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Volume 37, Issue 6
Displaying 1-23 of 23 articles from this issue
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Takahiro MORI, Kohhei OHSHIMA, Michiru TATENO, Hiroko TANI, Hideo OKUM ...1998 Volume 37 Issue 6 Pages 555-559
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Degenerative transitional cells with an increased nuclear/cytoplasmic ratio are often observed in the voided urine of patients with diabetes mellitus (DM). We examined the incidence of degenerative cells in the urine of DM patients.
Study Design: The urine of 54 patients with DM were available for the study. The urine of 1662 cases, which did not include that of patients with malignant tumors and/or with DM, was used as a control.
Results: Degenerative cells were observed in the urine of 17 cases with DM (31.5%), and in 118 control cases (7.1%), a markedly higher incidence in the urine of DM patients.
The majority of these degenerative cells seemed to be viral-infected, but we could not prove this. Degenerative cells of some cases were difficult to differentiate from malignant cells.
We must pay attention to the cytologic screening of the urine of DM patients.View full abstractDownload PDF (5197K) -
Kahori SHIMIZU, Tomoyasu KATOH, Hideo TESHIMA, Yuji ARAI, Hisashi SATO ...1998 Volume 37 Issue 6 Pages 560-566
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Initial radiotherapy for patients with endometrial cancer with complications is rare. The purpose of this study was to identify the acute cytologic changes in endometrial cancer induced by irradiation.
Study Design: From 1985 to 1997, 21 patients with endometrial cancer received initial radiotherapy. We reviewed ten cases of them cytologically from which we were able to estimate the acute changes in cancer cells.
Results: As the dose of irradiation increased, wrinkled edge of nuclei, cytoplasmic vacuolation, and coarse granular chromatin were diffusely observed. Nuclear swelling and giant cell formation appeared in a scattered manner. Compared with histologic specimens, we could observe intra-nuclear changes more clearly on the endometrial smear. We could also observe a decrease in large clusters and a significant increase in small clusters with degeneration when cancer nests collapse in histologic specimens.
Conclusion: We found that the cellular changes of endometrial cancer by irradiation generally resemble that of squamous cell cancer. We recommend complete full dose irradiation before assessing the prognosis of patients with endometrial cancer because radiosensitivity can be very variable.View full abstractDownload PDF (6549K) -
Focusing on type A stromataChikako INAMURA, Yasuyoshi ISHII, Keiko ICHINOSE, Toshiro OKA, Kouichi ...1998 Volume 37 Issue 6 Pages 567-576
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: In the diagnosis of well-differentiated adenocarcinoma (G 1 Ad-ca), we have focused particularly on arborescent clusters accompanied with type A stromata (bundles of blood vessels and interstitial tissues) in stratified epithelial cell clusters showing structural abnormalities. The present study was conducted to compare type A stromata in G 1 Ad-ca with those in complex atypical hyperplasia.
Study Design: Six cases diagnosed cytologically as class V and histologically as G 1 Ad-ca (average age 51.3) and six cases diagnosed cytologically as class IV and histologically as complex atypical hyperplasia (average age 47.3) were measured for; 1. average number and ratio of type A stromata consisting of 6 layers or more and those consisting of less than 6 layers, 2. number of layers and thickness (width) of type A stromata (per bundle), 3. nuclear dimensions (long and short axes) of the individual cells constituting type A stromata.
Results: 1. The ratio of type A stromata (6 layers or more: less than 6 layers) was 6: 4 for G 1 Ad-ca and 3: 7 for complex atypical hyperplasia. 2. Type A stromata of 11 layers or more and more than 50, am in width indicates a high probability of G 1 Ad-ca. 3. Thin type A stromata of less than 6 layers consisting of cells with large nuclei indicate a high probability of G 1 Ad-ca.
Conclusion: For differential diagnosis of G 1 Ad-ca and complex atypical hyperplasia, in addition to observing the number, number of layers, and thickness (width) of type A stromata, it is important to examine the sizes of the nuclei of cells constituting type A stromata of less than 6 layers.View full abstractDownload PDF (4236K) -
Takuo KANAHARA, Mitsuyoshi HIROKAWA, Michio SHIMIZU, Kanae ARIMITSU, K ...1998 Volume 37 Issue 6 Pages 577-582
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We investigated imprint smears of ovarian mucinous and serous tumors.
