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Volume 38, Issue 1
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Yuji ARAI, Atsuko HAGA, Yasuo HIRAI, Futoshi AKIYAMA, Masafumi TSUZUKU ...1999 Volume 38 Issue 1 Pages 1-5
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We studied the cytological characteristics of adenoma malignum of the uterine cervix.
Study design: Of eight adenoma malignum cases, five cases with well preserved Pap. smears were studied cytologically. The following cytological featvres were studied; 1) background and presence of tumor cells in the vaginal, cervical and endocervical smears, 2) cluster and arrangement of tumor cells, and 3) nucleus and cytoplasm of tumor cells.
Results: 1) A clean background with excess yellow or yellowish brown mucin was observed in Pap. smears from all locations, which had no tumor diathesis. Tumor cells were present in the ectocervical and endocervical smears but not in the vaginal smear. 2) Tumor cells were present in a large sheet with palisading arrangement at the periphery. 3) Tumor cells contained yellow or yellowish brown mucin in the cytoplasm. The shape of nuclei was round to oval. Nuclei had fine granular chromatin and showed frequent nuclear clearing, suggesting increased euchromatin.
Conclusion: The following cytological findings are very important to the diagnosis of adenoma malignum. 1) Presence of excess mucin in a clean background in the vaginal, ectocervical and endocervical smears; 2) presence of endocervical columnar cells which contain yellowish mucin in the cytoplasm and clusters in a sheet which is marginated with palisading cells; and 3) presence of many endocervical cells which appear to be normal but are incompatible with age.View full abstractDownload PDF (6147K) -
Sumiko IRIE, Hisayoshi NAKAJIMA, Naohiro TAKAO, Shingo MORIYAMA, Hidet ...1999 Volume 38 Issue 1 Pages 6-14
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We studied the cytological findings of well differentiated adenocarcinoma to facilitate early detection of adenocarcinoma of the uterine cervix in which the grade of the lesion is sometimes difficult to determine.
Study Design: The cytological findings were studied in early adenocarcinoma (EA) and adenoma malignum (AM). A morphometric study was also performed.
Result:(1), Coexistence of squamous cell abnormalities was detected in 75.0% of EA.(2) In EA, no tumor diathesis was found. The feathering of the nuclei were characteristically round with fine granular chromatin and middle-grade nucleoli.(3) In AM, mucous was observed in all cases. The cell cluster was arranged in a papillary or alveolar fashion, and an irregular arrangement of nuclei was observed. The nuclei were round to oval in shape, and nuclear enlargement was mild. Nuclear chromatin was fine granular or opaque and nucleoli were of middle grade.(4) Morphometric study disclosed that the nuclear contour index (NCI) of EA was lower than that of invasive adenocarcinoma and the NCI of AM was significantly lower than normal endocervical cells.
Conclusion: The present study suggested that it is possible to diagnose EA and AM when specimens are thoroughly observed for the background, cell cluster, and nuclear findings, in addition to performing image analyses of nuclei.View full abstractDownload PDF (7822K) -
Kyoko KON, Ryutaro NAKASHIMA, Mie ONODERA, Mayumi SHIRATORI, Hirotoshi ...1999 Volume 38 Issue 1 Pages 15-22
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The ami of this study was to evaluate the significance of cytoplasmic staining in sputum cytology for the detection of early squamous cell lung cancer.
Study Design: We studied the cytological findings of sputum from 190 patients with early squamous cell carcinoma detected by sputum cytology alone over the past 13 years, and examined the findings obtained by several variations of Papanicolaou's method.
Results: In 126 of 190 sputum specimens, brightly stained “lemon-yellow” or “pumpkin-orange” cytoplasma were found to be the most useful finding for screening and diagnosis. Furthemore, in 30 of these 126 specimens, these cytoplasmic staining patterns were the only information suggestive of early squamous cell carcinoma. A comparative study of staining methods revealed that the cytoplasm could be effectively and brightly stained a “lemon-yellow” or “pumpkin-orange” color by a protocol of Gill's hematoxilin for 20 sec. followed by 0.5% HC1 in 70% ethanol, OG-6 for four min. followed by 1.0% tungstophoric acid hydrate and 1% acetic acid in 95% ethanol, EA-50 for seven min. A 500-ml volume of each staining solution was able to stain as many as 1000 slides without losing the characteristic cytoplasmic color.
