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Volume 39, Issue 4
Displaying 1-12 of 12 articles from this issue
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Mitsuyuki KINJO, Cyorei YOHENA, Rieko NAGAMINE, Naomi SHIMOJI, Haruo K ...2000 Volume 39 Issue 4 Pages 233-238
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground:Pulmonary alveolar proteinosis (PAP) is a rare disease in which the alveolar spaces become progressively filled with a phospholipoproteinaceous material. We described the cytological characteristics, ultrastructural findings and carcinoembryonic antigen (CEA) levels in the bronchoalveolar lavage (BAL) specimens of a patient with PAP.
Case:A 45-year female with dyspnea and bilateral groundglass-like opacity on the chest roentgenogram was examined. BAL was performed and grossly, a milky white fluid was obtained for cytological diagnosis. The BAL sediment contained extracellular eosinophilic amorphous globules and macrophages dispersed within a background of finely granular material. No inflammatory cells were noted. The amorphous globules were 20-100 μ in diameter, positive for PAS, but negative for Alcian blue stain. Ultrastructurally, the BAL sediment contained numerous lamellar bodies characteristic of PAP. These bodies were also seen in a post -papanicolou-stained specimen.
High levels of CEA in patients with PAP have been reported in the literature. In our case also, elevated levels of CEA were found in both BAL and serum samples. The CEA levels in the BAL samples were higher than those in the serum. The serum CEA levels decreased after BAL. Subsequently, immunocytochemical examination of the BAL sediment revealed. Macrophages and finely granular materials positive for CEA, but the larger globules were negative.
Conclusion: PAP can be accurately diagnosed by cytologic and ultrastructural examination of BAL fluid specimens. Recognition of the BAL sediment characteristics is important for early treatment. Relapse of PAP could be predicted by monitoring the serum CEA values.View full abstractDownload PDF (6646K) -
Hirofumi SAKAMOTO, Yoshio MORI, Naoki YOSHIMI, Takuji TANAKA2000 Volume 39 Issue 4 Pages 239-241
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground:We present a case with a history of gastric carcinoid in whom metastatic carcinoid cells were found in the cerebrospinal fluid 4 years after the resection of the stomach tumor. There are few reports describing the cytological features of carcinoid cells in the cerebrospinal fluid.
Case:The patient was a 76-year-old Japanese male. In September 1993, a primary gastric tumor, 2 cm in diameter, was resected and was diagnosed histologically as a carcinoid tumor without associated metastases. In April 1997, cerebrospinal fluid cytology revealed the tumor cells with scanty cytoplasm, clustered in a trabecular pattern. The nuclei were uniformly small, round or oval and smoothly outlined with fine, granular chromatin. At autopsy, there were no other metastatic tumors except in the brainstem, diencephalon and meninges. The histological and cytological findings of there tumors were similar to those of the resected primary tumor. Immunohistochemically, the tumor cells were positive for NSE and chromogranin A, and electron microscopy revealed that most cells contained the typical dense-core neurosecretory granules.
Conclusion: We report the finding of metastatic carcinoid cells in the cerebrospinal fluid of a case treated for gastric carcinoid. Immunohistochemistry and electron microscopy, as well as routine histopathology, are useful for the diagnosis of metastatic carcinoid in the brain.View full abstractDownload PDF (3120K) -
Reiji HABA, Shoji KOBAYASHI, Hiroshi MIKI, Katuyuki NOMA, Keiko YAMAKA ...2000 Volume 39 Issue 4 Pages 242-246
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground:Giant hamartomatous polyps in Peutz-Jegher's syndrome are very rare, and preoperative diagnosis is difficult, especially when they originate in the small intestine. A cytological description of hamartomatous polyps in Peutz -Jegher's syndrome has not been reported until now.
Case:A 38-year-old man was admitted with the complaint of abdominal pain. His family history was negative for familial polyposis. Multiple large masses were found in the small intestine by ultrasonography, CT, and barium-X ray of the small intestine. Partial ileal resection and colonic polypectomy were emergently performed for ileus and intussusception. The largest solid tumor was about 8.7×7.1×4.8 cm in size. Carcinomatous transformation was suspected because of the mucinous appearance of the cut surface of the intramural lesion, but intraoperative cytological examination of many areas of the lesion excluded carcinomatous transformation.