Study design: Imprint smears of 52 cases of ovarian mucinous and serous tumors including mucinous adenoma (20), mucinous borderline malignancy (4), mucinous adenocarcinoma (3), serous adenoma (5), serous borderline malignancy (5), and serous adenocarcinoma (15) were examined cytologically.
Results: Mucinous tumor cells were tall columnar, and were characterized by the presence of intracytoplasmic mucin and semilunar-shaped nuclei. Serous tumor cells were low columnar and their cytoplasm was well stained lightgreen. Coffee-bean nuclei were a feature of mucinous adenoma. Adenoma showed flat sheets with regular-arranged nuclei and a honeycomb pattern. Borderline tumors tended to appear as small clusters. Adenocarcinomas were markedly cellular and appeared as single cells with nuclear indentation. Intestinal-type mucinous adenoma and mucinous borderline malignancy showed a psendo-cribriform pattern. Serous adenoma and serous borderline showed nuclei that protruded from papillary clusters. Psammoma bodies appeared in serous adenocarcinoma, mucinous adenoma and mucinous borderline malignancy. Although the presence of mucin on the background is characteristic of mucinous tumors, one case of serous borderline malignancy revealed a small amount of mucin in the background.
Conclusion: It may be possible to cytologically differentiate mucinous and serous tumors of the ovary.View full abstractDownload PDF (7813K) -
A special reference to borderline malignancyKeiko SHIMIZU, Seiko OGURA, Masayoshi MURATA, Yumi TAKAO, Shinya TOYOK ...1998 Volume 37 Issue 6 Pages 583-590
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Preoperative diagnosis of ovarian tumors is often difficult. Additional squashed smear cytology during surgery was undertaken for the correct diagnosis of mucinous cystic tumors of the ovary.
Study Design: We reviewed the cytological findings of imprint smear during surgery of 34 cases with mucinous cystic tumors of the ovary, especially borderline malignant cases, that we have experienced over an 8 year period (1990-1997). Additional squashed smears were applied in some recent cases and compared with the routine imprint smears.
Results: Characteristic cytological findings of mucinous cystic tumors of borderline malignancy were relatively clear background, crowded clumps of cells, and papillary and ball-like architectures.
In some cases, an additinal squashed smear technique was useful for the correctdiagnosis, because the structure of cell clusters became more apparent.
Conclusion: It was possible to differentiate borderline cases from malignancies, but was difficult to differentiate borderline cases from benign cases by cytological examinations.
The additional of the squashed smear technique was useful for correct cytological diagnosis.View full abstractDownload PDF (14709K) -
Hiroshi KIYOKU, Eriko MIYAZAKI, Miko MITANI, Hirofumi NAKAYAMA, Makoto ...1998 Volume 37 Issue 6 Pages 591-597
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Although the histological and ultrastructual features of large cell neuroendocrine carcinoma (LCNEC) of the lung are well described, the cytological features have not been reported.
Case: The patient was a 62 year-old man whose X-ray revealed an abnormal shadow of the right lung. The lung tumor was diagnosed as a small cell carcinoma by brush cytology, which showed Indian file arrangement and crush artefact (nuclear DNA streaming). However most of the tumor cells were large. Two months later, the patient died of pneumonia, and an autopsy was performed. Histologically the tumor was composed of large cells with neuroendocrine features and diagnosed as LCNEC of the lung.
Conclusion: We propose that it is possible to differentiate between LCNEC and small cell carcinoma by the tumor cell size. It is important to use immunohistochemical and/or special stains for differential diagnosis of LCNEC and poorly differentiated squamous cell carcinoma.View full abstractDownload PDF (10097K) -
Yuka IDEI, Satoe KAMADA, Kaori MINAMI, Yukari HIRATE, Sohei KITAZAWA, ...1998 Volume 37 Issue 6 Pages 598-602
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Small cell carcinoma of the biliary tract is a rare tumor, and therefore the cytological features of this tumor are not well characterized.
Case: We report a case of small cell carcinoma arising in the papilla of Vater. A 68-year-old woman presented herself to an outside hospital in March 1997 with epigastralgia, and dilatation of the common bile duct and pancreatic duct was detected by abdominal echogram. She was admitted to our hospital for further examination, and biopsy of tumor of the papilla of Vater suggested undifferentiated carcinoma. Pylorus-preserving pancreatoduodenectomy was performed.
