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Volume 42, Issue 6
Displaying 1-13 of 13 articles from this issue
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Hiroko YAMAZAKI, Hideaki YOKOO, Junko HIRATO, Yoichi NAKAZATO2003 Volume 42 Issue 6 Pages 405-411
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Astrocytic tumors account for a large proportion of brain tumors. We assessed the usefulness of imprint cytology for the intraoperative diagnosis of astrocytic tumors.
Study Design: Eighty-one cases of astrocytic tumors, consisting of 6 grade 1, 28 grade 2, 14 grade 3, and 33 grade 4 tumors, were selected from the files of the Department of Pathology, Gunma University School of Medicine, and the imprint cytological findings were compared with the histological features and grades of the corresponding cases.
Results: Astrocytoma grade I tumors had well preserved piloid or fibrillary cytoplasm. Grade II astrocytomas contained uniform round nuclei scattered on a fibrillary background. Grade III astrocytomas were characterized by mild nuclear atypia and high cell density in the clusters. Grade IV astrocytoma cells had well demarcated cell borders and features of severe cellular atypia, such as pleomorphic nuclei and single or multi-nucleated giant cells.
Conclusion: Imprint cytology has some limitations in terms of the final diagnosis of astrocytic tumors, because their classification largely depends on the cytoarchitecture of the tumor. However, our study indicates that imprint cytology has the advantages of rapid preparation of the specimen and detailed whole-cell observation and that it provides a great deal of useful information for grading astrocytomas.View full abstractDownload PDF (9404K) -
Maki KANASHIKI, Masayuki SOMA, Yoshihiro MATSUI, Yoko SAITO, Eiichi AK ...2003 Volume 42 Issue 6 Pages 412-416
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Chest X-ray was most effective in detecting peripheral lung cancer, and sputum cytology was most effective in detecting early cancer of major bronchus. We reviewed our cases of roentgenographically occult lung cancer.
Study Design: Subjects were 58 cases of lung cancer found by sputum cytologic screening between April 1995 and March 2001. We studied the stage and location of them.
Results: Mean age was 69.5±6.5 years old. The diagnosis was squamous cell carcinoma in 41 cases and adenocarcinoma in 11 cases. Of the roentgenographically occult cases 15% were carcinoma in situ and 46% were stage I, and 83% of the stage I were carcinoma of a major bronchus.
Conclusion: Sputum cytology led to the diagnosis of 58 cases of lung cancer over a 6-year period, and 70.1% of the cases were squamous cell carcinoma. There were more cases of roentgenographically occult cancer than cases diagnosed by conventional roentgenographic techniques (p=0.00152). Tumors located from the trachea to proximal portion of segmental bronchus (major bronchus) were more often found by sputum cytology than by chest X-ray (P=0.01337). Some early carcinomas of major bronchus may be detected by sputum cytology.View full abstractDownload PDF (565K) -
Toshie TERAUCHI, Michiho TAKENAKA, Manabu YAMASHITA, Yoshifumi ASAKURA ...2003 Volume 42 Issue 6 Pages 417-422
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Rhabdomyosarcoma is a highly malignant tumor that usually occurs in infants and juveniles. We report a case of alveolar rhabdomyosarcoma that occurred in a para-nasal sinus of an adult.
Case: A middle-aged female was found to have a tumor in the right para-nasal sinus, and a biopsy was performed. An imprint smear showed loosely clumped small round tumor cells with a high N/C ratio. The cells possessed clear cytoplasm and round nuclei, containing granular chromatin. Since the patient was middle aged and the tumor cells exhibited a mold-like arrangement, small cell carcinoma was suspected initially, however, because glycogen and a light green drop were observed in the cytoplasm, the final diagnosis was rhabdomyosarcoma. Electron-microscopic examination revealed ultrastructural characteristics of striated muscle, and the cells were desmin-positive immunohistochemically. In addition, molecular biology confirmed a PCR product of a genetic variant peculiar to alveolar rhabdomyosarcoma.
