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Volume 38, Issue 3
Displaying 1-17 of 17 articles from this issue
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Yoichi KOBAYASHI, Kaoru SAITO, Yosuke KANISHI, Seiko NODA, Kiyoshi SHO ...1999 Volume 38 Issue 3 Pages 201-204
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The diagnostic value of Cyto-pick was compared to cotton swab sampling for uterine cervical neoplasm screening in pregnant women.
Study Design: 83 cases of abnormal Pap. smear were included from a total of 4749 pregnant women examined at our hospital between January 1992 to December 1997. 53 of these cases were carefully followed throughout pregnancy by colposcopy and biopsy. The accuracy of Pap. smear cytological diagnosis with the correct histological diagnosis for the above two cytodiagnostic devices were compared in each case.
Result: A total of 12 of 29 cytological specimens sampled by cotton swab (41.4%) compared to 18 of 24 cytological specimens sampled by Cyto-pick (75%) were in agreement with the histological diagnosis, with Cyto-pick giving significantly better accuracy for cytological diagnosis (p=0.0140, x-square test). This difference was especially marked in lesions diagnosed as carcinoma in situ or as more advanced lesions; the accuracy of cytological diagnosis by Cyto-pick sampling was 100% compared to an accuracy of only 33.3% by cotton swab.
Conclusion: In pregnant women, Cyto-pick is a more accurate cytodiagnostic device in sampling for uterine cervical neoplasms compared to cotton swab.View full abstractDownload PDF (617K) -
Rira HOSHI, Masafumi TSUZUKU, Yukitoshi SATOH, Kazunori NISHIDA, Yuich ...1999 Volume 38 Issue 3 Pages 205-212
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: To examine whether cytology can accurately diagnose primary lung cancer sarcomatous component (PLCSC).
Study Design: We retrospectively studied cytologic materials obtained by fine needle aspiration biopsy, brushing and/ or sputum cytology of 8 PLCSC cases which were surgically resected and diagnosed at the Cancer Institute Hospital from 1993 to 1996.
Results: Cases were classified into 3 groups histologically: 1) squamous cell carcinoma (SqCC) with sarcomatous components (SC), 2) adenocarcinoma (ADC) with sarcomatous components, and 3) spindle cell carcinoma (SpCC). Sarcomatous components were divided into two elements cytologically: pleomorphic and spindle cell. SqCC with SC had both cytological elements and overt keratinizing caricinoma cells, ADC with SC had the spindle cell element only, and SpCC had the pleomorphic component only.
Conclusion: Cytologic considerations of morphology of both sarcomatous elements and overt carcinoma components enable accurate diagnosis of PLCSC and may allow classification into the three subtypes.View full abstractDownload PDF (9258K) -
Akihiko KAWAHARA, Toshiro YOKOYAMA, Setsuo SUGISHIMA, Hiroshi HARADA, ...1999 Volume 38 Issue 3 Pages 213-220
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We investigated the cytologic features of epithelial neoplasm of the major and minor salivary gland showing myoepithelial differentiation by an imprint cytologic procedure.
Study Design: A total of 24 patients with salivary epithelial neoplasm (15 with pleomorphic adenoma, 1 with myoepithelioma, 2 with basal cell adenocarcinoma, 4 with adenoid cystic carcinoma, and 2 with epithelial-myoepithelial carcinoma) were studied. All of the imprint cytologic smears were stained with Papanicolaou or Giemsa stain. Final diagnoses were established by histopathology for each case.
Result: The tumors with myoepithelial differentiation tended to represent small and uniform cells with scanty cytoplasm, and showed metachromasia which varied between histological types.
Conclusion: Differential diagnosis among salivary gland tumors is quite difficult because they represent various histological types from benign nature to high-grade malignancy. Therefore careful attention to the distribution and staining characters of metachromasia could be useful for more accurate differential dignosis of these tumors.View full abstractDownload PDF (9825K) -
Mitsuru KINJO, Tomoko SOEJIMA, Sumiko WATANABE, Katsuhiko HAMANO, Kazu ...1999 Volume 38 Issue 3 Pages 221-225
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The aim of this study is to elucidate themorphogenesis of “pair cells” on voided urine cytology.