Conclusion: We diagnosed a hamartomatous polyp in Peutz-Jegher's syndrome by intraoperative cytology and based on pigmentation of the oral cavity, lips, fingers and sole. Intraoperative cytological examination was useful as it allowed us to examine a wide area of the very large tumor in the present case.View full abstractDownload PDF (9674K) -
Keiko OHTA, Sonoe ITOH, Yuko NAKANO, Akemi UMEDA, Takahisa TSUKAMOTO, ...2000 Volume 39 Issue 4 Pages 247-253
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground:Primary leiomyosarcoma of the liver is a rare tumor, We report a case in a 15-year-old man with a solid mass in the left lobe of the liver.
Case:The tumor was detected as a nodular mass in the left lobe of the liver on a CT scan and measured 11×12 cm. The imprint smear showed clusters of spindle-shaped cells with fibrillar cytoplasm and atypical nuclei, mixed with giant cells and nuclear inclusion bodies. No mitoses or necrosis was found. Histologically, the tumor appeared to be fasciculated and highly cellular, with a herring-bone appearance in parts. The tumor cells were elongated and had eosinophilic cytoplasm. The cytoplasm contained a great deal of glycogen, which was positive by PAS staining. Silver staining revealed the tumor cells to be characterized by the presence of delicate reticulin fibers.
Immunohistochemical studies for vimentin, desmia, and α-SMA showed positive reactivity. Electron-microscopic examination of the tumor cells showed that they contained myofilaments and cytoplasmic dense bodies and were surrounded by basement-membrane-like material. Conclusion: Leiomyosarcoma was confirmed by pathologic diagnosis using immunohistochemistry and electronmicroscopy. Cytologically, the tumor cells appeared to be highly cellular and to be mixed with scattered giant cells with atypical nuclei. The tumor had metastasized to regional lymph nodes.View full abstractDownload PDF (12422K) -
Hiroyuki YANAI, Manabu MATSUMOTO, Masumi FURUTANI2000 Volume 39 Issue 4 Pages 254-257
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground:Desmoplastic small round cell tumor (DSRCT) is a recently recognized tumor that mainly affects the serosal surfaces of young males. It consists of nests of small round tumor cells and fibrous connective tissue surrounding the tumor cell nests. Since the tumor cells of DSRCT express various differentiation markers, the histogenesis of DSRCT is a matter of controversy.
Case:A 31-year-old man was admitted for abdominal discomfort and a tumor of the ileocecal region. Computer tomography depicted the ileocecal tumor and revealed metastatic foci in the liver. The ileocecal tumor was resected after chemotherapy, and an imprint cytology specimen showed a number of tumor cell nests. The tumor cells were small rounded cells with scant cytoplasm and granular nuclear chromatin. These histological findings were compatible with typical DSRCT. Immunohistochemically, the tumor cells were positive for cytokeratin, epithelial membrane antigen, vimentin, desmin, S-100, and neuron-specific enolase. Electron-microscopic examination revealed paranuclear aggregation of intemerdiate filaments, and a few desmosomes.
Conclusion: DSRCT tumor cells are difficult to differentiate from the cells of other small round cell tumors in cytological specimens, but the clinical findings and nested pattern seen on low-power examinations of imprint specimens are suggestive of DSRCT. An awareness of DSRCT during cytological examinations is also important in making the diagnosis.View full abstractDownload PDF (5950K) -
Hiroko OTAKE, Tomoe WATANABE, Hiroko YAMAZAKI, Junko HIRATO2000 Volume 39 Issue 4 Pages 258-262
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground:Primary leiomyosarcomas of the thyroid are very rare and the characteristie cytological features have not yet been clearly elucidated. We report a case of primary leiomyosarcoma of the thyroid in which fine needle cytology was performed.
Case:The patient was an 86-year-old woman with an enlarging tumor in the left lobe of the thyroid. The smears aspirated from the tumor suggested undifferentiated carcinoma or sarcoma. Immunohistochemical staining revealed that the tumor cells were positive for a-smooth muscle actin and desmin, and negative for cytokeratin and EMA. Electron microscopy revealed spindle-shaped tumor cells containing bundles of filaments with focal densities. The final diagnosis was primary leiomyosarcoma of the thyroid.
Conclusion: Primary leiomyosarcoma of the thyroid is difficult to differentiate from undifferentiated carcinoma and other histological types of sarcoma. We consider that the differentiation requires immunohistochemical staining and electron microscopy.View full abstractDownload PDF (8496K) -
Yoshinori KOYAMA, Akira ASOU, Toshitaka NAGAO, Yasuo ISHIDA, Isamu SUG ...2000 Volume 39 Issue 4 Pages 263-269
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Basal cell adenocarcinoma (BCAC) of the salivary glands is a rare tumor and a recently described entity. A case of BCAC of the parotid gland is reported with the cytological, immunohistochemical, and ultrastructural findings.
