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Volume 41, Issue 3
Displaying 1-17 of 17 articles from this issue
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Nobuo SAKUMA, Toshiaki KAMEI, Hidemi SHIBUTA, Hiroshi OKAMURA2002 Volume 41 Issue 3 Pages 145-149
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We assessed the diagnostic value of counting nucleus numbers for differentiating cells among lung adenocarcinoma (LC), malignant mesothelioma (MM), and reactive mesothelia (RM) with pleural effusion.
Study Design: Samples were obtained by thoracocentesis of 43 cases with pleural effusion (30 malignancies (14 LC and 16MM) and 13 benign (RM)). The following parameters were evaluated for each specimen:(1) percentages of cells with 1, 2, 3, and 4 or more nuclei among 300 consecutive cells (PN=1, PN=2, PN=3, PN≥4), (2) maximum nuclear count per cell for all cells (Nmax).
Results: (1) PN=1 of RM (90.0±2.0%) and LC (86.4±8.3%) was significantly higher than that of MM (77.2±7.3%).PN=2 of RM (8.7±1.6), and LC (12.5±7.2) was significantly lower than that of MM (20.1±7.0). PN = 3 of 2.0% or more was found only in malignant specimens (2 LC and 6 MM).(2) Nmax of MM was significantly higher than those of RM and LC, and Nmax of 10 or more was found in only 8 MM.
Conclusion: Counting the nucleus number may be helpful in differentiating these three diseases.View full abstractDownload PDF (3304K) -
Akinori ISHIHARA, Akira KAMIMORI, Hideyuki KOYAMA, Yutaka NAKAMURA, Ka ...2002 Volume 41 Issue 3 Pages 150-158
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We analyzed aspirated stromal breast lesion materials cytologically and discuss their diagnostic significance.
Study design: Cases were 282 of primary carcinomas and 218 of benign lesion of the breast.
Results: Stromal breast lesion materials were classified into 4 groups: fibrous tissue with a matrix component, fibrous cell component, vascular component and others (fat cell, bone and cartilage, and multinucleated giant cells, etc.). Elastic fibers and dispersive tumor cells among fat cells showed scirrhous carcinoma. Fibrous cell bundles were mainly found in invasive ductal carcinoma. Fibrous cell bundles with a myxomatous matrix were derived from stroma of fibroadenoma. Hyalinized stromal material was found in intraductal papilloma (IDP). Papillary cell clusters with vascular cores were typical of papillary carcinoma, papillotubular carcinoma, and IDP. Vascular network formation was seen in mucinous carcinoma and chronic mastitis.
Conclusions: Stromal materials aspirated by fine needle aspiration are useful in diagnosing breast lesions.View full abstractDownload PDF (10597K) -
Dai OKUYAMA, Kenji IIJIMA, Kenzou HIROSHIMA, Genichirou ISHII2002 Volume 41 Issue 3 Pages 159-163
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Because adenocarcinoma of Bartholin's gland is a rare vulval neoplasm, few reports exist on cytological findings for this carcinoma. We report a case of adenocarcinoma of Bartholin's gland with cytological and histoplatholigical findings.
Case : A 49-year-old woman noticing swelling of the right vulva visited our hospital. A lesion about 5cm in diameter was found in the right vulva and resected. Cytologically, tumor cells were round to oval with scanty cytoplasm, and arranged sheetlike with loose cell-to-cell adhesion. The chromatin of the nuclei was fine, and nucleoli were prominent. Differential diagnosis included adenocarcinoma of skin adnexa, dysgerminoma, and metastatic carcinoma, but it was difficult to make a definitive diagnosis from cytological findings. The final diagnosis was poorly differentiated adenocarcinoma of Bartholin's gland based on tumor localization and histopathlogical findings.
Conclusion: When adenocarcinoma cells are observed in vulval cytological examination, it is usually from carcinoma of skin adnexa or metastatic carcinoma. Adenocarcinoma of Bartholin's gland must be considered, however, as a possible diagnosis.View full abstractDownload PDF (9550K) -
Takako KIYOKAWA, Ayumi YAHAGI, Hiroyuki TAKAHASHI, Naoko IKEDA, Yukiko ...2002 Volume 41 Issue 3 Pages 164-170
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Few studies have described cytological features of neuroendocrine tumor arising in the uterine cervix (NTUC) except small cell carcinoma (SmCC).
