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Volume 52 (2013)
- Issue 6 Pages 495-
- Issue 5 Pages 399-
- Issue 4 Pages 287-
- Issue 3 Pages 181-
- Issue 2 Pages 77-
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Volume 52, Issue 6
Displaying 1-21 of 21 articles from this issue
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Original Articles
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—Its significance and cytological features—Ayana SUZUKI, Mitsuyoshi HIROKAWA, Nozomi TAKAGI, Yuri NOBUOKA, Naoki ...2013 Volume 52 Issue 6 Pages 495-501
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjective : Reports on liquid based cytology (LBC) of the thyroid are rare. The aim of this report was to clarify the cytological findings in thyroid disorders and discuss the significance of LBC of the thyroid.
Study Design : We examined 437 thyroid nodules by fine-needle aspiration cytology in Kuma Hospital from February to May 2012. After smears of the aspirated materials were prepared by the conventional method, we washed out the needles with LBC fixatives to obtain samples for the SurePath method.
Results : Preparations obtained using the CytoRichTM RED (CR-R) fixative showed a clean background and shrinkage of the cells in comparison with those obtained using the CytoRichTM BLUE (CR-B) fixative ; there were hardly any lymphocytes in the latter preparations. In comparison with the case in the conventional preparations (C-P), the N/C ratio and malignant/benign cell ratio in the LBC preparations (LBC-P) tended to be higher. The ground glass nuclei of papillary carcinoma could not be distinguished in the LBC-P. Clear zones surrounding the cell clusters was observed in adenomatous goiter, and zigzag nuclear membranes (convoluted nuclei) were observed in papillary carcinoma. The insufficient material rates were 8.1% for C-P, 5.3% for LBC-P, and 2.2% in cases where both methods were used.
Conclusion : Additional processing for LBC using materials adherent to the needles after preparation of the conventional smears can reduce the insufficiency rates in thyroid aspiration cytology. It is important to be aware of the cytological differences between C-P and LBC-P.View full abstractDownload PDF (532K) -
—Analysis of a preprocessing process removing a specimen unsatisfactory factor—Sachiko TSUCHIYA, Takashi UMEZAWA, Tomomi ASHIKAWA, Ayana FUKUMURA, Mi ...2013 Volume 52 Issue 6 Pages 502-506
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjective : BD SurePathTM is a standardized specimen preparation system for the preliminary preprocessing process of removal of mucus, blood, debris, etc. We added mucus (sputum) to BD SurePathTM to clarify the performance of this preprocessing process.
Study Design : We collected squamous cells and divided the sample so as to obtain about 10 squamous cells in each of 40×high-power fields (HPF) per slide. We then added 2000-5000μl of mucus into the abovementioned vials to prepare a BD SurePathTM specimen. The squamous cell counts were determined for each individual field, and the mean was calculated for each specimen. The Mann-Whitney U test was used to compare the results in the 5000-μl preprocessing and non-preprocessing groups (100 samples each in this case).
Results : The mean squamous cell counts was 10.6 in the 0-μl group, 42.3 in the 2000-μl group, 40.3 in the 3000-μl group, 35.9 in the 4000-μl group, 27.0 in the 5000-μl group and 5.0 in the 5000-μl group with no preprocessing. In preprocessing up to 5000μl, mucus was removed, and the squamous cell count increased. Mucus remained in the 5000-μl samples that were not subjected to the preprocessing, which showed a sharply reduced squamous cell count. The number of squamous cells in the non-preprocessing group was significantly lower in comparison with that in the preprocessing group (p<0.001).
Conclusions : The preprocessing process standardized for BD SurePathTM prevents elimination of important cells and possible misdiagnosis based on an unsatisfactory specimen due to mucus contamination. This contributes to more accurate detection of cervical lesions.View full abstractDownload PDF (442K) -
Sadayuki KABA, Mitsuyoshi HIROKAWA, Yuri NOBUOKA, Miyoko HIGUCHI, Naok ...2013 Volume 52 Issue 6 Pages 507-517
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjectives : We examined the characteristic cytological features of MALT lymphoma with extreme plasma cell (PC) differentiation (MALT-EPCD) in Papanicolaou-stained thyroid fine needle aspiration cytology (TFNA) specimens.
