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Volume 41, Issue 6
Displaying 1-18 of 18 articles from this issue
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Takahiko KASAI, Reiko MIYAZAKI, Taira ONODERA, Karin SUGIMOTO, Ichiro ...2002 Volume 41 Issue 6 Pages 381-387
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We studied the morphological characteristics, especially the cluster appearance, of pulmonary Clara/Type II pneumocyte adenocarcinoma in imprint cytological specimens, focusing on differences in histological classification.
Study design: Touch smear specimens of 2 cases of atypical adenomatous hyperplasia (AAH) and 23 cases of non-mucinous bronchioloalveolar carcinoma (nmBAC), 11 nmBAC and 12 nmBAC with sclerosis (nmBACs), were studied based on the following criteria: 1) solitary or cluster appearance of tumor cells; 2) size of tumor cluster; 3) appearance of nonoverlapping and overlapping clusters; 4) mitotic and inclusion figures; 5) background.
Results: Imprint cytology of AAH and nmBAC, compared to nmBACs, showed more frequent appearance in cell features as follows: 1) solitary appearance of tumor cells; 2) small tumor cluster; 3) ribbon-like and unibranch nonoverlapping tumor clusters; and 4) prominent nuclear inclusion and no mitotic figures.
Conclusion: Touch cytology of peripheral pulmonary adenocarcinoma is useful in distinguishing AAH and nmBAC from nmBACs based on tumor cluster appearance and size and the presence of mitotic figures in tumor cells.View full abstractDownload PDF (8264K) -
Emiko TANIGUCHI, Goro YOSHIMURA, Qifeng YANG, Tomoko KAGIYA, Xiaojuan ...2002 Volume 41 Issue 6 Pages 388-393
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: To establish a cytological grading system for breast cancer, 218 cases of Papanicolaou-stained, fine-needle aspirates were retrospectively evaluated in a semiquantitative manner.
Study Design: Fine-needle aspirates from 218 invasive ductal carcinomas were stained using the Papanicolaou method and examined for necrosis, cell size, nuclear/cytoplasmic ratio, nucleoli, chromatin granularity and density, and nuclear pleomorphism. A semiquantitative scoring system was established based on the above features, and correlations between the cytological findings and clinicopathologic variables were examined.
Results: The cytologic grade was positively correlated with the histologic grade and negatively with estrogen-receptor positivity. Moreover, a high cytologic grade was associated with nodal metastasis and proliferative index labeling using MIB-1.
Conclusion: This study showed that our grading system for breast cancer based on fine-needle aspiration cytology can be used for routine diagnoses.View full abstractDownload PDF (2973K) -
Ichiro MORI, Kayoko MAEKAWA, Emiko TANIGUCHI, Tomoko KAGIYA, Osamu NUN ...2002 Volume 41 Issue 6 Pages 394-398
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The purpose of this study was to clarify the cytological features supporting a diagnosis of lobular carcinoma of the breast.
Study Design: Four-hundred and nine cases of surgically treated primary breast carcinoma were reviewed, and 10 cases of lobular carcinoma were collected. Papanicolaou-stained, fineneedle aspiration cytology specimens obtained from these 10 cases were then reviewed.
Results: Nine of the ten lesions were correctly diagnosed as malignant (Pap. Class IV or V), and only one smear was indequate. No false-negative cases of lobular carcinoma were found among 954 cases with a negative cytology. A text-book description of Indian file arrangement was rarely ovserved (1 case), and intracytoplasmic lumina were also rare (2 cases). A low cellularity was also rare (1 case) in our study. In adequate smears, moderate-to-high cellularity was observed. Isolated tumor cells in small aggregates were observed, and the cell clusters were predominantly or partly dissociated. The chromatin was increased, and the chromatin pattern was granular in distribution. Myoepithelial cells were not identified in the smear background.
Conclusion: No cytological features enabling a confident diagnosis of lobular carcinoma were observed. The evaluation of nuclear chromatin and dissociated cell clusters composed of small-to-moderate sized cells in an adequate smear enabled malignant lesions to be diagnosed with a high rate (90%) of accuracy.View full abstractDownload PDF (3934K) -
Tomoko HAGIWARA, Tsunehisa KAKU, Tomoyoshi MARUYAMA, Hiroaki KOBAYASHI ...2002 Volume 41 Issue 6 Pages 399-405
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Clear cell adenocarcinoma of the endometrium (CCAE) accounts for about 4% of endometrial carcinoma and is often advanced when detected. We report cytological features of CCAE detected by endometrial smear.
