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Volume 42, Issue 1
Displaying 1-19 of 19 articles from this issue
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Motoi SASAGAWA, Koji NISHINO, Shigeru HONMA, Shoji KODAMA, Takeshi TAK ...2003 Volume 42 Issue 1 Pages 1-4
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We clarified the clinical significance of uterine cytology in the diagnosis of ovarian carcinoma.
Study Design: A clinical file of 85 cases of epithelial ovarian carcinoma was reviewed. A positive rate in preoperative cervical and endometrial cytology was calculated and factors correlated with the positive rate were analyzed.
Results: (1) Positive rates in cervical and endometrial cytology were 6% and 17%, (2) Of 27 cases in which both smears were taken, 5 showed positive endometrial and negative cervical smears, and 22 were negative for both.(3) The positive rate in cervical cytology was associated with clinical stage (p<0.05).(4) The presence of ascites and the result of peritoneal cytology did not correlate with the positive rate.(5) Positive rates of endometrioid adenocarcinoma in cervical cytology and serous adenocarcinoma in endometrial cytology were higher than in other histological types (p<0.01).(6) The histological grade did not correlate with the positive rate.
Conclusion: Although uterine cytology is not considered to be useful for early detection of ovarian carcinoma, several cases existed in which uterine cytology suggested the presence of ovarian carcinoma. If malignant glandular cells are observed and fractional curettage of the endometrium and endocervix fails to show carcinoma, the diagnosis of ovarian carcinoma must be borne in mind.View full abstractDownload PDF (593K) -
Satoshi IKEDA, Naoya FUNAKOSHI, Keiko SUZUKI, Hiroshi KIMURA, Emiko HO ...2003 Volume 42 Issue 1 Pages 5-9
Published: January 22, 2003
Released on J-STAGE: December 05, 2011
JOURNAL FREE ACCESSObjective: For a small number of non-small-cancer cells in respiratory cytological smears, we studied double immunocytochemical staining using high molecular weight cytokeratin (34βE12) and thyroid transcription factor-1 (TTF-1) antibodies for differential diagnosis of adenocarcinoma and squamous cell carcinoma.
Study Design: We studied 68 cases of imprint smears from lung carcinomas (48 adenocarcinomas. 20 squamous cell, 4 large cell, and 1 adenosquamous) surgically reflected. Smears were stained with 34βE12, then heat-treated using MW and stained with TTF-1. We also studied 20 cases of bronchial brushing and washing cytology smears diagnosed as positive routinely and supported by histology.
Results: In imprint smears, all cases of squamous cell carcinoma were positive for 34βE12 and negative for TTF-1, while 65.1% of adenocarcinomas were negative for 34βE12 and 95.3% positive for TTF-1. A significant reverse correlation existed between the expression of 34βE12 and adenocarcinoma tumor differentiation.
In a small number of cancer cells in cytology smears, 13 of 16 cases of adenocarcinoma were positive for TTF-1.
Three of 4 cases of squamous cell carcinoma were positive for 34βE12.
Conclusions: Our results suggest that double immunocytochemical staining using 34βE12 and TTF-1 was useful in differentially diagnosing adenocarcinoma and squamous cell carcinoma in routine cytological specimens.
In adenocarcinomas, the reduction of 34βE12 reflected tumor differentiation.View full abstractDownload PDF (3294K) -
Shinji HAMAKAWA, Kazuma MORI, Yoshimi KASHIWAZAKI, Mie TANABE, Youichi ...2003 Volume 42 Issue 1 Pages 10-16
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We reexamined archive effusion cytology of malignant mesothelioma to study typical molded cells with hump-like cytoplasmic processes.
Study design: Using effusion material from 4 patients with epithelial malignant mesothelioma, we conducted the usual cytological examination, and electron microscopic and immunocytochemical examinations.
