The Journal of the Japanese Society of Clinical Cytology
Online ISSN : 1882-7233
Print ISSN : 0387-1193
ISSN-L : 0387-1193
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Volume 49, Issue 5
Displaying 1-12 of 12 articles from this issue
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Original Articles
  • New cell findings on low-grade squamous intraepithelial lesions (LSIL)
    —minimizing the atypical squamous cells of undetermined significance (ASC-US) diagnosis rates—
    Kaori OKAYAMA, Mitsuaki OHKODO, Tomoko KUMAGAI, Hiromi YABUSAKI, Haruk ...
    2010 Volume 49 Issue 5 Pages 321-329
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.321
    JOURNAL FREE ACCESS
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    Objective : We studied cytological low-grade squamous intraepithelial lesions (LSIL) guidelines based on the detection of cells with a high-risk of human papillomavirus (HPV) infection in cases of atypical squamous cells of undetermined significance (ASC-US).
    Study Design : Study materials were liquid cervical cytological specimens from 151 cases diagnosed as ASC-US. We identified HPV infection using L1 polymerase chain reaction (L1-PCR) and identified HPV-infected cells using in situ PCR.
    Results : High-risk HPV was detected in 86.8% of ASC-US cases. Among 7 cell features indicative of HPV infection, binucleation (compression+) and nuclear enlargement (irregular chromatin distribution) had sensitivity exceeding 40% and specificity exceeding 90% in detecting high-risk HPV. High-risk HPV was detected by in situ PCR in 100% of cells showing binucleation (compression+) and in 81.9% of cells with nuclear enlargement (irregular chromatin distribution). The presence of cells with binucleation (compression+) and nuclear enlargement (irregular chromatin distribution) correlated significantly with high-risk HPV infection (p<0.001).
    Conclusions : LSIL can be diagnosed without HPV DNA testing when binucleated cells (compression+) are detected in cervical cytology specimens with ASC-US.
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  • Cytological and cytomorphometrical characterization of abdominal reactive mesothelia in various disorders
    Toshiyuki HABARA, Hiroshi SONOBE, Kyoko KAIHARA, Noriyuki FUJIMURA, Ak ...
    2010 Volume 49 Issue 5 Pages 330-336
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.330
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    Objective : We clarified cytological and cytomorphometrical reactive mesothelial cell (RMC) characteristics based on abdominal cavity appearance for circulatory disturbance, liver cirrhosis, carcinomatous penitonitis, and peritoneal dialysis.
    Study Design : We analyzed cytological and cytomorphometrical RMC patterns in ascites for 7 cases of circulatory disturbance, 25 of liver cirrhosis, 35 of carcinomatous peritonitis, and 9 of peritoneal dialysis effluent.
    Results : Individual cells and 2-to 4-cell clusters accounted for 94.6% to 98.6% of RMCs in each disorder. The mean individual cellular RMC area in peritoneal effluent was largest at 165.2μm2, followed by carcinomatous peritonitis at 145.8μm2, liver cirrhosis at 123.9μm2, and circulatory disturbance at 119.2μm2. Mean nuclear RMC area was 50μm2 in each group and the standard deviation significantly higher than that of nuclear area.
    Conclusion : RMCs are cytologically characterized by individual and cell cluster appearance and mild anisokaryosis even in markedly anisocytotic RMCs. Understanding these features is vital to accurate diagnosis in peritoneal effusion cytology.
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  • A clinicocytological study of tubular carcinoma of the breast
    Satoshi HAYASHI, Megumi YOKOYAMA, Fumiaki ISHIKAWA, Tomofumi YAMAZAKI, ...
    2010 Volume 49 Issue 5 Pages 337-341
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.337
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    Objective : We clarified the cytological features of tubular carcinoma (TC), a rare form of breast tumor.
    Study Design : We clinicocytopathologically examined 15 cases of TC.
    Results : TC was clinically low-grade, with a favorable prognosis. Cytological TC specimens were typified by (1) a cell-rich smear, (2) inconspicuous myoepithelium, (3) inconspicuous nucleoli, and (4) tubular and acinar structures. TC should be suspected when the aspiration cytology specimen from a breast tumor has these features.
