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Volume 38, Issue 4
Displaying 1-15 of 15 articles from this issue
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Toshiro KAWAI, Takeshi FUJII, Akiko ISHIDA, Kouji URASAKI, Sachiko KUB ...1999 Volume 38 Issue 4 Pages 299-304
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: To identify factors influencing the diagnostic accuracy of bile cytology for gallbladder lesions.
Study design: We retrospectively reviewed a series of 1245 cytologic specimens from 265 patients. We investigated the factors affecting the differences in method of obtaining bile. We also evaluated the correlation between the diagnostic accuracy of bile cytology and pathological factors including locations, and both macroscopic and histological types of the lesions in 25 patients who had undergone surgical resection of gallbladder carcinoma.
Results: 1. The overall sensitivity of bile cytology for gallbladder cancer was 67.3%. 2. Increasing numbers of cytologic specimens correlated with a higher rate of positivity although the frequency of cytologic examinations was not the only factor influencing diagnostic accuracy. 3. Numbers of specimens examined in false-negative cases tended to be fewer than those in positive cases. 4. The positive ratio per examination was 38.1% in cancer-bearing patients. 5. Based on method of obtaining bile, the positivity was 66.7% with ENBD, 64.2% with PTBD, and 76.0% with PTGBD. 6. Lower sensitivity was observed in cytologic specimens from macroscopically papillary and histologically well differentiated carcinomas.
Conclusion: In bile cytology for gallbladder lesions, the choice of method for obtaining bile and the number of specimens will affect the results.View full abstractDownload PDF (2628K) -
Mitsuaki OHKOUDO, Yoshio SHIINA, Junko IIJIMA, Kanae SAKUMA, Tomomi AI ...1999 Volume 38 Issue 4 Pages 305-311
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: A membrane filter is useful for collecting cells from the cerebrospinal fluid, because the cell component content is low and cells are easily damaged. However, cell collection using a membrane filter is expensive and has other problems, and thus it is not widely used in cytodiagnosis.
Study Design: Using the membrane filter method (FIL CUP Super), we studied the rate of cell collection, cell damage under different pressure, ability of trapping small cells, and the effects on special staining and the preservation of stained preparations. In addition, we also applied this apparatus to cerebrospinal fluid samples from 13 patients.
Results: This method was excellent for collection of cells without damaging them, and is applicable to various methods of special staining. Suction pressure was related to the degree of cell damage and ability to trap small cells. When applied to cerebrospinal fluid samples, the filtered preparations provided easy diagnosis in cases which were difficult to evaluate using the conventional smear preparations.
Conclusion: This method, although expensive, should be introduced for cytodiagnosis, particularly with selective samples of low cell concentration.View full abstractDownload PDF (7856K) -
Yasushi YAMASHIRO, Hiroshi TSUKUDA, Yuzuru YASUJI, Isao UCHIYAMA, Yuka ...1999 Volume 38 Issue 4 Pages 312-319
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: To investigate cytological findings that correlated with human papillomavirus (HPV) type.
Study design: We investigated 82 cytological specimens from uterine cervix of human papilloma virus (HPV) infection with PCR-RELP. Furthermore we analyzed the relationship among HPV type, histological diagnosis and cytological findings.
Results: 1) Significantly more cases of histological malignancy were pocitive for the HPV genome. 2) On cytology, the appearance of immature metaplastic cells was associated with HPV 16 and correlated with histological malignancy. Parakeratosis was associated with HPV 52. Orangeophilia was correlated with histological malignancy. 3) When we adopted it positive finding for HPV 16 infection immature metaplastic cells appeared more than 10.0 %o of total cells, we achieved a diagnostic sensitivity of 75.0% and a specificity of 92.7%.Conclusion: The appearance of immature metaplastic cells is a feasible marker for screening for HPV 16 infection.View full abstractDownload PDF (3250K) -
Useful application of immunocytochemistryYoshiaki INAYAMA, Takako INAYAMA, Kazuhisa KITAMURA, Miho KIKUCHI, Yuk ...1999 Volume 38 Issue 4 Pages 320-322
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Although chlamydial conjunctivitis is a common disease, there have been few cytological reports published. Here we describe a case that was examined both cytologically and immunocytochemically.
Case: A 67-year-old man presented with conjunctival injection and increased eye discharge. Ophthalmologic examinations revealed prominent follicle formation in the conjunctiva, and lymph node swelling in the bilateral preauricular regions was also noted. Chlamydial conjunctivitis was suspected, and brush cytology of the conjunctiva was performed. Diff-Quik-stained sections revealed inclusionlike bodies in the cytoplasm of the epithelial cells. Fine, highly dense granular or reticular bodies, red-purple in color were occasionally detected in the epithelial cells, a number of which also contained basophilic and rather coarse granules. Immunostaining for Chlamydia using bleached Diff-Quikstained sections indicated that only the latter structures showed a positive reaction, whereas the former seemed to be pseudo-inclusions.
