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Volume 47 (2008)
- Issue 6 Pages 407-
- Issue 5 Pages 351-
- Issue 4 Pages 269-
- Issue 3 Pages 171-
- Issue 2 Pages 81-
- Issue 1 Pages 1-
Volume 47, Issue 3
Displaying 1-17 of 17 articles from this issue
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Original Articles
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Naruaki MATSUI, Masanori YASUDA, Kanako WAKUI, Hitoshi ITOH, Kenichi H ...2008 Volume 47 Issue 3 Pages 171-176
Published: 2008
Released on J-STAGE: October 30, 2008
JOURNAL FREE ACCESSObjectives: We immunohistochemically analyzed glucose transporter-1 (GLUT-1) expression in endocervical squamous lesions to determine whether GLUT-1 was useful in evaluating cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC) grading.
Study Design: Cytological and histological specimens from 60 cases of CIN—20 each of CIN1, CIN2, and CIN3—and 10 cases of invasive SCC were immunostained using polyclonal GLUT-1 antibody (DAKO, Carpinteria, USA) and simple stain Max (PO) (NICHIREI, Japan). Semiquantitative evaluation was weak (1+), 10%<; moderate (2+), 10-60%; or strong (3+), 60%<.
Results: In normal cervical tissue, weak GLUT-1 staining (8%) was seen in basal squamous epithelial cells. GLUT-1-positive rates were 0% for CIN1, 55% for CIN2, 100% for CIN3, and 100% for invasive squamous cell carcinoma. Koilocytes in the superficial layer were not, however, always labeled with GLUT-1.
Conclusions: GLUT-1 expression is closely associated with CIN progression and is a potential surrogate for CIN evaluation.View full abstractDownload PDF (733K) -
Katsumi KOBATA, Morishige TAKESHITA, Yutaka KAMIHARA, Akiko OOGAMI, Sh ...2008 Volume 47 Issue 3 Pages 177-182
Published: 2008
Released on J-STAGE: October 30, 2008
JOURNAL FREE ACCESSObjective: We studied the cytological characteristics and infiltrating patterns of mediastinal large B-cell lymphoma (MLBL).
Study Design: Cytological, histological, and immunohistological studies were performed in 11 cases of MLBL.
Results: Cytologically, the lymphoma cells revealed 3 different infiltrating patterns. In two cases there was diffuse infiltration by round nuclear lymphoma cells. In the 5 other cases there were aggregates of lymphoma cells containing slightly irregular nuclei and small distinct nucleoli. Histologically, thick collagen bundles were found among the tumor cell nests. In the remaining 4 cases there were scattered infiltrates of lymphoma cells containing large or giant nuclei and large distinct nucleoli, and a well developed meshwork of reticulin fibers was seen. Immunohistologically, 8 cases in the latter 2 groups had an activated MUM-1 and CD30-positive phenotype.
Conclusions: Three different infiltration patterns were detected in 11 cases of MLBL. Aggregates of lymphoma cells were one of the typical features of MLBL, and they may be attributable to compression by the thick collagen bundles around the lymphoma cells. It was difficult to differentiate between the aggregated form of MLBL and other types of epithelial neoplasm. The scattered form of MLBL showed cytological findings similar to those of Hodgkin’s lymphoma.View full abstractDownload PDF (489K) -
Tomoko KAGIYA, Misa NAKAMURA, Ichiro MORI, Emiko TANIGUCHI, Keiko NISH ...2008 Volume 47 Issue 3 Pages 183-188
Published: 2008
Released on J-STAGE: October 30, 2008
JOURNAL FREE ACCESSObjective: We studied degeneration in DNA and RNA and urine cytology morphology based on storage conditions, temperature, and time.
Study Design: Voided urine stored at three temperatures —−20, 4, and 25°C— and for periods of 0, 3, 7, 11, and 15 days were submitted to DNA extraction using a DNA Purification Kit and RNA extraction using URTRASPEC RNA. They were examined for DNA by p53 PCR detection and for RNA by β actin RT-PCR detection. Urine cytology smears were simultaneously prepared and underwent Papanicolaou staining for morphological study.
