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Volume 40, Issue 3
Displaying 1-17 of 17 articles from this issue
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Chikako MINEGISHI, Yasuyoshi ISHII, Keiko ICHINOSE, Toshiro OKA, Kouic ...2001 Volume 40 Issue 3 Pages 237-243
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: In criteria for classifying endometrial cytology, Class IV refers to suspected complex atypical endometrial hyperplasia or beyond, and Class V to suspected endometrioid adenocarcinoma. A cytological finding common to both is the presence of arborescent clusters, albeit in differing numbers. We added several cases to our previous study and reinvestigated endometrial cytology classification, focusing on Classes IV and V.Methods: We investigated 8 cases of complex atypical endometrial hyperplasia and 10 of well-differentiated endometrioid adenocarcinoma with regard to type A stromata of less than 6 layers in arborescent clusters.Results: 1) The mean nuclear diameter of cells constituting a type A stroma of less than 6 layers was 9.8μm in the major axis and 2.6μm in the minor axis for complex atypical endometrial hyperplasia and 12.0μm in the major axis and 3.6μm in the minor axis for well-differentiated endometrioid adenocarcinoma.
2) Histograms, showed nuclei 8-11μm in the major axis and 2-3μm in the minor axis for complex atypical endometrial hyperplasia and 10-14μm in the major axis and 3-4μm in the minor axis for well-differentiated endometrioid adenocarcinoma, comprised 50%.
Conclusion: Cases with 1 to several arborescent clusters with mainly type A stromata of less than 6 layers are reported as Class IV. When nuclear diameters of cells constituting type A stromata of less than 6 layers are large, however, the possibility of well-differentiated endometrioid adenocarcinoma cannot be denied and must be investigated.View full abstractDownload PDF (11015K) -
The significance of androgen receptor immunostainingShousuke UETA, Tamotsu TAKAHASHI, Miko MITANI, Miho ICHIEN, Eiji OHARA ...2001 Volume 40 Issue 3 Pages 244-248
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We investigated the diagnostic cytologic features of salivary duct carcinoma (SDC) and the significance of androgen receptor (AR) immunostaining.
Study design: Subjects were 4 patients with SDC of the parotid gland. Fine needle aspiration and imprint cytology smears were stained with Papanicolaou and Periodic acid-Schiff. AR on paraffin sections and imprint smears, including 21 cases of benign and other malignant salivary gland tumors, were immunostained.
Results: Smears were cellular and contained clusters, sheets, and scattered epithelial cells with necrotic backgrounds. Some cell sheets showed a cribriform pattern. Tumor cells were polygonal, spindle and low columnar with abundant, finely granular and vacuolated cytoplasm. Nuclei were hyperchromatic, round to oval, with moderate anisokaryosis and often had prominent nucleoli. All SDCs were positive for AR, while other salivary gland tumors were negative.
Conclusion: Necrotic debris, a cribriform pattern, and intracytoplasmic vacuoles were diagnostic for SDC. Immunostaining for AR is important in diagnosing SDC in cytologic smears.View full abstractDownload PDF (7758K) -
Hiroshi MINATO, Tomoko HORITA, Motoji HISATOMI, Akitaka NONOMURA, Koui ...2001 Volume 40 Issue 3 Pages 249-256
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We assessed the usefulness of the Ultrafast Papanicolaou stain (UFP), incorporating air-dried rehydration in intraoperative diagnosis.
Study Design: This study involved 482 randomly selected surgical specimens for intraoperative consultation (32 organs from the systemic body: 311 benign and 171 malignant) and 51 cases of peritoneal washing fluid. Specimens were prepared for UFP, frozen sections, Papanicolaou (Pap.), Giemsa, and Alcian-blue stain. Each was diagnosed intraoperatively based on UFP and frozen sections, and postoperatively based on Pap. and permanent histological sections.
Results: UFP is simple and fast and produced results within 2 minutes. UFP color differed somewhat from that of Pap. but retained transparency with polychromasia. Nuclear features were clearly observed and nucleoli conspicuous. Lysis of erythrocytes resulted in a clear background. Overall UFP accuracy was 97.3%, frozen section 98.2%, and Pap. 96.1%. Final overall accuracy was 99%.
Conclusion: UFP conducted on air-dried smears has many advantages over direct wet fixation and, with adequate sampling for each specimen, is very useful in intraoperative diagnosis.View full abstractDownload PDF (4631K) -
Examination of immunoglobulin heavy chain gene rearrangement using cytological materialTsuyoshi IKEZAWA, Yukio MORISHITA, Hajime TSUNODA, Hiromi FUJIWARA, Ma ...2001 Volume 40 Issue 3 Pages 257-261
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report a relatively rare case of primary non-Hodgkin malignant lymphoma of the uterine cervix. We examined immunoglobulin heavy chain gene rearrangement using DNA extracted from the cytological specimen and histological specimens.