Conclusion:Cytoplasmic staining in sputum cytology is important in the detection of early squamous cell carcinoma of the lung.View full abstractDownload PDF (3312K) -
Naruaki MATSUI, Shin-ichi TSUCHIYA, Takashi KITAMURA, Hitoshi ITO, Yos ...1999 Volume 38 Issue 1 Pages 23-30
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We investigated the cytological and immunohistological characteristics of squamous cell carcinoma (SCC) of the mammary gland.
Study design: Five cases of primary SCC, which was histologically confirmed between 1992 and 1995, were studied with regard to their clinical, cytological, histological, and immunohistological features.
Result: Age at the onset ranged from 44 to 72 years (average 63.0). The diameter of tumors were relatively small; less than 3 cm in 3 cases. Necrosis or cyst formation was observed in 4 of the cases. Corresponding to histological features, cytological features could be classified into the following subtypes:(1) pure keratinizing SCC, showing complete absence of adenocarcinoma (AC) component (1 case);(2) mixture of AC and SCC (3 cases); and (3) SCC composed of tumor cells resembling squamous metaplasia (1 case). Immunohistological detection of keratin expression reflected the three subtypes well; the first type was DE-K 10 (+), MNF 116 (+), and CAM 5.2 (+); the second type was DE-K 10 (+), MNF 116 (+) at SCC, and CAM 5.2 (+) at AC, and the third type was DE-K 10 (-), MNF 116 (+), and CAM 5.2 (+).
Conclusion: Cytological findings of SCC of the mammary gland of these cases were diverse, and reflected the histological features of 3 subtypes:(1) pure keratinizing SCC;(2) mixed adeno-squamous carcinoma; and (3) SCC resembling squamous metaplasia. Immunohistological findings also reflected histological features.View full abstractDownload PDF (14858K) -
Its usefulness and detection of accompanying pathological changesShinya SATO, Kazuki NABESHIMA, Akinobu OHNO, Yuji HINOURA, Takeshi MIK ...1999 Volume 38 Issue 1 Pages 31-37
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: In cases of intracranial germinoma, it is important to obtain accurate pathologic diagnosis via streotaxic biopsy since radiation therapy is very effective for this disease. Intraoperative diagnosis with frozen sections alone is, however, difficult in some cases. In the present study, we examined the factors which cause difficulty in diagnosis and examined whether cytology is effective in such cases.
Study Design: We reviewed 12 cases of intracranial germinoma (intraoperative diagnosis (ID) with cytologic preparations, 9 cases; ID with frozen sections, 4 cases) with special reference to associated pathologic changes which caused difficulty in diagnosis.
Results: Inraoperative diagnosis of germinoma could not be obtained with frozen sections alone in 50% of cases because of prominent gliosis, crush artifacts and epithelioid granulomatous lesions. Histologically, gliosis was found in 8 cases (66.7%), marked crush artifacts in 2 cases (16.7%), and histiocyte aggregates in 8 cases (66.7%; epithelioid grnulomas in 2 cases). On cytologic preparations, gliosis was found in all 8 cases, and histiocyte aggregates, including epithelioid cell clusters, were also noted in 86% of the histologically positive cases. Moreover, cytologic preparations revealed the presence of germinoma cells in all the cases.
Conclusion: Cytologic preparations are not only effective for obtaining germinoma cells but also associated changes such as gliosis and granulomatous inflammation.View full abstractDownload PDF (10626K) -
A light-microscopic, immunohistochemical and ultrastructural study with diagnostic implications for tumors showing chondroid patternToshiaki MORIKI, Tamotsu TAKAHASHI, Masayo WADA, Shousuke UEDA, Miho I ...1999 Volume 38 Issue 1 Pages 38-44
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Chondroid chordoma is a controversial and confusing entity that was originally described by Heffelfinger and colleagues as a biphasic malignant neoplasm possessing elements of both chordoma and cartilaginous tissue. The aim of our study was to characterize the chondroid area and determine the specific characteristics of the tumors showing chondroid pattern.
