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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-
- Issue 1 Pages 1-
Volume 51, Issue 3
Displaying 1-13 of 13 articles from this issue
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Original Articles
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Yutaka MORIMURA, Ryoko TORAIWA, Takashi TSUKAHARA, Nami SATOH, Mikako ...2012 Volume 51 Issue 3 Pages 159-163
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSObjective : The Bethesda System in reporting a cervical cytology, has proposed atypical squamous cells with undetermined significance (ASC-US) but cannot rule out high- grade lesions (ASC-H). To clarify the importance of human papillomavirus (HPV) testing and to determine effective cancer screening, we use HPV testing with colposcopic biopsy in women with ASC-US and ASC-H cytology.
Study Design : Subjects were 143 women with ASC-US and 37 with ASC-H found in uterine cancer screening who underwent HPV testing in Fukushima Prefecture from April 2007 to March 2009. We analyzed HPV positivity and histological and follow up results.
Results : Among ASC-US subjects, 39 were negative in HPV testing and only 1 (2.6%) was positive with a≧CIN3 lesion. Most subjects (83.8%) had atypical cells disappear. The remaining 104 were HPV positive. ≧CIN3 was found in 12 and 80.0% of atypical cells disappeared. Among those with ASC-H, 12 were HPV negative and 4 had≧CIN3. Among those with ASC-H, 25 were HPV positive and 9 had≧CIN3.
Conclusion : Subjects with ASC-US and HPV (−) do not necessarily need detailed examination, but those with ASC-US and HPV (+) should undergo detailed examination and follow-up. Regardless of HPV results, those with ASC-H should undergo colposcopic biopsy.View full abstractDownload PDF (243K) -
Hiroyuki MORISAWA, Hiroyuki FUJIWARA, Yuji TAKEI, Yoshihumi TAKAHASHI, ...2012 Volume 51 Issue 3 Pages 164-168
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSObjectives : We investigated Pap smear histories of subjects with cervical carcinoma and CIN3 to determine factors that influencing screening test results.
Study Design : We reviewed clinical histories of 248 cervical carcinoma and CIN3 subjects treated between 2006 and 2009.
Results : Of the 248, 92 (37%) had undergone a Pap smear within three years of their diagnosis and 156 (63%) had no Pap smear history. The incidence of invasive carcinoma of stageIB or more was significantly higher in screening (−) compared to screening (+) (70.5% vs. 19.6% ; P<0.001). Screening (+), involved 18 cases of invasive carcinoma (SCC : 8, adenocarcinoma : 10). Adenocarcinoma incidence was significantly higher in this group than in all invasive carcinoma subjects (55.6% vs. 20.3% ; P<0.001). An evaluation of SCC subjects in the false negative group showed that small, internal, and keratinized tumors were reasons for false-negative results.
Conclusion : A comparison of Pap smear histories in cervical carcinoma and CIN3 subjects, clarified false-negative case features. Diagnostic precision to these samples is a future problem to improve.View full abstractDownload PDF (484K) -
Keiko NAGAMUNE, Midori NISHIYAMA, Hidehiro NUMAGAMI, Toshiki HAYASHIDA ...2012 Volume 51 Issue 3 Pages 169-177
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSObjective : Highly viscous or bloody samples are, by their nature, difficult to make into adequate cytology slides whether by following the Japan Society of Clinical Cytology (JSCC) manual or by conventional nonhemolysis. We found ways to improve such cytopreparation.
Study Design : We added CytokeepII and centrifuged highly viscous samples, which yielded sediment and three liquid layers, each of which was then pressed between two microscope slides. We centrifuged and obtained sediment from bloody samples ; added Rinse Liquid diluted with normal saline at 10-50 times sediment volume, and recentrifuged them. We them compared slides prepared conventionally to those made using our new approach.
Results : The new approach yielded satisfactory cell stainability and quantity in highly viscous samples and a clear background without degenerated cells in bloody samples. It also enabled us to examine previously unevaluable samples uniformly. Our approach used the solution which had long-term stability and required only a short time for hemolysis.