Study Design: Ninety cases in which cytological examination of voided urine and subsequent histological examination examination within 2 months was performed were studied. Those included 21 benign bladder lesions and 69 TCCs of various grades. Sixty-three typical single pair cells were chosen for MIB-1 immunocytochemical study after destaining of the Papanicolaou preparations.
Results: Histology of TCCs showed distinctive whorl structures in 14.5% of the tumor, which were very similar to pair cells in voided urine cytology. Incidence of whorl structures in TCCs varied according to the grades of TCCs. Incidence of pair cells in cytology were closely related to that of whorl structures on histology. However, the incidence of pair cells on voided urine cytology was not related that of whorl structures on histology by X2 analysis. Determination of proliferative activity revealed cleary positive reactions in 22 outer cells (37.3%) and 6 central cells (10.2%), when 59 of 63 typical single pair cells were examined using MIB-1 immunostaining. The outer cells seemed to show a significantly higher incidence of proliferactive cells than the central cells (X2 P-value: 0.0005).
Conclusion: The present study suggested that the pair cells might not be derived directly from the bladder tumor, but may be formed in the urine as a resrlt of unbalanced proliferative activity after detachment. However, detailed morphogenesis of the pair cells has not yet been solved and should be studied further.View full abstractDownload PDF (3400K) -
Junko MARUTA, Hiroto YAMASHITA, Shiro NOGUCHI1999 Volume 38 Issue 3 Pages 226-230
Published: May 22, 1999
Released on J-STAGE: December 05, 2011
JOURNAL FREE ACCESSObjective: Computerized measurement of the morphology of aspirated cell samples enables numerical evaluation of malignancy and reduces observer variation.
Study Design: We measured the area and peripheral length of ten or more cell clusters in every Papanicolaoustained smear sample from fine needle aspiration cytology of 20 papillary carcinomas, 20 follicular adenomas and 20 adenomatous goiters. The index represents the morphological complexity of the cell clusters and is calculated by; index=length (2×squareroot (pi×area))
Results: The mean area (95% CI) of cell cluster in papillary carcinoma of 2970 (2154-4095), μm2 was marginally larger than in follicular adenoma (1785 (1397-2281) μm2) or adenomatous goiter (1968 (1477-2623) μm2)(both p<0.08, Dunnett's multiple comparisons with control). The mean peripheral length of cell cluster in papillary carcinoma of 376 (304-464), μm was significantly longer than in follicular adenoma (237 (205-275) μm) or adenomatous goiter (248 (209-294) μm)(both p<0.004). The mean index of cell cluster in papillary carcinoma of 2.02 (1.84-2.19) was extremely significantly larger than in follicular adenoma (1.61 (1.53-1.69)) or adenomatous goiter (1.60 (1.51-1.69))(p<0.0001).A logistic regression analysis gave the equation: Probability (diagnosis=papillary carcinoma) =1/1+exp (-(-12.3+6.58 index)), indicating an odds ratio for papillary carcinoma to benign disease of 1.96 per every 0.1 unit increase of the index.
Conclusion: This index should complement thyroid aspiration cytology to improve the accuracy and reduce subjective variation in the reading of cytology characteristics by pathologists.View full abstractDownload PDF (4959K) -
Yasuo KOIKE, Naoki TERAI, Shin-ichi TSUCHIYA, Tatsuo WATANABE, Chie MA ...1999 Volume 38 Issue 3 Pages 231-238
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The results of aspiration biopsy cytology (ABC) were compared between doctor A and doctor B whose aspiration techniques were different. Further, the factors involved in misjudgement were investigated.