Conclusions: Although Prowazek bodies are known to be typical chlamydial inclusions, this is not always true, and inclusions that do not show the typical morphology have also been reported by other authors. Thus, immunostaining is considered to be useful for accurate diagnosis of chlamydial conjunctivitis from cytology specimens. This method seems more beneficial than other antigen detection methods such as immunofluorescence or enzyme immunoassay, because it shows more detailed morphology of the inclusions.View full abstractDownload PDF (3328K) -
Katsuhiko MAEDA, Masako ITOU, Hisatoyo KASAI, Hiroshi NAKANO, Akinori ...1999 Volume 38 Issue 4 Pages 323-327
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Epithelial-myoepithelial carcinoma of the parotid gland is a rare tumor that is mostly observed in females in their sixties, and is recognized as a low malignant tumor.
Case: The patient was a 60-year-old male, who noticed swelling of the parotid gland and underwent examinations in our hospital. Malignant tumor was suspected on cytodiagnosis of needle biopsy specimen. On needle biopsy, large and small cells were observed against backgrounds of hyaline component and pronucleus-like cells. Cells formed slightly sparse cell clusters. The cytoplasm was stained bright green and the nuclei were round or nearly round with small granular chromatin. The nucleli were clear. The small cells had small cytoplasm and formed dense cell clusters, partially showing a lumen-like structure. The nuclei were nearly round or round with granular chromatin and the nucleoli were clear. The large and small cells were more clearly distinguished by Giemsa stain than Papanicolau stain.
On histological examination, the tumor cells were divided by the hyalinized interstitium, which had a bilaminar structure. On immunohistochemical investigation, the former cells were positive for EMA and keratin and the latter cells were positive fora-SMA and S-100 protein.
Conclusion: On preoperative cytodiagnosis, monomorphic adenoma or adenocarcinoma was suspected, since the large and small cells were the same type and the case was reported as false positive. It may be possible to judge a tumor by cytodiagnosis, considering the cytological characteristics of this tumor.View full abstractDownload PDF (6135K) -
Report of a caseYasuo KATOH, Naomi IMAHAYASHI, Kazuhiro KOZAI, Keiko NOHARA, Yasushi Y ...1999 Volume 38 Issue 4 Pages 328-331
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Traditionally, most mesenchymal tumors of the gastrointestinal tract were diagnosed as smooth muscle tumors. Recently, however, immunohistochemical studies have revealed that gastrointestinal mesenchymal tumors are divided into two types, the first group consisting of tumors with smooth muscle or nerve sheath characteristics, and the second being tumors composed of cells of an undetermined lineage. The latter is now referred to as a gastrointestinal stromal tumor (GIST). We report a case of GIST arising in the stomach.Case: The patient was a 60-year-old woman. Abdominal computed tomography and magnetic resonance imaging showed a huge tumor filling the upper abdomen. Specimens obtained by aspiration biopsy cytology (ABC) revealed a large number of isolated or clustered spindle-shaped cells often with elongated blunt-ended nuclei and with scanty cytoplasm. Some nuclei showed snapped indentation. Macroscopically, the tumor measured 18×15×10 cm and showed wide areas of necrosis and hemorrhage. Histologically, the tumor appeared to have arisen from the muscularis propria of the stomach, and was composed of interlacing fascicles of spindle-shaped cells with eosinophilic cytoplasm. Mitotic figures were frequent and some of were atypical. Immunohistochemically, the tumor cells were positive for CD 34 and vimentin, and negative for myogenic markers (desmin, alpha-SMA and HHF 35) and for S-100 protein.Conclusion: It is possible on occasion to diagnose mesenchymal tumors of the gastrointestinal tract as GIST by the ABC method.View full abstractDownload PDF (6246K) -
Case reportYoko MIYAKE, Yoko MAEDA, Go OHMURA, Myota MIURA, Jun TAKATUKA1999 Volume 38 Issue 4 Pages 332-337
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: A glomus tumor is a benign neoplasm arising from a neuromyoarterial body. It is usually found in the peripheral region of the extremities and is rarely found in the stomach. We report a rare case of a glomus tumor in the stomach.Case: A 60-year-old woman had a submucosal tumor of the stomach which was diagnosed as leiomyoma clinically. During follow-up, enlargement of the tumor was noted. Therefore endoscopic partial gastrectomy was performed. The tumor was an encapsulated solid lesion with a diameter of 15×10×5 mm. In cytology, small round to oval tumor cells were detected as clusters of small nests with strong cohesiveness and there were no isolated cells. The tumor was also characterized by the presence of blood vessels which were closely associated with tumor cells.Conclusions: Among the submucosal tumors of the stomach, it is important to distinguish glomus tumor from carcinoid. We conclude that it is useful to perform cytological examination in addition to histological examination because the differential diagnosis of these tumors depends on the presence or absence of cohesiveness in cytology.View full abstractDownload PDF (8943K) -
