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Volume 48, Issue 1
Displaying 1-7 of 7 articles from this issue
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Original Articles
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Kyoko NISHIKIMI, Mitsuko TACHIBANA, Hiroshi SUZUKI, Ryoko MITSUHASHI, ...2009 Volume 48 Issue 1 Pages 1-4
Published: 2009
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSObjective : We reviewed the history of uterine cervical cancer screening preceding cancer diagnosis.
Study Design : (1)We studied the history of uterine cervical cancer screening before cancer was diagnosed in 70 cases.
(2)Among cases diagnosed as CINIII or invasive cervical cancer, 22 subjects had negative annual Pap smears for more than 3 years. One gynecologist and two cytotechnologists reviewed slides of these 22 cases, included 5 slides not available or reviewed.
Results : (1)In 17 of 70 cases, disease progressed from dysplasia to cancer during follow-up. Of the 70, 53 were found in mass screening. Of the 53, 43 had no screening history. Ten had a history of “negative” results in previous mass screening.
(2)Two cases were reviewed as truly negative. Of 8 having a few dysplastic cells, 1 had a few dysplastic cells, 7 had a few dysplastic cells and ASC-US, 7 had atypical cells, 3 had ASC-US, 1 had atrophic cells, 1 had multinucleated cells, and 2 had atypical cells that could not be classified.
Conclusion : The frequency of the cervical cancer found in mass screening is higher than the frequency found while following up dysplasia. We expect the uterine cervical screening accuracy to improve if Bethesda System 2001 is used in Japan.View full abstractDownload PDF (350K) -
Kikuko HAMANAKA, Fumiaki TEZUKA, Maki TAKAHASHI, Kayo HATAKEYAMA, Kuni ...2009 Volume 48 Issue 1 Pages 5-11
Published: 2009
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSObjective : We compared the efficacy of results of the current reporting of fine needle aspiration cytology of the breast (Japanese Society of Breast Cancer (JSBC) : 2004 Guideline) to that of our conventional modified Pap classification.
Study Design : Conventional data on 334 cases of fine needle aspiration cytology (FNAC) of the breast conducted from January 2007 to May 2008 and rearranged based on the diagnostic categorization of 2004 JSBC Guideline reporting was evaluated using quality assurance (QA) parameters calculated by United Kingdom Breast-Screening Programme formulae.
Results : Conventional Pap Class I/II, IV, and V were reasonably translated into “normal/benign,” “suspicious for malignancy,” or “malignant.” Class III was subdivided into “indeterminate” and “suspicious for malignancy.” QA parameters were calculated as inadequate 15.6%, indeterminate 4.2%, histologically malignant among suspicious 90.9%, absolute sensitivity 79.2%, specificity 72.4%, false negative 7.5%, false positive 0%, and positive predictive for malignant 100%.
Conclusions : We found current 2004 JSBC Guideline reporting to be more useful because of its specific categorization and quality assurance. It is rather easy to introduce the current system in addition to the diagnostic category in the conventional modified Pap classification generally accepted and used in Japan.View full abstractDownload PDF (479K) -
Toshie TERAUCHI, Katsuaki SATO, Michiho TAKENAKA, Manabu YAMASHITA, Yo ...2009 Volume 48 Issue 1 Pages 12-16
Published: 2009
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSObjective : We studied the intracytoplasmic lumina (ICL) using urine cytology to evaluate its usefulness in diagnosing urothelial carcinoma.
Study Design : Subjects were 63 consecutive cases of urothelial carcinoma initially diagnosed by histopathological examination and 22 cases of nontumor lesions from our hospital files. Cytological and histopathological specimens corresponded only chronologically. Type A ICLs containing secretory material in the lumen were examined and type B ICL excluded. Cases were regarded as ICL-positive when two or more ICLs were observed on a cytological specimen or two or more ICLs were observed in a high-power field on a histological section.
Results : In urothelial carcinoma cases, atypical cells with type A ICLs were observed in 16 of 63 cases (25.4%) in cytological specimens and in 17 of 63 (27.0%) in histological specimens. In nontumor lesion cases, ICLs were detected in one of 22 cases (4.5%) in histological specimens but not in cytological specimens. The number of ICL-positive cases was thus significantly higher in cytologically determined urothelial carcinoma than non-tumor lesions. ICLs in 12 of 27 high-grade urothelial carcinoma cases (44.4%) were significantly more frequently detected than in low-grade urothelial carcinoma (4 of 36 cases, 11.1%) in cytology.
Conclusion : Type A ICL is an important cytological diagnostic hallmark of urothelial carcinoma.View full abstractDownload PDF (353K)
Clinical Articles
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Toru TSUCHIDA, Tomomi IKOMA, Chie TSURUNO, Yoshiaki HORI, Jun KATOH, M ...2009 Volume 48 Issue 1 Pages 17-21
Published: 2009
Released on J-STAGE: November 27, 2010
JOURNAL FREE ACCESSBackground : Vaginal small cell carcinoma is extremely rare and its prognosis concomitantly dismal. We report such a case focusing on cytological findings.