Results: Malignant mesothelioma cells appeared in the following morphology, in a conceivably on going process; 1) single cells, 2) cell-to-cell apposition, 3) molded cells with hump-like cytoplasmic processes, 4) so-called pair cells, and 5) molded cell clusters. In these cells, immunocytochemistry was positive for calretinin, cytokeratin 5/6, WT1 and, EMA, and electron microscopy showed long thin microvilli and aggregates of intermediate filaments surrounding nuclei.
Conclusion: Typical molded cells with hump-like cytoplasmic processes are a diagnostic clue in effusion cytology for malignant mesothelioma and appear to be a stage in a conceivably on going process in which single mesothelioma cells mutually adhered, finally forming a small cell cluster.View full abstractDownload PDF (13809K) -
Cytological and histological comparison with adenoid cystic carcinoma of the salivary glandMikiko ISHII, Takashi KOJIMA, Tohru AKAMINE, Jun-ichi KAWANO, Tomoko S ...2003 Volume 42 Issue 1 Pages 17-21
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: A case of adenoid cystic carcinoma (“ACC”) of the uterine cervix is reported. An accurate diagnosis of this tumor is very difficult because “ACC” of the uterine cervix differs histologically from ACC in other sites.
Case: A 57-year-old woman was diagnosed as having “ACC” on the basis of an operative specimen. A preoperative cytological examination revealed cribriform-type cell clusters, but a definite diagnosis could not be made prior to operation.
Conclusion: “ACC” of the uterine cervix and ACC in other sites both exhibit cribriform cell nests, but the latter tumors also exhibit so-called pseudocysts, with a two-layer pattern lined with basement membrane and a myoepithelial layer, whereas the former is not characterized by these pseudocysts. As a result, the cribriform pattern is more obscure in “ACC” of the uterine cervix and is similar to that seen in ordinary adenocarcinoma. Careful observation and accurate knowledge should make it possible to diagnose this rare tumor.View full abstractDownload PDF (6125K) -
Nobuhiro TAKESHIMA, Tetsuya NAKAGAWA, Yuji ARAI, Yuko SUGIYAMA, Yasuo ...2003 Volume 42 Issue 1 Pages 22-26
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: The prognostic significance of positive peritoneal cytology in endometrial cancer remains unsettled. We previously classified malignant cell clusters on peritoneal smears into two morphologic types and found that those with irregular edges, so-called “scalloped clusters”, were associated with peritoneal seeding or a poor clinical outcome. We have also reported on the use of postoperative peritoneal washings to investigate residual malignant cells in the peritoneal cavity.
Case: A 56-year-old woman underwent surgery for endometrial cancer (grade 1 endometrioid adenocarcinoma). At operation, positive peritoneal cytology was found without obvious peritoneal seeding, so a tube for cytologic studies was inserted when closing the abdomen. Washings were obtained via the tube at 7 days and 14 days after surgery, and both sets of washings were also positive for malignant cells. All three peritoneal smears showed scalloped clusters. These findings strongly suggested the presence of occult metastasis in the peritoneal cavity that had been overlooked at operation. Despite adjuvant therapy, the patient developed intraperitonal recurrence 8 months after surgery.
Conclusion: Postoperative peritoneal washings and morphologic analysis of positive peritoneal smears are useful to determine the malignant potential of endometrial cancer with positive peritoneal cytology.View full abstractDownload PDF (5370K) -
Yoshinari TANAKA, Hiroshi OHTANI, Masao KISHIKAWA2003 Volume 42 Issue 1 Pages 27-30
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Idiopathic pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by deposition of proteineceous materials containing lipid in alveolar spaces. We report 3 cases of idiopathic PAP and describe cytological findings in bronchoalveolar lavage (BAL) fluid and histological findings of transbronchial lung biopsy specimens.
Cases: The 3 patients-all men 48 to 50 years old were a symptomatic and pointed out due to abnormal shadows in chest radiography in a medical examination. Findings in chest computed tomography indicated PAP. BAL sediments all showed numerous, amorphous, granular materials within a finely granular background. Two also contained thick well-circumscribed globules.