Conclusion : Cytological slides for highly viscous samples using CytokeepII and for bloody samples using Rinse Liquid solution were superior to conventionally prepared slides, and should help increase efficiency and improve diagnostic yield.View full abstractDownload PDF (1073K)
Clinical Articles
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Mayumi KOUNO, Shouzou WATANABE, Kumiko KAWAOKA, Aoi YAMASHITA, Emi ONO ...2012 Volume 51 Issue 3 Pages 178-182
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : Anal canal carcinoma is rare, accounting for 2-3% of colon cancers. We report a case of primary mucinous carcinoma arising in the anal canal gland.
Case : A 69-year-old man seen by a neighborhood doctor for anal induration with slight pain was found to have a 15×30 mm cystic lesion near the anal ring.
Fine-needle aspiration cytology (FNAC) following a small cut in the lesion showed mucinous adenocarcinoma cells.
Histological examination detected these adenocarcinoma cells only upon the third try, however.
Conclusions : FNAC is a good tool for detecting adenocarcinoma cells in deep-tissue mucinous adenocarcinoma with copious mucin.View full abstractDownload PDF (841K) -
Rika SUZUKI, Nobutaka ONO, Seiiti YOSHIKAWA, Syu SOEDA, Takeharu OHZEK ...2012 Volume 51 Issue 3 Pages 183-187
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : Extra genital metastasis to the uterine cervix is rare. Almost all cases of urothelial carcinoma (UC) have urine cytology and are treated surgically.
Case : A 77-year-old woman later suspected of having advanced nonkeratinizing squamous cell carcinoma had undergone radical cystectomy and urinary diversion for a UC (G3) diagnosis in cystoscopic biopsy at age 64. At age 72, she had classV uterine cervical cytology with malignant cells having irregular-shaped hyperchromatic nuclei and severe atypia. Despite CIN3 cervical biopsy, no malignancy was seen in uterine conization, although cytological and histological conization findings differed. Five years later, a 1.5 cm tumor was drained from the original urethra, suggesting UC recurrence. The woman died about a year later. Cytological and histological uterine and bladder specimens, reexamined retrospectively using immunohistochemical analysis were diagnosed as UC.
Conclusion : Detecting malignant cells in uterine cervical cytology may cause recurrent UC to be misdiagnosed, delaying treatment. The origin of malignant cells should therefore be investigated again if cytological and histological evaluations are inconsistent.View full abstractDownload PDF (779K) -
Takashi UMEZAWA, Kouichi NOMURA, Sachiko TSUCHIYA, Tomomi ASHIKAWA, Ay ...2012 Volume 51 Issue 3 Pages 188-191
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : Serous endometrial intraepithelial carcinoma (SEIC) is a putative precursor of serous adenocarcinoma of the uterine corpus. Due to its rarity, this tumor’s cytological features have yet to be fully determined. We report cytological findings on such SEIC.
Case : A 61-year-old postmenopausal woman presented with abnormal uterine bleeding. Radiological examination revealed uterine leiomyomas. No findings suggested uterine, bilateral ovarian, or fallopian tube malignancy, however. Endometrial cytology showed small atypical cell clusters accompanied by atrophic endometrial glandular cells in a clear background. Atypical cell clusters had irregular edges with nuclear protrusions. We suspected that ovarian or fallopian tube cancer cells were transferred to the uterine cavity via the fallopian tubes. Histologically, atypical cells resembling those of ovarian serous adenocarcinoma replaced the endometrial surface epithelium and normally situated endometrial glands, and proliferated in solid, tubular, cribriform, and papillary configurations. Mitoses and apoptosis were observed. Stromal invasion was lacking. The final diagnosis was SEIC.