Imprint cytology from resected regional lymph node showed small uniform tumor cells, with scant cytoplasm and a high nuclear/cytoplasmic ratio. The nuclear chromatin was fine and granular, and the nuclear margin was thin. Macroscopically, the tumor was ulcerated and was 1.9×1.2 cm in size. The cut surface of the tumor was grayish and solid. Histologically, the tumor consisted of atypical cells with round hyperchromatic nuclei and scant cytoplasm. The tumor cells had extensively invaded lumph vessels. Immunohistochemistry showed strongly positive staining for neuronspecific enolase, but leucocyte common antigen, keratin, and chromogranin A staining was negative. Ultrastructural examination revealed several endocrine granules in the cytoplasm of the tumor cells. The diagnosis of small cell carcinoma was established from these pathological findings.
Conclusion: The cytological features of tumor cells by imprint cytology seems to be a useful finding for the diagnosis of small cell carcinoma arising in the papilla of Vater.View full abstractDownload PDF (9184K) -
Kazuaki KIYOYAMA, Tadanobu KURIBAYASHI, Shoji TANIGUCHI, Hiroyoshi TAK ...1998 Volume 37 Issue 6 Pages 603-607
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Medullary carcinoma is a malignant tumor of the thyroid composed of cells showing evidence of C cell differentiation. It is possible to diagnose medullary carcinoma and its histological variants by fine-needle aspiration cytology, but some tumors are difficult to be diagnose this way.
Case: A 47-year-old woman was admitted to our hospital because of dyspnea and a sense of pressure in the throat. Ultrasonography and CT scan revealed a large tumor in the thyroid. The serum levels of CEA and calcitonin were normal. Spindle or polygonal tumor cells in a loosely connected and occasionally follicular pattern were observed in the aspiration cytology specimen. The nuclei of the tumor cells showed a fine granular chromatin pattern and had prominent nucleoli. The tumor cells were negative for staining for diaminopeptidase IV (DAP IV) activity, and were positive for calcitonin on immunocytochemistry. The diagnosis of medullary carcinoma was made on these cytological findings. The resected tumor tissue was diagnosed as medullary carcinoma, follicular variant, both histologically and immunohistochemically.
Conclusion: DAP IV activity staining may be a useful means to distinguish medullary carcinoma from papillary carcinoma.View full abstractDownload PDF (5913K) -
Miyuki MATSUBARA, Munehiro YOKOYAMA, Yasuhiko WATARAI, Yuichi SUGISAKI ...1998 Volume 37 Issue 6 Pages 608-612
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Small cell osteosarcoma is a rare variant of osteosarcoma, which is difficult to distinguish from other small cell neoplasms. We herein report fine needle aspiration cytology of a case of small cell osteosarcoma in the humerus.
Case: A 22-year-old male was admitted because of left shoulder pain. Radiological examination revealed an osteolytic and osteoplastic lesion in the proximal metaphysis of the left humerus with periosteal bone formation. Cytologically, the small-sized tumor cells exhibited a round or short-spindle shape, indistinct cell margin, cyanophilic scanty cytoplasm and eccentric nuclei. In pathological specimens, the tumor comprised densely packed, small, round cells with osteoid formation. These tumor cells were positive for vimentin, osteonectin and osteocalcin by immunohistochemistry. Electron microscopy demonstrated abundant mitochondria and rough-surfaced endoplasmic reticulum in the cytoplasm, and scattered hydroxyapatite deposition on the stromal collagen fibrils. These findings confirmed the diagnosis of small cell osteosarcoma.
Conclusion: In an appropriate clinical setting, small cell osteosarcoma could be diagnosed based on the cytological features described above, even though the osteoid matrix was unclear in cytological material.View full abstractDownload PDF (6821K) -
Miwako SHINAGAWA, Yoko MAEDA, Masako SHIMIZU, Mayumi ISHII, Yoko MIYAK ...1998 Volume 37 Issue 6 Pages 613-617
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: It is usually difficult to diagnose neurocutaneous melanosis (NCM) by routine cytology in cerebrospinal fluid (CSF). We report a rare case that was diagnosed as NCM by clinical findings, immunocytochemistry, and cerebral biopsy specimens.
