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Kyoko SHIDA, Toyomi SATOH, Isao OGAWA, Miho FUKUSHIMA, Sumio KOUYA, Ry ...
2000 Volume 39 Issue 5 Pages
287-291
Published: September 22, 2000
Released on J-STAGE: December 05, 2011
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Objective: To evaluate the significance of cervical cytology in young women<30 years of age.
Study Design: We analyzed cytology findings and age in 2, 491 patients who underwent cervical cytology at Ibaraki Seinan Medical Center Hospital from 1996 to 1998. The x
2test was used to analyze statistical significance of differences.
Results: The overall incidence of Class III a ≤ in all patients was 5.26%(131/2, 491). The incidence of Class IIIa ≤by age was 6.72%(9/135) at <19 years, 3.70%(17/460) at 20-24 years, 5.05%(29/574) at 25-29 years, and 5.75%(76/1, 322) at >30 years, showing no significant differences.
Conclusion: Young women <30 years old have a similar incidence of abnormal cervical cytology findings compared to women≥30 years old. We consider it inportant to examine such young women for cervical cytology.
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Yuriko GUNJI, Rieko NISHIMURA, Masahiko TSUJIMOTO, Kazuo KUROKAWA, Ayu ...
2000 Volume 39 Issue 5 Pages
292-297
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Objective: To assess the cytologic characteristics of poorly differentiated thyroid papillary carcinoma in aspiration cytology smears.
Study Design: Aspiration cytology smears of 33 cases of thyroid papillary carcinoma, 16 well and 17 poorly differentiated, were assessed using the following criteria: 1) background, 2) total number of tumor cells, 3) appearance of cell clusters, and 4) characteristics of individual tumor cells.
Results: Aspiration cytology findings for poorly differentiated thyroid papillary carcinoma were characterized as follows compared to well differentiated carcinoma: 1) presence of many tumor cells; 2) cell clusters with ill-defined, and irregular borders; 3) presence of many scattered tumor cells; 4) anisocytosis; 5) strong variation in nuclear/cytoplasmic ratio; and 6) variable sized nuclei and presence of oval nuclei.
Conclusion: Aspiration cytology enable us to distinguish poorly differentiated thyroid papillary carcinoma from the well differentiated form based on cell cluster size and border, individual tumor cells size, and the presence of oval nuclei.
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Katsuji TAGUCHI, Minoru IWAHARA, Masashi FUJITA, Yoshie MURAISHI, Tosh ...
2000 Volume 39 Issue 5 Pages
298-303
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Objective: We studied the morphological characteristics of
Trichosporon sp. in urine cytological specimens, focusing on differences from
Candida sp.
Study design: Four specimens of urine cytology showing
Trichosporon sp. confirmed by culture and 2 each of 3 different species of
Candida were studied for morphological characteristics and staining for
Trichosporon sp. under light microscopy.
Results: No difference in staining was seen for Giemsa's or Papanicolaou's stains between
Trichosporon sp. and
Candida sp. However, whereas staining of
Candida sp. for the PAS reaction was strong and uniform, that of
Trichosporon sp. was varied. Three different forms of Trichosporon sp.-yeast, pseudohypha, and hypha-were clearly observed in all specimens examined. Yeast was pleomorphic compared to that of Candida sp., and the major axis measured 6.9 ± 2.4μm and the minor axis 2.9±0.9μm. Hypha was mostly the same thickness as that of the yeast minor axis, showing 2 to 4 points of bifurcation. There were few blastoconidiae, but occasional arthroconidia.
Conclusion: Differences in morphology in urine cytology specimens for
Trichosporon sp. and
Candida sp. should be emphasized with evidence from pseudohypha, hypha, blastoconidia and arthroconidia.
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Second report: On usefulness of membrane filter method in endometrial cytology
Kanae SAKUMA, Yoshio SHIINA, Hiromi INOUE, Yumiko FUKUMOTO, Junko IIJI ...
