Bcl-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.
A 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.
We 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.
Cytologic 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.
We 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.
The 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.