Case: The case was a boy, aged of 1 year and 10 months, who had had a hunge congenital nevus on his back from the time of birth. He had been clinically diagnosed as NCM because of several clinical manifestations and MRI findings. In the first cytological examination of CSF, we observed atypical cells with a high N/C ratio, small and oval cells, polygonal nuclei and shaggy nuclei with prominent nucleoli, and few melanin granules. At that point, we strongly suspected amelanotic melanoma in malignant NCM. Therefore, we performed immunocytochemistry (HMB-45, S-100). Tumor cells were positively stained with both antibodies. Moreover, the tumor cells had few melanin granules in the cytoplasm and on findings of typical nuclei in amelanotic melanoma. Cerebral biopsy specimens showed the same findings on cytology. The final diagnosis was melanosis.
Conclusion: Our experience suggests that clinical data, in addition to pathological features, are required to distinguish melanosis from amelanotic melanoma in NCM.View full abstractDownload PDF (6429K) -
Miki KUSHIMA, Toshiaki KUNIMURA, Seiko ONOZUKA, Masako TUDA, Toshio MO ...1998 Volume 37 Issue 6 Pages 618-622
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Papillary squamous cell carcinoma (PSCC) and adenoid basal carcinoma (ABC) of the uterine cervix are rare tumors. This report describes an extremely rare case of PSCC concomitant with ABC.
Case: The patient was a 71-year-old Japanese woman who was found to have abnormal cervical cytology results. Such as clusters of squamoid atypical cells, atypical transitional cells and small basaloid cells. After the conization, total abdominal hysterectomy and bilateral salpingooophor-ectomy were performed.
Histologically, in the uterine cervix, the superficial lesion was represented by marked papillary proliferation of several layers of atypical cells resembling to non-keratinized squamous cell carcinoma and transitional cell carcinoma of the urinary tract (histological feature of PSCC). The deep lesion consisted of nests of basaloid cells with focal glandular or squamoid patterns (histological feature of ABC).
Conclusion: This report described an extremely rare case of PSCC concomitant with ABC. In this case, there were two histological features (PSCC and ABC) in close association with one another at the uterine cervix. We suspect that the histogenesis of this case is (1) coincidental appearance of two cancers (double cancer) or (2) differentiation of one cancer (PSCC or ABC) to the other.View full abstractDownload PDF (7483K) -
Nobuyuki KAWAI, Shigeru ISHIKAWA, Mikihiro SHAMOTO1998 Volume 37 Issue 6 Pages 623-626
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The presence of endometriosis is not uncommon even in ectopic organs such as intestines during the reproductive years. In rare cases, it is difficult to distinguish endometriosis from rectal cancer, and an accurate differential diagnosis is very important for the selection of therapy and strongly influences the prognosis of these patients.
Case: A rare case of rectal endometriosis is reported. A 21-year-old woman was admitted to our hospital because of rectal polyps pointed out by a practitioner, whose had been consulted for constipation and melena. Her family history was positive for familial polyposis. An endoscope revealed assemblin polyps and submucosal swelling in the rectum.Furthermore, a left ovarian cyst and hydronephrosis for the left ureteral stenosis were recognized. A partial rectal amputation and left ovariotomy were performed on the suspicion of rectal cancer or endometriosis.
Conclusion: We could rule out malignancy and suggest endometriosis from the frozen sections. Some tubular clusters which seemed to be normal proliferative phase endometrium, and scattered interstitial cells were intermingled in the imprint cytological specimens. Therefore, this case was diagnosed as a rectal endometriosis. Immunohisto-chemically, endometrial cells in the rectum were positive for both estrogen and progesterone receptors. Histological examination revealed endometriosis not only in the rectum, but also in the left ovary and the surrounding tissue of the left ureter.View full abstractDownload PDF (6038K) -
Kuniko SHINDO, Hideharu DOMOTO, Mikio ANZAI, Shinsuke AIDA, Kimiya SAT ...1998 Volume 37 Issue 6 Pages 627-631
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Cystic struma ovarii, a newly described disease entity reported by Szyfelbein et al, is characterized by a prominent cystic configuration and covering of non-specific cuboidal or flat epithelium on the inner surface. It may be difficult to differentiate from other cystic neoplasms of the ovary and may be misdiagnosed. We report a case of cystic struma ovarii which was effectively diagnosed by frozen histological section and imprint cytological examination.
Cace: A 16-year-old female was referred to our hospital with a complaint of abdominal distention, and left oophorectomy was performed. Gross findings of the left ovary exhibited a multilobular cystic tumor (greatest diameter about 20 cm) with a small solid component consisting of an aggregation of small cysts. Frozen histological diagnosis of cystic struma ovarii was made after excluding the presence of other known cystic tumors by imprint cytology.