Study Design : We studied the findings in TFNA specimens obtained from 27 cases of thyroid disease, including 7 cases of MALT-EPCD and 20 cases of Hashimoto’s thyroiditis (HT) that were diagnosed by histological and cytological examinations at Kuma Hospital.
We examined the percentages of PCs and of cells containing irregularly-shaped nuclei with prominent nucleoli (ISN-PN cells), the percent [sum of PCs plus ISN-PN cells], and the percentages of mountain range-like clusters (MRLCs) and LEL-like clusters (LELCs).
Results : MALT-EPCD : The findings were as follows : percentage of PCs, 24.0% (15-34%) ; percentage of ISN-PN cells, 9.3% (5-14%) ; percentage of MRLCs, 28.6% ; percentage of LELCs, 42.9%.
HT : Percentage of PCs, 2.6% (0-18%) ; percentage of ISN-PN cells, 10.1% (0-25%) ; MRLCs and LELCs were absent.
The mean percent [sum of PCs plus ISN-PN cells] was 33% (29-39%) in MALT-EPCD, 29% in the case of MALT-EPCD with the lowest percentage of PCs (PC : 15%) and 18% in the case of HT with the highest percentage of PCs (PC : 18%).
Conclusion : To differentiate MALT-EPCD from HT, it would be useful to examine #1) the percentage of PCs, #2) the percentage of ISN-PN cells and #3) the sum of #1 plus #2. Percentage of PCs of ≧15%, and percent [sum of PCs plus ISN-PN cells] of ≧30% were regarded as findings characteristic of MALT-EPCD. In addition, the detection of MRLCs or LELCs in MALT-EPCD, even at a low rate, could be helpful for differentiating MALT-EPCD from HT.View full abstractDownload PDF (1149K) -
Akiko ABE, Kenji UMAYAHARA, Akiko YAMAMOTO, Maki MATODA, Kohei OMATSU, ...2013 Volume 52 Issue 6 Pages 518-525
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjective : The objective of this study was to investigate the usefulness of cytology for detecting locoregional recurrence in cervical cancer patients treated by concurrent chemoradiotherapy (CCRT).
Study Design : This was a retrospective study of patients with stage Ib-IVa cervical cancer treated by CCRT. At our hospital, CCRT for cervical cancer failed in 14 patients. The cytologic and pathologic findings and MRI results before and after CCRT were evaluated, and the therapeutic response and status of local control were assessed on the basis of these evaluations.
Results : The evaluations could be completed in 14 patients (including 5 with squamous cell carcinoma, 5 with adenosquamous carcinoma, and 4 with adenocarcinoma), and the accuracy of cytology for the detection of recurrence was 50% (7/14). The reason for the false-negative cytological results in the remaining patients was necrotic change in the outer layer, and the presence of local residual diseases in these patients was confirmed by pathological evaluation and/or MRI.
Conclusion : Combined evaluation by cytology, pathologic examination, and MRI is useful for predicting residual disease in cervical cancer patients treated by CCRT.View full abstractDownload PDF (1132K) -
—Comparative analysis between smears processed by the conventional Papanicolaou method and the liquid-based ThinPrep method—Takako KOBAYASHI, Makoto MOTOI, Mieko OKADA, Ayako YOSHITO, Etsuko WAD ...2013 Volume 52 Issue 6 Pages 526-534
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjective : To clarify the cytological features of atypical squamous cells of undetermined significance (ASC-US) of the cervix, which are still not popular among cytotechnologists and cytopathologists in Japan.
Study Design : A total of 11,039 cervical samples enrolled from multiple hospitals in Japan were analyzed using split-sample processing by the conventional Papanicolaou (CP) and liquid-based ThinPrep (TP) methods. The cytological features of ASC-US were highlighted to compare the histological diagnoses, and all positive samples were examined for the prevalence of HPV by the Multiplex PCR method.