Study Design: Three cases of clival and one cervical vertebral chondroid chordoma were studied with light microscopy (including aspiration cytology smears of the two cases), immunohistochemistry and electron microscopy. Chondrosarcomas and pleomorphic adenomas with extensive chondroid features were also examined.
Results: Chondroid chordomas demonstrated epithelial characteristics by immunohistochemistry and ultrastructural studies. A case with frequent tumor recurrence showed high MIB-1 values and expressed p 53 protein. Aspiration cytology smears showed almost the same features among chondroid chordomas, chondrosarcomas and chondroid areas of pleomorphic adenomas.
Conclusion: Chondroid chordoma is a variant of chordoma which possesses a hyaline matrix, and immunohistochemical demonstration of epithelial markers such as cytokeratin and EMA is useful to distinguish it from chondrosarcoma and pleomorphic adenoma with extensive chondroid features. High MIB-1 values and p 53 overexpression may be related to frequent tumor recurrence.View full abstractDownload PDF (12920K) -
An analysis of twenty-seven casesTakuo KANAHARA, Kanae ARIMITSU, Mitsuyoshi HIROKAWA1999 Volume 38 Issue 1 Pages 45-49
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Schwannoma is a relatively common, benign, non-epithelial tumor, but the detailed cytologic findings have not been described.
Study design: Twenty-seven cases of schwannoma were collected, and cytologic preparations were examined under light microscopy.
Results: The scraped smears were cellular, but the imprinted smears revealed few or no cell clusters. In the smears from Antoni A type schwannoma, the cohesive, spindle shaped tumor cells showed fascicles, whorl formation, nuclear palisading and Verocay bodies. In the smears from Antoni B type, loosely-cohesive sheet-like arrangements of tumor cells and the cell clusters containing hemosiderin and collagen fibers were demonstrated. The nuclei showed a variety of shapes, such as oval, spindled, long-spindled, or indented. A few atypical nuclei and hyperchromatic nuclei were seen. The cytoplasm revealed a fibriller structure in all cases.
Conclusion: Cell clusters containing hemosiderin and collagen fibers and a sheet-like arrangement are cytologic features of Antoni B type schwannoma.View full abstractDownload PDF (6475K) -
Shunsaku SATO, Mayumi TOMIYAMA, Kazuaki FUJII, Emiko MARUYAMA, Yuko TO ...1999 Volume 38 Issue 1 Pages 50-54
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: To examine the quality of cytological specimens on endometrial cancer mass screening, we compared 311 cases of endometrial cytology with cell block specimens prepared from the residual endometrial tissue.
Study Design: After endometrial smears were made, the used tools were put into tubes containing 10% neutral formalin. Then, the tools were shaken well in order to detach the attached cell and tissue fragments. These cell and tissue fragments were centrifuged for 3, 000 rpm for 10 minutes, and histological specimens were made from cell pellets by standard methods.
Results: Four of 5 cases (80%), diagnosed as endometrial hyperplasia on cytology, were consistent with close examination. One case, suggested to be hyperplasia on cytology and histology was diagnosed as endometrial polyp on close examination. Twenty cases, diagnosed as endometrial hyperplasia on cell block specimens, were negative on cytological specimens. Therefore, we re-examined these 20 cytological specimens. Eight cases were suggested to be endometrial hyperplasia but 12 showed no abnormalities. From cell block specimens, 113 cases were diagnosed as inadequate due to insufficent tissue volume. However, 101 of these cases (90%) could be cytologically diagnosed. The other 12 cases could not be diagnosed even on cytological smears. Seven of 19 cases diagnosed as inadequate cytological smears could be diagnosed on cell block specimens.