Case: We report 3 cases of NTUC, 2 of large cell neuroendocrine carcinoma (LCNC), and 1 of atypical carcinoid, focusing on cytological features of LCNC. All cases had coexistent adenocarcinoma in situ and additional squamous cell carcinoma in situ in 1 case. Preoperative cervical cytology detected malignant cells in all cases but their neuroendocrine nature was only identified at biopsy. A review of cytology specimens confirmed NTUC origin in both cases of LCNC. Cytological features of LCNC were as follows: 1) presence of cell necrosis, 2) dispersion of tumor cells, some of which forming loosely arranged clusters with irregular stratification or in file-like fashion, 3) occasional nuclear protrusion at the periphery of clusters, 4) high N/C ratio with round to oval nuclei, 3 to 6 times in size of lymphocytes, 5) increased coarse granular chromatin and 1 to 3 prominent nucleoli, 6) which cytoplasm faintly stained light green and ill-defined cell border.
Conclusion: Although rare, NTUC can be diagnosed in cytology when the feature above are taken in account.View full abstractDownload PDF (9437K) -
Takashi UMEZAWA, Kouichi NOMURA, Setsuko HARUMA, Yutaka YAMAGUCHI, Mak ...2002 Volume 41 Issue 3 Pages 171-174
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report a case of endometrial neuroendocrine small cell carcinoma (NSCC).
Case: The endometrial smear specimen of a 51-year-old woman admitted for 7-month of vaginal bleeding showed small round atypical cells with a background of tumor diathesis. Tumor cells showed rosette-like trabecular patterns. Cytologically, uniform, darkly stained nuclei, coarse chromatin, and inconspicuous nucleoli were seen. Cytoplasm was scant. Preoperative cytological diagnosis was NSCC. Histologically, tumor cells showed small hyperchromatic nuclei and scant cytoplasm, and proliferated with ribbon-like, solid, and perivascular pseudorosette patterns. Argyrophilia was demonstrated in tumor cells by Grimelius staining. Immunohistochemically, tumor cells were positive for cytokeratin (CAM5.2), epithelial membrane antigen, synaptophysin, chromogranin A, and neuron-specific enolase. The patient died of cancer 9 months after surgery.
Conclusion: We diagnosed endometrial NSCC based on the above cytological findings.View full abstractDownload PDF (6324K) -
Hiromi KOUDA, Yoshiaki NORIMATSU, Youji WANI2002 Volume 41 Issue 3 Pages 175-179
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report 2 cases of well differentiated endometrioid adenocarcinoma of the uterine corpus containing many conspicuous morules in endocyte cytology specimens.
Cases: A 38-year-old woman visited the hospital due to irregular bleeding. A 35-year-old woman who reported irregular menstrual phases had been diagnosed with Turner syndrome. Both showed similar cytological findings:(1) Cell clumps combined solidly and tightly were diffuse.(2) Nuclei of morular cells were round or spindle-shaped and showed very little atypia. Nuclei were regularly arranged and cytoplasm borders were not clear.(3) Some clumps had transitional areas to squamous metaplasia.(4) Isolated atypical cells, mytosis, and necrosis were not seen. These findings made it relatively easy to determine the existence of morules and distinguish them from poorly differentiated adenocarcinoma or endometrial interstitial cells.
Conclusion: We know that several metaplasias of endometrial glands occur under different conditions, often coexisting with endometrial hyperplasia or endometrioid adenocarcinoma.
Recognizing morphology and features of morules is important, Since they should not be overdiagnosed as high-grade adenocarcinoma.View full abstractDownload PDF (4122K) -
Nana NUMATA, Yoshio AIDA, Sakiko HOSHIKAWA, Eio ATARI, Mamoru TADOKORO ...2002 Volume 41 Issue 3 Pages 180-185
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report a case of functioning ovarian strumal carcinoid.
Case: A 48-year-old woman with an ovarian tumor found by ultrasonography underwent oophorectomy under a clinical diagnosis of mature cystic teratoma of the ovary. Touch smear specimens showed sheet-like cell clusters and isolated cells with hemorrhage and amorphous materials. Tumor cells were small, oval to columnar in shape, withround nuclei. They occasionally showed follicular, rosette-like, and tubular patterns.
Conclusion: The typical arrangement of tumor cells and follicular structure with colloid are considered essential for the diagnosis of ovarian strumal carcinoid.View full abstractDownload PDF (9383K) -
Hideto SENZAKI, Mitsuko HAGIMOTO, Takehiko IKEYA, Mayumi OHARA, Takash ...2002 Volume 41 Issue 3 Pages 186-189
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Endometrioid carcinoma of the prostate is a rare tumor typically involving the prostatic urethra as its primary site. Due to this unique location, it may shed cells into urine specimens that may be detected cytologically. This report details cytologic features of this carcinoma in urine specimens.
