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Volume 48 (2009)
- Issue 6 Pages 353-
- Issue 5 Pages 257-
- Issue 4 Pages 159-
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- Issue 2 Pages 47-
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Volume 48, Issue 6
Displaying 1-13 of 13 articles from this issue
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Original Article
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Yuki SHIMIZU, Junko UEDA, Toshiaki KAMEI, Hiroshi OKAMURA, Hidemi SHIB ...2009 Volume 48 Issue 6 Pages 353-360
Published: 2009
Released on J-STAGE: March 10, 2010
JOURNAL FREE ACCESSObjective : We studied the origin of orangeophilic cells (OPCs) because such cells reported to be present in body-cavity fluids in malignant mesothelioma.
Study Design : The subject was one case of epoxy-embedded samples of malignant mesothelioma diagnosed at the Yamaguchi Grand Medical Center containing OPCs in smear samples. We consecutively prepared semi-thin sections (4.0μm) and ultra-thin sections (80 nm) from epoxy-embedded blocks. We removed epoxy resin from semi-thin sections and conducted Papanicolaou staining, microscopically observing OPCs. We also applied conventional electron staining to ultra-thin sections next to semi-thin sections, ultrastructurally observing OPCs in contrast to micrographs.
Results : Ultrastructurally, OPCs had microvilli, and intermediate filaments indicated that the origin was malignant mesothelioma. Malignant mesothelioma cells and OPCs had lipid droplets in cytoplasm.
Conclusions : Ultrastructural examination indicated that OPCs were derived from malignant mesothelioma or mesothelial cells. These results suggest that OPCs may be an indicator of malignant mesothelioma.View full abstractDownload PDF (637K)
Clinical Articles
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Rikiya NAKAMURA, Masahiro NORO, Bunshiro AKIKUSA, Katsuhiro NEMOTO, No ...2009 Volume 48 Issue 6 Pages 361-365
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Invasive micropapillary carcinoma (IMPC) of the breast has an extremely high incidence of lymph node metastases, lymph vessel invasion and poor clinical outcome. Therefore it is an important for decision making of operation to diagnose the histological subtype.
Case : A 1.7 cm intracystic tumor was found in the D area of the left breast of a 69-year-old woman in the ultrasonography. Fine-needle aspiration biopsy showed many micropapillary clusters. It was diagnosed as the suspicious for malignancy. Core needle biopsy showed inadequate specimen. To purpose of diagnoses and treatment, a breast conserving surgery with sentinel lymph node biopsy was performed. The pathological diagnosis was IMPC with intracystic bleeding.
Conclusion : It is very difficult for CNB to diagnose intracystic tumor of the breast. FNAC of IMPC is important role to confirm the preoperative diagnosis.View full abstractDownload PDF (616K) -
Noriyuki FUJIMURA, Hiroshi SONOBE, Kyoko KAIHARA, Toshiyuki HABARA, Ta ...2009 Volume 48 Issue 6 Pages 366-370
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Granular cell tumors (GCT) are uncommon and usually benign tumor, considered to be of Schwann cell origin. Primary GCT of the breast is exceedingly rare, accounting for 5% of all cases of GCT. We report a case of breast GCT having numerous intranuclear cytoplasmic inclusions.
Case : A 52-year-old woman reporting a nodule of the right breast was suspected of malignancy based on mammography and ultrasonography findings. Imprint smears from excised tumor tissue showed tumor cells in sheets or clusters or isolated cells and many naked nuclei against a granular background. Tumor cells had ill-defined abundant granular cytoplasm, round to oval small nuclei, conspicuous single small nucleli, and intranuclear cytoplasmic inclusions detected in 1.1% of tumor cells. Histologically, the tumor consisted of small nests or trabecular structures of polygonal cells with abundant eosinophilic granular cytoplasm. Granules were positive for periodic acid-Schiff (PAS) and diastase-resistant. Immunohistochemically, tumor cells were positive for S-100 protein and neuron-specific enolase.