Study Design: This study originated in a review of endometrial carcinoma cases treated at Kyushu University Hospital between 1993 and 2000. The 4 cases found represent a 1.5% frequency. We cytologically analyzed and compared there endometrial cytology with that of G1 endometrioid adenocarcinoma (G1EA) using NlHimaging (version 1.61), in addition to clinical and histopathological features.
Results: The smear background was necrotic. Cytologically, the solid type was sheet-like, while tubular and papillary types were papillary. A Ball-weed pattern was seen in 3 cases and a mirror ball pattern in 2. Psammoma bodies were present in 2 cases. Tumor cells had apparently clear, abundant cytoplasm with occasional vacuoles. Tumor cells had oval nuclei with anisonucleosis. In all cases, some tumor cells had multiple nuclei.
Conclusion: A clear understanding of the difference between CCAE and G1EA will enable us to decisively diagnosie presumed CCAE. Cytological examination of patients with CCAE is useful both in tumor detection and posttherapy patient follow-up.View full abstractDownload PDF (4670K) -
Junji NAGAHAMA, Keiji SATO, Hiroyuki TANAMACHI, Kenji KASHIMA, Tsutomu ...2002 Volume 41 Issue 6 Pages 406-410
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Calcifying epithelial odontogenic tumor (CEOT) is a rare tumor that accounts for about 1% of the odontogenic tumors. We report a case of malignant CEOT with nodal metastasis and describe its cytological features.
Case: The patient was a 56-year-old man with CEOT in his mandible. The tumor recurred four times in three years after the first resection. Cytologically, the third recurrent tumor was diagnosed as malignant CEOT, with small to large tumor cells present singly or in clusters. The small tumor cells had round to oval nuclei with prominent nucleoli, increased chromatin, and a high N/C ratio. The large tumor cells were mononucleated or multinucleated with abundant basophilic cytoplasm, increased chromatin and prominent nucleoli. Lamellar structures and perinuclear halos were observed in the cytoplasm. These cytologic findings were very similar to those of squamous cell carcinoma. Histologically, the tumor cells in the primary tumor showed solid proliferation and were round to oval in shape with eosinophilic cytoplasm and pleomorphic nuclei. Multinucleated cells were rare. Calcification and amyloid deposition were observed in the primary tumor but were not found in any of the recurrent tumors. The tumor cells in the third recurrent tumor were interpreted as malignant CEOT based on the marked cellular atypia and frequent mitotic figures. Vascular invasion was also evident. Three years after the fourth recurrence, metastasis to the supraclavicular lymph node was found.
Conclusion: Cytologically, pleomorphic cells of a squamoid type with amyloid deposition and calcification are characteristic features of CEOT. Based on the cytologic findings alone, it may be very difficult or even impossible to determine whether the tumor is benign or malignant. Physicians must take care not to misdiagnosc benign CEOT as a malignant tumor, such as squamous cell carcinoma or mucoepidermoid carcinoma.View full abstractDownload PDF (9330K) -
Kiyora MARUYAMA, Emi MATUI, Takahiro TSUDA, Hitosi ABE, Satosi KUSAKAR ...2002 Volume 41 Issue 6 Pages 411-414
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Paraganglioma typically arise from the extraadrenal para-ganglionic system and arc rarely observed in the middle mediastinum. We present a case of a paraganglioma located in the middle mediastinum.
Case: A 34-year-old man was found to have an abnormal mass during a chest X-ray examination. Fine-needle aspiration and imprint cytology showed that the tumor cells had round or oval nuclei with fibrous and/or vacuolated cytoplasm, some spindle cells in a hemorrhagic background were also present. The histological diagnosis of the rescctcd specimen was paragangioma.
Conclusion: Immunohistochemical techniques may be useful for the diagnosis of paraganglioma by fine-needle aspiration and imprint cytology.View full abstractDownload PDF (5874K) -
Noriko HOSAKA, Kenichi ARAI, Hirofumi SAKURAI, Akiko KAMIGAITO, Masami ...2002 Volume 41 Issue 6 Pages 415-421
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The utility of bronchial brushing cytology forthe diagnosis of epithelioid hemangioendothelioma of the lung has not been confirmed until now.