Conclusion : Although SEIC is a microscopic lesion and difficult to diagnose clinically, endometrial cytology shows that characteristic findings of SEIC is useful in early diagnosis.View full abstractDownload PDF (725K) -
Kazuhito MATSUMOTO, Kikuko HAMANAKA, Mami MANABE, Satoshi TAKITA, Maro ...2012 Volume 51 Issue 3 Pages 192-197
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : We report a case of endometrial stromal sarcoma with numerous cell clusters containing collagenous stroma observed by endometrial cytology.
Case : A 83-year-old woman reporting abnormal uterine bleeding found gynecological echography showed a mass filling the uterine cavity and invading the uterine muscle layer, suggesting corpus uteri carcinoma. Endometrial cytology and endometrial biopsy done after admission, showed numerous cell clusters with central cores mimicking adenocarcinoma. From these cytological findings, we first diagnosed adenocarcinoma, but histological examination showed the tumor to consist of oval to short spindle-shaped cells. Abundant round or amorphous collagenous stroma and many capillary and spiral arteriole-like vessels were found in stroma. Immunohistochemically, tumor cells were positive for CD10, vimentin, ER and PgR. The final tumor diagnosis was endometrial stromal sarcoma. Cell clusters containing collagenous stroma suggested this tumor was adenocarcinoma. Retrospectively, however, clusters appeared to reflect unusual histological findings.
Conclusion : Histologically, collagenous stroma is occasionally found in low-grade endometrial stromal sarcoma, requiring detailed cytomorphological observation in endometrial cytology to avoid tumor misdiagnosis.View full abstractDownload PDF (1095K) -
Makoto URANO, Maki FUJIWARA, Kouichi TANAKA, Satomi ITOH, Yutaka HIRAS ...2012 Volume 51 Issue 3 Pages 198-203
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : Myoepithelial tumor of the breast is rare, and its cytological finding in not well established. We report a case of myoepithelial carcinoma of the breast.
Case : A 71-year-old female noticed a mass in the right breast. Ultrasonography revealed a solid tumor, 1.5 cm in diameter. Fine needle aspiration (FNA) cytology specimens showed cohesive epithelial cell clusters and fascicular spindle cells accompanying numerous myxoid matrix which demonstrated metachromasia in Giemsa stain. Histologically, the tumor composed of spindle to polygonal cell proliferation with myxoid matrix and dense fibrosis. The tumor cells expressed several myoepithelial cell markers and showed “triple negative” pattern in immunohistochemistry.
Conclusion : It is important to recognize the various cell shape and cell arrangement of neoplastic myoepithelial cells in making accurate cytological diagnosis of myoepithelial lesions. Giemsa stain is useful to recognize stromal myxoid matrix which may indicate it myoepithelial cell origin.View full abstractDownload PDF (1170K) -
Sachiko ONIMATSU, Yasunobu FUNAMOTO, Takako HIRAGUCHI, Yukari MITANI, ...2012 Volume 51 Issue 3 Pages 204-208
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : The World Health Organization (WHO) classifies the angiomatous meningioma subtype as a category grade 1 tumor. We report a case in which squash preparation cytology provided useful diagnostic information for rapid pathological examination.
Case : A 75-year-old man admitted to an emergency department after a traffic accident was found in plain computerized tomography of the skull to have abnormal shadows in the right cranial fossa, suspected in magnetic resonance imaging (MRI) to be meningioma. Tumor resection was planned and a frozen section taken intraoperatively combined with squash cytology. The frozen tumor section consisted of numerous vascular and collagenous fibers against a background of tumor cells.
The tumor was, however, difficult to definitively diagnose histopathologically.
Squash preparation cytology showed large numbers of collagen or collagenous fibers.
Meningioma cells adjacent to these appeared meningothelial.
Rapid pathological examination thus showed meningioma confirmed in postoperative tissue examination to be angiomatous meningioma.