Conclusion : The breast lesion showed typical cytological features of benign GCT with fragile, granular cytoplasm and intranuclear cytoplasmic inclusions.View full abstractDownload PDF (539K) -
Mayuko KAWAHARA, Eiji SADASHIMA, Junko KINOSHITA, Kanako YAMASAKI, Nat ...2009 Volume 48 Issue 6 Pages 371-375
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Intraductal papillary neoplasm of the bile duct (IPN-B), a rare tumor, histologically resembles intraductal papillary mucinous neoplasm of the pancreas. No reports have, to our knowledge, detailed cytological IPN-B features. We report a case of intraductal papillary adenocarcinoma in situ with abundant mucin production in the intrahepatic bile duct and detail its cytological features.
Case : A 60-year-old woman seen for abnormal hepatic function in routine diabetes monitoring was suspected from ultrasound findings to have multiple cystic lesions within a hepatic portal lesion. Intraoperative cytology showed tumor cells with large cuboidal to columnar papillary clusters with fine chromatin against a mucin background, together with loose cohesive, conspicuous nucleoli. Histological examination of the resected lesion showed tumor stroma of the cyst wall to consist of dense fibrous tissue, with no mesenchymal stroma recognizable. Papillary proliferation of lining tumor cells with eosinophilic cytoplasm was marked. Some tumor cells showed clear cytoplasm with mucin production, but no definite stromal invasion by tumor cells was seen. Immunohistochemistry confirmed MUC 1 and MUC 5AC expression in cytoplasm.
Conclusion : Decreases in cohesive, conspicuous nucleoli are an important finding in cytological malignancy diagnosis. More cases must be accumulated to confirm these findings in cytological IPN-B diagnosis.View full abstractDownload PDF (648K) -
Yoko MIYAJIMA, Hitoshi ITOH, Nobuaki KATO, Akihiko SERIZAWA, Hiroshi K ...2009 Volume 48 Issue 6 Pages 376-380
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Cytological findings for typical carcinoid usually show uniform tumor cells. Atypical carcinoid (AC) shows atypia, pleomorphism, necrosis, and mitoses. We report a case of atypical carcinoid with atypical giant cells.
Case : A 64-year-old man with a middle right lung mass was found in bronchial brushing cytology to have a number of atypical giant cells, although no tumor cells were seen in bronchoscopic biopsy. Cytological features suggested pleomorphic carcinoma. In the tumor resection under video-assisted thoracoscopic surgery, intraoperative frozen sections suggested large cell carcinoma. Surgery was changed to right middle and lower bilobectomy under open thoracotomy because of an incomplete interlobal fissure. The well-circumscribed 20×19 mm tumor consisted of polygonal cells with abundant eosinophilic cytoplasm and atypical giant cells. Tumor cells were immunoreactive for chromogranin A, CD 56, and synaptophysin, yielding a diagnosis of AC.
Conclusion : Our rare case of atypical carcinoid with atypical giant cells was difficult to diagnose. Cytological diagnosis of carcinoid should be considered concurrently in clinical findings with imaging analysis.View full abstractDownload PDF (624K) -
Daisuke HAMAGUCHI, Katsuya MATSUDA, Michio KITAJIMA, Kohei KOTERA, Shi ...2009 Volume 48 Issue 6 Pages 381-385
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : We report a case of pelvic actinomycosis involving prolonged intra uterine contraceptive device (IUD) use diagnosed by postoperative cytology.
Case : A 50-year-old gravia 2 para 2 woman was admitted for continuous postlaparotomy lower abdominal pain and fever develop 20 years after having an IUD inserted. Laparotomy following antibiotic therapy showed a swollen right adnexal lesion.
Papanicolaou-stained smears of the right fallopian tube showed actinomyces-like organisms with radially arranged bacterial threads. The pathology specimen showed no actinomycosis.
