double screening system.
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Emiko TANIGUCHI, Yonekazu SAKAMOTO, Tsukumi IWATANI, Chieko NISHIMURA, ...
1997 Volume 36 Issue 2 Pages
141-145
Published: March 22, 1997
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Many cytology laboratories use Papanicolaou dyes from commercial sources for their samples. The staining protocol differs slightly among laboratories. As a result, the staining color tone usually differs among laboratories. For the purpose to standardized Papanicolaou staining tone, this study introduces the “Lab Color specification” to the evaluation of cytological samples. This method was formerly used in the textile industry to analyze fabric colors. The results are expressed as Lab and the subjective difference is detected objectively as numerical differences.
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The method of decision by the image cytometory
Shinsuke INAGAKI, Isao KOBAYASHI, Fumio HORIUCHI, Yoshio SHIINA, Masah ...
1997 Volume 36 Issue 2 Pages
146-150
Published: March 22, 1997
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PCNA has been recognized as one of the markers of cell proliferation activity. Its technology is simple, but determining a positive PCNA reaction depends upon personal subjec tive opinions. We examined the process of determining a positive PCNA reaction by imege cytometry for objective evaluation. Smears were obtained from 14 cases of sqamous cell carcinoma and 30 cases of adenocarcinoma that were detected by PCNA. The nuclei were measured for transparent luminosity by imege cytometry. The borderline of a positive PCNA reaction was set at a luminosity of (Maximum-Minimum) ×0.25+Minimum.
Results. The degree of the positive reaction was stronger for adenocarcinomas than for sqamous cell carcinomas. Furthermore, in the cases with cells piled on top of each other, measure could not be done. Accordingly, we considered ments making a monolayer smear to be necessary for PCNA to be used for imege cytometry.
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Shuichi KOHRI, Yoshio SHIINA, Mizue ODA, Mineo OHMURA
1997 Volume 36 Issue 2 Pages
151-156
Published: March 22, 1997
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We studied the appearance of a “bizarre stripped nucleus (BSN) ”, with cytomorphological and immunocytochemical methods, in cervical smears from cervical dysplasia with human papilloma virus (HPV) infection.
Cases with HPV infection were classified as Group I (appearance of BSN in four cases) and Group II (nonappearance of BSN in 25 cases). We analyzed BSN in terms of cytomorphological features, origin, and the correlations with the existence of koilocytes and HPV capsid antigen.
(1) Among the cytomorphological features of BSN, the stripped-nucleus lacks cytoplasm and shows bizarre nuclear forms of lobulation or multinucleation. The chromatin is reticulated and has a smudged structure with coarsely clumped chromatin. No nucleolei were seen.
(2) Of 24 BSNs, HPV capsid antigen was detected in 23 (95.8%).
(3) Koilocytes were detected in one of four cases (25%) in Group I and in six of 25 cases (24%) in Grup II.
(4) Among dyskaryotic cells, HPV capsid antigen was detected in 314 of 910 (34.5%) in Group I and 368 of 4374 (8.4%) in Group II.
(5) It was considered that the origin of BSN is over-proliferation of HPV.
(6) In BSN, the form was considered to be virion type.
We suggest, based on these new cytomorphological findings, that the appearance of BSN indicates HPV infection involving numerous virions.
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Kaoru YOKOSUKA, Yuhko KIMURA, Mayumi KUROSE, Aiko KIKUCHI, Shizuyo ISH ...
1997 Volume 36 Issue 2 Pages
157-162
Published: March 22, 1997
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The Bethesda system puts Human Papilloma Virus (HPV) infection and mild dysplasia in the same category as low-grade squamous intraepithelial lesions (SIL). This report cytologically reviews 74 cases of HPV infection (Group A), 61 cases of mild dysplasia (Group B) and 40 cases of mild dysplasia+HPV infection (Group C). The aim was as to evaluate the adequacy of regarding HPV infection and mild dysplasia as being equivalent clinically and cytopathologically. Patients underwent punch biopsy with colposcopy.
1. A comparison of accuracy rates between cytology and pathology yielded 39.2%, 45.9% and 67.5% in groups A, B and C, respectively.
Group C had a significantly higher rate than the other two (p<0.05).
2. According to the Bethesda system, the rates of combined high-grade SIL lesions in each gruop (A, B, C) were 13.5%, 14.8% and 15.0%, respectively (p: NS).