Conclusion: It is difficult to make the differential diagnosis of small round tumor cells cytologically. When a tumor is exam ined cytologically to confirm a diagnosis of rhabdomyosarcoma, it is important to find glycogen and a light green drop in the cytoplasm of the tumor cells.View full abstractDownload PDF (10328K) -
Nobuaki KATO, Hitoshi ITOH, Naruaki MATSUI, Youko MIYAJIMA, Masanori Y ...2003 Volume 42 Issue 6 Pages 423-426
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: A 72-year-old woman presented with invasive ductal carcinoma and extensive infarction in the left breast.
Case: Fine-needle aspiration cytology showed numerous scattered small cells with bare nuclei containing pyknotic nucle oli.
Histologically, massive infarction was observed in the tumor mass. A few viable carcinoma cells were identified around the area of infarction necrosis, and the tumor was diagnosed as invasive ductal carcinoma with massive infarction.
Conclusion: It is difficult to distinguish a benign lesion with infarction from a malignant tumor when only degenerating cells are obtained by fine-needle aspiration cytology of the breast.View full abstractDownload PDF (6746K) -
A case reportShousuke UETA, Miko MITANI, Miho ICHIEN, Tamotsu TAKAHASHI, Eiji OHHAR ...2003 Volume 42 Issue 6 Pages 427-430
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Secretory carcinoma of the breast is rare. It is most common in children and young adults and very rare in advanced
Case: A 74-year-old woman was admitted to Kochi Medical School Hospital because of a mass in the left breast. The tumor was diagnosed as breast cancer by needle biopsy, and partial mastectomy with axillary lymph node dissection was performed. Imprint smears obtained from the tumor were cellular and contained clusters or sheets of cells with moderate to abundant cytoplasm and intracytoplasmic vacuoles. Occasional signet-ring cells were also present. The tumor cells contained slightly hyperchromatic round nuclei and small nucleoli, and colloid-like and mucous material were present in the vacuoles as well as in the background. Characteristic structures referred to as “mucous globular structures” and aggregated forms like “bunches of grapes” were observed. Histologically, the tumor consisted of cells with glandular, solid, and papillary growth patterns. The tumor cells had frothy pale pink or amphophilic bubbly cytoplasm and round nuclei. Colloid-like material was observed in the gland lumens resembling thyroid tissue.
Conclusion: Cytological diagnosis of secretory carcinoma of the breast is possible on the basis of the characteristic features of the tumor.View full abstractDownload PDF (3785K) -
Yaeko KOBAYASHI, Hideo TESHIMA, Kuniko UTSUGI, Noriyuki FURUTA, Atsuko ...2003 Volume 42 Issue 6 Pages 431-434
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: We report a nongestational pure choriocarcinoma of the ovary that was diagnosed by imprint cytology. Nongestational pure choriocarcinomas of the ovary an extremely rare, and imprint cytology for this type of lesion has not been previously reported.
Case: A 16-year-old woman with abdominal pain was found to have an ovarian tumor the size of child's head. The patient's serum beta-hCG level was 4, 500 ng/ml and multiple lung metastatases were found. She underwent a right salpingo-oophorectomy. Imprint cytology showed abundant blood and necrotic substances, with some viable cells. These cells consisted of syncytiotrophoblasts, cytotrophoblasts and intermediate trophoblasts with atypical nuclear findings. The cytological findings were the same as those for gestational choriocarcinoma. The final histologic diagnosis was primary pure choriocarcinoma.
Conclusion: Imprint cytology is valuable for the diagnosis of nongestational primary choriocarcinoma of the ovary.View full abstractDownload PDF (6107K) -
Ayako NAKAJIMA, Kuniko UTSUGI, Yaeko KOBAYASHI, Kazuya TAMURA, Tetsuya ...2003 Volume 42 Issue 6 Pages 435-438
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Mucoepidermoid carcinoma of the uterine cervix, which has a unique cytopathology, is a rare condition. The term mucoepidermoid as such is excluded from the histological classification of cervical carcinoma and classified as adenosquamous carcinoma. Here we report a case of mucoepidermoid carcinoma of uterine cervix.