Results: In urine stored at −20 or 4°C for 15 day, p53 could be detected in extracted DNA. β actin could be detected in 11 day urine in extracted RNA. Morphologically, 4°C urine storage is superior to −20°C and 25°C.
Conclusions: For morphological preservation, 4°C urine storage is superior and for nucleic acid, −20 and 4°C storage is superior.View full abstractDownload PDF (412K) -
Kazunobu YAHATA, Tomio NAKAYAMA, Yoko KUSUNOKI, Tomoaki TERAMOTO, Masa ...2008 Volume 47 Issue 3 Pages 189-195
Published: 2008
Released on J-STAGE: October 30, 2008
JOURNAL FREE ACCESSObjective: The problems associated with telecytology using still images were examined to maximize the diagnostic yield.
Study Design: Photographs of 142 pulmonary cytologic specimens were taken with the optimal exposure according to auto bracketing function of a digital camera. In order to cover large field of view and the size of the cells a panoramic photograph was taken through a 20 power microscope objective lens and with a panorama assist mode of the digital camera, and a panoramic image was prepared with photo-editing software. To compare images of atypical cells side-by-side, index images were created using the photo-editing software. When the diagnosis of benign or malignant by the cytotechnologist and cytopathologist differed, they examined images prepared from additional photos of the same specimen and diagnosed it again.
Result: Over-diagnosis of atypical squamous cells because of overexposed photographs has been improved by using auto bracketing function of a digital camera. The panoramic image could cover large fields of view, and has reduced over-diagnosis of atypical squamous cells because of misunderstanding the size of the cells. The index image allowed comparism of cellular atypism and the size of atypical cells, and has increased the number of images to transmit. Repeat diagnosis by examination of images prepared from additional photos raised the concordance rate between histological diagnosis and cytodiagnosis.
Conclusion: The problems associated with telecytology using still images has been improved by using the functions of a digital camera and photo-editing software. Repeat diagnosis by examining images prepared from additional photos improved correct diagnostic rate.View full abstractDownload PDF (480K)
Clinical Articles
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Kayo HOSOI, Tomoko MANABE, Tadao SHIOOKA, Makoto SHIRAISHI, Masayuki N ...2008 Volume 47 Issue 3 Pages 196-199
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSBackground : Amyloid tumors are a very unusual cause of a lump in the breast. Amyloid tumors of the breast can easily be mistaken for breast carcinoma of the breast clinically or radiographically. We report a case of focal amylodosis of the breast in a patient with Sjögren’s syndrome.
Case : A 79-year-old woman who had sjögren’s syndrome noticed a tumor in her left breast. It was not make to diagnose though fine-needle aspiration cytology was performed. Because it showed amorphous material mimicking necrotic tissue, but no epithelial cells. Histologically, specimens obtained by segmentectomy showed deposition of eosinophilic amorphous substance around atrophic ducts and lobules of the breast. The amorphous substance stained Congo red positive, and exhibited green birefringence when examined by polarizing microscopy.
Conclusion : Amyloidosis should be included in the differential diagnosis when Papanicolau staining of cytologic material shows a light-green amorphous substance of that exhibits green birefringence when examined by polarizing microscopy.View full abstractDownload PDF (415K) -
Katsuaki SATO, Toshie TERAUCHI, Yoshifumi ASAKURA, Michiho TAKENAKA, M ...2008 Volume 47 Issue 3 Pages 200-204
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSBackground : Thyroid oxyphilic follicular carcinoma presents growth patterns ranging from apparent follicles to solid form. We report a case of oxyphilic follicular carcinoma with a distinct trabecular pattern.
Case : A 71-year-old woman found to have multiple thyroid tumors was further found in fine-needle aspiration (FNA) cytology of the right upper tumor to have large irregularly overlapped clusters with a trabecular structure and transgressing vessels against a clear background. Small tumor cells with ill-defined granular cytoplasm and round nuclei formed syncytial clusters. A few naked nuclei were seen. Nuclei presented fine chromatin and small but conspicuous nucleoli. The tumor was reported to be an oxyphilic cell tumor, but indeterminate in nature. The other tumor in the isthmus was determined to be papillary carcinoma, necessitating total thyroidectomy. Histologically, the 1.2 cm upper right tumor had widely invaded surrounding tissue and veins. Immunoreactivity for Ki-67 presented an average 5.6% of tumor cells.