3. HPV infection cases with high-grade SIL lesions showed dyskaryotic cells with slightly anisokaryotic nuclei, and cytoplasms were strongly stained with OG. Structures of the nuclei were unclear but not smudged (resembling moderate dysplasia, keratinizing type ; WHO teaching slide no. 79). These results suggest that HPV infection and mild dysplasia are cytologically equivalent, and it is a noteworthy that dyskaryotic cells (mentioned above) are usually seen in HPV infection combined with high-grade SIL lesions.
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Takaya KUNUGI, Shigemi SATO, Yoshiharu SAITO, Masaru SAKAMOTO, Tadashi ...
1997 Volume 36 Issue 2 Pages
163-166
Published: March 22, 1997
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Uterine cervical cancer cells obtained from 21 cases were studied for human papillomavirus (HPV) infection and intranuclear localization of HPV DNA and the c-myc gene by fluorescence in situ hybridization (FISH). The following results were obtained.
1. 60%(6/10) of CIS and 55%(6/11) of invasive cancer cases were HPV positive by the FISH method. HPV DNAs were detected visually in each nucleus.
2. There was only one case of CIS in which HPV DNA signals and c-myc gene signals were co-localized, suggesting that HPV DNA integration near the c-myc gene locus is uncommon in clinical cervical cancer specimens. In our interphase FISH study, this clear integration was easily detected.
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Takahiro SUZUKI, Eiki ITO, Masaki TAKEHARA, Motoiki KOIZUMI, Tomoyuki ...
1997 Volume 36 Issue 2 Pages
167-173
Published: March 22, 1997
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In the 10-year period from 1986 through 1995, 21 cases of metastatic uterine cancer were detected. We investigated these cases clinically, cytologically, and histologically. The mean age was 55 years. Among these 21 cases, the primary sources of the cancers were the ovary (13 patients), stomach (three), colon (three), breast (one), and lymphnode (one). We compared the cytology of primary uterine cervical and corpus cancer working on the hypothesis that by observing smears of metastatic uterine cancers we could detect the primary lesion.
Cytological features of the metastatic tumors were as follows: From breast cancer, small tumor cells had high nuclear-cytoplasmic rations, and showed conspicuous nucleoli. From stomach cancers, the cervical smears resembledl primary uterine cervical adenocarcinoma and malignant tumor cells appeared in all endometrial smears. From colon cancers, there were small clusters of tumor cells which showed conspicuous nucleoli. In smears metastasized from ovarian cancers, we observed several cytologies, which were similar in histology of the relevant pathological type.
We also discuss in this report the metastatic courses, colposcopic features, and prognosis of the cases.
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Cytological, pathological and immunological diagnosis
Masami SHIBASAKI, Isao SHITO, Akio KONNO, Toshikazu YUSA, Kiyoshi SHIB ...
1997 Volume 36 Issue 2 Pages
174-178
Published: March 22, 1997
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A rare case of pulmonary dirofilariasis occurring in a 63 year old man is presented. The patient was asymptomatic and a solitary pulmonary nodule was identified in the right upper field by chest roentgenography. Under the suspicion of lung carcinoma, he underwent a partial thoracotomy. The resected lung included a yellowish mass, measuring 3.2×2.0×1.0 cm, with central necrosis, in which a worm existed.
Cytological examinations of the fresh cut surface of the nodule revealed that a few lymphocytes and eosinophils were scattered among the cell debris.
Histological examinations exhibited granulomatous inflammation and worms were observed within the lumina of pulmonary arteries.
The diagnosis of pulmonary dirofilariasis was also confirmed by immunological examinations.
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Nobuyoshi FURUTANI, Kazuaki YAMADA, Shoukichi TAJIMA, Shoutarou MAEDA
1997 Volume 36 Issue 2 Pages
179-184
Published: March 22, 1997
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We report a case of smoldering adult T-cell leukemia (ATL) complicated by Pneumocystis carinii (P. carinii) and strongyloidiasis.
The patient was a 48-year-old woman, complaining of cough, sputum, general malaise and weight loss. Chest Xray and computerized tomography (CT) revealed diffuse fine granular shadows throughout both lung fields. Therefore, hypersensitivity pneumonitis was initially considered. P. carinii pneumonia was demonstrated by Grocott staining and immunoperoxidase for the BAL fluid specimen. After two weeks, strongyloides sterocoralis was detected by sputum cytology and was confirmed in the stool.
