Objective : We studied cytological findings in so-called lymphoepithelial carcinoma (LEC), including one case of nasopharyngeal carcinoma, arising from the upper aerodigestive tract.
Study Design : Subjects were 4 men aged 53 to 77 years diagnosed with LEC, including with primary tonsilar diffuse large B-cell lymphoma (DLBCL) showing cohesive growth.
Results : In WHO classification, three cases were differentiated and one undifferentiated. Cytologically, differentiated cases featured tightly aggregated clusters of tumor cells with relatively broad cytoplasm, distinct cell margins, and large oval or spindle-shaped nuclei with prominent nucleoli among small lymphocytes. The undifferentiated case featured loosely aggregated tumor cell clusters or dissociated tumor cells among small lymphocytes. Tumor cells had scant cytoplasm with indistinct cell margins and large oval nuclei with prominent nucleoli. In situ hybridization in the nasopharyngeal carcinoma case demonstrated numerous small RNA-positive Epstein-Barr virus (EBV)-encoded tumor cells.
Conclusion : Two LEC subtypes arising from the upper aerodigestive tract were delineated cytologically and histologically. The differentiated type was easily recognized as epithelioid. Occasionally however, the undifferentiated type should be differentiated from large cell lymphoma showing cohesive growth.

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Objective : I report cytological and histological exocervix, endometrium, vulva and breast examination results obtained during the 20 years from 1986 to 2005.
Study Design : Specimens were collected by scraping the exocervix with a wooden spatula, the endometrium with an endocyte, and the vulva with a wet cotton swab, Nipple discharge was obtained by pressing the breast. Papnicolaou smears were examined under a microscope. Histological specimens were prepared elsewhere.
Results : 1) Exocervical
I examined 37,872 women, averaging an annual 1,893, in their 20s to 80s (mean age : 45.7 years). The special examinaion requirement rate was 949/37,872=2.51%, the spical examination rate 726/949=76.5%, with identified or suspected cancer numbered 137. Overall cancer detection numbered 129 (0.34%) and false-positive tests numbered 8 (0.02%). None were false-negative or had indeterminate cyotology.
2) Endometrial
I examined 2,304 women, averaging an annual 115, in their 20s to 80s (mean age : 47.1 years) for reported irregular uterine bleeding. Immediately after cytological samples were obtained, endometrial curettage was done and specimens examined histologically. The special examination requirement rate was 279/2304=12.11%, the special examination (endometrial biopsy) rate 1199/2304=52.04%, the number of patients with identified or suspected cancer 37, the cancer detection rate (number of patients with identified or suspected cancer37-number of patients with indeterminate biopsy result 11) 26/1199=2.17%, the number with false positive tests 9/2304=0.39%, the number with false negative tests 2/2304=0.09%, and the number with indeterminate histology 11/1199=0.92%. Those with indeterminate cytology numbered 27 (1.7%).
3) Vulva
Among 431 women with vulvar erosion or ulcer, cytology was negative in 426 (98.84%) and false-positive in 5 (1.16%). None tested positive. Those testing false-positive were suspected of having Paget’s disease.
4) Breast
Palpation and ultrasonography were used to screen for breast cancer. Cytological nipple discharge specimens were obtained by breast pressing. Cytological findings for 365 patients were negative in 349 (95.62%), false-positive in 14 (3.84%), and positive in 2 (0.55%). Those with false-positive or positive breast cancer results were all confimed in follow-up checking elsewhere to have cancer.
Conclusion : Mass or individual patient-directed uterine cancer screening in Japan by gynecologists contributes significantly to detecting cancer.

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Background : We report a case of Epstein-Barr virus-associated B-cell lymphoproliferative disorder (EBV-LPD) with large Hodgkin/Reed-Sternberg (HRS) cell-like cells.
Case : A 68-year-old Japanese man with malaise and systemic lymphadenopathy was found in lymph node cytomorphology to have large scattered atypical cells similar to HRS cells in a background of abundant mature lymphocytes and histiocytes. Histology showed feature resembling cytomorphology and a few with slightly necrotic foci. Immunohistochemistry showed large HRS cell-like cells to be positive for CD20 and CD79a, but negative for CD30 and CD15. EBER-in situ hybridization (ISH) showed nuclear positivity of large cells. The patient tested negative for antihuman immunodeficiency virus antibody and had not received solid organ or bone marrow allografts, yielding a definitive diagnosis of EBV-LPD.
Conclusion : It is difficult to differentiate EBV-LPD from Hodgkin lymphoma and some non-Hodgkin variants, since large HRS-like cells are often encountered in these cases. We concluded that a detailed cytomorphological study, immunohistochemical study, a survey of pathological agents such as EBV, and adequate clinical informations are required to correctly subclassify lymphoma.