2000 Volume 39 Issue 5 Pages
304-311
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Objective: We developed an automatic fixation apparatus for making cytologic preparations to standardize procedures in endometrial cytology.
Study Design: We studied 100 scraped endometrial specimens by membrane filter (MF) and by direct smear (DS) and compared resulting cytomorphological features.
Results: MF involved difficulty aspiration in 25% of cases, mainly due to mucus. Endometrial epithelial cells were easier to observe due to decreased cellular blood materials and necrotic debris, and the histological structure of the endometrium was well preserved compared to DS preparation. Small irregularly shaped clusters with nuclear atypia were the most important feature in differentially diagnosing hyperplastic lesions endometrial adenocarcinoma, whereas closed tubular glands, pseudopapillary, and extended glandular clusters were most important in diagnosing hyperplasia.
Conclusion: MF preserved histological characteristics well, suggesting its usefulness in standardizing endometrial cytology.
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Hiroshi FUSHIKI, Hiroyoshi YUKI, Shintarou TERAHATA, Takeshi TASYO, Yu ...
2000 Volume 39 Issue 5 Pages
312-317
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: Primary serous adenocarcinoma of the uterine endometrial cancer is very rare. We report a case of primary coexistent serous and endometrioid adenocarcinoma in endometrial uterine cancer with positive estrogen and progesterone receptors and p53 protein.
Case: A 65-year-old woman was found to have abnormal cells in routine endometrial aspiration cytology. Cytological examination showed a tendency for malignant cells to form stratified clusters. Nuclei showed anisonucleosis with remarkable nucleoli. Microscopic examination showed coexistent serous adenocarcinoma and typical endometrioid adenocarcinoma. She was treated by adjuvant chemotherapy (cisplatin+adriamycin+cyclophosphamide) after modified radical hysterectomy.
Conclusion: Primary coexistent serous and endometrioid adenocarcinoma in endometrial uterine cancer is very rare.
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Yasuharu KAIZAKI, Kazunori HATA, Yukie MIZUNO, Hitomi FUJISAWA, Yoshie ...
2000 Volume 39 Issue 5 Pages
318-322
Published: September 22, 2000
Released on J-STAGE: December 05, 2011
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Background: Carcinosarcoma of the uterus with a clearcell adenocarcinoma component is an uncommon malignancy. We present a case of heterologous carcinosarcoma of the uterus with such a component.
Case: Preoperative cytology in a 77-year-old woman suffering from vaginal bleeding showed small clusters originating from endometrioid adenocarcinoma, and cauliflower-like clusters composed of cells with abundant clear cytoplasm, fine granular chromatin, and prominent nucleoli, derived from clear cell adenocarcinoma. Cervical and cervical canal specimens showed isolated large cells intermingled with naked nuclei originating from a nonepithelial tumor. Biopsy specimens from the endometrium and cervix showed no sarcomatous components. Histological examination of the resected specimen showed endometrioid adenocarcinoma and clear-cell adenocarcinoma as epithelial components and stromal sarcoma and chondrosarcoma as nonepithelial components. The pathologic diagnosis was of heterologous carcinosarcoma with clear-cell adenocarcinoma component.
Conclusion: Prognosis for patients with such tumors is considered worse than that for ordinary endometrioid adenocarcinoma. When an ordinary endometrioid adenocarcinoma component is found in the uterine smear specimen, other atypical epithelial and nonepithelial cells should not be thoroughly checked for.
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Yoshihiro IMAEDA, Yoshimune HORIBE, Kuniaki NIWA, Kazumi NAKAZAWA, Kun ...
2000 Volume 39 Issue 5 Pages
323-326
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: The occurrence of clear-cell adenocarcinoma (CCAC) in the uterine cervix is very rare. We report a case of CCAC diagnosed by preoperatively cervical smears.