Conclusion : In rapid pathological examination using frozen sections for meningioma cases squash preparation cytology proved very useful to us in diagnosing the angiomatous subtype.View full abstractDownload PDF (884K) -
Yuichi KINOSHITA, Kosho TAKASU, Takashi YURI, Kazuo ICHIBE, Shiho MATS ...2012 Volume 51 Issue 3 Pages 209-213
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : Autoimmune pancreatitis (AIP) is an inflammatory disorder causing a mass that is often operated on as pancreatic cancer. We report such a case.
Case : A 67-year-old man reporting had dysgeusia and brown urine had intrahepatic bile duct dilation pointed out on computed tomography and obstructive jaundice diagnose due to a tumor. Cytology of the bile showed small, irregularly arranged clusters against the bile pigment background. Cells forming clusters showed irregular nuclei and mildly increased of fine granule-shaped chromatin. Histologically, the lesion showed fibrosis between the pancreatic duct and pancreatic lobule, with distinct lymphatic infiltration and IgG4-positive plasma cells.
Conclusion : AIP which is an inflammatory disorder. Steroid therapy is very effective in treating. An accurate diagnosis is thus needed to avoid surgical excision. Confirmation by EUS-FNA cytology may be necessary when we must refer the clinical background and conduct a serological investigation.View full abstractDownload PDF (1023K) -
Noriko KOBAYASHI, Shouichiro SANADA, Tomoko HARADA, Tatsunari SATAKE, ...2012 Volume 51 Issue 3 Pages 214-219
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSBackground : In reporting the cytological features of small-cell carcinoma of the right ureter, we found small-cell carcinoma cells in cytological smears from both right pelvic urine and voided urine, but cytological diagnoses differed, as explained in the case.
Case : A 70-year-old woman seen for right lumbar pain at another hospital was found in ultrasonography and pyeloureterography to have right hydronephrosis and urinary tract infection suspected. Cytological smears of right pelvic urine obtained by ureter catheter showed malignant cells diagnosed as urothelial carcinoma. She was referred to our hospital for surgery. Cytological smears of voided urine obtained preoperatively were diagnosed as small-cell carcinoma, necessitating right nephroureterectomy. The final diagnosis was small-cell carcinoma.
Conclusion : The appearance of small-cell carcinoma cells in pelvic cytological smears or ureter urine require careful consideration. Different cytological diagnosis for pelvic and voided urine smears are thought to have been due to the nuclear size of small-cell carcinoma cells. Nuclei in catheter urine were larger than those in voided urine, which were smaller due to degeneration in the urinary bladder.View full abstractDownload PDF (870K)
Brief Notes
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Yoshikatsu KUROSHIMA, Kentarou OHTAKE, Satoko ENDO, Masanao SAIO, Naok ...2012 Volume 51 Issue 3 Pages 220-221
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSWe examined involvement mucus in liquid-based cytology (LBC) technology such as TACAS. All 2970 samples for gynecological mass screening from May 2009 to March 2010 were prepared by using TACAS and/or SurePath. We compared 869 cases using TACAS with 2101 cases using SurePath. The rate of inadequate cases and uneven dispersion specimen using TACAS were much worse than those using SurePath, although there were no significant differences in Papanicolaou staining properties. It is considered to be dependant on mucus-rich materials, so mucus in specimen preparation with LBC technology such as TACAS or ThinPrep requires careful attention.View full abstractDownload PDF (278K) -
Norikazu NAGATA2012 Volume 51 Issue 3 Pages 222-223
Published: 2012
Released on J-STAGE: September 04, 2012
JOURNAL FREE ACCESSWe report a case of calcifying aponeurotic fibroma (CAF), a rare benign soft-tissue tumor, arising in the left hip of a 6-year-old girl. Aspiration cytology showed benign-appearing spindle cells, cells with rich cytoplasm and round to oval nuclei including small nucleoli (chondroid cells), multinucleated giant cells, and calcified particles. These cytological findings correspond to histological CAF features. Cytological observation is thus useful in diagnosing CAF.View full abstractDownload PDF (340K)
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