Case: A 66-years-old woman (gravida 5, para 3) was admitted with genital bleeding. She had an exophytic mass 10 cm in diameter in the vaginal anterior wall. Cytological diagnosis was malignant lymphoma and histopathological diagnosis was diffuse large B cell non-Hodgkin lymphoma. Immunohistochemical staining of the specimen was positive for L 26 but negative for UCHL-1. DNA was extracted from a cytological touch smear sample, biopsy sample, and resected material. Using extracted DNA, we conducted polymerase chain reaction (PCR) analysis of the rearrangement of the immunoglobulin heavy chain gene. A single discrete sharp band is evident in the PCR product of each sample.
Conclusion: Analysis of rearrangement in the immunoglobulin heavy chain gene, using cytological specimens, is useful in cytological diagnosis of malignant lymphoma.View full abstractDownload PDF (7805K) -
Misako NAKAMURA, Yoshinori OTA, Kazuo INAMOTO, Kimiko HIRAO, Yoko FUJI ...2001 Volume 40 Issue 3 Pages 262-266
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report the fourth case of an ACTHproducing malignant ovarian tumor.
Case: A 64-year-old woman suffered from lower abdominal pain, right inguinal pain, and transient extremidial paralysis in May 1999. A colon polypectomy revealed, there hypokalemia, hyperglycemia, hyperthyroidism, and elevated CEA, LDH, cortisol, and ACTH. Hard masses about 3-4cm in diameter were palpable at the bilateral ovaries and a right inguinal tumor was seen. Aspiration biopsy from the right inguinal tumor showed secondary Cushing syndrome caused by the ectopic ACTH-producing malignant tumor. She admitted to the hospital and right inguinal lympharectomy showed a metastatics small-cell carcinoma tumor. She was treated twice with intraarterial chemothrapy using CBDCA, which ameliorated her symptoms and laboratory data became normal. A few months later, a tumor recurred. Second-line chemotherapy and radiation were inffective, and she died. Autopsy suggested a primary ovarian tumor.
Conclusion: This is, to owr knowledge, only the fourth case of an ACTH-producing malignant ovarian tumor of ovary reported anywhere. Other cases involved adenocarcinoma, and only this case involved small-cell carcinoma.View full abstractDownload PDF (6279K) -
Chio KATO, Toshiko JOBO, Masahide ARAI, Manami IMAI, Tadayuki KANAI, M ...2001 Volume 40 Issue 3 Pages 267-271
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Asymptomatic ovarian cancer without an enlarged mass is rate. We report an asymptomatic patient with ovarian carcinoma whose endometrial cytology was positive for malignant cells.
Case: A 68-years-old woman was screened cytologically for uterine carcinoma in January 1998. The endometrial specimen showed atypical cells with a high N/C ratio, anisonucleosis, and apparent nucleoli coexisting with nomal atrophic endometrial cells. These atypical cells formed small round or papillary clusters in a clear background. Four-direction endometrial biopsy was negative and no abnormal findings were seen on gynecologic examination or visual diagnosis except 97 u/ml serum CA 125. The patient underwent surgery. The uterus and both ovaries were macroscopically negative, although peritoneal cytology was positive and disseminating lesions less than 5 mm in diameter were observed in the omentum and on the peritoneal surface. A surgical specimen of the right ovary revealed serous adenocarcinoma 8×6 mm in size
Conclusion: Endometrial cytology is useful in the diagnosis of asymptomatic de-novo normal-sized ovarian carcinoma.View full abstractDownload PDF (6270K) -
Toshiko KANAMURO, Yuji NONAMI, Toshio NISHIKAWA, Takeshi KASAJIMA, Mot ...2001 Volume 40 Issue 3 Pages 272-275
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Primary pulmonary tumor includes adenocarcinoma, squamous cell carcinoma, large cell carcinoma, small cell carcinoma and sarcoma, and cytological diagnosis of these tumors may be made primarily based on the characteristics of nulei and secondarily on cytoplasm findings. Here we report a rare case of lung cancer with a cytological finding of peculiar intracytoplasmic inclusion.
Case: A 36-year-old man was operated on for right upper lobe lung bleeding. Preoperative cytology showed a few atypical cell clusters with peculiar translucent needle-like crystaloid inclusions in the cytoplasm. The resected lung showed a tumor 20 mm in diameter associated with multiple subpleural bullae and parenchymal bleeding. Histology revealed large cell carcinoma composed of cells with neeble crystal inclusions in cytoplasm.