Results : ASC-US was detected more frequently (p<0.0001) in the CP smears at the rate of 1.8% than in the TP smears at the rate of 1.1%. High grade squamous intraepithelial lesions or more advanced were detected more frequently (p<0.001) in the TP smears at the rate of 5.1% than in CP smears at the ratio of 4.1%. In regards to the cytological features of ASC-US in the CP smears, characteristic qualitative insufficiency of nuclear atypism was found due to dehydration or degeneration. Conversely, the TP smears showed an increased nuclear/cytoplasmic ratio with slightly increased chromatin.
Conclusions : For correct diagnosis of ASC-US, its definition and the differences in the features observed between smears processed by different methods must be understood clearly.View full abstractDownload PDF (909K) -
Hiroaki KASE, Sayaka INOUE, Kumiko SUZUKI, Toshihiko IKARASHI2013 Volume 52 Issue 6 Pages 535-539
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjective : To examine the cytological findings and biopsy results in patients with “atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) ” .
Study Design : We examined ASC-H cases encountered at our hospital over a period of 2.5 years.
Results : (1) Of 8,874 uterine cervix specimens, atypical squamous cells were found in 255 cases ; of these, ASC-H accounted for 57 cases (22.7%). (2) Lesions showing moderate dysplasia or greater (CIN2+) were confirmed in 32 (52.3%) of the 54 specimens for which biopsy results were obtained. (3) Atypical metaplasia-like aggregates were observed in 36 specimens, of which lesions showing CIN2+ were confirmed in 21 specimens (58.3%). Atrophic sheet-like aggregates making the cytological findings difficult to confirm were observed in 17 (65.4%) of 26 specimens, solitary atypical cells in 10 (66.7%) of 15 specimens, cervical gland hyperplasia-like aggregates in 6 (60.0%) of 10 specimens, and multilayered aggregates in 17 (70.8%) of 24 specimens. (4) The atrophic aggregates showed CIN2+ in 44.4% of postmenopausal patients, but 76.5% of premenopausal patients. (5) CIN2+ was observed in all of the specimens obtained from 5 pregnant patients.
Conclusion : The presence of multilayered aggregates and appearance of atrophic sheet-like aggregates making the cytological findings difficult to confirm in premenopausal patients might be important for the differential diagnosis of ASC-H lesions.View full abstractDownload PDF (458K) -
Yoshie KONO, Shizuko KOUMI, Osamu IWANARI2013 Volume 52 Issue 6 Pages 540-544
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjective : Evaluation of a sex education program to improve the participation rates in smear tests for women in their 20s.
Study Design : We performed a questionnaire on sexual experiences and screening history, simultaneously with a lecture on cervical cancer, which led to 389 young women joining our e-mail project. Using an e-mail registration system, participants were randomly divided into an ordinary and a reinforced education group. For one year, starting one month after the lecture, a sexual education program (e-mail magazine) was sent trimonthly to the ordinary, and monthly to the reinforced group. The e-mail questionnaire was sent the day after sending the e-mail magazine. Behavioral results relevant to screening and HPV vaccination were compared in two groups.
Results : Subsequent to participation in the project, the cervical cancer screening rates and HPV vaccination rates of the ordinary vs. reinforced group were 9.4% vs. 11.4% and 9.4% vs. 11.4%, respectively, showing no significant differences.
Conclusions : Through this investigation, operational procedures were established for a registration-based response system using e-mail. This system should be widely applicable for evaluating the effects of future educational participation programs.View full abstractDownload PDF (718K) -
Mitsuko TACHIBANA, Tokuzo KASAI, Yuko KUROKAWA, Yoko OHKI, Atsuko SODA ...2013 Volume 52 Issue 6 Pages 545-551
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSObjective : The aim of this study was to clarify the effectiveness of liquid based cytology and high-risk HPV testing for primary uterine cervical cancer screening.