Case: A 43-year-old man was admitted for a detailed examination and treatment of a lung tumor, although he had no specific complaints. A computed tomography examination revealed a discrete solitary tumor in segment 6 of the left lung. A bronchial brushing smear showed scattered tumor cells or small, epithelioid clusters of tumor cells, in which the cells were plump or round in shape and exhibited abundant, light-green-stained cytoplasm and atypical nuclei, some of which contained clear, sharply demarcated cytoplasmic vacuoles. The cytological features (histochemical, immunohistochemical, and ultrastructural) of tissues obtained during surgical exploration weresimilar to those obtained by the brushing cytology.
Conclusion: Brushing cytology may be a useful means of diagnosing epithelioid hemangioendothelioma based on the characteristiccytological features of this tumor.View full abstractDownload PDF (16073K) -
Maki NUNOMURA, Yoshiharu UCHINO, Takafumi SUZUKI, Noriko TAKAHASHI, Ju ...2002 Volume 41 Issue 6 Pages 422-426
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Nasopharyngeal carcinoma (NPC) is common in South China and often diagnosed by early manifestation of cervical lymph node swelling. Many investigations have progressed recently suggesting the Epstein-Barr virus (EBV) mayplay an important role in the pathogenesis of NPC, but its cytological features have not been fully described, particularly in Japan.
Case: A 39-year-old Chinese woman seen for cervical lymph node swelling was found in fine-needle aspiration cytology to heve many atypical cell clusters with lymphocytic infiltrate. Punch preparation of the resected lymph node showed atypical cells scattering among lymphocytes. Ilistologically, ill-demarcated nests of atypical cells bearing large nuclear and prominent nucleoli were seen with a dense lymphoid background. Atypical cells were immunohistochemically positive for cytokeratin AEI/AE3 staining and EBER-positive in situ hybridization. We diagnosed the lesion as undifferentiated carcinoma and recommended biopsy of the nasopharyngeal mucosa.
Conclusion: Cytologic examination of cervical lymph node metastasis helps determine the primary site in NPC.View full abstractDownload PDF (10555K) -
Kazuhito MATSUMOTO, Fukuji IKEZAKI, Hiroshi KAKIZAKI, Haruhiko YOSHIOK ...2002 Volume 41 Issue 6 Pages 427-432
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Hibernoma is a rare benign tumor derived from brown adipose tissue. Little information is available regarding its cytologic features, although its histopathology and ultrastructure have been well described.
Case: A 63-year-old woman presented with a mass in her left scapular region. A core-needle imprint cytology of the mass suggested a diagnosis of hibernoma, and the mass was extirpated. At the time of surgery, the mass was well-defined, soft, yellowish-brown, 8 × 8 × 3cm in size, and located in the subcutaneous fatty tissue.
An imprint cytology showed clusters of large round to polygonal cells often superimposed with delicate capillaries. The tumor cells were classified into 3 main types: those with fine granular cytoplasm, multivacuolated cytoplasm, and univacuolated cytoplasm.
Pigment granules were occasionally found in the cytoplasm. The nuclei were small and round to oval with a small nucleolus. The histological sections displayed the typical features of hibernoma and were stained positive with the Sudan III stain.
Ultrastructurally, numerous mitochondria and a varying number of lipid droplets were observed in the cytoplasm.
Conclusion: Hibernomas can be diagnosed by cytology based on the presence of the tumor's three characteristic cell types and the presence of occasional pigment granules. Imprint cytology may be useful for the diagnosis of this tumor.View full abstractDownload PDF (8052K) -
Masako OTANI, Tohru SHIMIZU, Hiromi SERIZAWA, Yoshiro EBIHARA, Koh NAK ...2002 Volume 41 Issue 6 Pages 433-438
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Apocrine sweat gland carcinoma is a rare lesion. and its cytological features have not been adequately reported. Recently, an immunohistochemical method recently for the diagnosis of this rare lesion has become available. We experienced two cases of apocrine sweat gland carcinoma arising in the axillary region.
Cases: Case 1 was a 49-year-old male who had undergone a tumorectomy in his left axilla 5 years prior to the recurrence. Fine-needle aspiration revealed isolated or small clusters of tumor cells with thickened cytoplasm. peripherally located nuclei, and decapitation secretion. Histologically, solid proliferated tumor cells with broad and eosinophilic cytoplasm, decapitaion secretiton and diastase-resistant PAS positive granules were observed. The tumor cells were positivie for GCDFP-15. Case 2 was a 53-year-old male with a 15-year history of a left axillary mass. Scratch cytology of a lymph node during a tumorectomy showed sheet clusters of rather large tumor cells with broad cytoplasm. peripherally located nuclei with distinct nucleoli. orange C-positive coarse granules, and decapitaion secretion. Histologically, the tumor consisted of mainly tubular structures that had invaded the subcutaneous tissue. The tumor cells with the eosinophilic cytoplasm and decapitation secretion were positive for GCDFP-15.