Case: A 54-year-old woman with a positive cervical pap smear was found to have FIGO stage Ibl of the uterine cervix and pathologically diagnosed with adenosquamous carcinoma. We conducted optimal surgery and the patient remains diseasefree 5 years postoperatively. Cytologically, cervical malignant cells formed small clusters without overlapping in the bloody background and each cell was rich in mucin in the cytoplasm. Most nuclei were small, oval and one-sided in the cytoplasm. These mucin-productive cells coexisted with squamous cells.
Conclusion: We reported a case of mucoepidermoid carcinoma of the uterine cervix. Since mucoepidermoid carcinoma is known to have more malignant potential than other types in lymph node metastasis, hematogenous and lymph node metastasis should be checked for preoperatively.View full abstractDownload PDF (3772K) -
[in Japanese], [in Japanese]2003 Volume 42 Issue 6 Pages 439
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (79K) -
Yasuaki HIROOKA, Hiromi OONISHI, Yoshimi OGAMI, Tsuyoshi UEDA, Kazunor ...2003 Volume 42 Issue 6 Pages 440-443
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The aim of this study was to determine whether the quantity of free cancer cells in peritoneal washing cytology specimens from gastric cancer patients affects the patients' prognosis.
Study Design: Sixty-one patients without peritonal metastasis but with positive intraoperative washing cytology, specimens were divided into two groups on the basis of whether they had more or less than 5 cancer cells in their cytological specimen. The survival rates between these two groups were then compared.
Results: No significant difference in survival rates was seen between patients with 5 or less cancer cells in their cytological specimens and those with more than 6 cancer cells. However, among the patients with fewer cancer cells, the survival curve of patients treated with intraperitoneal hyperthermic chemotherapy was similar to that of patients without peritoneal metastasis and a positive intraoperative washing cytology.
Conclusion: Evaluating the number of free cancer cells in the peritoneal washing cytology may be a useful predictor of the effects of intraperitoneal hyperthermic chemotherapy and the prognosis for of patients with gastric cancer.View full abstractDownload PDF (2301K) -
Hiromi OCHIAI, Tomoko SAKURAI, Kouichi USAMI, Yumiko KOBAYASHI, Kaori ...2003 Volume 42 Issue 6 Pages 444-452
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Peritoneal washing cytology provides valuable information for the staging of gastric cancer. The aim of this study was to evaluate the predictive value of intraoperative peritoneal washing cytology in patients with gastric cancer in Niigata Cancer Center Hospital.
Study Design: During the past 10 years, 698 patients with gastric cancer underwent a gastrectomy. Peritoneal washing cytology was requested for these patients. Using HE staining and the Papanicolaou technique, washing specimens were cytologically examined. Immunocytochemical studies for CEA and MOC-31 were also performed during the last three years.
Results: Patients with positive results for malignant cells had a significantly poor prognosis that was not related to tumor developement. As the extent of tumor invasion deepened, the rate of poorly differentiated adenocarcinoma increased. In poorly differentiated tumors, single tumor cells with cytologically low-grade atypia were apt to be observed in the peritoneal washings. The recurrence rate in patients with positive resutls for CEA or MOC-31 was significantly high. When immunocytochemical positivity was applied on a malignant cytology basis, the rate of positivity was 11%.