Study Design: The subjects were 1, 787 women with breast diseases who visited the breast clinic of Nagano Cancer Center on an out-patient dasis during the last 9 years. These patients were divided into two groups and we compared the results of ABC. One group included 1, 136 women who underwent aspiration by doctor A, the other 651 women were aspirated by doctor B.
Results: The proportion diagnosed as class V·IV for malignant breast diseases and those as class II·I for benign breast disease by both doctors were both over 80%. The false-negative (class II·I and undetermined) rate and false-positive (over class III b) rate of ABC were not significantly difference between doctors A and B, but the undetermined rate of doctor A was significantly lower than that of doctor B.
Sensitivity, specificity, positive predictability and accuracy of ABC were not different between both doctors. The true positive rate of ABC for breast cancers in terms of diagnosis by other diagnostic methods and histological types were not different between both doctors. The proportion of cases with insufficient material which was the most common factor for false negativity by doctor A were more than those by doctor B. False negativity for the cases with sufficient specimens were caused by technical problems, cancer in fibrodenoma, invasive lobular carcnoma and others.
The factors which affected false positivity were not different between both doctors. False positivity in cases with sufficient materials were caused by overestimation of aspirated cells, lesions with increased epithelial proliferation and papillary lesions.
Conclusion: The results of ABC are unaffected by aspiration technique, if aspiration is done by a skilled doctor.View full abstractDownload PDF (1086K) -
Yoshinori MANO, Takeshi TOYOZUMI, Kazuyuki FUJII, Yoshihiro KIKUCHI, I ...1999 Volume 38 Issue 3 Pages 239-243
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report the cytological findings and results of HPV investigation of a case of papillary squamous cell carcinoma (PSCC), which is a rate variant of squamous cell carcinoma of the uterine cervix.
Case: A 36-year-old female had a papillary tumor of the uterine cervix which showed exogenous growth and easy bleeding. It was clinically diagnosed as malignant neoplasm; however, cytological findings were interpreted as severe dysplasia or squamous cell carcinoma in situ (CIS). There were no obvious findings indicating invasive carcinoma.
Histologically, the resected specimens showed a papillary tumor with thin fibrovascular core and a part of stromal invasion. The diagnosis of PSCC (FIGO I b 2) was made. We investigated HPV by a PCR method and detected 16 HPV virus (high-risk type).
Conclusion: In general, it is difficult to define stromal invasion in PSCC by preoperative evaluation including cytology and biopsy, and PSCC therefore tends to be underdiagnosed as CIS. Nevertheless, it may be possible to reach the correct diagnosis of PSCC by both cytological findings, i. e. abundant tumor cells, rather large tumor cell clusters, cytological atypia of each tumor cells, and histological findings of biopsy material whenever PSCC is included in the differential diagnosis by gross and colposcopic findings.View full abstractDownload PDF (8544K) -
Toshihiko MICHIMATA, Yoshihiro YAMAKAWA, Satomi MIYAZAKI, Touru HASEGA ...1999 Volume 38 Issue 3 Pages 244-248
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Pelvic actinomycosis is a rare disease caused by the Gram-positiive anaerobic bacteria Actinornyces Israeli, and it is commonly associated with the prolonged use of an intrauterine device (IUD).
Case: We reported a case of IUD-associated pelvic actinomycosis whose cervicovaginal smear was useful for diagnosis. The patient was successfully treated with antibiotic therapy. A 41-year-old woman, gravita 2, para 2, presented with fever and bilateral leg edema. She had used an IUD for the previous 14 years. She was admitted to our hospital becase of bilateral leg edema and presented with bilateral hydronephrosis due to an extrinsic mass. Magnetic resonance imaging revealed a large mass in her pelvis which was elastic, hard and not mobile. A barium enema examination showed stenosis of the sigmoid colon and rectal colon (Ra). Repeated examination of cervicovaginal smear and edometrial biopsy showed the presence of central branching filaments and sulfur granules could be detected, findings characteristic of actinomycosis. The diagnosis was made using cytological and histological examination. After actinomycosis was diagnosed, she was treated with long-term penicillin, which resulted in a complete recovery. She has had no further complications and is well 2 years later.