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Background : Based on a review of the literature, we discuss typical but per haps not well known cytological findings associated with papillary renal cell carcinoma in light of our own case.
Case : A 72-year-old man found in computed tomography during a macroscopic hematuria work up (CT) to have an enlarged left kidney provided a radical nephrectomy specimen demonstrating multinodular formations occupying the entire kidney. Histologically, the tumor’s papillotubular structure consisted of atypical cells with eosinophilic cytoplasm and large nuclei with prominent nucleoli. Based on histological findings and immunohistological activity for CD10 and alpha-methyl CoA racemase (AMCAR), the tumor was definitively diagnosed as type 2 papillary renal cell carcinoma. Preoperative voided urine contained a few small clusters of atypical cells with prominent nucleoli. Intraoperative urine from the left ureter and touch−cytology during intraoperative consultation contained papillary clusters and hobnail patterns of atypical cells with hemosiderin-laden macrophages. Tumor cells had granular cytoplasm and large nuclei with prominent nucleoli.
Conclusion : Based on a comparison of previous reports with owr own case, type 2 papillary renal cell carcinoma typically presents cytological findings of papillary clusters, hobnail patterns, atypical large cells with granular cytoplasm and prominent nucleoli, and hemosiderin-laden macrophages.

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Background : Secretory adenocarcinoma is a rare neoplasm arising in the endometrium.
Case : A 76-year-old woman with irregular genital bleeding was found in transvaginal ultrasonography to have a 12 mm intrauterine tumor. Endometrial cytology indicated papillary clusters with fibrovascular cores. Tumor cells had vacuolated cytoplasm and round to oval nuclei with small unclear nucleoli. Cytological features were diagnostic of adenocarcinoma (classV). The excised uterus had a 25×15 mm endometrial tumor. Histological findings were consistent with secretory adenocarcinoma of the endometrium. PAS staining with and without diastase digestion showed glycogen accumulation in the cytoplasm. Immunohistochemically, tumor cells were positive for p53, ER, and vimentin (focal) and negative for PgR and HNF-1β.
Conclusion : Similar findings are cytologically observed in clear cell and mucinous adenocarcinoma of the endometrium. Differentiation from secretory adenocarcinoma is aided by 1) papillary clusters with fibrovascular cores resembling well-differentiated endometrioid adenocarcinoma and 2) vacuolated cytoplasm.

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Background : We report cytological findings for metaplastic and proliferating Brenner tumor.
Case : A case of borderline malignancy tumor examined using imprint smear cytology was found to be metaplastic and proliferating Brenner-like. Cytology showed a mucinous background and apparently transitional cells. Partial clusters resembled squamous or gland-like cells. Cell atypia was mild.
Conclusion : Metaplastic and proliferating Brenner tumors proliferate strongly. Cytological findings indicated a nearly benign Brenner tumor, however, making diagnosis difficult as to benign or malignant if we do not know about metaplastic and proliferating Brenner tumors.

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We report a typical extraskeletal myxoid chondrosarcoma (EMC) case and its histological, cytological, immunohistchemical, and cytogenetic findings. Histologically, the tumor was nodular, defined by fibrous septa filled with pale blue myxoid or chondromyxoid substance. Imprint cytology specimens contained abundant myxoid stroma with dispersed small, round to oval tumor cells. Some cells had coffee−been−like nuclear grooves. In cell block materials, tumor cells were immunopositive for S-100 protein. Cytogenetically, reciprocal translocation t (9 ; 17) (q22 ; q11) was detected. Our findings suggest that cytology could detect EMC.

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Liquid-based cytology (LBC) has the potential for multipurpose applications. We have evaluated fixatives in an application to fluorescence in situ hybridization (FISH). Fixatives containing methanol produced excellent hybridization signals even in specimens preserved over 3 months, but others did not. We concluded that LBC fixative selection is critical in FISH applications.

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