We use PCR to diagnose Pneumocystis carinii (PC) pneumonia together with cytology. In this report, we studied the difference in detection of PC between PCR and cytology, sputum, and broncoalveolar lavage samples suspicious for PC pneumonia. First, we made cytology smears from samples and treated them with Papanicolaou and Grocott stainng. DNA extractation from remnant samples and amplification of DNA specific for PC were also done. Using PCR, we detected PC in 12 of 22 (55%) samples of broncoalveolar lavage, but only 4 of 33 (12%) sputum samples (p=0.0018). In cytology, we similarly detected 6 cases (27%), but only 1 case (3%)(p=0.013). Broncoalveolar lavage samples were thus more suitable than sputum in detecting PC. PCR was significantly more sensitive than cytology (p=0.039). Grocott staining is generally used and is important for detecting PC. However, it could not confirm positive in case of insufficiency of PC on the smears. We concluded that detection using broncoalveolar lavage samples using PCR were suitable for detecting PC.
We report a case of anaplastic large cell lymphoma (ALCL) in the cervical lymph nodes. A 31-year-old woman had a diagnostic biopsy of swollen cervical lymph nodes. Imprint cytology showed many atypical cells with bizarre nuclei, which were similar to Hodgkin's cells and Reed-Sternberg cells. Histological findings indicated that the sinuses were distended and filled by lymphoma cells that showed atypical mitosis and contained large or giant nuclei and several prominent nucleoli. Immunohistochemical examination revealed that the lymphoma cells were immunopositive for LCA, Ki-1 and EMA. These cytological and histological characteristics were important for diagnosis of ALCL.
We report a case of cutaneous angiosarcoma of the left hip. A 79-year-old woman developing cutaneous angiosarcoma at the radiotherapy site for squamous cell carcinoma of the cervix uteri 15 years earlier was found in imprint cytology to have loosely clumped small round tumor cells with a high N/C ratio. Because she had undergone surgery for double cancer (gastric adenocarcinoma and squamous cell carcinoma of the cervix uteri), we initially suspected low-grade carcinoma metastasis. Malignant cells were stained with CD34 and factor VIII-related antigen by immunohistological study, yielding a final diagnosis of cutaneous angiosarcoma.
We report the case of a 68-year-old woman with inflammatory malignant fibrous histiocytoma of the retroperitoneum. Macroscopically, the cut tumor surface showed a solid mass with cystic components. Histologically, the tumor consisted of multinucleated giant cells, atypical large cells, many neutrophils, and xanthoma-like foamy cells within collagen fibers. Cytologically, large atypical cells appeared with neutrophils or xanthoma-like foamy cells as a background. Large atypical cells had multinucleated and bizarre nuclei. Some tumor cells resembled Reed-Sternberg cells. Immunohistochemical staining ruled out leiomyosarcoma and gastrointestinal stromal tumor. She has been followed up for 2 years without any evidence of local recurrence.