Conclusion : Smears are helpful in diagnosing actinomycosis in those with pelvic inflammation following prolonged IUD use.View full abstractDownload PDF (594K) -
Maiko TAKEDA, Takahiko KASAI, Yasunori ENOMOTO, Keiji SHIMADA, Noboru ...2009 Volume 48 Issue 6 Pages 386-389
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Malignant vaginal melanoma is rare. We report a case of primary vaginal malignant melanoma with sarcomatoid features.
Case : A 42-year-old woman seen for dysfunctional uterine bleeding was found to have a vaginal tumor. Whose preoperative cytological specimen contained a few atypical pleomorphic cells. Resected specimens showed a tumor mainly consisting of a proliferation of atypical polygonal and short spindle cells, indicating unclassifiable sarcoma. Immunohistochemically, tumor cells were positive for HMB45 and S-100 protein. Imprint cytology showed atypical short spindle cells with marked nuclear atypia forming many small clusters, associated with a small amount of melanin pigment in tumor cytoplasm. These findings were consistent with malignant melanoma.
Conclusion : Tumors consisting of pleomorphic cells should be considered in differential diagnosis to indicate malignant melanoma. Immunohistochemical and special staining were useful in definitively diagnosing this case.View full abstractDownload PDF (506K) -
Norihide MOCHIZUKI, Tomohisa MACHIDA, Hitoshi ITOH, Kenichi HIRABAYASH ...2009 Volume 48 Issue 6 Pages 390-394
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Endometrial stromal sarcoma (ESS) is a rare malignancy of the uterine body. We report a case of high-grade ESS mimicking leiomyosarcoma.
Case : A 65-year-old woman admitted for an enlarged uterus was found in magnetic resonance imaging (MRI) to have an 11 cm solid mass of the uterine body. Endometrial cytology showed proliferation of spindle cells with pleomorphism. Immunocytochemistry showed that tumor cells were positive for alpha-smooth-muscle actin (SMA). Our initial diagnosis was leiomyosarcoma. Although histological findings of biopsy and surgically resected specimens also showed a diffuse proliferation of spindle shaped cells, tumor cells were positive for CD10 and SMA and negative for desmin and h-caldesmon in immunohistochemistry, indicating high-grade ESS.
Conclusion : Differential diagnosis of high-grade ESS from other sarcomas and poorly differentiated carcinoma may be difficult. Cytology thus requires immunohistochemistry using both SMA and CD10 and h-caldesmon for distinguishing leiomyosarcoma from other conditions.View full abstractDownload PDF (691K) -
A case of endometrial stromal sarcoma diagnosed by immunocytochemistry using cell transfer techniqueMamoru MIKI, Katsumi HAGIWARA, Hiroshi HIRANO, Akira OKIMURA, Keiji NA ...2009 Volume 48 Issue 6 Pages 395-399
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Endometrial stromal sarcoma (ESS) of the uterus, a rare neoplasm, is detected immunochemically by CD10 expression. We report a case of ESS diagnosed with immunocytochemistry using cell transfer.
Case : A 68-year-old woman seen for abdominal swelling and suspected of having ovarian cancer following magnetic resonance imaging (MRI) underwent a hysterectomy with left adnexectomy. Touch cytology of the resected tumor showed numerous isolated cells that were spindle-shaped or markedly varied in size and shape against a hemorrhagic background. Neoplastic cells had indistinct cellular borders and enlarged nuclei, which showed a thin rim and a fine granular hyperchromatic pattern with distinct, irregular nucleoli. Immunocytochemically, neoplastic cells obtained by cell transfer were positive for CD10, yielding a diagnosis of ESS, compared to the histological diagnosis of high-grade ESS. Eighty days after surgery, tumors were detected surrounding the urinary bladder and subcutaneous abdomen. Aspiration cytology indicated neoplastic cells similar to the resected specimen and ESS metastasis. Tumors were resected, but the woman died 90 days postoperatively due to her worsened general condition.