Conclusions: Peritoneal washing cytology is important predicting the prognosis and possibility of relapse in patients with gastric cancer. However, morphological examinations, such as HE and the Papanicolaou technique, rarely fail to detect cancer cells. To improve diagnostic accuracy, immunocytochemical studies are needed.View full abstractDownload PDF (6240K) -
The rapid intraoperative cytological diagnosis using microwave irradiationTetsuya OKAZAKI, Kazuhisa ISHI, Katsunari KINA, Naoko OKUYAMA, Reiko K ...2003 Volume 42 Issue 6 Pages 453-461
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: Although Papanicolaou staining and May-Giemsa staining are commonly employed in intraoperative rapid cytology, there are occasions when PAS staining or immunocytochemical staining (enzyme immunoassay) is perceived to be necessary. Especially during surgeries for cancers of the digestive tract, differentiating between cancer cells and reactive mesothelial cells in intraoperative samples of intraabdominal lavage and ascites may be difficult. We examined the effectiveness of using a microwave rapid sample-processing instrument (Type MI-77, Azumaya Medical Instruments Inc.) for PAS staining and immunocytochemical staining as part of intraoperative rapid cytology examinations.
Study Design: Samples of intraabdominal lavage and intraoperative ascites obtained in our hospital were fixed in 95% ethanol and used in this study.
PAS staining and immunostaining (LSAB method, ChemMate ENVISION Kit; DAKO) were performed using a microwave instrument. Antibodies against EMA, CEA, Ber-EP4 and calretinin were used.
Results: By using the microwave rapid sample-processing instrument for PAS staining and immunostaining, the reaction was intensified and the staining time was shortened.
Conclusion: For PAS staining and immunocytochemical staining conventionally requiring lengthy staining procedures, the use of a microwave rapid sample processing instrument permits rapid protocols involving these staining methods to beperformed. This technique is expected to be useful for intraoperative rapid cytology.View full abstractDownload PDF (6778K) -
Hidemi SHIBUTA, Hiroshi OKAMURA, Toshiaki KAMEI, Kaori YASUNAGA, Yoshi ...2003 Volume 42 Issue 6 Pages 462-469
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We assessed the usefulness of preparing and staining cytologic specimens using the guidelines for rapid intraoperative peritoneal washing fluid cytology in patients with gastric cancer (J. JPn Soc. Clin. Cytol 2001; 40: 93-98)
Study Design: We examined 198 intraoperative peritoneal washing fluid samples, 34 peritoneal effusions, and 65 pericardial washing fluid samples from autopsies. The staining quality and other technical issues ware then evaluated.
Results: A minimal amount of cell shrinkage occured using silane-coated glass slides, compared with the use of uncoated slides. If specimens preparation could not be immediately performed, the degree of cytomorphologic alteration was lower in the samples stored in a refrigerator, compared with that inthan those left at room temparature. Adding serum to fluids reduced artificial cell changes. The lysis of erythrocytes made theidentification of individual cells easier, when preparing hemorrhagic effusions. If the fluids contained few cells or the time of fixation was limited, the Saccomanno concentration method was effective. The rapid Papanicolaou staining method was superior to the ultrafast Papanicoloau or Diff-Quik staining with regard to morphologic integrity and staining quality.
Conclusion: We confirmed the usefulness of cytopreparatory procedures based on the guidelines for intraoperative peritoneal washing fluid cytology (Jpn. Soc. Clin. Cytol). Adding serum to fluids is recommended to reduce degenerative changes.View full abstractDownload PDF (8653K) -
Rina KATO, Kiyoshi HASEGAWA, Yasuhiro UDAGAWA, Hiroshi HIRASAWA, Makot ...2003 Volume 42 Issue 6 Pages 470-471
Published: November 22, 2003
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a rare case of dedifferentiated liposarcoma with malignant granular cell tumor-like elements, this condition has not been previously reported. An 84-year-old woman had a large abdominal mass. CT and MRI examinations denmonstrated the presence of two masscs, both of which were subseguently excised. One of masses was a well-differentiated liposarcoma in the mesentry, whereas the other was a dedifferentiated liposarcoma that displayed dedifferentiation resembling a malignant grarnular cell tumor in the retroperitoneum, upon pathological examination. The latter mass was finally diagnosed as a late complication of a preexisting well-differentiated liposarcoma, not as de novo lesion, because of the coexistence of a component of well-differentiated liposarcoma.View full abstractDownload PDF (2660K)
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