Case: The patient was a 74-year-old woman whose endometrial smears were diagnosed as positive at another hospital. When she was referred to our hospital, she had some atypical genital bleeding. Her cervical smears showed CCAC. Simple total hysterectomy and adnexectomy were conducted based on her general condition. Cervical smears demonstrated varied tumor cells with remarkable cytoplasm, large nuclei, and bare nuclei-often large bare nuclei having lost cytoplasm and hobnail cells. Histologically, tumor cells showed a papillary structure with hobnail cells, solid nests, and composite areas.
Conclusion: CCAC of the uterine cervix difficult to diagnose in the absence of hobnail cells in smears. It becomes ever more difficult when other tumor cells appear independently in smears. Since CCAC prognosis is generally dismal, it is important that preoperative differential diagnosis be done carefully to derermine the most appropriate surgical procedure.
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Cytological findings in ascites
Hideaki NISHIDA, Tetsuo HASHIMOTO, Shuichi KITAMURA, Masahiko TSUKA, T ...
2000 Volume 39 Issue 5 Pages
327-331
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: Squamous cell carcinoma occasionally develops in ovarian mature cystic teratoma due to malignant transformation. Few reports cover cytological findings of ascites in such cases. We have encountered interesting findings in preoperative cytology specimens from such a case.
Case: A 48-year-old woman suffered from vaginal flour for about 5 months. CT examination revealed ascites and a left ovarian tumor. She underwent surgical exploration for the tumor and uterus. Preoperative cytology showed clusters of spindle cells and numerous inflammatory cells, including neutrophils, lymphocytes, and histiocytes. Large atypical cells with giant or multiple nuclei and abundant cytoplasm were also found. Nuclei were located in cytoplasm periphery and the nuclear membrane was thin. Prominent nucleoli were usually present. Histopathologihcally, well differentiated squamous cell carcinoma developed in a left ovarian cystic tumor containing hair and teeth. In the deep portion of the wall of the cystic tumor, poorly differentiated parts were also found. These cancer cells invaded the uterus, right fallopian tube, and right ovary with a small mature cystic teratoma.
Conclusion: Poorly differentiated squamous cell carcinoma cells in the deep portion of the wall of cystic tumor may be present in ascites.
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Shunichiro OTA, Takanobu KAWATA, Masae KITADA, Keizo FUJIYOSHI, Kimio ...
2000 Volume 39 Issue 5 Pages
332-334
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: It is difficult to diagnose efrly adenocarcinoma of the utrine cervix, including in situ adenocarcinoma. We report a case of adenocarcinoma
in situ suggested by cervicovagisnal cytology.
Case: Cervicovaginal cytology in a 41-years-old woman Showed atypical glanduler cells showing Rosset-shaped clusters. Tumor cells had round or oval nuclei with fine chromatin. These findings indicated early adenocarinoma of the uterine cervix. Histological examination confirmed the diagnosis, emphasizing the usefulness of cytology. We conducted a hysterectomy after conization.
Conclusion: This case indicates the importance of histological examination, such as cervical conization, when we encounter a case of positive cytology with glanduler atypia of the uterine cervix.
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Cytology and immunohistochemical features
Kohji TSUTA, Takako AKAMATSU, Kimiaki OKANO, Tokurou NAKAJIMA, Masako ...
2000 Volume 39 Issue 5 Pages
335-339
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: Apocrine adenocarcinoma is a rare condition only sporadically reports in short series in the literature. We report the cytological features of apocrine adenocarcinoma originating in the right axial.
Case: A 68-year-old man had a left axial apocrine adenocarcinoma resected 3 years before. Due to skin and lung metastasis, he was treated with chemotherapy and radiaton therapy. However, pleural effusion progressively increased and he died of respiratory failure. An autopsy examination disclosed lung, adrenal, and retroperitoneum metastasis. Histological examination showed that tumor cells with eosinophilic cytoplasm and prominent nucleoli were positive for EMA, GCDFP-15, and B 72.3 but negative for CEA, α-SMA, PgR, and ER. Cytological examination of sputum, pleural effusion, and urine
in vivo showed tumor clusters arranged in sheets. Tumor cells consisted of oval nuclei with prominent nucleoli and nuclear groove and having abundant cytoplasm. Tumor cells were positive for GCDFP-15 and B 72.3.