Conclusion: Microscopic examination of BAL sediment is useful for a definite clinicopathological diagnosis of PAP. Early diagnosis and treatment for PAP may lead to a good prognosis.View full abstractDownload PDF (5023K) -
Masaru KAWAI, Naoto KISHIKAWA, Takashi ITOH, Shiro ADACHI2003 Volume 42 Issue 1 Pages 31-34
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Glomus tumors are benign and usually found in the skin and soft tissue. They also arise in the gastrointestinal tract, mostly in the stomach.
Case: A 34-year-old woman undergoing endoscopic examination for severe anemia was found to have a submucosal tumor in the stomach, which was resected by the local excision. The tumor was a well-circumscribed solid mass distributed in the submucosa and muscle layer. Touch-smear cytology of the tumor showed tightly packed clusters of uniform, round cells with scanty clear cytoplasm. Nuclei were uniform and round and contained inconspicuous nucleoli. These cytological features suggested gastric glomus tumor, confirmed by histological examination.
Conclusion: In determining cytological features of gastric submucosal tumors, fine-needle aspiration biopsy or touchsmear examination are useful, rapid, and cost-effective in diagnosing submucosal neoplasms.View full abstractDownload PDF (6586K) -
Seiji TSURUTA, Yutaka NOMOTO, Chiharu SHINBO, Harumi NEGISHI, Hanako A ...2003 Volume 42 Issue 1 Pages 35-38
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report here on a case of primary gastric marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) with cytoplasmic azurophilic granules.
Case: A 66-year-old man was admitted to the hospital with diarrhea and appetite loss. Endoscopic examination revealeda slightly elevated ulcerative tumor in the gastric fundus. Biopsy revealed MALT lymphoma, and partial gastrectomy was performed. The intraoperative cytology specimen was composed of numerous medium sized tumor cells with scatterd small lymphocytes and plasma cells. Papanicolaou staining showed the tumor cells had a moderate amount of clear cytoplasm, with indented nuclei enclosed in a thick nuclear menbrane, containing conspicuous nucleoli and finely dispersed chromatin. Giemsa stained specimens revealed coarse azurophilic granules in the mildly basophilic cytoplasm of approximately 21% of cells. Immunohistochemistry revealed the tumor cells were CD20cy (+), CD79a (+), CD3 (-), CD5 (-), CD10 (-), cCD23 (-) and Granzyme B (-).
Conclusion: The findings in the present case suggest thatMALT lymphoma also exhibits intracytoplasmic azurophilic granules.View full abstractDownload PDF (6053K) -
Report of a caseKayoko WATANABE, Eiji OHNO, Manabu HATTORI, Masaru YOKOYAMA, Jun WATAN ...2003 Volume 42 Issue 1 Pages 39-44
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Small cell carcinoma of the stomach is a rare tumor. We report imprint cytological findings of the tumor, in addition to specific immunocytochemical and electron-microscopic findings.
Case: A 65-year-old man was found in gastric endoscopy to have a Borrmann type 3 lesion 9.4×7.0cm at the posterior wall of the upper stomach, necessitating total gastrectomy. Intraoperative imprint cytology showed that small tumor cells with scanty cytoplasm were scattered or clustered in a molding pattern on a necrotic background. Oval to elliptical nuclei contained fine granular chromatin and occasionally prominent nucleoli. These findings were consistent with small cell carcinoma of the lung. Histopathological findings showed diffuse proliferation of tumor cells with scanty cytoplasm, and round, elliptical, or sphenoidal nuclei. Some tumor cells formed peripheral palisading. Immunocytochemistry and histochemistry confirmed that tumor cells were positive for synaptophysin and chromogranin A. Electron microscopy identified endocrine granules positive for chromogranin A. A small focal tubular adenocarcinoma lesion found incidentally next to the main tumor, was also positive for neuroendocrine granules.