Yutaka HIRASAWA, Kensuke SUDO, Yuko ITO, Makoto KURODA, Makoto URANO, ...1999 Volume 38 Issue 4 Pages 338-341
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Syringomatous adenoma of the nipple is a benign, locally infiltrating tumor, that histologically resembles syringoma originating from a skin appendage.Case: The patient was an 87-years-old woman. A lump was discovered close to the nipple of her right mammary gland, during treatment for hypertension at our hospital. The tumor was about 1 cm in diameter. Fine needle aspiration cytology showed clusters of atypical cells, keratotic substances and multi-nuclear giant cells. Histologically, tubular, duct-like structures and keratinizing cysts were present. This case was finally diagnosed as syringomatous adenoma of the nipple.Conclusion: The presence of keratotic substances in the findings of aspiration cytology was thought to be characteristic of syringomatous adenoma.View full abstractDownload PDF (6705K) -
A case reportKen SHIMIZU, Masafumi NISHIKAWA, Hideo SASAKI, Kazuharu MISAKA, Yoshih ...1999 Volume 38 Issue 4 Pages 342-347
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Clear cell hidradenoma is a relatively rare skin appendage tumor, the cytologic findings of which have not been well documented.
Case: A 60-year-old male had noticed a gradually enlarging mass in his right breast for 2 years. Fine needle aspiration biopsy cytology revealed moderately cellular smears composed of tumor cells showing distinctive two types and/or patterns ; 1) clusters of squamoid cells with a sheet-like arrangement, possessing a polyhedral cytoplasm that stained faintly with light-green and centrally located oval nuclei, 2) discohesive or individual clear cells with irregularly shaped hyperchromatic naked nuclei, and discohesive squamoid cells also showing naked nuclei. The former clusters also contained scattered small cells with dark-stained nuclei resembling myoepithelial cells. No bipolar naked nuclei were seen. The cytologic diagnosis was Class II, a benign tumor derived from skin appendage or mammary gland. Histological examinations of the submitted material revealed a clear cell hidradenoma (3.5 cm in size) in the dermis supporting our cytological diagnosis.
Conclusion: We should take into consideration the possibility of skin appendage tumor in the differential diagnosis when the cytologic specimen has been aspirated from subcutaneous or soft tissue.View full abstractDownload PDF (6221K) -
Hideaki NISHIDA, Tetuo HASHIMOTO, Kazutaka IKEDA, Takuji TANAKA1999 Volume 38 Issue 4 Pages 348-351
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Sarcoidosis is a granulomatous disorder that may uncommonly be accompanied by a palpable muscle nodule. Muscular sarcoidosis may be classified as nodular, atropic myopathic, and acute myositis. The present case report demonstrates the cytological features of nodular-type muscular sarcoidosis which developed in a 35-year-old Japanese man without any symptoms. Muscular histopathology confirmed the cytological diagnosis.
Case: A 35-year-old Japanese man found a painless tumor in the lateral portion of his right thigh. Ultrasound examination showed a well-defined, homogeneous, and hypoechoic tumorous nodule in the lateral part of the right femoral muscle. Imprint smear obtained from surgically resected tumor revealed a large number of lymphocytes, a few clusters of epithelioid cells and multinuleated giant cells without atypism were interpreted. There was no necrotic debris in the background. The overall cytologic features suggested muscular sarcoidosis. The histologic findings showing noncaseating granulomas confirmed this diagnosis.
Conclusion: Cytological features in conjunction with characteristic findings of ultrasound examination enable us to correctly diagnose nodular-type muscle sarcoidosis in this patiemt.View full abstractDownload PDF (5504K) -
Hiroo KAWANO, Mutsuo TAKAHASHI, Fumiko HIRAOKA, Yoshinobu HOSHII, Tosh ...1999 Volume 38 Issue 4 Pages 352-357
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Epithelioid hemangioendothelioma (EH) is a low-grade malignant tumor of vascular origin. Common sites of occurrence include soft tissue, bone, lung, and liver. Because of its resemblance to epithelial tumors, the tumor may be misdiagnosed as a metastatic carcinoma. A case of EH of bone is presented and the results of cytological, histological, immunohistochemical, and ultrastructural studies are described.