Conclusion: Cytological features retained the characteristic cytological appearance of apocrine sweat glands and positive for GCDFP-15 and B 72.3, which enable a diagnosis of carcinoma of apocrine sweat gland origin.
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Hiroshi UOZAKI, Takeshi KASHIMA, Kengo TAKEUCHI, Akira SETA, Tsuyoshi ...
2000 Volume 39 Issue 5 Pages
340-342
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: Rosai-Dorfman disease (RDD ; sinus histiocytosis histiocytosis with massive lymphadenopathy) is a rare histiocytic disorder of unknown etiology characterized by enlarged cervical lymph nodes, fever, leukocytosis, and hypergammaglobulinemia. We describe a case of RDD presenting as a nasal polyp.
Case: A 50-year-old woman presented with a nasal obstruction for a year. Biopsy of the nasal polyp revealed massive histiocytic infiltration suggesting RDD, as confirmed by subsequent biopsies of the laryngeal polyp and swollen lymph nodes of the neck. Touch smear cytology of the cervical node distinctly showed emperipolesis of lymphocytes by histiocytes surrounded by small lymphocytes and plasma cells. They showed no cytologic atypia. Immunohistochemically, cells engulfing lymphocytes were positive for S 100 protein and CD 68. Engulfed lymphocytes include T and B cells.
Conclusion: RDD is indicated by cytology showing emperipolesissurrounded by lymphocytes and plasma cells.
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Tetsuo NEMOTO, Miki MORIYAMA, Yasuko SAKATA, Yoshiko YAMAMOTO, Yoshino ...
2000 Volume 39 Issue 5 Pages
343-346
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: Familial adenomatous polyposis (FAP) is caused by APC gene germline mutation. FAP is often associated with thyroid papillary carcinoma in young women. A new variant of thyroid papillary carcinoma called cribirform-morular variant (CMV) has been proposed, because almost all reported cases of thyroid carcinoma associated with FAP show histological features of CMV not common in sporadic thyroid carcinoma.
Cases: Thyroid tumors were diagnosed in 2 woman, both 20, who suffered from FAP. Cytological characterization of aspiration materials is as follows: 1) tubular structure with tall columnar cells, 2) solid cell clusters with polygonal or spindle cells, and 3) cribriform pattern with cuboidal cells.
Conclusion: The coexistence of the above findings indicate the CMV of thyroid carcinoma and suggest FAP even if the first manifestation is a thyroid tumor.
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Akira SATO, Sono TANIOKA
2000 Volume 39 Issue 5 Pages
347-353
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: Biliary tract candidiasis is rare and initially diagnosed by culturing bile obtained at operation and/or histological study of the gallbladder at autopsy. We know of no case reports of biliary candidiasis diagnosed by aspiration cytology of gallbladder bile.
Case: A 81-year-old man suffering from fever and anorexia was admitted to our hospital on suspicion of pneumonia. Effective therapy with wide-spectrum antibiotics was started and continued due to remaining slight fever. Due to development of a biliary tract infection with cholelithiasis and endotoxemia, we conducted percutaneous transhepatic puncture of the gallbladder. Cytologically, the gallbadder bile contained numerous fungi with cyanophilic birefringent nonbranching pseudohyphae with budding blastospores. Two thirds of fungi were molded in bile. Fungi were diagnosed as Candida albicans and were the only organisms cultured from the bile. The patient died of biliary tract candidiasis with pneumonia and a hemorrhagic gastric ulcer. Autopsy revealed that cholecystitis with cholelithiasis and fungal balls had developed into systemic candidiasis.
Conclusion: This report describes a case of biliary tract candidiasis probably following gram-negative bacterial infection, which developed into systemic candidiasis. Longstanding administration of wide-spectrum antibiotics and cholestasis with cholelithiasis predisposed the patient to biliary tract candidiasis, which invaded through the alimentary tract. Aspiration cytology of the bile was thus found to be useful in rapidly diagnosing biliary tract candidiasis.