Study Design : We compared the data on the number of unsatisfactory slides, number of work-up examinations needed and the rate of lesions more severe than CIN2 (CIN2+ rate) between 2006-2011, when only conventional cytology was used for mass screening, and 2012, when liquid based cytology and high-risk HPV testing were used in combination for the mass screening.
Results : The unsatisfactory slide rate was 0.042% during the period when conventional cytology was used and 0% during the period when liquid based cytology was used.
The number of work-up examinations and CIN2+ rate using liquid based cytology were 21 (1.8%) and 6 (0.5%) in town A, and 36 (2.3%) and 9 (0.6%) in village B, respectively in 2012, the rates being higher as compared to those in 2006-2011 when only conventional cytology was used.
We found 5 cases of ASC-US among the 95 slides subjected to high-risk HPV testing which were diagnosed as NILM in the first screening.
Conclusion : The CIN2+ rate increased with the use of liquid based cytology, because of the reduction in the rate of unsatisfactory slides.
Further examination is needed to determine the effectiveness of high-risk HPV testing.View full abstractDownload PDF (343K)
Clinical Articles
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Kana KIRA, Tamotsu TAKAHASHI, Eriko MIYAZAKI, Asuka TAKAHASHI, Eiji OH ...2013 Volume 52 Issue 6 Pages 552-556
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : Mucinous adenocarcinoma of the Bartholin’s gland is extremely rare. Herein, we report a case of mucinous adenocarcinoma of the Bartholin’s gland suggested by brushing cytology of the vulva.
Case : An 82-year-old woman with a history of colon cancer and Paget’s disease of the breast presented with a cystic mass on the left side of the vulva. Brushing cytology revealed tumor cells forming small clusters or isolated tumor cells in a mucinous background. Many of the cells had crescent-shaped nuclei and intracytoplasmic mucin, so-called signet-ring cells. Based on these findings, mucinous adenocarcinoma was suspected. Histologically, the tumor cells had abundant cytoplasm and eccentric nuclei, and were found floating loosely or in a fence-like arrangement in a mucus lake. The tumor tissue revealed transition from the normal Bartholin’s gland tissue. Immunohistochemically, the tumor cells were positive for CK20, CK7, CDX2, ER and CA125, and negative for GCDFP-15. Histopathologically and immunohistochemically, this tumor was distinguishable from colon cancer metastasis, Paget’s disease of the breast, and mucinous adenocarcinoma arising in ectopic breast tissue.
Conclusion : Mucinous adenocarcinoma of the Bartholin’s gland can scarcely be diagnosed definitively on the basis of cytology alone. Clinical information, including imaging study findings, as well as the vulvar cytologic, histopathological and immunohistochemical findings should be concurrently considered for accurate diagnosis of mucinous adenocarcinoma of the Bartholin’s gland.View full abstractDownload PDF (804K) -
Kayo KONTANI, Hirohiko TANAKA, Kuniaki TORIYABE, Syuichirou IWAMI, Har ...2013 Volume 52 Issue 6 Pages 557-561
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : It is sometimes difficult and challenging to make a treatment decision when there is a discrepancy between preoperative cervical cytology and histology. Herein, we present a case report of cervical clear cell adenocarcinoma (CCA). Although adenocarcinoma was suspected cytologically, no malignancy could be detected by histological examination. The final diagnosis made by histopathological examination of the total hysterectomy specimen was microinvasive cervical CCA (stage IA1 based on FIGO classification).
Case : A 69-year-old woman was referred to our hospital for positive endometrial smears. Cytologically, the tumor cells had prominent nuclei, marked nucleolus large nuclei, prominent nucleoli and a clear cytoplasm, arranged in tubular and sheet-like patterns ; based on these findings, adenocarcinoma (probably clear cell) of the cervix was suspected. However, transvaginal ultrasonography and MRI revealed no evidence of a tumor. Histological examination of endometrial and endocervical curettage specimens also revealed no abnormal findings. However, since malignant tumor could not be excluded, total hysterectomy and bilateral salpingo-oophorectomy was performed. Postoperatively, a shallow (less than 3 mm) tumor was detected in the cervical glands.