Conclusion : Immunocytochemical findings obtained with cell transfer were useful in definitively diagnosing ESS.View full abstractDownload PDF (636K) -
Masami IMAKITA, Yasuhiko MINOURA, Yuki OOCHO, Yuka YONEKURA2009 Volume 48 Issue 6 Pages 400-403
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : Small cell carcinoma of the endometrium is rare, and tumors may be mixed with other endometrial malignancies such as adenocarcinoma, adenosquamous carcinoma, or mixed mullerian tumors. We report a case of endometrial small cell carcinoma mixed with endometrioid adenocarcinoma presenting with cerebellar metastasis.
Case : A 41-year-old woman admitted for a cerebellar tumor was found in histological examination to have suspected metastatic small cell carcinoma. Magnetic resonance imaging (MRI) showed an endometrial tumor and multiple uterine myomas. Cervical cytology showed small atypical cells with scanty cytoplasm and nuclear pleomorphism, while endometrial cytology showed adenocarcinoma cells with mild to moderate atypia and small atypical cells. Histological examination showed small cell carcinoma coexisting with endometrioid adenocarcinoma. Small tumor cells with finely distributed chromatin, inconspicuous nucleoli, and scant cytoplasm showed focal immunoreactivity with neuron-specific enolase, chromogranin A, synaptophysin, and CD56.
Conclusion : Because most subjects with endometrial small cell carcinoma face a dismal prognosis, detection of a small cell carcinoma component by endometrial cytology in endometrial carcinoma is an important prognostic factor.View full abstractDownload PDF (645K) -
Kanako WAKUI, Naruaki MATSUI, Masanori YASUDA, Hiroshi KAJIWARA, Hitos ...2009 Volume 48 Issue 6 Pages 404-408
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSBackground : We report a case of small cell carcinoma (SMCC) of the endometrium.
Case : A 62-year-old woman seen for irregular genital bleeding was found in magnetic resonance imaging to have a 40 mm tumor of the uterine body. Endometrial cytology showed nuclei to be small, denuded, and granular, with characteristic molding of the nuclei suggesting SMCC. Peritoneal cytology, however, indicated adenocarcinoma cells were more predominant than SMCC. The hysterectomy specimen was diagnosed as SMCC combined with minor endometrioid adenocarcinoma. Immunohistochemically, neuroendocrine differentiation of SMCC was proven by chromogranin A and CD56 expression.
Conclusion : The significant difference in cytological patterns between endometrial and peritoneal cytology demonstrate that a variety of tumor cells may be encountered in SMCC.View full abstractDownload PDF (718K)
Brief Notes
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Ayako ARAKAWA, Moriyuki NAKAMA, Yukinori MURATA, Tsuyoshi ISHIDA2009 Volume 48 Issue 6 Pages 409-410
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSWe report the cytological features of bile containing shape-changed bacilli. A 52-year-old man with acute cholecystitis was treated using intravenous β-lactum antibiotics. Bile contained a few epithelial cells and numerous shape-changed filament and mixed bacilli positive for periodicacid schiff (PAS) reaction, making it necessary to distinguish them from fungal hyphae. The morphology of shape-changed bacilli and their possible presence in bile is important in precisely diagnosing bile duct infection.View full abstractDownload PDF (254K) -
Moriyuki NAKAMA, Ayako ARAKAWA, Yukinori MURATA, Toshikazu MURAKAMI, T ...2009 Volume 48 Issue 6 Pages 411-412
Published: 2009
Released on J-STAGE: March 18, 2011
JOURNAL FREE ACCESSWe report a case of Langerhans cell histiocytosis of the occipital bone in a 6-year-old boy. Imprint smears of the lesion showed scattered Langerhans cells with convoluted nuclei and pseudopodia-like cytoplasmic projections against a background of eosinophils, neutrophils, lymphocytes, and multinucleated histiocytic giant cells. We diagnosed the lesion cytologically as Langerhans cell histiocytosis, confirmed by histological findings. Pseudopodia-like cytoplasmic projections are considered an additional typical cytological finding for Langerhans cells in imprint smears.View full abstractDownload PDF (247K)
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