Conclusion: Imprint cytology is useful in diagnosing small cell carcinoma of the stomach. Immunocytochemical and immunoelectron microscopic findings confirmed the diagnosis.View full abstractDownload PDF (11612K) -
Miko MITANI, Tamotsu TAKAHASHI, Toshiaki MORIKI, Shousuke UEDA, Miho I ...2003 Volume 42 Issue 1 Pages 45-48
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Amebic liver abscess (ALA) is commonly diagnosed by detecting moving ameba and serological tests. Few reported ALA cases were diagnosed based on cytology.
Case: A 49-year-old man admitted with a high fever and abdominal pain was found in ultrasonography and computed tomography to have an intrahepatic abscess. ALA was suspected because he had traveled to China. After medication with an antiprotozoal agent, a gray yellowish-colored aspirated material from the lesion was inspected by phase-contrast microscopy. Culture and serological tests were done but Entamoeba histolytica (EH) was not detected. Cytological examination was done with the same material and trophozoites of EH associated with abundant necrotic cellular debris, degenerated hepatocytes, and mixed inflammatory cells with Charcot Leiden crystals were observed. EH had small vesicular nuclei and vacuolated cytoplasm containing some phagocytosed red blood cells. The diagnosis was confirmed by immunostaining using anti-EH antibody on the cytological specimen.
Conclusion: Although our case was unusual from the gross appearance of aspirated material and the negative serological result, EH with typical staining by Papanicolaou and periodic acid-Schiff was observed in the cytologic specimen. Immunostaining for EH was considered very useful for confirming the diagnosis of ALA.View full abstractDownload PDF (5617K) -
Youko MIYAJIMA, Hitoshi ITOH, Shinobu UMEMURA, Masanori YASUDA, Yoshiy ...2003 Volume 42 Issue 1 Pages 49-54
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Phyllodes tumor is a rare type of fibroepithelial tumor accounting for 0.3-0.5% of breast tumors. We present the cytologic features of phyllodes tumors, these features enabled preoperative diagnoses to be made.
Cases: Two women (46 and 44 years old) presented with a tumor mass in the B area of their breasts and were admitted to hospital. Smears showed discohesive cells with abundant cytoplasm predominating. The tumor cells had hyperchromatic round or oval nuclei containing prominent nucleoli. These cells appeared to be pleomorphic and varied in size. Scattered atypical, multinuclear giant cells were also observed. The cytologic preparation contained normal epithelial cells and some foamy cells in the background. The specimens were differentiated from stromal sarcoma, carcinosarcoma, and spindle cell carcinoma based on the absence of malignant epithelial cells and the presence of normal ductal cells and foamy cells in the background. We suspected the tumors to be malignant phyllodes tumors.
Conclusion: A wide local excision, with an adequate margin of normal breast tissue, is the preferred initial therapy for phyllodes tumor of the breast, even in malignant cases. Therefore, it is very important to differentiate phyllodes tumor from breast cancer, for which more extensive treatments are required.View full abstractDownload PDF (9631K) -
[in Japanese], [in Japanese]2003 Volume 42 Issue 1 Pages 55
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (102K) -
Akinori ISHIHARA, Akira KAMIMORI, Hideyuki KOYAMA, Yutaka NAKAMURA, To ...2003 Volume 42 Issue 1 Pages 56-63
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We histologically and cytologically analyzed stromal materials from scirrhous carcinoma (SC) of the breast.
Study Design: Subjects were 285 patients with invasive ductal carcinoma and 9 with invasive lobular carcinoma of the breast, studied using fine needle aspiration.
Results: Stroma of SC of the breast consisted of abundant bundled collagen fibers and (myo) fibroblasts. Dense hyalinous fibrous tissue and elastic fibers were demonstrated at the center of SC. Insufficient or indeterminate cytologic materials were obtained from central tumor tissue. Cytologically, the incidence of stromal materials was 73% in patients with SC. Elastic fibers and dispersive tumor cells among fat cells showed SC.