Conclusion : Cytology is often more valid than cervical curettage for the diagnosis of early cervical adenocarcinoma. Although HPV testing is important for early detection of cervical neoplasms, cytological diagnosis may play an important role in the checkup for early cervical adenocarcinoma.View full abstractDownload PDF (979K) -
Hiromitsu MAKINO, Maki TAKAHASHI, Kunimichi SAITO, Hiroyoshi SUZUKI2013 Volume 52 Issue 6 Pages 562-567
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : While the incidence of uterine cervical glandular lesions has increased recently, early detection is more difficult than that of squamous intraepithelial lesions (SIL) because of problems associated with both sampling and interpretation.
Case : A 31-year-old woman underwent surgery because atypical glandular cells (AGC) were found during follow-up of SIL, and was diagnosed as having invasive cervical adenocarcinoma with carcinoma in situ, based on operative findings. Cytologically, the characteristic features were the presence of cellular clusters with findings suggestive of both SIL and AGC. Moreover, histopathologically, we observed atypical cells having the properties of both squamous and glandular cells in the regions of glandular involvement. In addition, we found the cervical adenocarcinoma to be in the deeper parts of the lesions alone and that the MIB1 proliferation index was high. We concluded that these were the factors that made early detection of cervical adenocarcinoma difficult.
Conclusion : During follow-up of SIL, it is important to recognize the presence of cellular clusters showing the features of both SIL and AGC and not to miss glandular lesions.View full abstractDownload PDF (1363K) -
Makiho KATAKURA, Shu SOEDA, Kazuhiro TASAKI, Sigenori FURUKAWA, Takafu ...2013 Volume 52 Issue 6 Pages 568-572
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : Primary squamous cell carcinoma of the endometrium is rare and is usually at an advanced stage even at diagnosis. Herein, we report a case of endometrial squamous cell carcinoma that was diagnosed by repeated endometrial cytology.
Case : A 72-year-old woman visited our hospital complaining of vaginal discharge. Ultrasonography and MRI revealed no hyperplastic endometrial lesions. Cervical cytology showed slightly atypical squamous cells and endometrial cytology showed normal atrophic endometrium with atypical squamous cells. Colposcopy showed unsatisfactory colposcopic findings and endometrial biopsy revealed atypical squamous cells ; therefore, we determined that the origin of the specimen was the uterine cervix and made the diagnosis of CIN1. The cytologic features of the cervix and endometrium changed to squamous cell carcinoma-like, therefore, conization was performed using a harmonic scalpel. Histological examination of the conization biopsy specimen did not reveal any carcinoma or atypical cells. After conization, the abnormal endometrial cytology findings persisted, therefore, hysterectomy was performed. Based on histopathological examination of the resected specimen?, the patient was diagnosed as having stage 1a endometrial squamous cell carcinoma.
Conclusion : When atypical squamous cells are observed on endometrial cytology, endometrial squamous cell carcinoma should be considered in the differential diagnosis.View full abstractDownload PDF (933K) -
Tomoko SUMIKURA, Yuzuru YASUDI, Hiroko FUKUSHIMA, Takeshi INOUE, Mari ...2013 Volume 52 Issue 6 Pages 573-578
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : We perform transcervical needle biopsies for uterine myoma-like tumors. In the case reported herein, we carried out imprint cytology examinations of transcervical needle biopsy specimens, and report its usefulness for differential diagnosis between uterine leiomyoma and leiomyosarcoma.
Case : A 59-year-old female patient presented to us with the chief complaint of hematuria, and a diagnostic CT revealed a degenerated uterine myoma. Uterine sarcoma was suspected on MRI and PET-CT. We performed transcervical needle biopsies of the uterine tumor ; the specimens showed atypical spindle cells with a mitotic index of 5, but no evidence of coagulative tumor cell necrosis. Imprint cytology of the biopsy specimens showed many loosely adherent spindle cells, apoptotic cells and mitotic cells on a necrotic background, suggesting the diagnosis of leiomyosarcoma. Surgery was performed, and the final histopathological diagnosis was leiomyosarcoma.