    Conclusions : TC has a good prognosis, and tumor histology is best determined based on cytological features.
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Clinical Articles
  • A case of extraskeletal myxoid chondrosarcoma cellular variant diagnosed by squash preparation cytology
    Marisa KAWASHIMA, Noriyuki FURUTA, Rira HOSHI, Hiroaki KANDA, Yasuo HI ...
    2010 Volume 49 Issue 5 Pages 342-346
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.342
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    Background : We report a case of extraskeletal myxoid chondrosarcoma cellular variant (ESMCSCV) preoperatively diagnosed by squash preparation cytology.
    Case : A 69-year-old man had a left thigh mass difficult to diagnose histologically due to high cellularity and minimal myxoid stroma. A characteristic, well-differentiated structure was absent. Squash preparation cytology, however, identified a coffee-bean-like nuclear groove and myxoid-hyalizing stroma and a cord-like pattern.
    Conclusions : Cytological features effectively identify ESMCSCV, especially in the minute material from preoperative needle specimens.
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  • Granulocytic sarcoma detected by pleural effusion cytodiagnosis—A case report—
    Kanako YAMASAKI, Mayuko KAWAHARA, Eiji SADASHIMA, Junko KINOSHITA, Nat ...
    2010 Volume 49 Issue 5 Pages 347-351
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.347
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    Background : We report a case of granulocytic sarcoma accompanying a mediastinal tumor diagnosed based on pleural effusion cytodiagnosis.
    Case : A 50-year-old woman admitted for a right breast tumor and dyspnea associated with facial edema had no abnormalities in blood tests or biochemical profile. Computed tomography (CT) showed pleural thickening and effusion, a mediastinal tumor, and a lymph node lesion. Suspecting either malignant lymphoma or malignant mesothelioma, we cytologically diagnosed the pleural effusion. Findings showed individually dispersed round tumor cells, and cytoplasm showed basophilia with some small vacuoles. Tumor cells showed little cytoplasm, mild pleomorphism, and an irregular contour, and contained multiple nucleoli. Cell views suggested malignant lymphoma, but tumor cells were immunohistochemically negative for CD3, CD20, and CD79a. Giemsa staining identified both azurophilic granules and Auer rods in reexamination. The many peroxidase-positive cells yielded a diagnosis of granulocytic sarcoma based on flow cytometry (FCM) and immunohistochemistry findings.
    Conclusion : Cases of granulocytic sarcoma are often diagnosed incorrectly as malignant lymphoma, and we recommend immunohistochemistry evaluation to select the most appropriate treatment and thereby improve prognosis.
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  • Multiple myeloma with tumor cells appearing in the pleural effusion—A report of two cases—
    Shigeru TSUCHIDA, Masaru KOJIMA, Satomi TABATA, Harumi KAMIYAMA, Yoshi ...
    2010 Volume 49 Issue 5 Pages 352-355
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.352
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    Background : Myelomatous pleural effusion is a rare clinical condition associated with a pessimistic clinical outcome. We report cytological findings for two such cases.
    Cases : Case 1 involved gamma immunoglobulin (IgG) myeloma with myelomatous pleural effusion in initial clinical presentation. Cytological pleural fluid specimens showed scattered plasmacytoid lymphocytes (plasmablasts) with numerous mature plasma cells. Plasmablasts were two to three times larger than red blood cells and showed moderate basophilic cytoplasm, along with large, eccentrically placed nuclei with prominent nucleoli with fine nuclear chromatin. The subject died 11 months after onset. Case 2 involved alpha immunoglobulin (IgA) myeloma with a 10-year history of multiple myeloma. Cytological pleural fluid specimens showed numerous immature and mature plasma cells. Immature plasma cells had broad basophilic cytoplasm with large, eccentrically placed nuclei with one to three prominent nucleoli and coarse nuclear chromatin, together with some vacuoles. The subject died 11 months after myelomatous effusion developed.
    Conclusions : As indicated, our two subjects had advanced disease and a pessimistic prognosis. Giemsa-stained specimens are important in evaluating plasma cell differentiation when pleural effusion contains numerous anaplastic myeloma cells.