Conclusion: These results suggest that cytological smears may be inadequate despite sufficient endometrial aspirated materials. Therefore, sufficent cells must be included in the preparation of cytological smears.View full abstractDownload PDF (3763K) -
Michiko BEPPU, Masamichi HIURA, Takayoshi NOGAWA, Yosuke KAWAKAMI, Tak ...1999 Volume 38 Issue 1 Pages 55-59
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Ovarian carcinoma usually presents symptoms including abdominal pain, abdominal distension, and early satiety, and the most significant sign at the initial presentation is a pelvic mass. It is extremely rare for ovarian cavcinoma to have distant lymph node metastases in the axillary region. We described a case cytologically diagnosed as ovarian endometrioid adenosquamous carcinoma by cytopuncture of right axillary lymph node metastases.
Case: In a 48 year-old woman with right axillary lymphadenopathy as the chief complaint, MR showed two pelvic tumor masses, and serum CA 125 and CA 15-3 values were 217.2 U/ml and 15.5 U/ml, respectively, Exploratory laparotomy revealed primary ovarian carcinoma and intraperitoneal disseminations but no retroperitoneal lymph node metastasis. Histologic diagnosis of ovarian tumor revealed endometrioid adenosquamous carcinoma. The samples of axillary lymph node and of the ovarian tumor were considered to be cytohistologically identical.
Conclusion: We think that axillary lymph node metastases might occur through the subcutaneous lymphatic networks into which the deep lymphatic channels of the abdominal wall or the lymphatic trunks of the diaphragm drained from the parietal peritoneal lesion as well as the subphrenic lesion. This case indicated the clinical importance of examining the superficial lymph node involvement in patients with ovarian carcinoma.View full abstractDownload PDF (6817K) -
Its distinction from a benign processKyoichi MIYAGAWA, Emiko NAKAMURA, Yukari NAITO, Toshio SHIMIZU, Kaoru ...1999 Volume 38 Issue 1 Pages 60-65
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Papillary syncytial metaplasia of the endometrium is characterized by syncytial aggregates of eosinophilic cells forming papillary tufts along the surface epithelium.
It is observed in many pathologic conditions such as dysfunctional bleeding, endometritis, hyperplasia or even adenocarcinoma. Bacause of its architectural atypia and cytologically bland growth, the differential diagnosis with atypical hyperplasia or adenocarcinoma may be difficult at times.
Case: We experienced a case of endometrioid adenocarcinoma with extensive papillary syncytial metaplasia in a woman aged 64 years. A definite diagnosis could not be made prior to treatment. To confirm the key findings that distinguish it from benign process, we re-evaluated cytopathological findings of previous biopsy specimens.
Conclusion: Disastrous “under-diagnosis ” can be averted by meticulous attention to specific cytopathological findings including:
1. Large amounts of tissue with prominent papillarity due to cellular stratification and budding.
2. Significant cellular atypia with enlarged round nuclei, chromatin condensation, and prominent nucleoli in the underlying stratified epithelium.
3. Mitotic figures.View full abstractDownload PDF (7427K) -
Shinji KAGAMI, Tuyoshi NAKAYAMA, Taizo SHIRAISHI, Ryuichi YATANI1999 Volume 38 Issue 1 Pages 66-70
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Nasopharyngeal carcinomas account for 4-10% of all head and neck tumors. The cytomorphology of nasopharyngeal carcinoma has not been well described.
Case: This case showed poorly differentiated squamous cell carcinoma of the epipharynx which was discovered as a neck mass. The patient was a 78-year-old man. Aspiration cytology was performed from the cervical lesion. The cells appeared as isolated cells. The cytoplasm was relatively scant, and some naked nuclei revealed nuclear indentation. The nuclei were finely granular, and had evenly distributed chromatin, distinct nuclear membranes, and large eosinophilic nucleoli. Cytological findings of lymph node imprint and sputum were almost identical with those obtained from cervical lymph nodes, except for the small size of clusters and loose cohesiveness.
Conclusion: Cytologic diagnosis of nasopharyngeal carcinoma was not confirmative. However, examination of sputum cytology was effective to specify the primary lesion.View full abstractDownload PDF (7273K) -
A case reportTakako KANEKO, Mamoru MOCHIZUKI, Sakiko IGARI, Hando HAKOZAKI1999 Volume 38 Issue 1 Pages 71-75
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackgrounds: Intraoperative washing cytology of the peritoneal cavity is useful in evaluating the post-operative prognosis of gastric cancer patients. However, the cytodiagnostic value of the intraoperative scrape cytology of the serous membrane has not been well documented.