Conclusion : FNA cytology suggested oxyphilic cell tumors, and hypercellularity, irregularly overlapped clusters, small cells with high nuclear/cytoplasmic ratio and ill-defined cytoplasm, and distinct nucleoli suggested malignancy. The difference from poorly differentiated carcinoma is that single cells and naked nuclei are not observed abundantly.View full abstractDownload PDF (604K) -
Yukari OBANA, Toshinori OINUMA, Masahiko SUGITANI, Kyoko KOMATSU, Tosh ...2008 Volume 47 Issue 3 Pages 205-210
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSBackground : Malignant mesothelioma is rare, but its incidence has been increasing in recent years. We report a case of malignant mesothelioma of the pleura.
Case : A male in his sixties who presented to a local physician with a chief complaint of a back pain was found to have a pleural effusion on an X-P radiograph of the chest. He was referred to our hospital for further examination, because malignant mesothelioma was suspected based on a cytological examination of the pleural effusion. Chest X-P radiographs, CT of the chest, and thoracoscopy failed to reveal any tumor mass. Thoracoscopic pleural biopsy resulted in a final pathological diagnosis of malignant mesothelioma of the pleura, epithelial type.
Conclusion : It is well known that diagnostic imaging in patients with pleural mesothelioma show pleural effusion and diffuse pleural thickening and/or masses. However, it should be kept in mind that there are occasional cases without any diagnostic radiographic or thoracoscopic findings in which the cytological findings may be the only clue to the diagnosis of malignant mesothelioma.View full abstractDownload PDF (727K) -
Tomoko KIMURA, Masaki MORI, Hideki MAEGAWA, Makoto OHTA, Sakon NORIKI, ...2008 Volume 47 Issue 3 Pages 211-215
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSBackground : Malignant melanoma of the paranasal sinuses is a rare entity. This report describes a case of malignant melanoma of a paranasal sinus with malignant pleural effusion, including the cytological and histopathological findings.
Case : A 72-year-old woman presented with a chief complaint of nose bleeds. A CT scan showed a left paranasal sinus mass with invasion of the left orbit and base of the skull. A biopsy specimen of the left paranasal sinus tumor revealed epithelioid cells in the epithelium and subepithelium, and some of the tumor cells contained melanin granules. The patient later developed dyspnea due to a massive left pleural effusion. Cytology of the left pleural effusion revealed the presence of round tumor cells in small clusters or individually dispersed against a bloody background. The tumor cell nuclei were large and vesicular and contained prominent eosinophilic nucleoli, but no melanin pigment was visible in the tumor cell cytoplasm. Immunocytochemically, the tumor cells were positive for melan A (MART-1), PNL2 (melanoma), HMB45, and S100 protein. The cytological diagnosis of the left pleural effusion was metastatic malignant melanoma.
Conclusion : The differential diagnosis in this case included malignant mesothelioma and metastatic carcinoma, because there were no melanin granules in the tumor cells in the malignant pleural effusion. Immunocytochemical staining was useful in making the cytological diagnosis in this case.View full abstractDownload PDF (600K) -
Yasuyuki KITAGAWA, Nobuhito FUJII, Hironori KATAYAMA, Hiroaki ISOBE, Y ...2008 Volume 47 Issue 3 Pages 216-219
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSBackground : Pleomorphic rhabdomyosaroma is a rare and highly malignant tumor that tends to occur in deep soft tissues of adults. Reports on the cytological features of pleomorphic rhabdomyosaroma have been limited.
Case : An 84-year-old female complained of a 6-month tumor in her left forearm. The tumor was large (about 18 cm in long diameter), nodular, relatively hard, and immobile. The tumor exhibited iso-intensity and partially higher intensity to muscle on T1-weighted images, and mixture of higher intensity, iso-intensity and lower intensity to muscle on T2-weighted images. Fine needle aspiration cytology was carried out. The tumor showed high cellularity against a hemorrhagic background. The tumor cells were round, spindle and polygonal, and showed marked atypism and size variation. Many cells had cytoplasmic processes. The tumor cells were positive for myoglobin by immunocytochemistry after performing the cell-transfer technique. A diagnosis of pleomorphic rhabdomyosaroma was made by fine needle aspiration cytology using Papanicolaou staining and immunocytochemistry. The diagnosis was confirmed by core needle biopsy. Amputation was performed at the level above the elbow.