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Masaru YAMAZAKI, Hideo YOSHIMURA, Harumi NAKAMURA, Yasuyuki YOSHIDA, M ...
2000 Volume 39 Issue 5 Pages
354-358
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: We report here a case of mammary myofibroblastoma, a rare benign mesenchymal tumor.
Case: A 75-year-old woman reported a gradually growing mass in the right breast, and visited Osaka University Medical Hospital. It was clinically diagnosed as a borderline phyllodes tumor. Aspiration biopsy cytology showed spindle or ovoid tumor cells were present solitarily or fascicularly. Different-sized vacuoles suggestive of adipose tissue and light-green-stained band-like material suggestive of collagen fiber were admixed. No epithelial component was observed. The cytologic diagnosis at the time was a borderline phyllodes tumor. Histological examination of mastectomy specimens showed the tumor to be composed of spindleshaped cells with eosinophilic cytoplasm with scattered fat globules, hyalinized collagenous bands, and myxoid material present. Although relatively high mitotic activity was observed in some areas, nuclear atypia was mild. Immunohistochemistry showed that tumor cells were strongly positive for vimentin and a-smooth muscle actin. MIB-1 staining showed approximately 20 positive cells per 100 tumor cells in some areas. The histologic diagnosis of the tumor was myofibroblastoma of the mammary gland.
Conclusion: Myofibroblastoma is a tumor difficult to diagnose with certainty by cytology, but it is important to consider the possibility when fat cells are admixed with spindle-shaped tumor cells.
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Mieko HORIKOSHI, Tutomu ISHIHARA, Satoshi BAN, Masaru TAMURA, Takatomo ...
2000 Volume 39 Issue 5 Pages
359-363
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: We report a case of primary leptomeningeal malignant melanoma whose diagnosis is verified by cytological examination of the cerebrospinal fluid (CSF).
Case: A 20-year-old man reported shoulder discomfort, headache, nausea, and vomiting lasting about 1 year. Cytological study of the CSF disclosed scattered atypical cells with a high nuclear-cytoplasmic ratio and prominent nucleoli. Although a provisional diagnosis of malignant lymphoma was made based on cytological features, the immunocytochemical study did not support this. Second cytological examination of the CSF showed scattered, loosely clustered atypical cells in which cytoplasmic brown pigments were found after extensive observation. These pigments were positively stained with DOPA reaction and Fontana Masson stain. An immunohistochemical study showed positive reactivity of atypical cells with S-100 protein and HMB 45 antibodies.
Conclusion: A careful search of abnormal cytoplasmic pigments in atypical cells is therefore essential in diagnosing malignant melanoma in CSF cytology.
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A case report
Jun KANEMOTO, Emiko NAKAMURA, Kyoichi MIYAGAWA, Toshio SHIMIZU, Akemi ...
2000 Volume 39 Issue 5 Pages
364-367
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: We report a case of cutaneous nocardiosis effectively diagnosed by aspiration cytology.
Case: A 79-year-old man with nephrotic syndrome was undergoing steroid therapy. Seven months after steroid administration, a subcutaneous mass was found in the chest. Aspiration biopsy cytology showed scattered collections of branching fine filamentous organisms with a background of numerous neutrophils and lymphocytes, macrophages, and necrosis in Papanicolaou-stained samples. Organisms were positive for periodic acid Schiff, Grocott, Gram stain, and Ziehl-Neelsen (Fite's method) staining. These findings strongly suggested the presence of Nocardia. Subsequent biochemical studies revealed a bacterium identical to
Nocardia farcinica.
Conclusion: Based on special stains including PAS, Grocott, and Ziehl-Neelsen (Fite's method), we found it of practical importance for cytology laboratories to recognize this filamentous organism.