Conclusion : Needle biopsy is a useful diagnostic method for differentiation between uterine sarcoma and uterine leiomyoma. Evaluation should be performed in the most highly developed section of the tumor, however, this area is not always included in the small specimens obtained by needle biopsy, resulting in the risk of under-evaluation. The combination of imprint cytology of the needle biopsy specimens, including an evaluation of the number of imprinted tumor cells, may provide useful information for differential diagnosis between these tumors.View full abstractDownload PDF (1138K) -
Yuichi KINOSHITA, Kosho TAKASU, Takashi YURI, Mayuka SUZUKI, Sachiko N ...2013 Volume 52 Issue 6 Pages 579-582
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : Heterogeneous carcinosarcoma of the uterus is very rare. Herein, we report a case of heterogeneous carcinosarcoma of the uterus with metastasis of the rhabdomyosarcoma component to the pleura.
Case : The patient was a 69-year-old woman, gravida 1, para 1, who consulted our hospital for irregular vaginal bleeding. Operation was carried out after endometrial cytology and biopsy, and the diagnosis of heterogeneous carcinosarcoma was made by histology. After 6 months, pleural effusion was detected. Cytologic examination of the pleural aspirate revealed tumor cells containing hyperchromatic and irregularly shaped nuclei. Immunohistochemical examination using the cell block technique revealed positive staining of the tumor cells for myogenic markers, but negative staining for epithelial markers.
Conclusion : Although heterogeneous carcinosarcoma of the uterus is very rare, early and accurate diagnosis are of importance, as the tumor carries a poor prognosis. This case serves to underscore the importance of the cell block technique for the diagnosis.View full abstractDownload PDF (585K) -
Kaori SATO, Junko HIRATO, Tetsunari OYAMA, Toshio FUKUDA2013 Volume 52 Issue 6 Pages 583-588
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : Schizophyllum commune (S. commune) is a basidiomycete fungus found throughout Japan, commonly in dry logs and dead wood. S. commune is considered edible and is rarely identified as a causative agent of allergic bronchopulmonary mycosis. Herein, we report the cytological and histological features of a typical case of allergic bronchopulmonary mycosis.
Case : A 48-year-old female presented with a 2-week history of persistent fever. A plain chest X-ray revealed evidence of pneumonia in the right middle lobe and mucoid impaction in the rt. B4. Laboratory examination revealed increased serum levels of CRP (12.58 mg/dl) and IgE (5542.6 IU/ml). Serology revealed strongly positive test results for anti-S. commune IgG and IgE antibodies. Transbronchial brush cytology and biopsy were performed to identify the cause of the post-obstructive pneumonia. Cytological and histological finding were as follows. Within a mucinous, inflammatory and allergic background containing eosinophils and Charcot-Leyden crystals, mycotic hyphae were observed. The hyphae were thin and smooth in contour, with a branching mode different from that of Aspergillus fumigatus. Hump-like swellings, called clamp connections, which are known to be characteristic features of S. commune, were visualized near the septae.
Conclusion : S. commune hyphae resemble those of A. fumigatus, which may cause difficulty in the differential diagnosis. However, the characteristic clamp connections of S. commune hyphae can be easily observed in cytological specimens. In patients presenting with pulmonary atelectasis, mucoid impaction and an allergic background, cytological screening bearing in mind the possibility of S. commune is important.View full abstractDownload PDF (647K) -
Daisuke NAGAYAMA, Takahisa TSUKAMOTO, Yoshiki NAITO, Sonoe ITO, Yoshit ...2013 Volume 52 Issue 6 Pages 589-594
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : Solid-growth type solid-pseudopapillary neoplasms (sSPNs) are extremely rare. While a precise elucidation of the cytological features is important for a proper disgnosis, there have been only a few published reports of sSPNs. Herein, we report the cyto-immunocytochemical features of sSPNs in comparison with those of pancreatic neuroendocrine tumors (PNETs).