Case: A 57-year-old Japanese woman presented because of nausea and vomiting. Upper GI tract endoscopy showed severe pyloric stenosis of the stomach; however, biopsy specimens of the gastric mucosa did not reveal malignancy. At operation, exploration of the abdominal cavity disclosed a tumor measuring 4×4 cm in the gastric pylorus. Scrape and touch smear specimens obtained from the serous membrane at the pyloric tumor, using sterile cotton swabs and steile slide glasses, showed both a dense clump of cells and group of isolated cells. These tumor cells had enlarged eccentric nuclei, fine granular nuclear chromatin, prominent nucleoli, and lacy cytoplasm. We finally made a diagnosis of serosal invasion of gastric carcinoma. She underwent subtotal gastrectomy, and final microscopic examination of the resected stomach revealed well-differentiated tubular adenocarcinoma deeply invading with stromal fibrosis: se, INF β, ly 2, vl, nl (+), D 2, Stage III a.
Conclusion: This case suggests that intraoperative scrape and touch smear cytology of the serous membrane is useful for making diagnosis of some advanced cases of gastrointestinal malignancies.View full abstractDownload PDF (9030K) -
Report of a caseTakuo KANAHARA, Mitsuyoshi HIROKAWA, Kanae ARIMITSU, Keiko FUKUOKA, Ke ...1999 Volume 38 Issue 1 Pages 76-79
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The cytologic findings of teratocarcinoma of the testis have not been well described. We report the cytological findings of such a case.
Case: The patient was a 29-year-old male with a right testicular mass, measuring 8.5×7.5×8.0 cm in diameter. The imprinted specimen from the cut surface of the mass revealed large atypical cells showing pseudopapillary and glandular clusters or individually scattered appearance. Their cell membrane was indistinct, and the cytoplasm was granular and weakly stained lightgreen. The chromatin pattern was coarse granular. Eosinophilic and irregularshaped nucleoli were noted. In addition, a few sheets composed of small, non-atypical glandular epithelium were observed. There were no squamous epithelium, hair, bone, or cartilage.
Conclusion: Germ cell tumors may be composed of several types of tumor cells, and therefore cytologic preparations should be observed carefully.View full abstractDownload PDF (6243K) -
Report of a caseTakuo KANAHARA, Mitsuyoshi HIROKAWA, Kanae ARIMITSU, Michio SHIMIZU, T ...1999 Volume 38 Issue 1 Pages 80-83
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: It may be difficult to make a diagnosis of burned-out tumor of the testis by a biopsy of a metastatic site. We report a case of burned-out tumor which was diagnosed by a biopsy of a retroperitoneal mass and its imprint cytology.
Case: The patient was a 53-year-old male with a retroperitoneal mass. The imprint smears from a biopsy core of the mass revealed large round atypical cells and small lymphocytes. In Diff-Quik staining a tigroid appearance was observed on the background. The cytological findings suggested metastatic seminoma and an immunohistochemical examination confirmed the diagnosis. Subsequently, left orchiectomy was performed and fibrotic scar measuring 1 mm was noted.
Conclusion: The presence of tigroid appearance in Diff-Quik stainig was useful in diagnosing metastatic seminoma, and differentiating it from malignant lymphoma.View full abstractDownload PDF (5977K) -
Kyoko SEKIDO, Shinobu UMEMURA, Hiroo MOCHIZUKI, Makoto SHIBUYA, Jou TO ...1999 Volume 38 Issue 1 Pages 84-88
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Lipid rich carcinoma is a rare variant of breast carcinomas, characterized by abundant, foamy and vacuolated cytoplasm of tumor cells.