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Kiyora MARUYAMA, Kaori KAMEYAMA, Emi MATSUI, Hitoshi ABE, Satoshi KUSA ...
2000 Volume 39 Issue 5 Pages
368-372
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Background: Acinic cell carcinoma of the parotid gland isrelatively rare, and usually difficult to diagnose using fineneedleaspiration because tumor cells have low-grade atypia.
Case: A 28-year-old woman reported that her left parotid gland had become swollen. The mass was suspected to be a neoplastic lesion based on ultrasound sonography and CT scan. Fine-needle aspiration revealed numerous tumor cell clusters with round nuclei, basophilic granules, and vacuolated cytoplasm. Granules were PAS-positive and shown to be basophilic by Gimesa staining, strongly suggesting acinic cell carcinoma. We conducted a glandectomy a few days later, and histologically diagnosed acinic cell carcinoma with papillary-cystic and colloid-like structures.
Conclusion: Cytopathological features of acinic cell carcinoma determined by fine-needle aspiration were consistent with the tumor's unique histological findings, which are important in the diagnosis of acinic cell carcinoma.
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[in Japanese], [in Japanese]
2000 Volume 39 Issue 5 Pages
373
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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With emphasis on structural abnormalities
Mizue ODA, Yasuyoshi ISHII, Mineo OHMURA, Norikoto ISHIDA, Tomoko TAKE ...
2000 Volume 39 Issue 5 Pages
374-380
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Objective: We believe that the presence of arborescent clusters is indicative of endometrial cancer in endometrial cytology.
Study Design: We compared the accuracy of endometrialcytological diagnosis in 183 patients examined from 1979 to 1988 based mainly on cellular atypia and 294 patients examined from 1989 to 1997 based on structural abnormalities, and clinical staging of endometrial cancer. Using specimens from other institutions, we also assessed the diagnostic accuracy of direct (44 patients) and washout / crushed (44 patients) smear in endometrial cancer.
Results: 1) Of 183 patients whose diagnosis was interpreted based mainly on cellular atypia, 51 were diagnosed as class V. Of these, 29 (56.9%) were diagnosed with endometrial cancer and 13 (25.5%) showed no marked histological change. 29 of 33 diagnosed with endometrial cancer were diagnosed as class V. Of 294 patients whose diagnosis was based mainly on structural abnormalities, 110 were diagnosed as class V. Of these, 91 (82.7%) were diagnosed with endometrial cancer and 5 (4.5%) showed no marked histological change. All 95 of those with endometrial cancer were diagnosed as class IV or V.
2) Of 33 patients diagnosed with endometrial cancer detected when interpretation was based mainly on cellular atypia, clinical staging was stage 0 or I A in 4 (12.2%). Of 95 detected after the focus was changed to structural abnormalities, clinical staging was stage 0 or I A in 24 (25.3%).
3) Diagnostic accuracy of direct smear in endometrial cancer was 54.6% (24 of 44 patients) and that of washout was 79.6% (35 of 44 patients).
Conclusion: Based on these results, we believe that focusing on structural abnormalities effectively raises the accuracy of endometrial cytological diagnosis.
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Toshiko JOBO, Rinya SATO, Tadayuki KANAI, Manami IMAI, Hiroyuki KURAMO ...
2000 Volume 39 Issue 5 Pages
381-388
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Objective: To assess the accuracy of endometrial cytology criteria, we focused on architectural atypism.
Study Design: Between January 1988 and December 1997, we samplied cell endocytes from the endometrial cavity directly smeared on glass slides, then fixed and stained with routine Papnicolaou staind. We analyzed the results of endometrial cytology in patients with endometrial carcinoma and atypical complex hyperplasia and the histological findings of patients with suspicious or positive cytology.