Conclusion: Stromal elastic fibers and dispersive tumor cells among fat cells are useful in diagnosing SC of the breast.View full abstractDownload PDF (13107K) -
How to make a correct diagnosis by FNA cytologyShotaro MAEDA, Masaru HOSONE, Hironori KATAYAMA, Hiroaki ISOBE, Yumi Y ...2003 Volume 42 Issue 1 Pages 64-72
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Scirrhous carcinoma of the breast (SCB) is difficult to diagnose by fine-needle aspiration cytology (FNAC), so we focused on how to make a correct diagnosis more easily.
Study Design: Surgeries numbering 112 for SCB were divided into 3 types-(1) SCB without papillotubular and solidtubular carcinoma components (Pure SCB);(2) SCB with papillotubular carcinoma components (papillotubular SCB);(3) SCB with solid-tubular carcinoma components (solid-tubular SCB) based on Japanese breast cancer classifications and studied cytological findings for each type.
Results: In 27 cases of pure SCB, a few cells (67%), dyshesive cells (63%), small groups of cells (78%), a trabecular arrangement (89%), and intracytoplasmic lumina [ICL](56%) were frequently observed. In 72 cases of papillotubular type SCB, numerous cells (69%), dyshesive cells (74%), solitary cells (58%), small groups of cells (82%), and a trabecular arrangement (83%) were frequently observed. In solid-tubular SCB, numerous tumor cells (92%), dyshesive cells (77%), prominent cellular atypia (77%), solitary cells (85%), small groups of cells (85%), and ICL (54%) were frequently observed.
Conclusion: These features are important for accurately diagnosing SCB by FNAC. More difficult cases may indicate core needle or excisional biopsy.View full abstractDownload PDF (8840K) -
Sachiko NAGUMO, Tsutomu KASUGAI, Jyunichi ASHIMURA, Akihiko NAKAIZUMI, ...2003 Volume 42 Issue 1 Pages 73-81
Published: January 22, 2003
Released on J-STAGE: December 05, 2011
JOURNAL FREE ACCESSObjective: We studied results of aspiration cytology and cytological findings in scirrhous carcinoma (SC) of the breast, including pure and mixed subtypes, differences in cytological findings between pure SC and invasive lobular carcinoma.
Study Design: We reviewed cytologic findings in SC in preoperative aspiration cytology of 86 patients (pure: 16; papillotubular: 34; solid-tubular: 36) who underwent surgical resection and compared these findings to those for invasive lobular carcinoma in 14 patients. Items checked included presence, arrangement, nuclear morphology, chromatin density, nucleolus, and intracytoplasmic lacunae (ICL) of cancer cells. For 10 cases of pure SC and 10 of invasive lobular carcinoma, we measured nuclear area. All specimens were stained by the Papanicolau method.
Results: Positive percentages of aspiration cytology were 81.2% for pure, 94.1% for papillotubular, and 100% for solid-tubular SC. Common cytological findings were trabecular and boxtype arrangement regardless of the number of cancer cells. Pure SC was marked by the small number of cancer cells. Papillotubular SC featured various cancer cells and cuneiform and tubular arrangements. Solid-tubular SC featured frequentcellularity of cancer cell nests and single cells. Cytologic findings for pure SC were very similar to those of invasive lobular carcinoma. Differential findings were as follows: increased chromatin density, low frequency of ICL (38%), large nucleus (mean nuclear area: 50.0 μm2), and broad range of nuclear area in pure SC. No cuneiform or tubular arrangement, high frequency of ICL (64%), small nucleus (mean nuclear area: 34.5 μm2), and small range of nuclear area in invasive lobular carcinoma.