Conclusion : Pleomorphic rhabdomyosaroma could be diagnosed by fine needle aspiration cytology using Papanicolaou staining and immunocytochemical analysis with multiple antibodies using the cell-transfer technique.View full abstractDownload PDF (340K)
Special Articles <Quality improvement in endometrial cytology>
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[in Japanese], [in Japanese]2008 Volume 47 Issue 3 Pages 220
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSDownload PDF (123K) -
[in Japanese]2008 Volume 47 Issue 3 Pages 221
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSDownload PDF (118K) -
Takaki SAKURAI, Keiko SHIMIZU, Seiko OGURA, Yoshiaki NORIMATSU2008 Volume 47 Issue 3 Pages 222-226
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSEndometrium could show variable histological and cytological changes in the carcinogenesis step and in response to various stimuli, e. g., endometrial polyp, endometritis, leiomyoma, and climacterium. It is often difficult to discern neoplastic changes from physiological changes in biopsy and cytology because these morphologic changes may occur together with neoplasm but also occur independently. We must there-fore observe endometrial histology and cytology from structural and cytological viewpoints to avoid misdiagnosis.
Histological glandular crowding in endometrium corresponds to cytological glandular variability in structure. We present structural variation seen under variable benign conditions. Cytological atypia are frequently confusing because cellular changes seen in ischemic endometrium could show atypia that hampers correct diagnosis. We present a case of anovulatory endometrial cytology. We should avoid considering this type of cellular atypia as neoplastic, but this type of atypia may be seen in endometrial proliferative diseases and adenocarcinoma. If we see this degenerative atypia, we must pay attention to background cells to search for more definite atypia.View full abstractDownload PDF (949K) -
Shioko YOSHIDA, Nanako KUSUNOKI, Koji ISHIYAMA, Takao SUGIYAMADA, Yosh ...2008 Volume 47 Issue 3 Pages 227-235
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSObjectives : We determination criteria for improving the diagnostic accuracy of suspicious cases in endometrial cytology.
Study Design : Material consisting of 17 cases of NEP, 18 of EGBD, 13 of EH, 6 of AEH, and 16 of G1 was investigated for (1) the frequency of each type of atypical cell clump—dilated or branched pattern, irregular protrusion (proliferative endometrium-like cell type, metaplastic cell type ; papillo-tubular pattern ; (2) frequency of each type of atypical cell clumps—excluded irregular protrusion (metaplastic cell type) ; (3) occurrence of associated features—small clumps of atypical cells, isolated epithelial cells, necrotic background, and squamous metaplastic cells ; (4) the occurrence of more than 20 condensed clusters of stromal cells ; and (5) rediagnosis of 97 suspicious cases.
Results : Certain lesion features were observed : in EH, a predominantly dilated or branched pattern ; in AEH, a predominantly dilated or branched pattern and irregular protrusions (proliferative-like cell type) ; in G1, predominantly irregular protrusions (proliferative-like cell type) ; and a predominantly papillo-tubular pattern. Associated features were significant ; in EGBD, predominantly condensed clusters of stromal cells and irregular protrusions (metaplastic cell type). Of rediagnoses for 97 suspicious cases, 67 (69.1%) agreed with the histological diagnosis.
Conclusions : Our results indicate that a grasp of cell clump features of lesions is useful in improving diagnostic accuracy.View full abstractDownload PDF (684K) -
Kenji YANOH, Yoshiaki NORIMATSU, Akira KAMIMORI, Yutaka NAKAMURA, Taku ...2008 Volume 47 Issue 3 Pages 236-242
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSObjective : To overcome problems related to the preparation of endometrial cytological specimens and to propose a reporting procedure for endometrial cytology.
Study Design : 1. We defined requirements for adequate endometrial cytological specimens and reevaluated endometrial cytological specimens using this definition. 2. We studied problems related to the preparation of endometrial cytological specimens.