Conclusion: If a patient is an IUD wearer and presents with pelvic mass, actinomyces should in particular be carefully searched for in both cervicovaginal smear and endometrial smear. Special attention should be paid to patients with a long history of IUD use. If the diagnosis of actinomycosis can be obtained, such cases should be preoperatively treated with removal of the IUD and antibiotic treatment which may lead to complete resolution.View full abstractDownload PDF (6272K) -
Toshiyuki HABARA, Mitsuyoshi HIROKAWA, Noriyuki FUJIMURA, Masahiro HAS ...1999 Volume 38 Issue 3 Pages 249-253
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Sclerosing hemangioma of the lung is an unusual tumor. Recently, we encounterd a case of sclerosing hemangioma that showed a predominantly solid pattern and cytologically mimicked papillary adenocarcinoma. We report the cytologic and histologic findings of this case, and discuss a diagnostic clue for mast cells in diagnosing sclerosing hemangioma.
Case: A 59-year-old Japanese female had an abnormal shadow first detected on chest roentgenography two years prior to her admission. CT scan revealed a tumor mass in the right lower lobe, measuring 1.5 cm in diameter. Sclerosing hemangioma was suspected, but carcinoma could not be ruled out. Partial lobectomy of the right lower lobe was performed, because the mass had gradually increased in size. Imprint cytology revealed numerous round to polyhedral tumor cells showing a papillary structure with a fibrovascular core. Intranuclear cytoplasmic inclusions and nuclear grooves were found. Diff-Quik stained preparation revealed numerous mast cells that were located within the cell clusters and on the background. Histologic examination of the tumor revealed pulmonary sclerosing hemangioma with a predominant solid pattern. Most mast cells were present within the tumor cell nests rather than stromal connective tissue.
Conclusion: As the presence of mast cells within the cell clusters is characteristic of sclerosing hemangioma even with a predominantly solid pattern, we should perform Giemsa stain or Diff-Quik stain on cytologic preparations when sclerosing hemangioma is suspected.View full abstractDownload PDF (7385K) -
Haruhiko MIYAYAMA, Toshio BABA, Kiminari KAWANO, Kouji SHIMAMOTO, Rits ...1999 Volume 38 Issue 3 Pages 254-258
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Primary extragenital choriocarcinoma in men may occur in the retroperitoneum, testis, and pineal body. Primary male choriocarcinoma of the lung is extremely rare. Since 1977, 14 cases have been reported in the English literature.
Case: Choriocarcinoma of the right S9 area was found in a postmortem examination in 78-year-old Japanese man.
A cytological sxamination had suggested adenocarcinoma, but chest X-ray and CT examinations failed to show abnormal shadow in any field of the lung.
Histologically, the tumor was choriocarcinoma consisting of atypical cytotrophoblastic cells surrounded by syncytiocyto trophoblastic ones.
Immunohistological studies revealed strong of human beta-chorionic gonadotropin reactivity in the anaplastic syncytiotrophoblasts.
Conclusion: A few cells admixed in the clustered CTs area show immunoreactive to epithelial common membranous antigen, suggesting that pulmonary choriocarcinoma may result from dysdifferentiation of pulmonary epithelial cells.View full abstractDownload PDF (6275K) -
Youichi SASAKI, Masahiko KAKIHANA, Masahiro URASAKI, Kikue NOHARA, Kat ...1999 Volume 38 Issue 3 Pages 259-267
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The anorectal Basaloid carcinoma is a rare disease that shows histological resemblance to basal cell carcinoma of the skin, but may metastasize leading to a wrong prognosis. We experienced a case of basaloid carcinoma in 1993, that has never been reported in Japan, and studied its imprint smear cytology.Case: A 76-year-old woman visited our hospital because of anal pain during evacuation. Physical, radiological and endoscopic examinations revealed a submucosal tumor in anorectal junction. Cytologic features of imprint smear of endoscopic biopsy specimen of the tumor are classified into three patterns; 1. small round cell pattern, which is composed of many clusters of tumor cells with small, uniform, round nuclei and scanty cytoplasms. 2. spindle cell pattern, showing small clusters with palisade-like appearance. 3. squamous cell pattern. Histologic diagnosis of the biopsy specimen is Basaloid carcinoma of anorectum, that shows nests which form solid circumscribed clumps which are composed of; 1. small round cell zone in the midst of the nest, 2. peripheral palisading of spindle cells in the border of nest, and 3. few concentric whorls of squamous cells in the nests of tumor. These three types correspond to each of the cytologic figure patterns.