Results: Detection of endometrial carcinoma was 96.6% of 297 patients and of complex atypical hyperplasia, 81.8% of 22. False negative results numbered 4.7% of 129 with G 1 adenocarcinoma, 3.7% of 81 with G 2 adenocarcinoma, and 8.3% of 13 with carcinosarcoma. Endometrial cytology was diagnosed as suspicious or positive in 1, 955 and in 1, 324 of those cases endometrial biopsy was undertaken. We diagnosed 41 with endometrial carcinoma and 241 with endometrial hyperplasia in 1, 003 suspected cancer patients. Among 321 positive patients, 266 were diagnosed with endometrial carcinoma and 6 with endometrial hyperplasia.
Conclusion: Endometrial cytology is accurate and useful in screening for endometrial carcinoma and hyperplasia. Paying attention to architectural atypism is especially important when diagnosing endometrial cytology in such screening
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Highly dense glandular clumps
Yoshiaki NORIMATSU, Takuya MORIYA, Hiromi KOUDA, Yuri TAMADA, Chotatsu ...
2000 Volume 39 Issue 5 Pages
389-395
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Objective: When endometrial cytology suggests endometrioid adenocarcinoma, glandular cell clumps are analyzed.
Study Design: In 40 patients with endometrioid adenocarcinoma G 1, we studied the incidence of highly dense glandular and dendritic clumps and the number of glandular lumens in highly dense glandular clumps, and compared them with atypical endometrial and complex endometrial hyperplasia.
Results: 1) The incidence of highly dense glandular clumps was high compared to that of dendritic clumps.
2) The mean number of glandular lumens in highly dense glandular clumps was 16.9 in endometrioid adenocarcinoma, 11.7 in atypical endometrial hyperplasia, and 6.5 in complex endometrial hyperplasia, all statistically significant (p<0.01)
15glandular lumens may be associated with lesions other than atypical endometrial hyperplasia and more than 21 with endometrioid adenocarcinoma.
Conclusion: Observation of the glandular lumen number in highly dense glandular clumps is important in cytodiagnosis and is useful in general judgment taken together with other items of diagnostic factors.
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Nobuyoshi OZAWA, Keiko OTOMO, Setsuko KAME, Mieko SATO, Tsutomu SUZUKA ...
2000 Volume 39 Issue 5 Pages
396-401
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Objective: Endometrial suction biopsy is recommended to detect endometrial hyperplasia and carcinoma in the US. We evaluated the efficacy of endometrial suction biopsy.
Study design: We conducted simultaneous suction biopsy with a pipet curet (Milex) and endometrial cytology and histology in cell block specimens with Endosearch and Endocyte for 84 patients.
Results: 1) The difficulty and pain of insertion into the uterine cavity were almost same with both the pipet curet and Endosearch.
2) In 4 patients, specimens from the pipet curet were too scanty for histological diagnosis. These patients averaged 56 years of age, were all menopausal, and showed endometrial thinning in transvaginal ultrasonography.
3) In 60 patients with negative cytology, suction biopsy revealed 3 with simple hyperplasia and 3 with complex hyperplasia. In 12 patients with suspicious sytology, 8 were normal and 1 each diagnosed with simple hyperplasia, complex hyperplasia, atypical complex hyperplasia, and adenocarcinoma.
4) Endometrial glands in a specimen from the pipet curet numbered about 2 to 127 times that in a cell block specimen with Endosearch.
Conclusion: We found suction biopsy with the pipet curet to be useful. with Endosearch.
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Kunio AKADA, Futoshi NAKANISHI, Sakae MURAKAMI, Kazuo KATO, Nobuo NAKA ...
2000 Volume 39 Issue 5 Pages
402-403
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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Malignant tumors of the female urethra are reportedly uite rare. We report a case of clear-cell carcinoma in a 42-year-old woman treated by urethrectomy. The tumor was located mainly in the muscular layer and tubulopapillary proliferation was microscopically evident. Hobnail and clear cells were observed histologically in some areas, with similar findings seen in voided urine. Immunohistochemical stains for prostate-specific acid phosphatase and prostatespecific antigen were negative. Tumor cells in this case were similar to those of ovarial clear-cell caricnoma. Further studies are needed, however, to establish the origin ofurethral clear-cell carcinoma.