Case: We experienced a case of lipid rich carcinoma of the breast arising in a 54-year-old woman. She was admitted to our hospital with a complaint of a palpable mass in the right breast. The malignant tumor was suspected by imaging techniques, and a histological diagnosis of invasive carcinoma was confirmed by excisional biopsy. Quadrantectomy and lymph node dissection were performed. The carcinoma cells on imprint preparation had abundant and foamy cytoplasm, hyperchromatic and irregularlyshaped nuclei. There was considerable accumulation of mucin, glycogen, secretory protein and lipid, and therefore from the cytologic characteristics signet ring cell carcinoma, glycogen rich clear cell carcinoma, secretory carcinoma and lipid rich carcinoma were all suggested. Cytochemically, lipid accumulation was proven in the foamy cytoplasm of the tumor cells by positive Sudan N staining, but PAS, Alcian Blue and immunocytochemical study were negative.
Conclusion: It is important to consider lipid rich carcinoma to prevent underdiagnosis because of their rarity and low N/C ratio due to their abundant, clear and foamy cytoplam.View full abstractDownload PDF (7202K) -
Tomoe YAMAUCHI, Kaori KAMEYAMA, Satoshi KUSAKARI, Hitoshi ABE, Teruko ...1999 Volume 38 Issue 1 Pages 89-92
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Necrotic change is uncommon in salivary gland tumors. We report here a rare histological variant of pleomorphic adenoma of the parotid gland with massive necrosis.
Case: A 40-year-old male complained of left parotid swelling in 1994. The mass enlarged suddenly with tenderness in Sep. 1997 and a tumorectomy was performed followingfine needle aspiration (FNA). The FNA revealed many large clusters of epithelial cells and a stromal component with mucous degeneration against a background of necrotic debris. Epithelial cells had small pyknotic smudged nuclei, but no malignant features. Based on these findings, the lesion was suspected to be a pleomorphic adenoma. Necrosis is unusual in pleomorphic adenoma, and therefore we were not able to rule out malignancy. The excised tumor was 3×3 cm and showed broad central necrosis with a small amount of tumor tissue beneath the fibrous capsule. Histological examination revealed variable features, including solid or tubular epithelial proliferation and myxoid or chondroid stroma. Squamous metaplasia was seen focally. A histological diagnosis of pleomorphic adenoma with massive necrosis was made.
Conclusion: This case indicates that cytologists should be aware of the possibility of a benign lesion, even if necrotic material is aspirated from a salivary gland tumor.View full abstractDownload PDF (7445K) -
A case reportAkiko HINO, Takanori HIROSE, Junko YAMADA, Chikako TAKAI, Miki YAMAGUC ...1999 Volume 38 Issue 1 Pages 93-97
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Pituitary adenomas are usually slow-growing tumors in the sella turcica, However, they occasion-ally grow aggressively, and destroy the skull base and adja-cent bones, and intrude into the nasal cavity.
Case: A 64-year-old woman visited hospital complaining of right nasal obstruction and epistaxis. There was a large polyp in the right nasal cavity. Magnetic resonance imaging demonstrated a large tumor involving the sphenoidal, ethmoidal, and maxillary sinuses, nasal cavities and sella turcica, The tumor was resected by a transsphenoidal approach. Cytologically, tumor cells had abundant cytoplasm and round nuclei with fine-granular chromatin. Histologically, tumor cells were arranged in sheets, cords, perivasclar pseudorosettes and microcysts. No atypia or mitoses were observed. Immunohistochemically, tumor cells were positive for cytokeratin, chromogranin A, and synaptophysin. The tumor expressed no hormones of the anterior pituitary. Ultrastructurally, tumor cells had dense core granules in their cytoplasm. The tumor was diagnosed as pituitary adenoma, null cell type.
Conclusion: Pituitary adenomas invading paranasal sinuses and nasal cavity may be confused with malignant round cell tumors, such as malignant lymphoma, olfactory neuroblastoma, small cell carcinoma and rhabdomyosar-coma. Immunohistochemistry and electronmicroscopy as well as cytological findings are useful for the diagnosis of invasive pituitary adenoma.View full abstractDownload PDF (6740K) -
Kiyokazu HARA, Toshiaki MATSUMOTO, Yoshihiko IKEDA, Chikao YUTANI, Yos ...1999 Volume 38 Issue 1 Pages 98-102
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The cytological features of a rare case of persistent pericardial effusion caused presumably by cardiac amyloidosis is reported.
