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Volume 44, Issue 3
Displaying 1-13 of 13 articles from this issue
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Modified Papanicolaou's classification vs The Bethesda System 2001Hidehiro TAKEI, Bernardo RUIZI, Maki TAKAHASHI, Hiroyoshi SUZUKI, Fumi ...2005 Volume 44 Issue 3 Pages 111-117
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We compared differences in the diagnosis of cervicovaginal (Pap.) smears between Japan (modified Papanicolaou classification) and the U. S.(The Bethesda System 2001).
Study Design: Pap smears from 109 American women previously diagnosed by cytopathologists in the U. S. were independently reexamined by an experienced cytotechnologist in Japan. Original and new cytological diagnoses were compared and classified as complete agreement (CA), partial agreement (PA), and others. Pap smears with a diagnosis of atypical squamous cells of undetermined significance (ASC-US) were classified by Japanese classification.
Results: Overall CA and PA rates were 39.4%. The CA rate of high-grade intraepithelial lesion (HSIL), was 84.6, of low-grade intraepithelial lesion (LSIL) 41.4, and reactive/negative 74.1%. Approximately 50%, was classified by the Japanese classification as reactive, and 40% of ASC-US as mild dysplasia.
Conclusion: Overall agreement in cytological diagnoses by two different classifications was relatively high (CA+ PA: about 80%), especially that of HSIL and reactive/negative. Diagnostic criteria for these categories appeared to be equivalent. In contrast, agreement for LSIL diagnosis was low, possibly contributing to the major difference in diagnosis between the two classifications.View full abstractDownload PDF (2307K) -
Focusing on distinctive features observed by Papanicolaou staining and immunocytochemical staining of bcl-2 proteinKoji KISHIMOTO, Takashi KITAMURA, Takao SUZUKI, Atsuko MASUNAGA, Gensh ...2005 Volume 44 Issue 3 Pages 118-123
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We analyzed cytomorphological differential diagnosis between follicular lymphoma (FL) grade 1 and reactive follicular hyperplasia in Papanicolaou (Pap.) smears and the advantage of immunocytochemical analysis of bcl-2 for differentially diagnosing of FL grade 1 Study Design: Ten cases of reactive follicular hyperplasia and 20 cases of FL Grade 1 were screened by ×40 objective microscopy and identified with ×100 objective microscopy. The percentage of bcl-2 positive cells was also calculated.
Results: Screening showed that FL grade 1 showed 1) the high appearance of two-nuclei-like cleaved cells and 2) none or few tingible body macrophages compared to reactive follicular hyperplasia. Identification analysis showed that 1) approximately half of FL Grade 1 cases showed similar appearance of individual cells to those of reactive follicular hyperplasia and 2) nucleoli larger than one, μm and cleaved nuclei were high in number, and bcl-2 protein was highly positive in FL grade 1.
Conclusion: Cytomorphological differential diagnosis of FL grade 1 from reactive follicular hyperplasia is relatively difficult. We found that two-nuclei-like cleaved cells and nucleoli in small lymphocytes observed by ×40 objective microscopy were high in number in diagnosing of FL grade 1 in Pap smears.View full abstractDownload PDF (2291K) -
Hiroo MOCHIZUKI, Shinobu UMEMURA, Masaharu KAWAGUCHI, Masami TANIGUCHI ...2005 Volume 44 Issue 3 Pages 124-131
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjectives: We studied whether cytological grading correlates with histological grading, estrogen receptor status, HER 2 status, and nodal status, and which parameters correlate with lymph node metastasis and clinical outcome (recurrence).
Study Design: FNAC from 50 cases of primary invasive ductal carcinoma were stained by the Papanicolaou method. We studied nuclear diameter, nuclear cytoplasmic ratio, nuclear pleomorphism, nucleoli, chromatin pattern presence of mitosis, and characteristics of the three grading categories, Grades 1-3.
Results: Statistically significant differences were seen between cytological and histological grading, estrogen receptor status, HER 2 status, and nodal status. Among parameters, chromatin and cell dissociation correlated significantly with lymph node metastasis. Statistically significant differences were seen among recurrence and estrogen receptor status, and nodal status.
Conclusion: We found that our cytological breast carcinoma grading correlated well with histological grading and otherprognostic factors. Cytological grading was a useful prognostic indicator that could be determined routinely in clinical practice and preoperative clinical management.View full abstractDownload PDF (2413K) -
Kayo KUYAMA, Sisilia F. FIFITAI, Takashi MATSUMOTO, Hiroyasu ENDO, His ...2005 Volume 44 Issue 3 Pages 132-138
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We analyzed clinicopathological characteristics and cytological features of oral candidiasis to improve screening accuracy.
Study Design : Subjects were 258 patients showing yeast-like fungi in the oral cavity selected for clinical pathology and cytological examination. Patient age, location, symptoms, clinical diagnosis and Papanicolaou classification were analyzed. Culture tests were conducted in 50 in whom candidiasis was suspected clinically. Decolora Decoloration, PAS reaction and rescreening were done on specimens in which results of culture testing were positive and cytological screening negative. Morphological image analysis was done in 13 subsequently confirmed to have candidiasis based on culture and cytology. Controls were 20 patients with vaginal candidiasis.