Immunodificiency was suspected and, finally, the patient was diagnosed as having smoldering ATL, based on a detailed clinical examination which showed HTLV-I antibody in serum and atypical lymphocytes with convoluted nuclei including the so-called “flower cell”.
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Setsuo SUGISHIMA, Toshiro YOKOYAMA, Tomoko YOSHIDA, Hiromi TAKAGI, Tos ...
1997 Volume 36 Issue 2 Pages
185-189
Published: March 22, 1997
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The authors report a case of accessory breast carcinoma, arising in the axilla, diagnosed with fine needle aspiration cytology.
A 74-year-old woman was found to have a subcutaneas nodule 1.5 cm in diameter in the right axilla. A high density tumorous shadow appeared in the right axillary region on mammography.
Aspiration cytology of the nodule showed small or medium sized clusters composed of tumor cells with marked atypia and pleomorphism, similar to those of mammary ductal carcinomas. Histological diagnosis of the nodule was scirrhous carcinoma of the mammary gland. A mastectomy was done to eliminate the risk of occult breast cancer. However, the breast was free of malignancy.
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Mitsugu ISHIZAWA, Kunio MIZUGUCHI, Masataka TANNO, Akihiko YAMAMURA, H ...
1997 Volume 36 Issue 2 Pages
190-194
Published: March 22, 1997
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We report a case of epithelioid leiomyosarcoma of the ileum initially showing malignant cells of unknown origin in the ascites. The patient was a 63-year-old woman. Cytological features in the ascites included a scattered distributioti or minimally cohesive cluster of large atypical cells with an inflammatory background. The unclei of the tumor cells were oval and nucleoli were prominent. The cytoplasm was densely stained light green. Occasionally, the cytoplasm was pale and vacuolated. Macroscopically, the tumor was 18×8×7 cm in size growing through the entire wall of the ileum with ulcer formation. This tumor had ariser from the muscularis propria. Invasions to the mesentery, the omentum and the urinary bladder were observed. The cutsurface was solid and whitish with central necrosis. Histological features of the tumor were a compact proliferation of round or spindle-shaped cells with epithelioid arrangements. The individual tumor cells were surrounded by well -developed reticulin fibers.
Immunohistochemical analysis revealed positive staining for EMA, cytokeratin, vimentin and smooth muscle actin, while staining for desmin and myoglobin was negative. Ultrastructural findings included abundand myofilaments in the cytoplasm. From these findings, we diagnosed this tumor as epithelioid leiomyosarcoma of the ileum. However, in this case, it was very difficult to make an accurate cytological diagnosis. It is thought to be important to consider the possibility of this tumor when epithelioid cells are recognized in ascites fluid.
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Katsumi TAKAHASHI, Mamoru MOCHIZUKI, Haruhiro EJIRI, Sumitaka HISA, No ...
1997 Volume 36 Issue 2 Pages
195-199
Published: March 22, 1997
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We herein describe a rare case of primary multilobated B -cell lymphoma of the small intestine.
A 43-year old Japanese man presented to our hospital because of nausea, vomiting and abdominal distension. Intraoperative exploration of the gastrointestinal tract showed two tumor lesions in the small intestine: one in the jejunum directly invading the transverse colon; the other in the ileum. The patient underwent left-sided colectomy and partial resection of the small intestine.
The imprint materials obtained from the jejunal tumor showed an abundance of isolated tumor cells consisting of medium to large-sized atypical lymphocytes. The tumor cells showed clumping of nuclear chromatin and relatively abundant cytoplasms. The tumor cells had characteristic nuclear shapes which were recognizable three dimensionally as follows: 1) rough consecutive curvature appearing as twisted short sticks, 2) a certain point at which nuclear indentation concentrated in the nucleus itself, creating the appearance of a flower in bloom, 3) nuclear multilobulations similar to those of neutrophils. Approximately 26% of the tumor cells in the imprint materials had nuclear multilobulation, i.e., three to six lobules. Based on histological examination of the surgical materials including immunohistochemical analysis, we finally confirmed this case as belonging to the category of multilobated B-cell lymphoma.