Case: An 84-year-old woman with persistent pericardial effusion was admitted to our hospital in 1993. The cytological appearance of mesothelial cells obtained from pericardial fluid showed papillary cell clusters with swelling of nucleoli, irregular shaped nuclei, mitosis, multinucleated giant cells, and psammoma bodies, however no amyloid substance was detected in pericardial fluid. Although cytological findings strongly suggested that those cells were reactive mesothelial cells, clinical findings could not rule out the possibility that these cells were derived from low malignant mesothelioma.
We continued to obtain the same cytological findings for four years until the patient died in 1997.
Conclusion: Since an autopsy revealed that amyloid was widely deposited in the subendocardium, cardiac muscle layer, and pericardial membrane, we suppose that those cells obtained from pericardial fluid were active mesothelial cells.View full abstractDownload PDF (7081K) -
Report of a caseMayumi OOHARA, Junko NAKAMURA, Fusayo TANAKA, Takehiko IKEYA, Mitsuko ...1999 Volume 38 Issue 1 Pages 103-108
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The cytology of Langerhans' cell his-tiocytosis (LCH) remains poorly characterized. We report the cytologic, histologic and electron microscopic findings of LCH.
Case: A 2-year-old boy complained of frequent cough, tachypnea and discharge from both ears, in the middle of November, 1996, he complained of dyspnea and was then admitted to the Saiseikai Nakatsu Hospital, Osaka. At that time, eczema was found on the whole of his scalp. Head X-ray showed multiple punched-out lesions of the skull and chest X-ray showed multiple cystic lesions in both lung fields.
Scraping smears from the eczema of his scalp showed many scattered single histiocytic cells. Their cytoplasm stained light green, and nuclei were mostly round or oval in shape and eccentrically located. Chromatin was finely granular without hyperchromasia. Histology showed the proliferation of histiocytic cells. Immunohistochemistry showed that S-100. CD 68 and HLA-DR were positive in these cells. Electron microscopicy showed Birbeck granules in the cytoplasm. These granules looked like a tennis racquet and went through the inner canal to the outside of cells.
Conclusion: Cytologic features of LCH were reported.were eccentrically located without hyperchromasia. Sometimes nuclear indentations or nuclear grooves were observed. Electron microscopy revealed the presence of Birbeck granules. NucleiView full abstractDownload PDF (9938K) -
Midori SAITO, Ryo KONNO, Tsukasa IGARASHI, Satoshi OKAMOTO, Shinji SAT ...1999 Volume 38 Issue 1 Pages 109-110
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBcl-2 expression has been reported in a number of malignancies, and is closely associated with the grade of cervical lesions. The present study was designed to evaluate the use of immunocytochemistry for bcl-2 protein in cervical cells. We analyzed the expression of bcl-2 protein in a total of 35 exofoliative cervial smears with emphasis on the association with the grade of cytological atypia. The samples were obtained from 13 healthy women and 22 patients with cervial lesions, including 19 dysplasia (cytological diagnosis; class III), 1 carcinoma in situ (class IV), and 2 invasive squamous cell carcinoma (class V). Expression of bcl-2 was closely related with the grade of cytological diagnosis (0% in class I and I1, 63.2% in class Ill, and 100% in class IV and V). Immunocytochemistry of bcl-2 protein may be useful for prediction of the clinical course of cervical lesions.View full abstractDownload PDF (2182K) -
Norikazu NAGATA, Takashi CHIBA1999 Volume 38 Issue 1 Pages 111-112
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA case of undifferentiated carcinoma of the endometrium a 42-year-old woman is reported. Endometrial cytology revealed tumor cells showing small clusters or dispersed distribution. The tumor cells had almost round nuclei, fine increased chromatin, small nucleoli, and a high N/C ratio. These findings indicated undifferentiated carcinoma, although histology was not diagnostic due to massive necrosis of the tumor. Histological examination of the resected uterus confirmed the diagnosis, emphasizing the usefulness cytology.View full abstractDownload PDF (4772K) -