Conclusion: Intracytoplasmic inclusions were assumed due to cellular degeneration in alkyl compounds such as cholesterol.View full abstractDownload PDF (6077K) -
Takaaki SUZUKI, Kazuhiko HAYASHI2001 Volume 40 Issue 3 Pages 276-280
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report a case of pulmonary actinomycosis diagnosed by imprint and squashed specimen cytology.
Case: A 22-year old woman reported left anterior chest pain and fever since February 1999. Chest X-ray and chest computed tomography (CT) scan showed an infiltrative shadow and pleural effusion due to pneumonia with pleuritis. She suffered from hemoptysis during treatment and was admitted to the hospital. Sputum cultures showed normal flora and sputum cytology was negative for malignant disease. It is often very difficult to diagnose pulmonary actinomycosis clinically. Transbronchial lung biopsy failed to establish a diagnosis. Due to frequent hemoptysis, a lobectomy of left lower lobe was conducted. Imprint and squashed cytological examination revealed Actinomyces organisms in clusters. The cytological features of Actinomyces organisms were aggregated “sulfur granules” forming irregular islands of amorphous clumps. Large aggregates were green to brown, with numerous filamentous structures radiating from the center.
Conclusion: Close observation of sulfur granules from fresh specimens obtained by cytological examination is very important in diagnosing pulmonary actinomycosis.View full abstractDownload PDF (7965K) -
Masaya KIYUNA, Takayoshi TODA, Kazuhiro HIGA, Manabu SHIROMA2001 Volume 40 Issue 3 Pages 281-285
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Primary effusion lymphomas (PEL) are very rare. We report a case of PEL and its cytological, immunocytochemical, and ultrastructural findings.
Case: A 63-year-old man undergoing hemodyalysis due to diabetic nephropathy reported dull pain radiating from the right shoulder to the chest wall. Computed tomography.(CT) disclosed marked paricardial effusion. Atypical cells with a high N/C ratio demonstrated by aspiration cytology reacted positively with antibodies for EMA and CD 30 but were negative for L 26 and CD 15. No atypical cells were seen in peripheral blood or bone-marrow puncture material. CT and gallium scintigraphy showed no systemic lymph node swelling. Anti carcinogenic drugs were administered systemically together with pericardial effusion, but the man died 2 months after disease onset. An autopsy showed a 1.5×0.5 cm subcutaneous tumor in the chest wall, but no significant lymph node swelling.
Conclusion: A man reporting pain radiating from the right showlder to the chest wall was found on autopsy to be suffering from primary effusion lymphoma.View full abstractDownload PDF (5917K) -
Kazue ASAKAWA, Takeshi ASANO, Masao YAMAMOTO, Yuichi SUGISAKI2001 Volume 40 Issue 3 Pages 286-289
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Desmoplastic small cell tumor (DSRCT) is a rare malignancy mainly involv ing the peritoneum of adolescent males. Only a few reports on the cytology of body fluid from patients with DSRCT have been documented.
Case: We present the cytological findings for an ascitic fluid sample taken from a 13-year-old Japanese male with intraabdominal DSRCT. The patient was admitted to our hospital for abdominal distention and gross ascites. A cytological evaluation of the ascitic fluid revealled the presence of monotonous small round cells and a small number of another kind of large atypical cells with thick cytoplasm corresponding to the characteristic perinuclear round hyaline material of DSRCT. The tumor was resected, but the patient died from a recurrence two years later.
Conclusion: DSRCT should be considered as a differential diagnosis of gross ascites accompanied by a bulky intra-abdominal tumor in adolescents.View full abstractDownload PDF (3826K) -
Tomoko KAGIYA, Emiko TANIGUCHI, Misa NAKAMURA, Yasushi NAKAMURA, Ichir ...2001 Volume 40 Issue 3 Pages 290-293
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Atypical adenoma of the thyroid is rare and may lead to malignant misdiagnosis cytologically. We report a case of atypical adenoma of the thyroid with details of cytological findings.
Case: A 61-year-old woman with a right thyroid mass underwent aspiration cytology that revealed a large number of clusters in follicular arrangement and dispersed cells in the cytological smear. Nuclei of the tumor varied in size and shapes, having darkly stained chromatin and thick nuclear membranes. The presence of nuclear grooves and a few intranuclear cytoplasmic inclusion bodies suggested papillary carcinoma. Severe cellular atypia indicated undifferentiated carcinoma, and from the follicular structure, we speculated follicular carcinoma. Histologic findings demonstrated a well-encapsulated tumor with follicular and solid patterns. Histologically, no capsular or vascular invasion was found, so it was diagnosed as atypical adenoma.