Case: A 73-year-old woman was admitted to our hospital for further examination of a tumorous lesion in her left fibula. Distinguishing cytological features included cytoplasmic vacuolation consistent with primitive intracytoplasmic vascular formation. Histologically, two types of tumor cells were identified. Either spindle-shaped cells were dispersed in abundant myxomatous or collagenous stroma, or polygonal epithelioid cells were arrnged in nests. Immunohistochemically, both types of tumor cells reacted with anti-Factor VIII-related antigen, CD 34, and Ulex europaeus antibodies. Electron microscopy and immunohistochemical studies proved the endothelial nature of the epithelioidappearing cells of the neoplasm
Conclusion: The cytological feature of an epithelioid appearance with cytoplasmic vacuolation seems to be an important finding to suggest EH in imprint smear.View full abstractDownload PDF (8967K) -
Yuji SHIOZAWA, Yukio ISHII, Kimie YAMAGISHI, Yoshiya THOME, Yoshio UEI1999 Volume 38 Issue 4 Pages 358-362
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Double cancer in female genital organs is very rare, and preoperative diagnosis is very difficult. Coexistence with clear cell adenocarcinoma of the ovary and adenocarcinoma in situ of the cervix is also rare. It is possible to diagnose double cancer by cytological findings of a cervical smear.
Case: The patient was a 37-year-old woman whose abdominal CT scan revealed an irregular shaped solid mass in the cystic right ovary. The characteristic findings of the cervical cytology were as follows: 1. Two types of malignant cells were found. One from clear cell adenocarcinoma, the other from cervical adenocarcinoma in situ. 2. One showed clusters with enlarged nuclei, prominent nucleoli, a distinct cell border, collagenous stroma within the cell ball on a clean background. 3. The other showed aggregated atypical glandular cells, enlarged nuclei with protrusions from the cytoplasm, and fine granular chromatin. The histological postoperative diagnosis was clear cell adenocarcinoma of the ovary and adenocarcinoma in situ of the cervix.
Conclusion: It is possible diagnose coexistent clear cell adenocarcinoma of the ovary and adenocarcinoma in situ of the cervix by cytological findings of a cervical smear.View full abstractDownload PDF (9564K) -
Tsutomu TABATA, Nobuhiro TAKESHIMA, Hidetaka NISHIDA, Yasuo HIRAI, Kat ...1999 Volume 38 Issue 4 Pages 363-366
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackgroundI: Glassy cell carcinoma of the uterine cervix has been classically regarded as a poorly differentiated adenosquamous carcinoma, comprising 1-2% of all cervical cancers. The cytologic diagnosis for this tumor has been considered difficult.
Cases: Two patients with glassy cell carcinoma were presented. Both patients complained of vaginal bleeding. One patient was classified as stage I b, and the other IIb. With respect to cytologic findings, the presence of adenocarcinoma or glassy cell carcinoma was suspected in one patient, whereas the cytologic diagnosis of the other case was glassy cell carcinoma or clear cell carcinoma. Both patients underwent a radical hysterectomy with pelvic lymphadenectomy and currently have no evidence of disease.
Conclusion: The cytologic characterisics of glassy cell carcinoma were as follows. 1. The cytoplasm is stained faintly blue and exhibits so-called ground-glass appearance with distinct cytoplasmic borders. 2. The nuclei are large in size and oval or round in shape, the nuclear membrane is slightly thin, and the chromatin is usually granular. 3. Few large nucleoli are noted.View full abstractDownload PDF (6123K) -
Toshiro KAWAI, Sachiko KUBONO, Akiko ISHIDA, Kouji URASAKI, Ken SAITO1999 Volume 38 Issue 4 Pages 367-368
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of oxyphilic cell adenoma of the thyroid gland in a 79-year-old female. Fine needle aspiration cytology revealed isolated or sheetly-arranged tumor cells which had abundant eosinophilic granular cytoplasm. Eccentric nuclei showed intranuclear cytoplasmic inclusions and grooves. Histologically, a follicular adenoma, oxyphilic cell type was well-encapsulated and did not show vascular invasion or metastasis.View full abstractDownload PDF (4503K) -
Takenobu NAKAGAWA, Naomi SAKASHITA, Makiko TANAKA, Osamu NAKAMURA, Kiy ...1999 Volume 38 Issue 4 Pages 369-370
Published: July 22, 1999
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of angiosarcoma arising from the frontal scalp in an 82-year-old woman. Imprint cytology from a metastatic lung tumor showed that most tumor cells were spindle or polygonal, and were arranged in a trabecular pattern. Some tumor cells contained hemosiderin granules in the cytoplasm, and severe hemorrhage occurred in the background, consistent with the cytological features of angiosarcoma. Furthermore, immunocytochemical examination revealed that the tumor cells were positive for vimentin, Factor VIII-relating antigen, and CD 34. These results sugges that a cytological approach including immunocytochemistry is potentially useful to establish a precise diagnosis of angiosarcoma.View full abstractDownload PDF (3331K)
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