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Volume 50 (2011)
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Volume 50, Issue 6
Displaying 1-10 of 10 articles from this issue
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Original Articles
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Tsuyoshi IKEZAWA, Tomoko KAWAMURA, Fumiaki OONUKI, Yukio MORISHITA2011 Volume 50 Issue 6 Pages 313-319
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSObjective : The factors influencing on quality of cytological specimen that was obtained during endoscopic retrograde cholangiopancreatography (ERCP) were examined.
Study Design : Epithelial cells were brushed using 23 gallbladder specimens that were resected for cholecystolithiasis and cholecystitis. The specimens were smeared directly and suspended in saline and contrast medium of an equal volume of different dilution fluids. We stained the preparations by the Papanicolaou technique and analyzed quality in each preparation.
Results : Inadequate specimens with not able artificial changes were brushing smears immersed in contrast medium and suspended materials using non-diluted contrast medium and doubling to eightfold diluted fluid. The artificial features included diminished cells and cell clusters, smudging nuclei and Orange-G stained cytoplasm. The smears using brush after immersion into 16-and 32-fold-diluted contrast medium and the washing smear with 32-fold diluted contrast medium showed findings that were similar to saline-washing smear.
Conclusion : Contrast medium was suggested to be inhibitor of alcohol fixation. It was concluded that brush-washing materials, in which contrast medium was diluted were more effective than brushing smear with non-diluted contrast medium in during ERCP.View full abstractDownload PDF (1249K) -
Yuichi KINOSHITA, Kosho TAKASU, Yasushi ADACHI, Takashi YURI, Shiho MA ...2011 Volume 50 Issue 6 Pages 320-324
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSObjective : We clinically and cytologically examined vitreous body and intraocular perfusion fluid and its uses.
Study Design : We studied 64 fluid samples for age, gender, symptoms, clinical suspicion, cytology, and final diagnosis in vitreous body and intraocular perfusion.
Results : Median age at onset was 60.8 years. No gender difference in incidence were indicated. Vitreous opacity was seen in most ocular findings and uveitis and endophthalmitis were suspected. Infection, sarcoidosis, and malignant lymphoma were diagnosed cytologically.
Conclusions : Molecular biological studies in diagnosing intraocular lesions show promise but are limited by the small vitreous body fluid samples. Laboratory procedure chosen based on intraocular perfusate cytology may help improve precision in intraocular lesion diagnosis.View full abstractDownload PDF (521K) -
Satoshi HAYASHI, Megumi YOKOYAMA, Fumiaki ISHIKAWA, Tomofumi YAMAZAKI, ...2011 Volume 50 Issue 6 Pages 325-331
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSObjective : We studied the clinicocytopathological features of invasive micropapillary carcinoma (IMPC) retrospectively.
Study Design : Ten subjects with IMPC were clinicocytopathologically compared to 500 subjects with invasive ductal carcinoma (IDC) patients. Samples of 9 cytological IMPC features were compared to 8 of papillotubular carcinoma.
Results : No difference was seen in age, time of menopause onset, chief complaint, or familial breast carcinoma history between subjects with IMPC and IDC. 100% of IMPC were diagnosed as category 4 or 5, and 81.6% of IDC. “Pure” IMPC featured a dual cytological pattern. It was not so difficult to presume IMPC in fine-needle aspiration (FNA) cytology. The pathological median tumor size was 10.0 mm in IMPC and 14.8 mm in IDC (p<0.05). Of subjects with IMPC, had 6 lymphatic invasion and 6 vessel invasion. No difference was seen between subjects with IMPC and IDC in hormone receptor status or HER2 protein expression. Axillary lymph node metastasis was seen in 20.0% of those with IMPC and 25.8% of those with IDC. Of the 10 subjects with IMPC, 1 (10.0%) had postoperative lymph node recurrence, but none died of disease.
Conclusion : It is not so difficult to presume “pure” IMPC in FNA. The prognosis among our subjects with IMPC was fairly favorable thanks to early-stage detection and the high positive hormone receptor incidence.View full abstractDownload PDF (793K) -
Tomomi KATOH, Masanori YASUDA, Saki YAJIMA, Shin-ichi HORI, Michio SHI ...2011 Volume 50 Issue 6 Pages 332-340
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSObjective : To improve cytological evaluation of therapeutic effects induced by radiation therapy (RT) and concurrent chemoradiotherapy (CCRT) in uterine cervical squamous cell carcinoma (UCSCC), we reevaluated routine cytological diagnosis.