Conclusion: When making a cytological diagnosis of thyroid aspirate, we should keep the histological tumor type in mind, and look for evidence of structural or cellular characteristics before make concluding whether the tumor is benign or malignant.View full abstractDownload PDF (3583K) -
Katsuyuki KATO, Yoshiaki NORIMATSU, Yoji WANI2001 Volume 40 Issue 3 Pages 294-295
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe reported a case of malacoplakia of the urinary bladder in which urine cytology was helpful for diagnosis. A 71-year-old woman consulted our hospital for macrohematuria. Urine cytology showed many macrophages containing Michaelis-Gutmann bodies the cytoplasm. Cystoscopy revealed a widely based papillary tumor in the urinary bladder. Histologically, the lesion was granulomatous inflammation consisting of diffusely infiltrated macrophages with Michaelis-Gutmann bodies. The electoron microscopic study demonstrated the myelin-like, small granular structures consistent with Michaelis-Gutmann bodies.View full abstractDownload PDF (4574K) -
Yoshio HOSHINO, Kenichi TOBITA, Noriko ISHIHARA2001 Volume 40 Issue 3 Pages 296-297
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of squamous cell carcinoma (SCC) in the diverticulum of the urinary bladder. A 73-year-old women reported macroscopic hematuria. Voided urine cytology was negative. Image diagnosis revealed a diverticulum associated with an intradiverticular tumor.
Washing cytology of the urinary bladder showed a small number of cyanophilic cancer cells with dispersed chromatin distribution. Initial diagnosis was transitinal cell carcinoma. Retrospectively, however, a few orangeophilic cancer cells consistent with SCC were also found. The resected diverticulum showed a polypoid tumor that was a histologically pure form of keratinizing SCC involving the myometrium (NIT pT 2).
SCC accounts for about 20% of all neoplasia from the diverticulum of urinary bladder, and urine cytology is positive in most cases.View full abstractDownload PDF (4185K) -
Yoshihito YOKOYAMA, Hidetoshi MARUYAMA, Shigemi SATO, Kazuhito MATSUMO ...2001 Volume 40 Issue 3 Pages 298-299
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSIn case of tuberculous uterine cervicitis, the presence of epithelioid cells arranged in clusters mixed with Langhans' giant cells in uterine cervical smears was highly suggestive of tuberculosis. The diagnosis was confirmed by the detection of acid-fast bacilli in cultures from the uterine cervix.View full abstractDownload PDF (2671K) -
Takeshi KONDO, Riko KITAZAWA, Sakan MAEDA, Sohei KITAZAWA2001 Volume 40 Issue 3 Pages 300-301
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of lung adenocarcinoma with sarcomatous component. A 68-year-old man with a lung tumor in 1999 had undergore left nephrectomy for renal cell carcinoma confined to the kidney in 1996. Cytological examination of bronchial brushing material revealed adenocarcinoma cells. Sarcomatous cells were found in the pleural effusion. Histology of the lung tumor resected by right lower lobectomy was mucinous bronchiolo-alveolar carcinoma with a sarcomatous component. Immunohistochemically, the sarcomatous component was positive for epithelial markers such as keratin and EMA, suggesting that it derived from an epithelial component.View full abstractDownload PDF (2522K) -
Takao SUZUKI, Koji KISHIMOTO, Takashi KITAMURA, Genshu TATE, Toshiyuki ...2001 Volume 40 Issue 3 Pages 302-303
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of Burkitt's lymphoma infiltrating into pleural and peritoneal effusion.
A 20-year-old man admitted to Showa University Fujigaoka Hospital in July 1998 reported abdominal colic. Ultrasonography and computed tomography (CT) were used to image the thickness of the small intestine and pleural and peritoneal effusion. Cytological examination of pleural effusion and ascites showed many neoplastic lymphoid cells with a high N/C ratio. Cytoplasms were basophilic and had small vacuoles stained by oil red 0. A chromosome spread showed the characteristic translocation of t (8; 14)(q24; q32). Based on these cytological findings, we diagnosed this case as Burkitt's lymphoma.View full abstractDownload PDF (2271K) -
Yutaka NAKAMURA, Akinori ISHIHARA, Akira KAMIMORI, Hideyuki KOYAMA, Ta ...2001 Volume 40 Issue 3 Pages 304-305
Published: May 22, 2001
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of Merkel cell carcinoma of the right thigh. A 76-year-old man had a tumor of the right thigh about 6 cm in diameter consisting of small round cells diagnosed as Merkel cell carcinoma based on histological, immunohistochemical and electron microscopy examination.
Fine-needle aspiration cytology showed small round cells with solid, trabecular, and rosette-like arrangements. Tumor cells had button-like globules in the cytoplasm that were positive for cytokeratin 20, chromogranin A, and neurofilaments.View full abstractDownload PDF (3808K)
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