On imprint cytology of the lymphoma, we assumed that the presence of lymphoma cells possessing abundant cytoplasms and characteristic nuclear shapes such as those described above was suggestive of multilobated B-cell lymphoma.
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Cytological features
Noriko MOTOII, Tsuyoshi ISHIDA, Hajime HORIUCHI, Teruaki OKA, Yuko KOB ...
1997 Volume 36 Issue 2 Pages
200-204
Published: March 22, 1997
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A case of subependymoma of the lateral ventricle in a 62-year-old female is reported with special emphasis of cytological features. The patient had dizziness with no other neurological symptoms and signs. Computed tomography and magnetic resonance imaging revealed a left lateral ventricular tumor, measuring 3 cm in diameter. The tumor was totally excised surgically. In smear cytology of the specimen with Papanicolou stain, sparsely distributed spindle -shaped or round tumor cells were found in a large amount of fibrillary matrix with occasional hemosiderin deposition. The tumor cells had an oval, round, or elongated and spindle -shaped nucleus with homogenous, evenly distributed fine chromatin and indistinct cytoplasm. Some tumor cell nuclei showed irregular nuclear margins. In Giemsa stained specimens, some tumor cells tended to have loose connections with each other and formed a small cluster of tumor cells. Histologically, proliferation of round tumor cells in the prominent fibrillary matrix was observed and the tumor cells were scattered or focally accumulated. Microcystic change was also recognized. A histopathological diagnosis of subependymoma was made. In conclusion, subependymoma can be differented from fibrillary astrocytoma, pilocytic astrocytoma, and schwannoma by a combination of clinical and cytological features.
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Maki NAGASHIMA, Ryo ICHINOHASAMA, Hirosyu MIURA, Chika KANEKO, Michiyo ...
1997 Volume 36 Issue 2 Pages
205-210
Published: March 22, 1997
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A case of nodal CD 30
+p 80
+ anaplastic large cell lymphoma (ALCL) with positive urine cytology is described. A 22-year-old Japanese male presented with CD 30
+p 80
+ ALCL, involving bilateral cervical lymph nodes. Expression of CD 30 antigen on the lymphoma cells was identified, but there were no antigens associated with T, B and NK cells. However, DNA analysis revealed gene rearrangements of TCR β and δ. Both examinations showed that the lymphoma cells were of null phenotype and T cell genotype. Although no metaphases were seen of cytogenetic analysis, p 80
NPM/ALK protein, indicating the presence of t (2; 5)(p 23; q 35), was retrospectively examined immunohistochemically and was positive for lymphoma cells. The tumor responded adequately to the initial chemotherapy, but he relapsed with a huge retroperitoneal mass compressing the left kidney, with an aggressive clinical course. At this time, atypical large cells were seen in the urine making it difficult to distinguish lymphoma cells from carcinoma cells only by Papanicolaou and Giemsa staining because of cellular degeneration. As immunohistochemical examination of the cells in the urine smear revealed the large atypical cells to be positive for CD 30 and p 80 but negative for LCA and cytokeratin, a final cytological diagnosis of invasive lymphoma cells in the urinary tract was made. Despite additional chemotherapy and irradiation, the patient died 47 months after the onset.
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Shuji HAMAZAKI, Yasuko OGURA, Yumiko MORISHITA, Hiromi MATSUOKA, Midor ...
1997 Volume 36 Issue 2 Pages
211-215
Published: March 22, 1997
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The patient was a 41-year-old female who developed sudden right flank pain. Examination by ultrasonography, pyelography and CT-scan disclosed hydronephrosis and a mass involving the ureteropelvic junction and measuring 2×5 cm. No abnormal cells were found on urine cytology. Right pelvic urine obtained during ureteroscopy showed a few large lymphoid cells appearing in the inflammatory background. Due to the paucity of suspicious cells and the inflammatory background, a specific diagnosis could not be made by cytological examination alone. Histological and immunohistochemical examination of the biopsied mucosa disclosed a diffuse large cell lymphoma of B cell type. No other lymphomatous localizations were found by subsequent roentgenologic and hematologic examinations, and the diagnosis of primary malignant lymphoma of the ureteropelvic junction was made.
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Tadanori YAMAGUCHI, Yoshiaki IMAMURA, Tomoko SHIMAMOTO, Takako KAWADA, ...