Case: A 58-year-old man referred to Osaka Saiseikai Nakatsu Hospital for macroscopic hematuria and symptoms of bladder outlet obstruction was found in ultrasonography to have a tumor of the bladder neck. Cystoscopy of the lower urinary tract showed a papillary tumor of the prostatic urethra. Although preoperative urine cytology was class II, we conducted a transurethral resection. Histologically, the tumor was endomertrioid adenocarcinoma of the prostate. Immunohistochemically, tumor cells were positive for prostatic-specific antigen (PSA) and prostatic-specific acid phosphatase (PSAP). Postoperative serum PSA was 17.0ng/ml (normal>4.0 ng/ml). Retrospectively, urine cytology showed papillary or sheetlike fragments of epithelial cells with columnar features. Nuclei were round to oval and nuclear pseudopalisading was evident. The chromatin was granular. Some contained small but distinct nucleoli. Cells in urine were also positive for PSA.
Conclusion: When urine cytology revealed papillary fragments of epithelial cells, we should consider the possibility of endometrioid adenocarcinoma of the prostate as a differential diagnosis.View full abstractDownload PDF (5922K) -
Wakako SATO, Yoshio AIDA, Yoshihiro SATO, Yoshihiko OMATA, Masahiro SH ...2002 Volume 41 Issue 3 Pages 190-193
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Intracranial paragangliomas are very rare. We report a case of paraganglioma originating in the parasellar region.
Case: A 59-year-old man admitted with dizziness, muscular weakness of the left extremities, and cold sweating was found in computed tomography and magnetic resonance imaging to have a tumor in the parasellar region. Surgery was conducted under a clinical diagnosis of meningioma. Imprint cytology of the tumor showed isolated, loosely attached sheet-like tumor cells with abundant cytoplasm and round to oval nuclei. Histologically, the tumor consisted of round and polygonal cells in small packets separated by vascular fibrous septa. Immunohistochemically, tumor cells were positive for NSE, S-100 protein, chromogranin A, and synaptophysin.
Conclusion: We report cytologic features of a rare case of parasellar paraganglioma.View full abstractDownload PDF (6628K) -
Iwao NISHIYA2002 Volume 41 Issue 3 Pages 196-200
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSRecent criticism of cervical diagnostic cytology has focused on ambiguous terminology and classification in cervical intraepithelial neoplasia (CIN).
From the outset of Bethesda system development as a new classification, it has required reevaluation and revision. Neither be precisely described based on cellular morphology and clinical behavior, however.
Fluorescence in situ hybrlidization (FISH) is a powerful tool for detecting chlomosomal abnormalities in interphase cells. FISH with chromosomal-specific repetitive DNA probes was applied to cervical smears of CIN 1, 11, and 111 to detect numerical aberrations of chromosomes 1 and 17. FISH was applied to the same specimens after Pap staining, and copies in marked atypical and abnormal cells were counted.
The 9.49 ± 2.59/9.72 ± 1.40 (%, No.1/No.17) cells showed an aneuploid pattern in CIN 1, 22.5 ± 3.98/15.5 ± 3.02 in CIN 11, 44.3 ± 7.18/45.1 ± 5.61 in severe dysplasia and 52.66 ± 6.32/48.9 ± 7.55 in Ca. in situ. The loss of chromosomes in CIN 111 and the gain of chromosomes in Ca. in situ cases should be noted (p<0.01).View full abstractDownload PDF (2801K) -
Retrospective study on suspicious casesReiko HAYASHI, Hiroyuki KURAMOTO2002 Volume 41 Issue 3 Pages 201-208
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Most cases in which endometrial cytology is suspicious show no organic disease, although endometrial carcinoma and hyperplasia may be detected. We reanalyzed the cytology of dysfunctional bleeding, whose main representatives were of nonorganic disease.
Study design: Subjects were 365 cases of suspicious endometrial cytology including 104 with dysfunctional bleeding. Of these, 87 with no organic diseases underwent endometrial biopsy within 1 year. Endometrial cytology slides were rescreened and reevaluated based on our criteria (12 parameters) in diagnosing complex endometrial hyperplasia.
Results: (1) Of 365 cases with suspicious cytology, 221 (60.5%), had no organic abnormality, and 104 (47.0% of nonorganic cases, 37.0% of all suspicious cases) were diagnosed as dysfunctional uterine bleeding.(2) After rescreening, 74.4% of 87 cases (negative group) were evaluated as negative and 25.3%(suspicious group) remained suspicious.(3) Concerning 12 parameters for complex endometrial hyperplasia, 22.7% cases in the suspicious group had more than 8 parameters, whereas all cases in the negative group had less than 4 parameters.(4) In the negative group, causes for initially suspicious cytology were due to cyclic changes in the endometrium (37.0%), abnormal hormonal status (39.9%), and metaplasia/tissue repair and infection (23.1%).