Conclusion: To make a cytologic differential diagnosis of the various tumors of the anal canal, cytologists should study the cytologic features of basaloid carcinoma.View full abstractDownload PDF (20018K) -
Koh NAKAZAWA, Satoshi SHIOZAWA, Satohiko KUBOTA, Kyoko USUDA, Sayuri H ...1999 Volume 38 Issue 3 Pages 268-271
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Primary small cell carcinoma of the esophagus is an uncommon malignancy. We report a case of primary small cell carcinoma of the esophagus with cytological, histological, immunohistochemical and ultra structural findings.
Case: A 78yearold woman visited a hospital complain ing of an unusual feeling on swallowing. Endoscopic exami nation revealed a polypoid mass protruding into the lumen with shallow ulcer on its surface. In the excised esophagus, the tumor mainly involved the submucosa with infiltration into the muscle layer and tunica adventitia. Cytological preparation was characterized by small round to oval cells having increased chromatin and scant cytoplasm in isolation or in clusters. A part of the specimen showed rosettelike structure. Histologically the tumor was composed of solid sheets of small, round to oval cells with hyperchromatic nuclei and scant cytoplasm. These cells were immunohisto chemically positive for chromogranin A and ultrastructurally contained membranebound intracytoplasmic dense core granules. A part of the tumor showed definite differentia tion to basal cells and to keratinizing squamous epithelium.
Conclusion: This is a rare case of small cell carcinoma arising in the esophagus with focal differentiation to basal and squamous cells. The cytological findings obtained by imprint specimens were valuable for diagnosis of small cell carcinoma arising in the esophagus.View full abstractDownload PDF (6369K) -
Osteosarcoma of breastEmiko TANIGUCHI, Misa NAKAMURA, Xuefeng JING, Yasuishi NAKAMURA, Toyoh ...1999 Volume 38 Issue 3 Pages 272-275
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Osteosarcomas is rare tumor in breast and only few reports described cytologic appearance of this breast tumor.
Case: The patient was a 57-year-old woman who developed a right breast mass. Fine needle aspiration cytology showed pleomorphic and spindle cells, which were scattered all over the slides. No bone or cartilage was found in the smear. The cytoplasm was stained with light green on Papanicolaou stain. The nucleus stained hyperchromatic and a moderate density. Chromatin distribution was uniform. Mitosis was seen frequently in these cells. Multinucleated gaint cells were also seen in the specimen. These giant cells were positive with tartrate resistant acid phosphatase stain, suggestive of osteoclastic differentiation. Immunohistchemical examination of vimentin was positive but keratin presented negative results when applied to the histologic samples.
Conclusion: Because of no preceding lesion found, it was diagnosed as primary osteosarcoma of the breast.View full abstractDownload PDF (6072K) -
Setsuo SUGISHIMA, Akihiko KAWAHARA, Toshiro YOKOYAMA, Itsuro HAYASHI, ...1999 Volume 38 Issue 3 Pages 276-280
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Primary squamous cell carcinoma (SCC) of the mammary gland is a very rare disease accounting for 0.1% of breast cancers. We report the cytological and histological findings of two cases of primary SCC of the mammary gland.
Cases: Two cases of SCC, a 62-year-old female (Case 1) and a 48-year-old female (Case 2) were examined. The tumors of both cases involved the left breast, and were 3.0 and 4.5cm in diameter, respectively. These tumors showed solid growth.