1997 Volume 36 Issue 2 Pages
216-222
Published: March 22, 1997
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We report a case of solid cystic tumor (SCT) arising in the mesentery in a 62-year-old woman. The tumor was localized in the mesentery and there was no continuity with the pancreas. No other tumor lesions were detected in the pancreas or other organs.
Macroscopically, the tumor was surrounded by a fibrous capsule. The cut surface was partly solid and partly cystic. The fine needle aspiration smears showed a monotonous population of tumor cells forming acinar like arrangements or pseudopapillary structures with fibrovascular stalks as well as single tumor cells. The chromatin was finely granular. One to several nucleoli were present in most cells. The nuclei were round to oval and generally smooth. Histologically, the tumor consisted of solid or papillary growth of eosinophilic neoplastic cells. Mitotic figures were rarely seen. Immunohistochemically, the tumor cells were diffusely positive for alpha-l-antitrypsin (AAT) and neuron-specific enolase (NSE). Ultrastructural examination revealed numerous lysosomes and zymogen-like granules, as well as some neuroendocrine granules, within the tumor cells.
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Minoru MATSUDA, Kouichi MATSUBARA
1997 Volume 36 Issue 2 Pages
223-227
Published: March 22, 1997
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A case of calcifying epithelioma detected by fine-needle aspiration cytology is reported. A nine-year-old girl was noted to have a nodule above the left eyebrow. The nodule showed apparent slight enlargement, prompting a visit to Hinokage Hospital. Fine-needle aspiration of the nodule was performed and the cytologic smear was sent to the Chuo Medical Technology Laboratory. We microscopically observed the Papanicolaou stained smear and diagnosed the tumor as benign but could not verify the histological diagnosis. Microscopic examination of the specimen obtained by extraction of the nodule revealed a calcifying epithelioma. The tumor cells in the aspirated material were scattered as well as arranged in loose clusters. They had scanty cytoplasm and thus looked like naked unclei. The nuclei were usually round. Nuclear borders were thin. Finely granular chromatin was evenly distributed. The nucleoli were often distinct. Subsequently, amorphous materials bordered by light-green were also observed. After comparison of cytologic and histologic findings, we considereed the former to be basaloid cells and the latter to be shadow cells.
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A case report
Kaoru Yokosuka, Jui-Tung Chen, Kazuhiro Yamauchi, Katsuhiko Hasumi, No ...
1997 Volume 36 Issue 2 Pages
228-232
Published: March 22, 1997
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A vulvar adenoid basal cell carcinoma was diagnosed by smear from an ulcerous lesion of a right vulvar tumor, with confirmation on a subsequent surgical specimen. This rare tumor of the vulva should be considered in patients showing vulvar swelling, ulcers, bleeding and tumors. Cytologic examination is sufficient for accurate diagnosis of this tumor using the criteria mentioned below:
(1) small, uniform, spindle or cuboidal cells with round or oval nuclei and scanty basophilic cytoplasm,
(2) high N/C ratio,
(3) evenly dispersed, finely granular chromatin,
(4) nucleoli are not prominent, and mitosis is rare,
(5) the cluster is solid and packed densely, and has some fragments with distinct, sharp borders,
(6) palisade of the peripheral cell layer, and
(7) presence of a gland-like formation which looks like a “punched out” pseudo-gland and includes a mucin-like substance.
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Takanori HIROSE, Junko YAMADA, Yosuke YAMAMOTO, Nobuya SANO, Akiko HIN ...
1997 Volume 36 Issue 2 Pages
233-237
Published: March 22, 1997
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Neuroendocrine carcinoma is a rare tumor in the uterine cervix. We report a case of small cell neuroendocrine carcinoma arising in the cervix of a 30-year-old, pregnant (29 weeks) female. A ping-pong ball-sized tumor was detected when the patient visited a physician complaining of abnormal genital bleeding. Radical hysterectomy was performed, followed by high dose chemotherapy and peripheral blood stem cell transplantation. However, she died due to the complication of bone marrow suppression at 7 months postoperatively. The cervical smear showed small atypical cells with scant cytoplasm which were scattered individually or aggregated in small clusters against a necrotic background. Microscopically, small tumor cells were arranged in nests, cell cords and a ribbon pattern, and contained argyrophilic granules as demonstrated by the Grimelius method. Immunohistochemically, tumor cells were positive for chromogranin A, neuron specific enolase and synaptophysin. Therefore, the tumor was diagnosed as small cell neuroendocrine carcinoma of the uterine cervix. It is mandatory to distinguish this type of tumor from small cell, non-keratinizing squamous cell carcinoma or poorly differentiated adenocarcinoma, in that small cell neuroendocrine carcinoma is more aggressive and requires more intensive therapy. Cytologic examination is important in the differential diagnosis of this tumor.