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  • A case of ascite fluid cytology showing a number of mesothelial cell clusters with collagenous stroma
    Toshiyuki HABARA, Hiroshi SONOBE, Kyoko KAIHARA, Noriyuki FUJIMURA, Hi ...
    2010 Volume 49 Issue 5 Pages 356-360
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.356
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    Back ground : Ascites cytology occasionally involves, malignant cell clusters with collagenous stroma (CS), but nonneoplastic cell clusters with CS are rare. We report a case involving numerous reactive mesothelial cell clusters with CS.
    Case : A 46-year-old woman admitted for resection of a liver tumor histologically diagnosed as neuroendocrine carcinoma experienced tumor recurrence with peritoneal dissemination and abundant ascites 4months postoperatively despite anticancer therapy.
    Cytological examination of ascites showed numerous intermediate or small cell clusters, most with CS at the center. Cells were round to cuboid with clear cytoplasm and round to oval nuclei with fine granular chromatin and immunopositive for calretinin, D2-40, WT-1, and podoplanin, but not for synaptophysin or EMA—findings corresponding to those of reactive mesothelial cells, but not of cancer cells. CS was positive for type IV collagen at the periphery.
    Conclusions : Our case, showing numerous reactive mesothelial cell clusters with CS, should alert pathologists and cytotechnicians to the unusual nature of such an case.
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  • Cytological features of parathyroid carcinoma with anaplastic transformation
    Yu SUZUKI, Miyuki UEMATSU, Hiroaki MIYOSHI, Gen TAMURA
    2010 Volume 49 Issue 5 Pages 361-363
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.361
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    Background : Parathyroid carcinoma is a rare neoplasm accounting for only 1-3% of primary hyperparathyroidism cases. We report the cytological features of parathyroid carcinoma with anaplastic transformation.
    Case : A 70-year-old man seen for a nodular right-lung lesion found in chest X-ray screening was found in computed tomography (CT) to have a cervical tumor posterior to the lower right thyroid gland. Blood calcium and parathyroid hormone (PTH) levels were elevated. Suspected parathyroid carcinoma with pulmonary metastasis necessitated excision with right thyroid lobectomy. Smear cytology showed two types of tumor cells-differentiated with round nuclei and anaplastic with large pleomorphic nuclei. Transition was noted from differentiated to anaplastic tumor cells. Postoperative blood calcium and PTH levels returned to normal and the pulmonary lesion shrank markedly without further treatment.
    Conclusion : Gene analysis showed that anaplastic tumor cells carried a p53 gene point mutation, while remaining differentiated carcinoma cells had the wild-type p53 gene. These findings suggest that p53 gene mutation is associated with anaplastic parathyroid carcinoma transformation.
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  • Abdominal wall endometriosis after cesarean section
    Tomohito TANAKA, Yoshito TERAI, Masahide OHMICHI
    2010 Volume 49 Issue 5 Pages 364-368
    Published: 2010
    Released on J-STAGE: November 17, 2010
    DOIhttps://doi.org/10.5795/jjscc.49.364
    JOURNAL FREE ACCESS
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    Background : Abdominal wall endometriosis is rare and difficult to diagnose. Overall abdominal wall endometriosis incidence has been reported 0.03-1.0% of women with cesarean section scar.
    Case : We report the case of a 26-year-old woman with no endometriosis history. The 15×3×3 cm tumor was firm and located at a right angle from the incision of a cesarean section conducted 2 years earlier along the rectus abdominis muscle to the umbilicus level. Regardless of treatment with a gonadotropin-releasing hormone (GnRH) analog for 6 months, the woman showed ongoing, increasing symptoms fluctuating with her menses, and the lesion also gradually grew. Fine-needle aspiration cytology (FNAC) showed cellular sheets of epithelial and stromal cells against a hemorrhagic background that confirmed the presence of endometrium and excluded carcinoma. The woman was clinically diagnosed with abdominal wall endometriosis, eventually undergoing wide local excision of the lesion with negative margins. Follow-up at 18 months showed continued recovery.
    Conclusion : We found FNAC to be useful in preoperative diagnosis, and surgical management provides the best option for both a definitive diagnosis and effective treatment of large abdominal wall endometriosis.
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Brief Notes
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