Results: 1. Among all cases of oral candidiasis, 74.4% occurred in individuals over 60 years old, and erythema was clinically manifested in 75.2%.2. Dysplasia was noted in 14.2% of class III cases. 3. Oral candidal hyphae were dimorphic and significantly wider than those of vaginal Candida. 4. A prospective study of 50 cases showed that 22.0% were positive in culture, even though no Candida was detected cytologically. PAS and rescreening of these cases showed that 63.6% were positive for yeast-like fungi. 5. Culture identified 96.0% of cases as Candida albicans.
Conclusion : The accuracy of oral exfoliative cytology in oral candidiasis improves with precise knowledge of clinical findings, and the combined use of PAS, and careful screening.: The accuracy of oral exfoliative cytology in oral candidiasis improves with precise knowledge of clinical findings, and the combined use of PAS, and careful screening.View full abstractDownload PDF (3249K) -
Kanoko IKO, Hidenori SASA, Masashi TAKANO, Kenichi FURUYA, Yoshihiro K ...2005 Volume 44 Issue 3 Pages 139-143
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Carcinosarcoma of the uterine cervix is a very rare neoplasm. We report a case of primary cervical carcinosarcoma we had great difficulty diagnosing.
Case: A 58-year-old woman with atypical bleeding, abdominal pain, and a vaginal mass that bled easily and appeared to arise from the cervix similar to a protruding or prolapsing myoma was found in an imaging study of the pelvis to have an en bloc mass of the uterus. Cervical cytology showed class V with adenocarcinoma cells.Cervical biopsy showed poorly differentiated carcinoma with both adenomatous and squamous differentiation. Postoperative histopathological findings showed that the carcinomatous component was adenocarcinoma with squamous differentiation and that the sarcomatous component was heterologous sarcoma. Malignant cells invaded the endocervix more deeply than other areas and extended to the entire uterus.
Conclusion: Cervical carcinosarcoma is very rare, but if auterine tumor is difficult to diagnose clinically, this type ofneoplasm may have to be considered.View full abstractDownload PDF (4657K) -
Takashi UMEZAWA, Kouichi NOMURA, Yutaka YAMAGUCHI, Shigemitsu KOBAYASH ...2005 Volume 44 Issue 3 Pages 144-148
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Ovarian small cell carcinoma of the hypercalcemic type typically occurs in young women and is associated with a poor prognosis. Cytological findings remain imperfectly understood.
Case: A 25-year-old woman with lower abdominal swelling suspected of having ovarian carcinoma, underwent right salpingooophorectormy, omentectomy, and lymph node resection. The1 9×11×9.5cm ovarian tumor was solid and cystic with focal hemorrhage and necrosis. Imprint specimens of the tumor showed small cells with a high nuclear-cytoplasmic ratio and round nuclei appearing alone. Large polygonal cells with abundant cytoplasm formed small loose clusters. A few signet ring cells were also observed. Ascites specimens showed naked nuclei-like small cells with nuclear molding. Histologically, small cells with a high nuclear-cytoplasmic ratio proliferated with a predominantly diffuse pattern. Follicle-like structures were observed, as were large polygonal cells andsignet ring cells. Immunohistochemically, tumor cells were positive for cy tokeratin and epithelial membrane antigen but negative for α-inhibin. The tumor was diagnosed as hypercalcemic small cell carcinoma. The woman died of the tumor 9 months after surgery.
Conclusion: Understanding the cytological findings of small-cell carcinoma is useful for diagnosing ascites specimens and intraoperative imprint specimens of the peritoneum for ovarian carcinoma staging.View full abstractDownload PDF (3199K) -
Kanako OGURA, Kazuhisa ISHI, Hiroshi NAKAMURA, Tetsuya OKAZAKI, Junich ...2005 Volume 44 Issue 3 Pages 149-152
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSBackground: Extrauterine low-grade endometrial stromal sarcoma is extremely rare and has not, to our knowledge, been cytologically reported in Japan.
Cases: A-45-year-old Gravida 2, para 1, woman unsuccessfully for treated endometriosis was found to have soft yellowish white tumors 8 cm and 4.5 cm in diameter, in both periovaries. Tumors were composed chiefly of stromal cells histologically resembling endometrial stroma. Imprint cytology showed isolated and focally clustered cells. Tumor cells had oval nuclei and scant cytoplasm. Nuclei had fine chromatin and nucleoli were not visible. Nuclear atypia was mild and mitotic figures were not found. Immunocytochemically, tumor cells were positive estrogen and progesterone receptor.
Conclusion: It was difficult to diagnose this case by cytology alone, but imprint cytology in conjunction of histology and observing tumor cells were important in definitive diagnosis. If small round cells of idiopathic origins are found, immunohistochemical staining of hormone receptors is useful in diagnosis.View full abstractDownload PDF (2566K) -
[in Japanese], [in Japanese]2005 Volume 44 Issue 3 Pages 153
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSDownload PDF (92K) -
Takayoshi NOGAWA, Masamichi HIURA, Mayu YUNOKAWA, Keiziroh ITOH, Takaf ...2005 Volume 44 Issue 3 Pages 154-160
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We studied the effect of long-term tamoxifen (TAM) treatment for breast cancer on the endometrium of patients.
