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Volume 51 (2012)
- Issue 6 Pages 395-
- Issue 5 Pages 315-
- Issue 4 Pages 235-
- Issue 3 Pages 159-
- Issue 2 Pages 93-
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Volume 51, Issue 2
Displaying 1-10 of 10 articles from this issue
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Review Article
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Yoshiaki NORIMATSU2012 Volume 51 Issue 2 Pages 93-104
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSIn recent years, about detection of the increased endometrial carcinoma in Japan, it is well known that use of cytologic examination is initial method. However, because it is reported that 30-60% of a suspicious diagnosis are overdiagnosis, endometrial cytological diagnosis was not accomplished as the role enough. As the reason, because hormonal influence and cellular change (metaplasia) are added to endometrial glandular cell and endometrial stromal cell, various cytologic findings appeared, and those cytologic findings were misdiagnosed as endometrial hyperplasia or carcinoma. Therefore, as for the improvement of precision in endometrial cytology, grasp of a characteristic of a cytological findings for dysfunctional uterine bleeding due to anovulatory cycle (Endometrial glandular and stromal breakdown ; EGBD, Disordered proliferative phase ; DPP) is important.
As a result of study, the following was clarified ; it was revealed that “fragmented cluster” and “condensed cluster of stromal cells” and “metaplastic clumps with irregular protrusion which contains condensed stromal clusters” were useful for the cytologic assessment of anovulatory EGBD. In addition it was considered that a diagnosis is negative and in need of follow-up if EGBD was suspected. As for a DPP case, the occurrence of “cell clumps with dilated or branched” was same as an endometrial hyperplasia case, and discrimination of both in cytology is difficult. Therefore, if criteria of suspicious diagnosis is satisfied about the occurrence of “cell clumps with dilated or branched”, the histological diagnosis must be confirmed.
Dysfunctional uterine bleeding due to anovulatory cycle happens frequently, and many patients need cytological examination in gynecology outpatient clinic.View full abstractDownload PDF (1880K)
Original Articles
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Miwa KINO, Yuko SUGIYAMA, Kimihiko SAKAMOTO, Hidetaka NOMURA, Maki MAT ...2012 Volume 51 Issue 2 Pages 105-109
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSObjective : We compared the clinical utility of the brush method (Honest Super Brush) to the aspiration method (Masubuchi method).
Study Design : Between 2005 and 2007, 1099 endometrial cytology samples from 856 subjects were collected using aspiration and brush methods. Cytological examination results showed suspicious or positive findings in either or both methods compared to those of histological examinations.
Results : In the 1099 samples, the difference in the proportion of samples unsatisfactory for evaluation in the aspiration and brush methods was statistically significant at 15.6% versus 5.3% (p<0.01). Among 160 subjects with suspicious or positive results in either or both methods, 120 (75%) had endometrial cancer or associated lesions. The rate of suspicious or positive findings in the aspiration method was 94.2% (113/120) versus the brush method at 93.3% (112/120).
Conclusion : The diagnostic accuracy of the brush method appears equivalent to that of the aspiration method. The ratio of samples unsatisfactory for evaluation with the brush method was significantly lower, however, than for evaluation with the aspiration method. The brush method may therefore be advantageous when used as a tool for screening endometrial cancer.View full abstractDownload PDF (254K) -
Yutaka MORIMURA, Seiko CHIBA, Yukari ARAKI, Yoshinori SOETA, Takashi T ...2012 Volume 51 Issue 2 Pages 110-115
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSObjective : The Bethesda System (TBS) defines specimen adequacy.
Study Design : We analyzed TBS adequacy by mass-screening 69,584 smears to compare the unsatisfactory TBS rate to that by conventional criteria. Conventional criteria were defined as self-made items that were unsatisfactory but evaluable. We verified criteria appropriateness using the result of a to follow-up study of participants.
We defined the number of cells adequate, i. e. evaluable although unsatisfactory in mass-screening, as a central value of a minimum of 500 cells.
Result : We found 77 unsatisfactory specimens in conventional criteria and 590 unsatisfactory specimens by TBS criteria. The unsatisfactory rate of 0.85% in TBS criteria was significantly higher than that of 0.11% in conventional criteria.