Study Design : Cytological specimens numbering 207 from 53 UCSCC subjects-13 undergoing RT and 40 CCRT-were divided into positive, negative, and indeterminate categories and reevaluated together with Ki-67 expression and human papilloma virus (HPV) infection status. Histological reevaluation was also done with a magnetic resonance imaging (MRI) study.
Results : Positive cytological reevaluation ratios declined linearly-30 Gy at 69%, 40 Gy at 44%, 50 Gy at 30%, 60 Gy at 13%-somewhat differing from routine diagnosis. The Ki-67 index was consistent with reevaluation-30% positive, 0.6% negative, and 6% indeterminate. HPV infection persisted in positive specimens, and 73% of cytological reevaluation agreed with imaging study diagnosis.
Conclusions : Cytological examination quality in determining RT and CCRT effects is improved by comprehensively evaluating clinical-information-based cytological specimens. Three-tiered positive, negative, and indeterminate evaluation is recommended instead of Papanicolaou classification.View full abstractDownload PDF (723K)
Clinical Articles
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Reiko NUMAZAKI, Hisasi OSIRO, Etsuko MIYAGI, Yosiaki INAYAMA, Kazuhisa ...2011 Volume 50 Issue 6 Pages 341-345
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSBackground : Lymphoepithelioma-like carcinoma (LELC), a rare cervical squamous cell carcinoma variant, rarely metastasizes to regional lymph nodes and shows a less dismal prognosis than more common cervical squamous cell carcinoma.
Case : A 66-year-old Japanese woman diagnosed with stageIIb cervical LELC underwent radical hysterectomy including bilateral salpingo-oophorectomy. The pre-operative cervical smear showed immature tumor cells scattered and associated with abundant plasma cell and lymphocyte eosinophil infiltration, in addition to scattered multinucleate giant cells. Immunohistologically, tumor cells expressed marked amounts of cytokeratin, and lymphocytes expressed CD3 and CD8. The woman’s condition was negative for Epstein-Barr virus (EBV) and human papilloma virus.
Conclusion : LELC notably features the growth of large tumor cells with intermingled lymphocyte infiltration and polynuclear giant cells.View full abstractDownload PDF (928K) -
Junko KINOSHITA, Mayuko KAWAHARA, Eiji SADASHIMA, Kanako YAMASAKI, Nat ...2011 Volume 50 Issue 6 Pages 346-350
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSBackground : We report 2 cases of mammary neuroendocrine ductal carcinoma in situ (NE-DCIS) characterized by the absence of a breast mass and bloody nipple discharge proving useful in making the final diagnosis.
Cases : Case 1 : A 70-year-old women seen for bloody right nipple discharge was found in cytological examination to have numerous neoplastic cells scattered in overlapping predominantly monolayered epithelial clusters. The epithelium consisted of small round or polygonal cells with abundant eosinophilic granular cytoplasm and rounded, eccentrically placed nuclei. Case 2 : A 60-year-old woman seen for bloody discharge from both nipples was found in cytological examination to have scattered loose sheets and overlapping clusters of tumor cells. Cells were small round or polygonal with eosinophilic granular cytoplasm. Immunocytochemical staining showed tumor cells to be positive for synaptophysin.
Conclusions : The two NE-DCIS cases reported were diagnosed by nipple discharge. Although it is difficult to determine whether NE-DCIS is benign or malignant, careful cell form observation and immunohisto/cytochemical studies enable an accurate diagnosis.View full abstractDownload PDF (1058K) -
Rina NAGAYAMA, Takuji FUJITA, Yukiko TASAKI, Shoko KITADE, Shinichiro ...2011 Volume 50 Issue 6 Pages 351-354
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSBackground : Brain metastasis from cervical cancer is extremely rare. We report such a case found early on postoperatively.