Conclusion: Apocrine sweat gland carcinoma must be differentiated from an apocrine carcinoma originated from accessary breast and metastatic adenocarcinoma. Cytologically, this lesion (including metastatic lesions) exhibits features that are specific to apocrine sweat glands, enabling an accurate diagnosis.View full abstractDownload PDF (12110K) -
Nobuo SAKUMA, Hidemi SHIBUTA, Toshiaki KAMEI, Hiroshi OKAMURA2002 Volume 41 Issue 6 Pages 439-442
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: In the diagnosis of maxillary cancer, some investigators have reported on the usefulness of cytological examinations; cytology of nasal discharge, sputum and specimens obtained by irrigation of the maxillary sinus. We found atypical squamous cells in cytological specimens from postnasal discharge. Further examinations revealed carcinoma of the maxillary sinus.
Case: A 72-year-old Japanese woman without a history of cigarette smoking visited a clinic. For a week prior to the visit, she had been suffering from slightly bloody rhinorrhea with right cheek pain. Cytology of the postnasal discharge showed moderately atypical squamous cells with keratosis among large numbers of neutrophils, lymphocytes and eosinophils. Otolaryngological examinations including open biopsy of the maxilla gave a diagnosis of squamous cell carcinoma of the right maxillary sinus (T3N0M0), which was treated with radiation therapy an & surgery.
Conclusion: Cytology of nasal discharge may be helpful in diagnosing maxillary cancer.View full abstractDownload PDF (5602K) -
Tsutomu ARAI, Toshiko JOBO, Izumi SUZUKI, Jun WATANABE, Keiichi IWABUC ...2002 Volume 41 Issue 6 Pages 443-447
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare tumor. This type of tumor rarely metastasizes to the regional nodes and has shown a better outcome than the more common squamous cell carcinoma of the cervix.
Case report: A 56-year-old woman complaining of genital bleeding was diagnosed as having stage IIb carcinoma of the uterine cervix and underwent a radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Metastases were found in the left common iliac, left external iliac, and bilateral internal iliac nodes. Histologically, the immature tumor cells with ill-defined cytoplasm had one to three prominent nucleoli. The nuclear membrane was irregular, and anisonucleosis was prominent. The nests of epithelial cells were surrounded by inflammatory infiltrates rich in lymphocytes. A cervical smear showed that the immature tumor cells were scattered or in clusters and were associated with abundant lymphocytes in the background. Anisonucleosis was evident, and the chromatin was peripherally marginated. One to three prominent nucleoli were observed. The cytoplasm was finely granular, and the cell borders were indistinct. No evidence of keratinization or glandlike formation was seen.
Conclusion: Cytological findings are useful for the dettection LELC. The present case of LELC exhibited multiple lymph node metastases.View full abstractDownload PDF (5723K) -
Masato NISHIMURA, Makoto HIROI, Mikio MIYAUCHI, Hiromi IOKI, Natsu SAK ...2002 Volume 41 Issue 6 Pages 448-452
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Villograndular papillary adenocarcinoma (VPA) of the uterine cervix was first described by Young and Scully in 1989. About 50 cases have been reported thus far. Despite its excellent prognosis, hysterectomy has been done in almost all cases. We report a case of VPA, treated by conization alone, resulting in long remission.
Case: A 38-year-old Japanese woman reporting abnormal vaginal bleeding and increased discharge was found to have the cervix invaded by a papillary tumor. Cytological findings showed many papillary clusters with mild nuclear hypercromatism. Conization was done in August 1997. The tumor showed exophitic growth with superficial myometrial invasion, and was diagnosed as VPA. No cancer cells were seen in the surgical margin. The patient wished to have children, so no hysterectomy was done. She survives without recurrence at 5years and months as of this writing.
Conclusion: We reported a case of VPA treated by conization. The most important cytological features in VPA diagnosis are papillary clusters with nuclear hypercromatism.View full abstractDownload PDF (6659K) -
Masaru SHINYA, Kuniaki OOURA, Kazumi KABUMOTO, Toru HARADA, Takako KIY ...2002 Volume 41 Issue 6 Pages 453-456
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Endometrial tuberuculosis is a rare condition. We report a case of endometrial tuberuculosis with chronic renal failure who was receiving hemodialysis.