The follow-up study of participants showed proved no serious misdiagnosis with specimens as defined in this paper.
Conclusions : The strict indication of TBS criteria in mass-screening is not practical. Our criteria as defined, i. e. a central value of a minimum 500 cells, to avoid an increase in the unsatisfactory rate, we should define unsatisfactory but evaluable specimens more satisfactorily.View full abstractDownload PDF (323K)
Clinical Articles
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Chiemi EBIZUKA, Jun MAKINO, Tsuyoshi KOYAMA, Hiroki IMAI, Mutsuko WATA ...2012 Volume 51 Issue 2 Pages 116-119
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSBackground : Spindle-cell carcinoma is rare, accounting for 0.3% of all breast carcinoma. We report a case of fibromatosis-like spindle-cell carcinoma difficult to diagnose using fine-needle aspiration cytology.
Case : A 48-year-old woman seen for a mass she found in the left breast was found in fine-needle aspiration cytology to have large numbers of atypical spindle-shaped cells with clear cytoplasmic borders in a mucinous-like material, suggesting a phyllodes tumor. Histological findings of excisional biopsy demonstrated proliferation of spindle-shaped and longoval mesenchymal-like cells. Based on immunostaining, we diagnosed this as fibromatosis-like spindle-cell carcinoma.
Conclusion : Atypical spindle-shaped cells found in primary breast-tumor cytology, may be fibromatosis, stromal sarcoma or phyllodes tumor. Cell numbers differentiated our case from fibromatosis and cellular atypia from stromal sarcoma, but it was difficult to differentiate it from phyllodes.View full abstractDownload PDF (648K) -
Akihiko KAWAHARA, Tomohiko YAMAGUCHI, Hideyuki ABE, Tomoki TAIRA, Tomo ...2012 Volume 51 Issue 2 Pages 120-124
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSBackground : We report a case of primary lung cancer having to be distinguished from breast cancer lung metastasis focusing on liquid-based bronchial brushing cytology, immunocytochemistry, and epidermal growth factor receptor (EGFR) mutation.
Case : A 60-year-old woman with a breast cancer history seen for back pain was found in computed tomography and bone imaging to have bone metastasis and a pulmonary nodule. Liquid-based bronchial brushing cytology results yielded a diagnosis of primary lung cancer. Immunocytochemistry and peptide nucleic acid-locked nucleic acid polymerase chain reaction clamp assay results showed an EGFR mutation exon 21 L858R.
Conclusions : EGFR mutation may also be detected by immunocytochemistry. Immunocytochemistry and molecular techniques using cytological material in personalized medicine are necessary.View full abstractDownload PDF (588K) -
Kiyoshi TONE, Keiko KOJIMA, Haruhiko YOSHIOKA, Kiyotada WASHIYA, Jun W ...2012 Volume 51 Issue 2 Pages 125-131
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSBackground : Most pyothorax-associated lymphoma (PAL), a rare late complication of tuberculous pyothorax or induced artificial pneumothorax, has a B-cell but rarely a T-cell phenotype. We report a case of T-cell PAL with Epstein-Barr virus (EBV) diagnosed by imprint cytology of a chest wall mass.
Case : An 86-year-old man undergoing artificial pneumothorax for pulmonary tuberculosis at age 27 and seen for left hypochondrial pain. He was found in incisional biopsy of the mass to have a tumor diagnosed as T-cell lymphoma with EBV infection by imprint cytology. The final tumor diagnosis was peripheral T-cell lymphoma not otherwise specified histologically or immunohistochemically.
Conclusions : In the unique, very rare T-cell PAL case we report, we determined the lymphoma type and EBV infection through imprint cytology combined with proactive immunocytochemical staining.View full abstractDownload PDF (1391K) -
Takeshi UMAZUME, Yukiharu TODO, Yukiko AOYAGI, Yoshihiro SUZUKI, Shini ...2012 Volume 51 Issue 2 Pages 132-136
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSBackground : Primary vaginal lymphoma is very rare. We report cytological findings for a vaginal stump and urine in a case of vaginal large B cell lymphoma (DLBCL).