Case: A 68-year-old woman presented with a right parotid gland tumor. Computer tomography revealed a tumor measuring 24 mm in diameter, parts of whose boundary were ill-defined. Fine-needle aspiration cytology showed basaloid-cell clumps accompanied by characteristic peripheral features, including palisading, poor cohesiveness, and/or intermingling with fat cells. The basaloid cells had hyperchromatic nuclei and scant cytoplasm. Histologically, the basaloid cells had invaded in a trabecular and/or solid-nest pattern. Immunohistochemistry disclosed dual epithelial and myoepithelial differentiation of the tumor cells. Ki-67 was frequently positive, together with p 53 and EGFR.
Conclusion: Although cytological differential diagnosis between benign and malignant basaloid cell tumors might be very difficult, the poor cell cohesiveness and intermingling with fat cells at the periphery of tumor cell clumps seemed to be characteristic of BCAC.View full abstractDownload PDF (11994K) -
Tomoko YAMAMOTO, Miho KANAZAWA, Toshiko KANAMURO, Yuji NONAMI, Makio K ...2000 Volume 39 Issue 4 Pages 270-271
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA 61-year-old man who died of adrenocortical carcinoma is reported. Stump specimens were prepared from the cut surface of a metastatic tumor in the liver obtained by autopsy. The specimens showed a necrotic background with numerous apoptotic bodies. The tumor cells formed loosely cohesive clusters. The nuclei showed atypia and anisonucleosis and the cytoplasm was granular or vacuolated. Mitotic figures were occasionally observed. These findings were compatible with a diagnosis of adrenocortical carcinoma, but the tumor cells resembled those of a renal cell carcinoma or hepatocellular carcinoma both cytologically and histologically.View full abstractDownload PDF (4383K) -
Junichi FUKUSHIMA, Mika YAMADA, Hiroshi TANAKA2000 Volume 39 Issue 4 Pages 272-273
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of adenoid cystic carcinoma of the breast. A 48-year-old female presented with a solid mass with a cystic region measuring 1.7×1.5 cm in the left breast. The radiological differential diagnosis included phylloides tumor, fibroadenoma, and carcinoma. Intraoperative histological frozen section examination did not reveal any typical features of adenoid cystic carcinoma. Imprint smears from the breast tumor showed many spherical clusters predominantly composed of small round cells with finely granular chromatin, suggestive of myoepithelial cells, and also cells with relatively large nuclei, suggestive of epithelial cells.View full abstractDownload PDF (3248K) -
Yasushi HORIE, Masako KATO, Mitsuko NAGAMI, Chieko SUGIHARA, Shoji YAS ...2000 Volume 39 Issue 4 Pages 274-275
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA case of BCG-related lymphadenitis is presented. After BCG vaccination, an enlarging mass was noted in the left axillary region of a 1-year-old boy. Imprint smear cytology of the extirpated lesion revealed aggregates of epithelioid and tingible-type histiocytic cells without a necrotic background. Histologically, the lesion showed granulomatous nodules composed of epithelioid histiocytic cells and Langhans' giant cells without associated caseous necrosis. Immunohistochemically, the epithelioid histiocytic cells were positive for and-BCG antibody, lysozyme and CD 68. It is necessary to distinguish this BCG-related lymphadenitis from tuberculous lymphadenitis.View full abstractDownload PDF (2480K) -
Toshihiko TOKI, Kiyoshi KATO, Ikuo KONISHI, Mieko HORIKAWA, Masahiro A ...2000 Volume 39 Issue 4 Pages 276-277
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe describe a case of uterine leiomyosarcoma associated with acute infection. A 56-year-old woman presented with atypical genital bleeding. Endometrial cytology revealed isolated bizarre spindle-shaped or fibrous cells. The cytological diagnosis was malignant mesenchymal tumor (probably uterine leiomyosarcoma). She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Macroscopically, the intramural tumor showed massive hemorrhagic areas and necrosis. Histologically, the tumor showed smooth muscle differentiation with marked cytologic atypia and increase in mitotic figures, and the diagnosis was leiomyosarcoma.View full abstractDownload PDF (2831K) -
[in Japanese], [in Japanese]2000 Volume 39 Issue 4 Pages iv
Published: July 22, 2000
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (74K)
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