Conclusion: Although it was difficult to locate the thyroid follicle due to the small solid portion and the small number of surgical specimens taken, imprint cytology was particularly effective for establishing the diagnosis in the present case.View full abstractDownload PDF (7404K) -
Hiroshi HIRANO, Tamachi MAEDA, Yoshikatsu OKADA, Terumasa SASHIKATA, M ...1998 Volume 37 Issue 6 Pages 632-635
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Small cell neuroendocrine carcinoma, which usually occurs in the lung, is described to have a poor prognosis. This tumor derived from the cervix of the uterus is very rare. The clinicopathological features of this tumor have not been well characterized. The preoperational diagnosis is very difficult. We report a case of small cell neuroendocrine carcinoma of the uterine cervix and discussed the histological, immunohistochemical and electron-microscopic findings.
Case: A 46-year-old woman suffering from continuous genital bleeding was admitted to the Hyogo Medical Center for Adults. Findings from brushing cytology of the cervix showed that small cells assembled in nests or were loosely arranged. The cells had scarce cytoplasm and showed no prominent nucleolus. The border between these cells was unclear. Histologically, the cells with scarce cytoplasm were characterized by round to oval nuclei and solid arrangement. The immunohistological analysis demonstrated positive staining for neuron specific enolase (NSE), chromogranin, and S-100 protein and was negative for keratin.Ultrastructurally, the neuro-endocrine granules were visible in the cytoplasm.
Conclusion: Although the resected specimen disclosed small cell neuroendocrine carcinoma of the uterine cervix by immunohistochemical and electron analysis, we could make a diagnosis by brushing cytology. We believe it is possible to diagnose small cell neuroendocrine carcinoma of the uterine cervix by cytology.View full abstractDownload PDF (6760K) -
[in Japanese], [in Japanese]1998 Volume 37 Issue 6 Pages 636
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (101K) -
Rinya SATO, Toshiko JOBO, Manami IMAI, Satoshi OHKAWARA, Hiroyuki KURA ...1998 Volume 37 Issue 6 Pages 637-642
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The incidence of endometrial carcinoma in Japan is increasing. Endometrial hyperplasia is thought to be a precancerous lesion of endometrial carcinoma due to the following reasons.(1) The hyperplasia progresses to endometrial carcinoma after long-term follow-up, (2) in the cases with endometrial carcinoma which progressed from endometrial hyperplasia the hyperplasia oxccupies a large area of the endometrium and (3) endometrial hyperplasia often coexists with early endometrial cancer. According to these findings, close examination of endometrial hyperplasia might be expected to reveal early stage endometrial carcinoma. Endometrial hyperplasia is classified into 4 groups based on the presence or absence of cytologic atypia and architectural complexity (General rules for clinical and pathological management of uterine corpus cancer, 1996); simple hyperplasia, complex hyperplasia, simple atypical hyperplasia and complex atypical hyperplasia.
Conclusion: Our cytological findings of complex hyperplasia were;(1) 1 the back ground is not usually necrotic, but is bloody, (2) cellular clusters of normal-looking cells appear more often in hyperplasia than normal proliferative endometrial phase, (3) papillary or peninsula-like structures protruding from the periphery of cellular clusters are observed, (5) back to back structures and stratification in the clusters are seen, and (6) the palisading pattern of the border of clusters appears irrgular. In cases of complex atypical hyperplasia, additional findings are prominent stratification of cellular clusters and marked anisonucleosis and prominent nucleoli.View full abstractDownload PDF (829K) -
Kunio ABE, Kaichiro YAMAMOTO, Koshio OBATA, Hiroshi HOSHIAI, Kiichro N ...1998 Volume 37 Issue 6 Pages 643-649
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We studied the endometrial aspiration cytology of endometrial hyperplasia.
Study design: Cytological findings were studied in 22 cases of endometrial hyperplasia, simple, in 91 cases of endometrial hyperplasia, complex, in 18 cases of atypical endometrial hyperplasia, simple, and in 9 cases of atypical endometrial hyperplasia, complex.
Results: The endometrial cell samples were negative in 63.6% of the cases of endometrial hyperplasia, simple, in 49.5% of endometrial hyperplasia, complex cases, 44.4% of atypical endometrial hyperplasia, simple cases, and 33.3% of atypical endometrial hyperplasia, complex cases. No cellular atypia was found in endometrial hyperplasia, simple; it was very mild in endometrial hyperplasia, complex, and was present in atypical endometrial hyperplasia, simple and complex. Regular, clubbed or regular, papillary protuberances around clusters were chiefly observed in endometrial hyperplasia, complex and atypical endometrial hyperplasia, simple.Irregular, clubbed or irregular, papillary protuberances were observed in atypical endometrial hyperplasia, complex.