Conclusion: Dysfunctional uterine bleeding accounted for 37.0% of all suspicious cases in endometrial cytology, 74.7% of suspicious dysfunctional bleeding cases can be ruled out when specimens were strictly evaluated based on hormonal status, metaplasia/tissue repair, and complex hyperplasia criteria.View full abstractDownload PDF (4058K) -
A proposal from the pathologistShotaro MAEDA2002 Volume 41 Issue 3 Pages 209-215
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSCytology progressed dramatically in the 20th century, and has matured beyond being an ancillary diagnostic method. Even so-called “borderline” lesions in some organs can be diagnosed by cytology alone. The definition of borderline lesions is fuzzy, however, especially for “precancerous” lesions. In some other organs, borderline lesions are difficult to diagnose by cytology alone.
The concept and problems with borderline lesions must be clearly defined and a consensus reached on criteria for cytological diagnosis.
Borderline and precancerous lesions should be clarified using imaging, immunocytochemistry, DNA ploidy analysis, and molecular biology. I hope this proposal will be accepted in the near future.View full abstractDownload PDF (940K) -
Takuya MORIYA2002 Volume 41 Issue 3 Pages 216-224
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDuctal carcinoma in situ (DCIS) of the breast has been increasingly detected due to advances in screening mammography. Cytological diagnosis of DCIS is less accurate than that of invasive ductal carcinoma, probably due to lower atypicality and fewer epithelial cells in smears. Cytological findings of DCIS differ among histological subtypes. Atypical ductal hyperplasia (ADH) tends to be diagnosed as benign or suspicious by cytology. This lesion is less than 2mm in the diameter, by definition, and its cytological findings may be influenced by lesion sampling. A new concept, “intraepithelial proliferative lesion of the breast, ” has been proposed, and cytological scoring has been proposed for fine-needle aspiration cytology. Further study is needed for analyzing biological behavior, correlation between needle core biopsy methods, and indications for evaluating surgical margins of breast-preservation surgery by cytology.View full abstractDownload PDF (9660K) -
Yoshiyuki OSAMURA, Hitoshi ITOH, [in Japanese], [in Japanese], [in Jap ...2002 Volume 41 Issue 3 Pages 225-229
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSIn clinical cytology, the application of immunohistochemistry (IHC) in body fluid diagnosis has become very useful in problematic cases. We detuil IHC staining for cytokeratin 7 and 20 in differential diagnosis of carcinoma. In situ hybridization (ISH) is very useful for identifying subtypes of HPV DNA in tissue sections and cytological smears.
Technologies expected to be useful for patient care include tissue microarray (TMA) and laser capture microdissection (LCM). TMA is a panel of numerous tiny tissue blocks subjected to IHC and ISH or fluorescence in situ hybridization (FISH). LCM is the only way to dissect particular cells to analysze genetic abnormalities. Humanized antibody herceptin is clinically useful in patients with metastatic breast cancer, provided they express overexpression or amplification of HER2. Effective selection of patients depends on IHC and FISH done on histological and cytological specimens. This indicate a new role of pathology and cytology in tailor-made medicine.View full abstractDownload PDF (9921K) -
Shunji KAMAZAWA, Hiroaki ITAMOCHI, Yasunobu KANAMORI, Junzo KIGAWA, Na ...2002 Volume 41 Issue 3 Pages 230-231
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of a 69-year-old woman with endometrial mucinous adenocarcinoma distinguished histochemically from clear cell adenocarcinoma and anatomically from endocervical adenocarcinoma. Endometrial cytology showed papillary shaped tumor cell clusters and bubbles in cytoplasm.View full abstractDownload PDF (4071K) -
Report of a caseNaoki HOSAKA, Masaru OGAWA, Toshio MATSUMOTO, Hitomi OGAKI, Susumu IKE ...2002 Volume 41 Issue 3 Pages 232-233
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a rare case of rosette-forming thymoma. Imprinting cytology specimens from the tumor showed tumor cells arranged in small clusters with radial fibrous bands on their surface. These cells also showed epithelial cells without cellular atypia. These cytological findings were helpful in distinguishing this tumor from a carcinoid tumor or thymic cancer. Although 2 years have passed since surgical resection, the patient is mostly well and has no tumor recurrence. To our knowledge, this is the first report on cytological figurs in a tumor.View full abstractDownload PDF (3028K) -
Takae KAJIHARA, Mitsutoshi SHIBA, Akira ISHIKAWA, Katsuhiro KOUNOIKE, ...2002 Volume 41 Issue 3 Pages 234-235
Published: May 22, 2002
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of tongue cancer found by sputum cytology in mass screening. Atypical squamous cells were detected in a sputum cytology specimen from a 70-year-old man. After 2-year follow-up with sputum cytology. a lesion was found and diagnosed as poorly differentiated squamous cell carcinoma of the tongue. Compared to lung cancer, cancer cells of the tongue showed more frequent bizarre squamous cells. Glassy cytoplasm of orangephilic cells was common and nuclear chromatin of light green cells was fine. Sputum cytology is thus effective in diagnosing tongue cancer and lung cancer or pharyngeal cancer.View full abstractDownload PDF (3151K)
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