Mamoru MOCHIZUKI, Katsumi TAKAHASHI, Haruhiro EJIRI1999 Volume 38 Issue 1 Pages 113-114
Published: January 22, 1999
Released on J-STAGE: December 05, 2011
JOURNAL FREE ACCESSWe describe a rare case of cystic islet cell tumor of the pancreas diagnosed by fine needle aspiration (FNA) cytology. A 63-year-old female presented with a cystic mass, measuring 8×8 cm, in the pancreatic tail. FNA yielded cystfluid containing both isolated neoplastic cells and loosely packed cell clusters. The cells had a high N/C ratio, round nuclei, stippled nuclear chromatin, prominent nucleoli, and fine granular cytoplasm. This case suggests that a stippled nuclear chromatin pattern is one of the most important findings for distinguishing islet cell tumors from acinar cell tumors and solid and cystic tumors of the pancreas.View full abstractDownload PDF (3075K) -
Taizo SHIRAISHI, Tsuyoshi NAKAYAMA, Masato KITAMOTO, Hiroshi NAKANO, T ...1999 Volume 38 Issue 1 Pages 115-116
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSCytologic findings of salivary duct carcinoma (SDC) of the parotic gland obtained by fine needle aspiration are described. The aspirates contained predominantly broad flat sheets and surrounding isolated cells. These were large polygonal epithelial cells with abundant eosinophilic cytoplasm, round to oval nuclei, fine granular chromatin and predominant nucleoli. Though some cells revealed intracytoplasmic lumen on histologic sections, this was inconspicuous cytologically.
The cytologic differential diagnosis included mucoepidermoid carcinoma, oncocytic carcinoma, acinic cell carcinoma, and metastatic carcinoma. The presence of ICL has only been described in one article that demonstrated it electronmicroscopically.View full abstractDownload PDF (3703K) -
A case reportMamoru MOCHIZUKI, Katsumi TAKAHASHI, Yohei HOSOKAWA, Haruhiro EJIRI1999 Volume 38 Issue 1 Pages 117-118
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe describe a case of malignant pericardial effusion as an initial presentation of well-differentiated pulmonary adenocarcinoma. A 68-year old Japanese man was brought the emergency department because of dyspnea and chest oain. An echocardiogram demonstrated the presence of a Iarge pericardial effusion. Cytological examination of the aunctuated effusion showed many cell aggregates composed of papillary cell clusters. The neoplastic cells had centrally located round nuclei, coarse granular nuclear chromatin, and abundant clear cytoplasm. Postmortem examination revealed pericardial dissemination of pulmonary adenocarcinoma. We suggest that the morphological variety of cells is an important finding to help distinguish pulmonary adenocarcinoma from malignant mesothelioma.View full abstractDownload PDF (3255K) -
Yoshiyasu HORIOKA, Motomu TSUJI, Masao MORIKAWA, Tetsuya ARAKI1999 Volume 38 Issue 1 Pages 119-120
Published: January 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSThe imprint cytologic features of malignant peripheral nerve sheath tumor (MPNST) are reported. The patient, a 40-year-old woman, with von Recklinghausen's disease noticed a gradually enlarging subcutaneous nodule on the right shoulder. CT revealed the nodule was a tumor, measuring 9 cm in diameter. The imprint smear of the surgically resected tumor consisted of loosely cohesive groups of spindle-shaped cells and isolated cells. Most of the tumor cells had fusiform nuclei with coarse granular chromatin and indistinct, fibrillary cytoplasm, including cells with twisted nuclei and comma-shaped cells. Moreover, some isolated cells showing large and pleomorphic nuclei with granular chromatin and a few multinucleated cells were found. Intranuclear vacuoles were occasionally observed in these anaplastic cells. Histologic sections demonstrated swirling and interlacing fascicle patterns of spindle-shaped cells. Multinucleated and pleomorphic cells with intranuclear vacuoles were also found around the necrotic areas in the tumor. The majority of the tumor cell were positive for S-100 protein immunostaining.View full abstractDownload PDF (4371K) -
1999 Volume 38 Issue 1 Pages e1
Published: 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (30K)
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