Case : A 76-year-old woman admitted for vaginal bleeding had a 48×51×53 mm mass at the vaginal stump found in cytological examination to have large round solitary cells with scant cytoplasm. Cytological urine examination also showed loosely aggregated cells with scant cytoplasm, round or irregular nuclei with conspicuous nucleoli, and a coarse granular chromatin pattern. Immunohistochemical staining of a vaginal tumor biopsy specimen indicated DLBCL.
Conclusion : Primary vaginal DLBCL should be suspected when cytological tumor examination shows isolated lymphoid cells with scant cytoplasm or groups of loosely aggregated lymphoid cells with scant cytoplasm.View full abstractDownload PDF (817K) -
Mieko DOI, Yoshihiko SHIMIZU, Tomoko MITSUHASHI, Mineko KINNO, Hidekaz ...2012 Volume 51 Issue 2 Pages 137-142
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSBackground : Yolk sac tumors rarely occur in ascitic fluid cytology specimens. We analyzed cytologic features in such cases and compared them to those in imprint cytology of resected specimens.
Case : Ascitic fluid cytology specimens were obtained from two patients (10 and 42 years old) with yolk sac tumor of the ovary. Hemorrhagic, necrotic background was observed in the imprint cytology, whereas histiocytes were seen in the ascitic fluid cytology. Irregular cohesive three-dimensional cell balls were noted in both the imprint specimens and the ascitic fluid specimens. Channels folded over several times like a long, narrow balloon pinched at its jonts, i.e. “balloon animal”-like cell clusters, acute-angled cytological atypia, and hyaline globules were also observed in both specimens. Regarding the nucleoli, the imprint cytology showed conspicuous nucleoli while the ascitic fluid cytology showed inconspicuous nucleoli.
Conclusion : Important findings in diagnosing yolk sac tumors in ascetic fluid specimens are so-called “balloon-animal”-like cell clusters, acute-angled cytological atypia, and hyaline globules, in conjunction with clinical information.View full abstractDownload PDF (795K) -
Michiyo USHIJIMA, Yoshihiro YAMAKAWA, Yuuko TAKAGOSHI, Mutsuko MAEDA, ...2012 Volume 51 Issue 2 Pages 143-146
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSBackground : Clear cell uterine-cervix adenocarcinoma is extremely rare, accounting for just 4% of cases. We report such a case diagnosed preoperatively from cytological and histological findings.
Case : A 62-year-old woman was seen for suspected cervical clear cell adenocarcinoma found in a Pap test. A readily bleeding polypoid tumor found arising in the cervical canal was resected. Cytologically, tumor cells had round nuclei, a prominent nucleolus, and clear cytoplasm, arranged in sheet-like, glandular, and “mirror ball” patterns. Histologically, the tumor consisted of clear or “hobnail” cells in papillary, tubocystic, or solid patterns. Radical hysterectomy with bilateral salpingo-oophorectomy including pelvic lymph node dissection showed that, grossly, the uterine cervix wall had no residual tumor. Histologically, no residual cancer was seen.
Conclusion : Early-stage cervical adenocarcinoma is difficult to diagnose. Our case may have been found and treated early thanks to exophytic growths such as an endocervical polyp and cytological features.View full abstractDownload PDF (776K)
Brief Note
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Tomoko KAWAMURA, Tsuyoshi IKEZAWA, Fumiaki OONUKI, Akihiro ARAKI, Yuki ...2012 Volume 51 Issue 2 Pages 147-148
Published: 2012
Released on J-STAGE: June 27, 2012
JOURNAL FREE ACCESSWe report a rare case of ascites cytology showing renal cell carcinoma. Malignant cells in ascites have abundant, clear, and vacuolated cytoplasm, including glycogen and unusual nucleoli. Sudan III staining showed positivity for lipoid granules in cytoplasm. Atypical cell clusters resembled a chrysanthemum flower.
In cell block specimens, immunohistochemical staining showed significant renal cell carcinoma findings. Cell block specimens were useful in differentiating adenocarcinoma in ascites fluid. A Sudan III staining proved simple and useful in helping to determine renal cell carcinoma.View full abstractDownload PDF (329K)
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