Results : 1. A lack of clinical information was seen most frequently among unsatisfactory specimens (9.0%), followed by insufficient cell cluster collection (5.7%). 2. In specimen preparation, crushing was not suitable for subsequent specimen review. Bloody backgrounds and distorted cells or cell clusters caused by air drying must be eliminated using proper equipment and appropriate care.
Conclusions : The importance of providing adequate, correct clinical information for making a cytological diagnosis cannot be over emphasized. Obtaining high-quality specimens requires proper equipment and appropriate care in cell sampling. Using an endometrial cytology reporting format enables diagnoses based on high-quality specimens and thus improves diagnostic accuracy.View full abstractDownload PDF (369K) -
—Cytologic features of metaplasia—Yoshiaki NORIMATSU, Keiko SHIMIZU, Hiromi KOUDA, Mika HARADA, Hironori ...2008 Volume 47 Issue 3 Pages 243-248
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSObjective : We clarified cytology in metaplastic changes recognized in endometrial glandular and stromal breakdown (EGBD).
Study Design : Materials involved 32 cases of EGBD, 38 of disordered proliferative phase (DPP), 49 of NPE, 34 of SH, and 29 of CH concerning (1) the frequency of metaplastic cells, (2) the frequency and proportion of metaplastic clumps with irregular protrusions (MCIP), (3) the frequency of MCIP with condensed stromal clusters, and (4) immunostaining of CD10 for condensed stromal clusters in MCIP.
Results : Metaplastic cells were seen in 93.8% of EGBD cases. MCIP was seen in 90.6%, consisting of 16.1% of epithelial cell clusters. MCIP with condensed stromal clusters was seen in 93.1% of EGBD cases. All findings were significantly more frequently seen in EGBD cases than others. Condensed stromal clusters in MCIP were immunocytochemically positive for CD10.
Conclusions : Our findings indicate that the presence of MCIP, with condensed stromal clusters, is derived from papillary metaplasia occurring on endometrial surface epithelium. Cytological observation of these cells may be useful in providing the nature of EGBD endometrium.View full abstractDownload PDF (677K) -
—By a new criteria based on architectural atypia—Keiko SHIMIZU, Yoshiaki NORIMATSU, Seiko OGURA, Takaki SAKURAI, Takuya ...2008 Volume 47 Issue 3 Pages 249-254
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSObjective : To improve endometrial cytology accuracy, we evaluated the usefulness of architectural atypia as a possible diagnostic criterion. Our criterion was not satisfactory in consistency and reproducibility. We examined the utility of new criteria combined with cell clumps.
Study Design : We selected 144 cytologically suspicious cases for which histological diagnoses were available, dividing them into 2 groups-106 in group A with criteria for a decision that cell clusters were classified into nine types, and 38 in group B with new criteria for a decision that cell clusters were classified in four types.
Results : Histological findings for Group A showed 40 (37.7%) that were benign, 65 (61.3%) that were endometrial hyperplasia, and 1 (1.0%) that was endometrial adenocarcinoma, grade 1. In group B, 12 (31.6%) cases were benign, 25 (65.8%) were endometrial hyperplasia, and 1 (2.6%) was endometrial adenocarcinoma, grade 1. No significant difference was observed between groups.
Conclusions : New criteria combined with cell clumps were comparable in diagnostic accuracy for endometrial hyperplasia.View full abstractDownload PDF (934K)
Brief Note
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Takahiko SAKUMA, Ryuichi TAKAMIZU, Michiko FURUTA, Hiroshi OHASHI, Kiy ...2008 Volume 47 Issue 3 Pages 255-256
Published: 2008
Released on J-STAGE: October 28, 2010
JOURNAL FREE ACCESSWe report a case of acinic cell carcinoma of the parotid gland. A 33-year-old man noticing a slow-growing mass in the right parotid gland was found in fine-needle aspiration to have abundant epithelial cells with little atypia. Although rich cellularity suggested a neoplastic nature, other cytological clues for specific diagnosis were not seen. The resected tumor was histologically acinic cell carcinoma. With this histological diagnosis, reviewing the FNA specimens indicated that, in the cases of low-grade cancer, cellular atypia were of little help as diagnostic clues. Detailed knowledge of histological subtypes of acinic cell carcinoma appears to be essential for accurate cytological diagnosis.View full abstractDownload PDF (273K)
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