Conclusion: In the cytologic diagnosis of endometrial hyperplasia, it is important to evaluate the protuberances around clusters.View full abstractDownload PDF (3452K) -
With emphasis on morphologically abnormal cell clumpsYoshiaki NORIMATSU, Takuya MORIYA, Hiromi KOUDA, Yuri OZEKI, Chotatsu ...1998 Volume 37 Issue 6 Pages 650-659
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The objective of this study was to establish cytological criteria for the diagnosis of endometrial hyperplasia and grade 1 endometrioid adenocarcinoma.
Study Design: The incidence of each of 12 morphological types (8 morphological types of cell clumps reflecting tissue architecture and 4 types reflecting cell atypism) was examined in 11 cases of simple endometrial hyperplasia, 31 cases of complex endometrial hyperplasia, 10 cases of atypical hyperplasia, 38 cases of grade 1 endometrioid adenocarcinoma, and 35 individuals with normal endometrium.
Results: 1. If the percentage of abnormal cell clumps is over 20%, endometrial hyperplasia or more severe disease is suspected. If the percentage is over 70%, atypical hypertilasia or more severe disease is suspected.
2. Simple endometrial hyperplasia is suspected in cases where clumps of dilated glands (with a maximum width more than twice the minimum width) are predominant.
3. Complex endometrial hyperplasia or more severe diseases are suspected in cases where irregular protruding clumps, papillary clumps, clumps with high densities of glands, or dendriform clumps are predominant.
4. Dendriform clumps are a characteristic of grade 1 endomatrioid adenocarcinoma. Thus, the presence of dendriform clumps with two or more bifurcations strongly suggests grade 1 endometrioid adenocarcinoma.
5. Small clumps of atypical cells and the presence of necrotic background suggest grade 1 endometrioid adenocar-cinoma. Uptake of inflammatory cells and squamous metaplasia of cells suggest atypical hyperplasia or more severe disease.
6. Swelling or size irregularity of nuclei suggest atypical hyperplasia or more severe disease.
Conclusion: Evaluation of specific morphological types of cell clumps, reflecting tissue architecture, is essential when making a diagnosis of endometrial hyperplasia or grade 1 endometrioid adenocarcinoma.View full abstractDownload PDF (7067K) -
Tadaaki IMAI, Hideki YOKONO, Takafumi IZUMI, Tatsuo GENDA, Tadashi MOT ...1998 Volume 37 Issue 6 Pages 660-665
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The glandular cell clusters obtained from complex hyperplasia were observed in detail.
Study Design: Endometrial glandular cell clusters which deviated from normal glandular cell clusters (n-GCC) were defined as atypical glandular cell clusters (a-GCC), and their morphological features and mode of appearances in the specimens were analyzed.
Result: A-GCC found in hyperplasia revealed the typical findings of:
(1) Irregular palisades arranging in the two opposite sides of a rectangular cluster,
(2) unevenness in the outer line of palisade arrange-ments,
(3) obscurity in the border between the palisades and the inner cell layers and,
(4) piling-up of the cells in the central area.
Conclusion: It is concluded that a-GCC, i.e. atypical structural arrangement of cells, is one useful screening parameters for complex hyperplasia which is usually difficult to diagnose through cellular atypism.View full abstractDownload PDF (10883K) -
Junzo KIGAWA, Yasunobu KANAMORI, Takashi IRIE, Yukihisa MINAGAWA, Naok ...1998 Volume 37 Issue 6 Pages 666-669
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The aim of the present study was to determine whether it is possible to estimate endometrial hyperplasia according to the WHO classification with cytologic specimen.
Study Design: Cytological features of endometrial hyperplasia were analyzed by quantitative and qualitative methods. Additionally, we tried to classify endometrial hyperplasia according to the WHO classification in cell block specimens.
Results: There were no differences between atypical hyperplasia and hyperplasia in nuclear diameter and number of nucleoli. Stratification of more than 3 layers was observed only in complex hyperplasia. The accuracy of the qualitative analysis for complex hyperplasia was better than for simple hyperplasia. The proliferation index relating to nuclear atypia did not differ between atypical hyperplasia and hyperplasia. It was difficult to classify endometrial hyperplasia in cell block specimens.