Case: A 44-year-old female with atypical genital bleeding and anemia was referred from the Internal Department. Cervical and endocervical smears were normal, but an endometrial smear revealed a number of lymphocytes, epithelioid cell clusters, and Langhans-type giant cells. A pathological examination indicated a chronic granulomatous inflammatory disease, such as tuberculosis. Ziehl-Neelsen stainings, a mycobacterium culture, and the tuberculin reaction test were positive, although mycobacterium DNA was not detected. The patient was therefore diagnosed as having endometritis. She was given medicine for tuberculosis, after 3 months of treatment, a second endometrial smear revealed a number of lymphocytes without Langhans-type giant cells and normal endometrial cells.
Conclusion: Endometrial tuberculosis is a rare, but important disease. Endometrial smears are a useful diagnostic tool and may also be used to evaluate the curative effect of medicine.View full abstractDownload PDF (3937K) -
Akiko KAMIGAITO, Hirofumi SAKURAI, Atsushi MORI, Noriko HOSAKA2002 Volume 41 Issue 6 Pages 457-458
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA 74-year-old wolnan was admitted becase of a large amount of ascites. The patient also pointed out the presence of a breast tumor. Aspiration cytology of the breast tumor and a cytology exalnination of the ascites were pcrformed.
Cytologicaly, the tumor cells in the ascites were small. sized and uniform-In celis with a low N/C ratio, the chromatin pat. tern was fine and uniform. ICL was observed in the cytoplasm. The tulnor cells were individually dispersed.
The cytological findings strongly suggested that these cells were reactive mesothelial cells.
Histologlcally, the breast tumor was diagnosed as an invasive lobular carcinoma that was positive for CA19-9. The peritoneum biopsy was diagnosed as a metastasis of the invasive lobular carcinoma of the breast. Thus, the cells which had been regarded as reactivc mesothelial cells were in fact adenocarcinoma cells.View full abstractDownload PDF (4244K) -
Kumiko KITAI, Hiroshi KAJIWARA, Toru SHIMIZU, Shingo KAMOSHIDA, Yoshiy ...2002 Volume 41 Issue 6 Pages 459-460
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of an extramedullary relapse of acute myelogenous leukemia [M2 t (8; 21)] in the parotid gland and parapharyngeal space of a 50-year-old male. A Papanicolaou stain, revealed scattered small blasts with enlarged. nuclei. The blast-like cells were difficult to definitively diagnose by Papanicolaou stain. but the clinical findings enabled a diagnosis of the extramedullary spreading of acute leukemia cells to be confirmed using immunohistochemistry for peroxidase as well as May Giemsa staining. The possibility of extramedullary extensions or relapses should be kept in mind during the cytological examination of solid mass lesions in patients undergoing chemotherapy for acute myelogenous leukemia.View full abstractDownload PDF (4724K) -
Yoji NAGASHIMA, Atsuko OSAWA, Ryoko TAKAKU, Noriko NAKAMURA2002 Volume 41 Issue 6 Pages 461-462
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of chromophobe renal cell carcinoma in a 39-year-old woman. The squash cytological specimen showed tumor cell clusters composed of large-sized polygonal cells with a low nucleocytoplasmic ratio. The cytoplasm was characteristically cloudy and reticular or eosinophilic granular. Occasionally, a perinuclear halo was visible. The nuclei were spherical and contained small nucleoli. The unique clinicopathological and molecular biological characteristics of chromophobe renal cell carcinoma make cytology a very useful tool for its correct diagnosis.View full abstractDownload PDF (4091K) -
Takumi KURABAYASHI, Hiroaki KASE, Hiroshi MATSUSHITA, Etsuko NAGAI, Ke ...2002 Volume 41 Issue 6 Pages 463-464
Published: November 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of fetal abdominal cyst that was prenatally diagnosed using aspiration cytology. An abdominal cyst with a diameter of 6 cm was detected by ultrasonography in a 30-weekold female fetus in a twin pregnancy. Transitional cells were detected in a aspiration cytology specimen from the dilated ureter. The fetus was delivered at 34-weeks by Cesarean section, and she is presently alive, although she has some urogenital anomalies. Cytology is a useful method for prenatal diagnosis.View full abstractDownload PDF (4335K)
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