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Yuji TOKUDA, Katsuo MORIYA, Tadashi KUMON, Keiko WATANABE, Nobuhisa YO ...
2000 Volume 39 Issue 5 Pages
404-405
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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We report a case of peritoneal malignant mesothelioma in a 66-year-old man, comparing ascites aspiration cytology and the tumor imprint at autopsy. Cytology showed papillary clusters of epithelioid cells with hyperchromatic nuclei and prominent nucleoli. Autopsy showed mainly atypical spindle cells intermingled with epithelioid cell islands. Findings of imprint cytology reflect the histological structure making it useful in differentiating mesothelioma from adenocarcinoma.
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Tohru TSUJIMURA, Ayako SUGIHARA, Nobuyuki TERADA, Ryouji HARIYAMA, Tad ...
2000 Volume 39 Issue 5 Pages
406-407
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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A 57-year-old woman with an adenomatous goiter of the thyroid gland for 3.5 years, suffered rapid enlargement of the thyroid gland. Aspiration cytology showed only a few tumor cells having bizarre nuclei and abundant cytoplasm. Thyroidectomy and subsequent chemotherapy were ineffective, and the patient died within 4 months after the thyroidectomy. Thyroid gland histology showed an undifferentiated carcinoma composed of pleomorphic tumor cells with a few osteoclast-like giant cells. The present case shows that a few tumor cells with bizarre nuclei in cytology during the course of an adenomatous goiter of the thyroid gland indicates development of an undifferentiated carcinoma.
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Miyuki MATSUBARA, Masashi KAWAMOTO, Yasuhiko WATARAI, Yuichi SUGISAKI
2000 Volume 39 Issue 5 Pages
408-409
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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In hypersensitivity pneumonitis (HP), bronchoalveolar lavage (BAL) sometime show atypical lymphocytes (AT). We compared lymphocytes from (5 patients) with BAL flui from small lymphocytic lymphoma and leukemia (LL from 6 patients). In a Giemsa-stained specimen, 500 lymphocytes per case were categorized as N (normal), A (smaller than a neutrophil, atypical nuclear shape), AS (A with abnormal chromatin), and AL (larger than a neutrophil, with atypia), then calculated the ratio of each category. AT accounted for 14 to 22%(A + AS, AL= 0%) in HP, but LL showed a high A+AS ratio (>51.7%) with AL (>0.2%). Thus, calculating the ratio of small AT is important to avoid misinterpretation of BAL samples when AT is observed.
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Satoshi YODONAWA, Minoru HIRANO, Isao OGAWA, Sumio KOYA, Hiroaki SHIMO ...
2000 Volume 39 Issue 5 Pages
410-411
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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A 31-year-old woman presented with a solid 4×4 cm right breast tumor on echography, which further showed an irregular border and a heterogenous internal echo. Aspiration cytology showed clusters of atypical small cells indicating invasive ductal cancer, so modified radical mastectomy was done. Stamp cytology showed atypical lymphoid cells without clusters, indicating malignant lymphoma. The histological diagnosis was diffuse mixed B-cell malignant lymphoma.
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Yasushi HORIE, Masako KATO, Mitsuko NAGAMI, Chieko SUGIHARA, Shoji YAS ...
2000 Volume 39 Issue 5 Pages
412-413
Published: September 22, 2000
Released on J-STAGE: November 08, 2011
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A rare case of subependymal giant cell astrocytoma without tuberous sclerosis is documented. A tumor was detected in the anterior horn of the left lateral ventricle of a 12-year-old boy. Both imprint smear cytology and histology revealed the presence of large epithelioid cells with eccentric nuclei and thick eosinophilic cytoplasm. Most epithelioid cells were strongly positive for S-100, vimentin, and neuron specific enolase on immunohistochemistry, and a few cells showed weak a positivity for glial fibrillary acidic protein and neurofilament. These large epithelioid cells were considered to represent an intermediate lineage between astrocytes and neurons.
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