Cytologically, two types of tumor cells were observed in both cases. One was large overlapping cluster of tumor cells with hyperchromasia, and the other was tumor cells with abundant cytoplasma and centrally-located nucli arranged in small sheet clusters. Cases 1 and 2 were diagnosed as SCC by aspiration cytology. Histologically, the tumor of Case 1 showed SCC with a small focus of adenocarcinoma. The tumor of Case 2 was almost entirely composed of SCC.
Conclusion: The diagnosis of primary SCC in these cases was preoperatively established by cytology. Generally, the prognosis of mammary SCC is bad when compared with that of ductal carcinoma of common type. Therefore, fine needle aspiration cytology was thought to be a very important method for detection of early stages of primary SCC of the breast.View full abstractDownload PDF (7614K) -
Kenichi TAZAWA, Shinobu UMEMURA, Hiroshi KAJIWARA, Youko MIYAJIMA, Hit ...1999 Volume 38 Issue 3 Pages 281-286
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The cytologic features of papillary carcinomas of the thyroid gland associated with chronic thyroiditis have not been fully determined. We present cytologic and histopathological findings of four cases in the present report.
Cases: All of the cases were female and ranged their age were between 49 to 52 years (mean; 50.5). The chief complaint was neck tumor mass in all cases. Cellular components aspirated from thyroid tumors were sufficient for the diagnosis of papillary carcinoma in all of the 4 cases, while aspirated lymphocytes were not sufficient for the preoperative diagnosis of chronic thyroiditis, except for one case. To avoid the misinterpretation or underdiagnosis of papillary carcinoma cells as metaplastic follicular epithelial cells, careful observation of the epithelial components, especially nuclear features, is important. In aspiration cytology of the other three cases, carcinoma cell clusters with a papillary pattern, grooved features, ground glass appearance of nuclei, and intranuclear cytoplasmic inclusion bodies were identified.
Conclusion: By aspiration from the tumor center, a sufficient number of carcinoma cells and a few metaplastic follicular epithelial cells could be aspirated. This will help the correct cytologic diagnosis of papillary carcinoma associated with chronic thyroiditis.View full abstractDownload PDF (4702K) -
Kikuo MORI, Shigeyuki ASANO, Kyoko YOSHIDA, Michiko HIRUTA1999 Volume 38 Issue 3 Pages 287-288
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSAn 87-year-old Japanese man, who had suffered from pneumoconiosis because he worked for over 25 years as a coal miner, visited the hospital with the chief complaint of dullness of chest and back. Chest X-ray revealed bilateral abnormal multiple nodules and calcification of hilar nodes. The fine needle aspiration biopsy cytology from the right supraclavicular lymph node revealed black fine carbon granules. silic acid salts and carbon-laden macrophages. These findings showed silicoanthracosis of the lymph node. We must be aware that cervical lymph node swelling can indicate not only carcinoma metastasis and tuberculosis but also nodal involvement of pneumoconiosis.View full abstractDownload PDF (2324K) -
Masako KATO, Yasushi HORIE, Mitsuko NAGAMI, Chieko SUGIHARA, Shoji YAS ...1999 Volume 38 Issue 3 Pages 289-290
Published: May 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of a 73-year-old man with inflammatory pseudotumor of the left renal pelvis. The tumor was histologically composed of spindle-shaped cells with mild atypia and some multinucleated giant cells, lymphocytes and plasma cells. Cytological features revealed spindle-shaped fibroblast-like cells with enlarged oval nuclei with slight atypia. These cells had thin nuclear membranes and a fine chromatin structure. Imprint smears also contained lymphocytes and foreign-body type multinucleated giant cells. Immunostaining was positive for α-SMA and vimentin. These features were thought to be compatible with those reported for inflammatory pseudotumor. Its cytological differential diagnosis was briefly discussed as well.View full abstractDownload PDF (2570K)
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