Case : A 36-year-old woman with atypical genital bleeding was found to have a 2 cm cervical cancer lesion. Cytologically, small cells with granular hyperchromatic nuclei occurred in clusters. Nuclear molding-forming patterns were also seen. Histologically, the tumor included small cell-like lesions, but was finally diagnosed as non keratinized squamous cell carcinoma. Some 5months postoperatively the woman exhibited dizziness and vomiting, and then was found to have a 5.5 cm brain tumor necessitating resection. The brain lesion was more poorly differentiated than the primary lesion.
Conclusion : Brain metastasis from cervical cancer should be kept in mind if atypical cytological findings are pointed out.View full abstractDownload PDF (532K) -
Michiyo USHIJIMA, Yoshihiro YAMAKAWA, Yuuko TAKAGOSHI, Mutsuko MAEDA, ...2011 Volume 50 Issue 6 Pages 355-359
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSBackground : Endometrial serous adenocarcinoma accounts for 2-10% of all endometrial carcinoma and a poorer prognosis than the usual endometrial carcinoma. The case we report arose from the atrophic endometrium covering prolapsed submucosal leiomyoma.
Case : A 70-year-old woman seen for abnormal uterine bleeding was found in a gynecological examination to have a mass resembling prolapsed myoma. Cytological and histological findings showed poorly differentiated adenocarcinoma. Based on magnetic resonance imaging (MRI) alone, endometrial cancer was difficult to distinguish from that of the the uterine cervix, necessitating radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. The pedunculated mass was suspended from the uterus and prolapsed through the cervix. Histologically, the diagnosis was submucosal leiomyoma, with serous adenocarcinoma observed within the myoma and the endometrium covering the tumor. Immunohistochemical staining showed tumor cells partially positive for ER, PR, and p53.
Conclusion : Our rare case of serous carcinoma involved only nonmetastatic pedunculated submucosal myoma arising from the endometrium covering prolapsed submucosal leiomyoma.View full abstractDownload PDF (1024K) -
Tomoko HAGIWARA, Manabu OKUZONO, Ryuji NAKANO, Tsunehisa KAKU, Keita M ...2011 Volume 50 Issue 6 Pages 360-365
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSBackground : Female genital lymphomas account for about 1% of all extranodal lymphomas. Vaginal lymphomas, which are extremely rare, are nonepithelial and thus difficult to diagnose using scraping smear or punch biopsy. We report a case of diffuse large B-cell lymphoma (DLBCL) detected by aspiration cytology.
Case : An asymptomatic 66-year-old woman was seen for a vaginal mass 9 cm in diameter. Scraping smear and punch biopsy specimens suggested a nonspecific tumor-cell-free inflammatory reaction. Aspiration cytology, however, indicated typical malignant lymphoma findings of large atypical lymphoid cells with a high nucleocytoplasmic ratio scattered in a bloody background. Round to oval nuclei were cleaved or noncleaved with fine nuclear chromatin and contained one to three prominent nucleoli. Excisional biopsy yielded a diagnosis of IEA-stage primary vaginal DLBCL. Two modified R-CHOP cycles and radiation therapy completely reduced the mass, suggesting a complete response.
Conclusion : Physicians should be aware that malignant lymphoma may arise from the vagina, and that fast, simple aspiration cytology may aid in making an early diagnosis.View full abstractDownload PDF (857K)
Brief Note
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Atsushi KIHARA, Tomonori USHIJIMA, Keiko TAKEDA, Junichi FUKUSHIMA, Ha ...2011 Volume 50 Issue 6 Pages 366-367
Published: 2011
Released on J-STAGE: February 09, 2012
JOURNAL FREE ACCESSWe report a case of fetal adenocarcinoma of the lung in a 70-year-old woman whose bronchial washing cytology showed many large overlapping palisaded tumor cell clusters. Cells had round or oval nuclei with fine granular chromatin and indistinct nucleoli. Cytology also showed two other small cluster types-one with nuclear molding and the other with clear cytoplasm and round nuclei with hypochromasia. The differential diagnosis included low-grade lung adenocarcinoma, metastatic adenocarcinoma, pulmonary blastoma, and carcinoid tumor. This case suggests that fetal adenocarcinoma shows a variety of clusters in bronchial washing cytology.View full abstractDownload PDF (427K)
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