Conclusion: The present study suggests that it is difficult to classify endometrial hyperplasia according to the WHO classification by smear specimen.View full abstractDownload PDF (481K) -
Mizue ODA, Yasuyoshi ISHII, Mineo OHMURA, Norikoto ISHIDA, Tomoko TAKE ...1998 Volume 37 Issue 6 Pages 670-676
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: When endometrial cytology reveals papillary clusters with structural abnormality, we suspect endometrial hyperplasia, complex, and judge it to be suspicious or classify it as class III.
Study Design: In this study, we examined the structural abnormality of papillary and arborescent clusters recognized in 146 specimens from 138 cases classified as class III, and obtained the following results.
Results: 1) The incidence of papillary clusters with glandular cavity back-to-back-like structures was; no remarkable histological change 17%, endometrial hyperplasia, complex 30%, atypical endometrial hyperplasia, complex 59%, well differentiated adenocarcinoma 100%.
2) The incidence of arborescent clusters was; no remarkable histological change 3%, endometrial hyperplasia, complex 4%, atypical endometrial hyperplasia, complex 46%, well differentiated adenocarcinoma 100%.
Conclusion: These results show that when cases containing mainly papillary clusters with back-to-back-like structures contain even a small number of arboresent clusters, the probability of cases with these types of cytological findings are atypical endometrial hyperplasia, complex or worse, cautious clinical management is necessary.View full abstractDownload PDF (3450K) -
Its practical significance and disadvantageMasanori YASUDA, Hitoshi ITOH, Youko MIYAJIMA, Midori KAWADA, Hiroshi ...1998 Volume 37 Issue 6 Pages 677-682
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Following revision of The General Rules for Clinical and Pathological Management of Uterine Corpus Cancer (The 2nd Edition, March 1996), classification of endometrial hyperplasia was also revised and divided into four categories.
Design: According to the classification, we retrospectively evaluated 242 specimens of both endometrial cytology and biopsy (composed of 203 cases) independently.
Results: A total of 92.6%(13/14) of specimens cytologically diagnosed as endometrial hyperplasia, simple (EHS) were in agreement with the histological diagnosis, while only 8.3%(13/157) of those histologically diagnosed as EHS were in agreement with the cytological diagnosis. A total of 41.5%(17/41) of specimens cytologically diagnosed as endometrial hyperplasia, complex (EHC) were in agreement with the histological diagnosis, and 35.4%(17/48) of those histologically diagnosed as EHC matched the cytological diagnosis. Only 6 specimens were histologically diagnosed as atypical endometrial hyperplasia, simple (AEHS), but no specimens were cytologically diagnosed as AEHS. A total of 80.6%(25/31) of specimens cytologically diagnosed as atypical endometrial hyperplasia, complex (AEHC) were in agreement with the histological diagnosis, and 43.9%(25/57) of those histologically diagnosed as AEHC matched the cytological diagnosis.
Comments: With precancerous lesions or uterine endometrial adenocarcinoma of low potential malignancy, it is important to cytologically diagnose endometrial hyperplasia on the basis of the revised classification. We believe that Papanicolaou's classification for endometrial hyperplasia, generally accepted in many institutes, should be reviewed more practically. Above all, subclassifying class III is thought to be one of problems which ought to be tackled.
Canclusions: The proposal presented in this article is as follows; EHS= class Em-II; EHC=class Em-IIIa; AEHS and AEHC=class Em-IIIb.View full abstractDownload PDF (940K) -
Hideko KIGUCHI, Yukio ISHIKAWA, Masayoshi IWAGAMI, Shigeki ISHIGURO, H ...1998 Volume 37 Issue 6 Pages 683-684
Published: November 22, 1998
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA case of ameloblastoma of the maxilla is presented. Its incidence is high in the mandible, but extremely low in the maxilla. Needle aspirates of the tumor revealed some dyskeratotic cells and tight clusters of squamous-like cells. Histopathogically, the tumor was characterized by abundant densely collegenous stroma with small nests and strands of odontogenic epithelium. Odontogenic epithelium of ameloblastoma differentiated into squamous epithelium. The cytologic features of ameloblastoma are diagnostic, and incorrect diagnosis may be prevented if sufficient attention is paid to determining the benign squamous differentiation of odontogenic epithelium.View full abstractDownload PDF (5269K)
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