Case : A 58-year-old woman with dysuria was found up on examination to have a 5 cm vaginal tumor arising from the anterior vaginal epithelium and invading the pubic bone. We detected no other tumors. Cytological findings from a vaginal smear showed small, round, oval cells with hyperchromatic nuclei and scant cytoplasm against a necrotic background. The tumor stained positive for TTF-1. Based on the clinical course and cytological, pathological, and immunohistochemical findings, and diagnostic imaging, we diagnosed the tumor as small cell carcinoma of the vagina. Following chemoradiotherapy, the primary tumor was no longer detectable in the vagina, but 3 months after primary chemoradiotherapy, distant metastases were found in the right tibia and lung.
Conclusion : In this case, the patient’s vaginal tumor was diagnosed as vaginal small cell carcinoma. Although small cell carcinoma is usually sensitive to chemotherapy and radiotherapy, metastases can easily occur to other organs. In the present case, further treatment with other chemotherapy is necessary.View full abstractDownload PDF (679K) -
Chie HAYAKAWA, Junki KOIKE, Sakiko HOSHIKAWA, Yoshio AIDA, Masayuki TA ...2009 Volume 48 Issue 1 Pages 22-26
Published: 2009
Released on J-STAGE: November 27, 2010
JOURNAL FREE ACCESSBackground : Angiomyolipoma (AML) is a relatively rare benign tumor consisting of smooth muscle, blood vessels, and mature fat cells. We report a case of hepatic AML focusing on cytological findings.
Case : A 60-year-old woman reporting irregular vaginal bleeding and diagnosed with Grade 2 endometrioid adenocarcinoma based on endometrial biopsy and admitted for surgery was found in preoperative computed tomography (CT) to have an irregular tumor at S6 of the liver. Based on a suspicion of metastasis from endometrial cancer, partial hepatectomy was conducted preceding gynecologic surgery. AML was diagnosed based on the immediate intraoperative histology of surgical specimens. Immediate imprint cytology showed inflammatory cells, fat cells, and spindle-shaped cells in the background. Spindle-shaped cells formed large clusters with clear margins, which contained capillary blood vessels, mature fat cells, and large and small atypical cells. Some atypical cells had irregular nuclei, large nucleoli, and intranuclear vacuoles and required a differential diagnosis of benign or malignant tumor. Although a nonepithelial tumor was suspected, we could not determine whether the tumor was benign or malignant. The definitive cytological diagnosis was ClassIII. Large atypical cells were human melanosome (HMB45) positive in immunostaining.
Conclusion : Patients with AML may present large atypical cells that require a differential diagnosis regarding malignancy, emphasizing the need for careful observation in diagnostic cytology.View full abstractDownload PDF (585K) -
Yoshie MURAISHI, Tomoko KAWABATA, Masashi FUJITA, Minoru IWAHARA, Yuki ...2009 Volume 48 Issue 1 Pages 27-31
Published: 2009
Released on J-STAGE: November 27, 2010
JOURNAL FREE ACCESSBackground : We report a rare case of breast carcinoma with cartilaginous and osseous metaplasia.
Case : A 77-year-old woman presenting with bloody nipple discharge and a palpable mass in the left breast underwent mastectomy based on needle biopsy results interpreted as carcinoma. Fine-needle aspiration cytology and touch smear cytology showed typical cytological findings of 1) carcinoma cells showing papillary growth, 2) small clusters of large round cells having weak intercellular adhesion, 3) diffusely distributed spindle−shaped to polygonal sarcomatous cells, and 4) cartilaginous and osseous metaplasia.
Conclusion : Osseous and/or cartilaginous metaplasia is a vital but very rare finding in breast carcinoma. When metaplastic features are unclear, it is important to confirm small clusters of atypical large round cells indicating the transition from carcinoma to sarcomatous cells.View full abstractDownload PDF (818K) -
Miyuki MATSUBARA, Shinichi TSUCHIYA, Oi HARADA, Masashi KAWAMOTO2009 Volume 48 Issue 1 Pages 32-34
Published: 2009
Released on J-STAGE: November 27, 2010
JOURNAL FREE ACCESSBackground : In Clinical diagnosis, diabetic mastopathy, a rare, benign, diabetes-related fibrous breast lesion, must often be distinguished from invasive carcinoma.
Case : A 50-year old woman reporting a right breast tumor and found in ultrasonography to have a hypoechoic tumor with an irregular margin in the right AC region suggesting possible cancer under went aspiration cytology that showed a small number of lymphocytes and a cluster of epithelial cells reminiscent of normal terminal duct lobular unit. Core needle biopsy was yielded a diagnosis of diabetic mastopathy.
Conclusion : Clinical, histopathological, and cytological findings in diabetic mastopathy must be considered both clinically and pathologically to prevent unnecessary surgery.View full abstractDownload PDF (287K)
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