Study Design: We analyzed changes in the maturation index (MI), endometrial cytology, and clinicopathological features of subsequent endometrial malignancy.
Result: MI shifted to the right with the dominance of intermediate layer cells. Glandular cells of the endometrium had oval round nuclei with fine granular chromatin in sheets somewhat resembling the secretory phase. Some varied moderately in nuclear or cell size, atrophic change with pyknotic small nuclei, and disordered cell arrangement after 4-5 years of TAM treatment.
Four subsequent cases of uterine corpus cancer were diagnosed after 1-2 year of TAM treatment as endometrioid adenocarcinoma, 2 as adenoacanthoma (all stage Ia and Gl), and 1 as stage IIIc carcinosarcoma. Some previous endometrial cytology showed strongly proliferative findings such as three-dimensional cell groups and tubular structures.
Conclusion: During TAM treatment, early regular cytologic examination of the endometrium is important detecting subsequent uterine corpus malignancy.View full abstractDownload PDF (6292K) -
Kenji NIWA, Keiko TAGAMI, Emiko SHIMONAKA, Takayuki HATTORI, Kuniyasu ...2005 Volume 44 Issue 3 Pages 161-167
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: The purpose of this study was to clarify the effectiveness of endometrial cytology during conservative therapy for early endometrial carcinoma in young woman.
Study Design: Twelve women were treated with repeated whole wall endometrial curettages once every four weeks while being treated with medroxyprogesterone acetate (400-600 mg/day) for 6-10 months, and cytological and histological examinations were performed. The abnormal pathological findings disappeared within 3-8 months in all 12 cases. Serial cytological examinations were available for evaluation in six of the twelve cases. To evaluate the cytological findings, the diagnoses of the endometrial cytology specimens were categorized into three groups: positive, suspicious and negative. The cytological diagnoses were then compared with the histological findings.
Results: Of the 28 cytological examinations performed in six cases, 25 specimens corresponded to the histological findings (89%).
Conclusions: Endometrial cytology during conservative therapy may be useful for evaluating therapeutic effects in the treatment of early endometrial carcinoma in young woman.View full abstractDownload PDF (5473K) -
Yoshiaki NORIMATSU, Takuya MORIYA, Yoji WANI, Choutatsu TSUKAYAMA2005 Volume 44 Issue 3 Pages 168-176
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSEndometrial cytology involves many difficulties, in part because criteria for differential cytological diagnosis is not standardized. To improve the accuracy of endometrial cytology, it is important to observe the architecture of cellular clumps and to standardize sampling. With these consideration in mind, we considered that grasping the number and frequency of appearance of abnormalcellular clumps were very important.
Although some cases can be presumed based on the type of abnormal cellular clump, this has limitations so at our institution, we diagnose all endometrial hyperplasia as suspicious.
In conclusion, we propose taking sufficient consensus before definitively diagnosing suspicious cases.View full abstractDownload PDF (6815K) -
Hidenobu OGATA, Fumitaka NUMA, Kohtaro SUEOKA, Shuji TAKIGUCHI, Hajime ...2005 Volume 44 Issue 3 Pages 177-180
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSObjective: We studied the clinical background of false-positive cases in which no endometrial lesion was found in a biopsy sample.
Methods:We analyzed 102 cases of abnormal endometrium cytology for biopsy results and the presence of concomitant disease. We analyzed 49 cases of endometrial cancer and 30 of endometrial hyperplasia for cytology results and biopsy motives for cases with falsenegative cytology.
Results: Many cases with cytology overdiagnosis involved concomitant disease, such as submucosal uterine myoma. Malignancies at other sites were also found among cases with abnormal cytology but no endometrial lesion. Endometrium thickness in ultrasound examination and clinical progress, such as atypical genital bleeding, motiveated biopsy in cases with false-negative cytology and
Conclusion: In judging endometrium cytology, we must consider the clinical background of each case. Abnormal endometrium cytology may also lead to finding other sites of malignancy. endometrial lesions.View full abstractDownload PDF (531K) -
A case report with cytological findingsShizuko KOUMI, Mie KOUNO, Toshiko TODA, Hironobu ADACHI2005 Volume 44 Issue 3 Pages 181-182
Published: May 22, 2005
Released on J-STAGE: November 08, 2011
JOURNAL FREE ACCESSWe report a case of a 77-year-old woman with endometrial tuberculosis who had to abnormal changes in cervical or endocervical cytology. Endometrial cytological findings showed a number of epithelioid cell clusters with a few Langhans giant cells. A histological examination of the endometrium indicated chronic granulomatous inflammatory disease involving epithelioid cells, Langhans giant cellsand lymphocytes suggestive of tuberculosis. Culture and mycobacterium tuberculosis DNA tests (PCR assay) were positive. Endometrial cytology is thus a useful tool for diagnosing endometrial tuberculosis.View full abstractDownload PDF (1113K)
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