Conclusion: Typical cytological findings were useful in detecting subtypes of SC and invasive lobular carcinomaView full abstractDownload PDF (11191K) -
Noriyuki BABA, Jiro SASAKI, Etsuko UCHIDA, Takehisa NAGAYAMA, Kazuhiko ...2003 Volume 42 Issue 1 Pages 82-86
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We used ultrasound (US) to guide fine-needle aspiration cytology (FNA) in breast cancer to avoid sampling errors due to incorrect puncture.
Study Design: We used a 20cc syringe with a 21G needle and a puncture pistol. Under US, we punctured breast masses freehand.freehand. We checked in real-time US imaging that puncture needles were correctly guided into masses.
Results: We studied 215 cases of breast cancer, finding 206 positive for breast cancer.
Surgical biopsy was necessary for 9 cases, but, only 3 cases were biopsied due to an inappropriate sampling.
Conclusions: We concluded that US-guided fine-needle aspiration is useful in obtaining sufficient materials for cytopathological diagnosis and improves FNA accuracy.View full abstractDownload PDF (5672K) -
Masato SUZUKI, Takeshi NAGASHIMA, Hiroshi YAGATA, Hideyuki HASHIMOTO, ...2003 Volume 42 Issue 1 Pages 87-93
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Cytological diagnosis of fine needle aspirates of scirrhous breast invasive ductal carcinoma (scirrhous carcinoma, (SC)) is sometimes difficult because of insufficient material. We present fine needle aspiration cytology (FNAC) and computerized morphometric analysis of breast aspirates.
Study Design: Ultrasound (US)-guided FNAC was conducted for 73 invasive ductal carcinomas. We evaluated the successful obtaining of sufficient materials for diagnosis and diagnostic value. Computerized morphometric analysis was conducted for 120 invasive breast carcinomas. We calculated NACV (coefficient of variation of nuclear area) as an objective parameter of anisonuclosis, and estimated SC using this parameter.
Results: US-guided FNAC revealed 98.6% success. NACV was correlated with histological grade. Even in the “small nucleus” group, NACV of SC was greater than that of other types of breast carcinoma (29.5±9.7%, 25.5±6.9%, p>0.05).
Conclusion: US-guided FNAC is useful and morhometric analysis is supportive in diagnosing SC.View full abstractDownload PDF (8943K) -
Katsuhiko MAEDA, Hisatoyo KASAI, Masako ITOU, Masatoshi WATANABE, Taiz ...2003 Volume 42 Issue 1 Pages 94-95
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of cutaneous metastasis of prostate cancer, A 73-year-old man had a nodular lesion in a chest tumor. Aspiration cytology showed a cribriform pattern of tumor cells with oval and round nuclei and fine granular chromatin. Histologically, the tumor consisted of various-sized glands and cribriform structures. Immunohistochemical staining for prostate-specific antigen was positive in tumor cells and confirmed in transrectal biopsy of the prostate. When aspiration cytology is used in cutaneous tumors, prostate cancer should be considered as a differential diagnosis.View full abstractDownload PDF (3674K) -
Tomoyuki ASARI, Kouiti NARA, Sadahiro HOSOBE, Ken SAITO2003 Volume 42 Issue 1 Pages 96-97
Published: January 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSA 78-year-old male reporting cough and hemoptysis was found in chest radiography to have multiple hazy nodular shadows in both lungs but computed tomography and ultrasonography did not indicate a primary lesion in other organs. He died 12 days later. Autopsy showed multiple blood-tinged tumors in the lung but not in other organs. Cytology imprinted from 1 pulmonary tumor showed atypical cells occasionally forming small clusters and lumen-like structures. Nuclei were irregular and byperchromatic with large nucleoli. Some tumor cells showed erythrophagia in the marginal cytoplasm. Immunohistochemically, tumor cells were positive for factor VIII and CD31, lading to a diagnosis of angiosarcoma. Cytologically. it was difficult, but possible to diagnose angiosarcoma by erythrophagia.View full abstractDownload PDF (2518K)
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