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Imprint cytologic findings
Man Ling Zhao, Motoshige KUDO, Mitsuyasu TOYODA, Etsuko KOIKE, Yoshiro ...
1997 Volume 36 Issue 2 Pages
238-243
Published: March 22, 1997
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A case of signet ring cell predominent mucinous adenocarcinoma of the endometrium is reported. A 64-yearold woman with a gynecological history of
60 Co irradiation for cervical precancer (histologic type unclear) at 29, and early menopause at 32, underwent total hysterosalpingoophorectomy for an ovarian tumor diagnosed by image analysis. Pathologically, the tumor was demonstrated to be a cystically dilated uterus, containing abundant mucotenacious, necrotic and hemorrhagic substances. The imprint cytologic preparations showed mucinous adenocarcinoma with signet ring cells, being virtually identical to that arising in various other organs. Microscopically, the tumor was composed of mixed papillary tall columner mucinous cells and signet ring cells, and was almost completely confined to the inner surface of the uterus, with small invasive tumor foci in the vasculature and on the serosal aspect. Furthermore, the cervix, fallopian tubes, and ovaries were all tumor free and atrophic. The tumor might have arisen in mucinous metaplastic cells, observed in small areas in this case. If so, one could speculate that the early menopause was probably due to radiation therapy for the uterine cancer, then played a role in the development of the mucinous metaplasia, considering experimental evidence of an increased incidence of intestinal metaplasia of gastric mucosa due to irradiation to the stomach region in ovariectomized rats. Incidentally, the majority of patients with metaplastic changes of the endometrium are said to be postmenopausal and most have a history of oral estrogen replacement therapy. There was, however, no such history in this patient. In any case, mucinous adenocarcinoma of the endometrium with signet ring cell predominance is exceptional, and, to our knowledge, no similar cases have been reported in the literature, to date.
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Report of two cases
Kyousuke TAKEUCHI, Matsuto MOCHIZUKI, Souhei KITAZAWA, Kazuhiko NAKAJI ...
1997 Volume 36 Issue 2 Pages
244-248
Published: March 22, 1997
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Multilocular peritoneal inclusion cysts (MPIC) are an infrequent postperative complication and are characterized by frequent intra-abdominal recurrences without distant metastasis. This report describes two cases seen after gynecologic operations for unrelated conditions, and details the usefulness of fine-needle aspiration (FNA) cytology in the management of MPIC. FNA in both cases yielded specimens which consisted of a monomorphorous population of mesothelial cells lacking cytologic atypia which were arranged as single cells. The background was clean with neither necrotic debris nor abundant inflammatory cells. The mesothelial cells were not arranged in prominent papillary formations; no mitotic figures were found. Both cases were treated successfully, laparoscopically or with hormonal therapy after FNA cytology, which facilitated determination of the characteristics findings of MIPC.
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Masako KATO, Makoto MOTOI, Yukisato KITAMURA, Keiichi ICHIHARA, Shigek ...
1997 Volume 36 Issue 2 Pages
249-250
Published: March 22, 1997
Released on J-STAGE: November 08, 2011
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Daisei YASUDA, Chiaki YAMAGAMI, Masuo ISHIGAMI
1997 Volume 36 Issue 2 Pages
251-252
Published: March 22, 1997
Released on J-STAGE: November 08, 2011
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Anobservation of a case
Masaji KADOYA, Chihiro KONDA, Tatsunari SATAKE, Yoshiro TOKORO, Soji K ...
1997 Volume 36 Issue 2 Pages
253-254
Published: March 22, 1997
Released on J-STAGE: November 08, 2011
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Sayuri SHIBAO, Mayumi ISHIZU, Yoshimi YAMASHITA, Toshiaki KAMEI, Yoshi ...
1997 Volume 36 Issue 2 Pages
255-256
Published: March 22, 1997
Released on J-STAGE: November 08, 2011
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