Case : A 16-year-old woman was admitted with complaints of abdominal pain. An abdominal CT and MRI revealed a lesion measuring 25×15 mm in the tail of the pancreas, and distal pancreatectomy was performed. Imprint cytology of the tumor revealed tumor cells in small loose clusters or scattered as single cells in a background of hemorrhage. There was no clear evidence of formation of a pseudo-papillary pattern. Macroscopically, the lesion was a solid tumor, and microscopically, nest-growth type proliferation of the tumor cells was observed, without clear formation of a pseudo-papillary pattern. Comparison of the cytopathological findings between sSPN and PNET revealed that the chromatin pattern was different between sSPNs and PNETs, with the latter showing salt and pepper chromatin pattern. Immunohistochemical analysis (IHC) of the sSPN revealed positive staining for vimentin and CD10, but negative staining for synaptophysin and chromogranin A.
Conclusion : We suggest that examination of the chromatin pattern and IHC examination to determine the expression patterns of vimentin, CD10, synaptophysin and chromogranin A are important and critical for accurate diagnosis of sSPNs.View full abstractDownload PDF (1153K) -
Yosuke SASAKI, Takashi KITAMURA, Atsuko MASUNAGA, Genshu TATE, Mayumi ...2013 Volume 52 Issue 6 Pages 595-601
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSBackground : Pleomorphic adenoma (PA) is the most common of salivary gland tumors. We report a case of PA with the fine-needle aspiration (FNA) cytology findings of richly arborescent cell clusters without mucinous stromal components in the background and tumor cells showing nuclear grooves and intranuclear inclusions.
Case : A 40-year-old woman was admitted with a one-year history of left submandibular swelling. Neck ultrasonography showed a well-defined mass measuring 17.4 mm×13.5 mm in size in the left submandibular gland. Cytology showed large and richly arborescent cell clusters including epithelial cells. Some tumor cells showed nuclear grooves and intranuclear inclusions. Histological examination confirmed the diagnosis of PA. The resected tumor consisted largely of solid components with a small mucinous stromal component.
Conclusion : When a difficult case of salivary gland tumor cytology is encountered, it is important to bear in mind PA in the differential diagnosis.View full abstractDownload PDF (934K)
Brief Notes
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Satoko NAKADA, Hiromi TSUBATA, Nozomu KUROSE, Hiroshi MINATO, Takayuki ...2013 Volume 52 Issue 6 Pages 602-603
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSChordoma is a rare low-grade malignant neoplasm, commonly found in the sacrococcygeal region and clivus of adults. The tumor is extremely rare in children. A case of chordoma diagnosed by nasopharyngeal biopsy in a 5 year-old-boy is reported. During surgery for the clinical diagnosis of adenoid hyperplasia, specimens were submitted for frozen section diagnosis. Imprint cytology showed typical physaliphorous cells occurring in clusters. A postoperative MRI revealed a lobulated tumor measuring 6 cm in size extending from the clivus to the nasopharynx, visualized as a hyperintensity. Cytology is useful for the diagnosis of chordoma, especially in very rare cases like this one.View full abstractDownload PDF (303K) -
Nozomi IWAMOTO, Mitsuaki ISHIDA, Keiko YOSHIDA, Muneo IWAI, Hidetoshi ...2013 Volume 52 Issue 6 Pages 604-605
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSWe report a case of pilomatricoma diagnosed in a 3-year-old girl. Fine-needle aspiration smear of the cheek nodule revealed uniform tightly packed aggregates of basaloid cells with a high nuclear/cytoplasmic ratio and round nuclei containing nucleoli. Histopathological study of the resected tumor confirmed the diagnosis of pilomatricoma.
Cytodiagnosis of pilomatricoma may be difficult because of the presence of basaloid cells, which can be misdiagnosed as carcinoma. However, the absence of nuclear pleomorphism and coarse chromatin, and the presence of tight aggregates of basaloid cells may allow ruling out of the presence of malignancy.View full abstractDownload PDF (300K) -
Kazuhiko IZURU, Kouichi TADA, Midori YAHAGI, Mitsunori YAMAKAWA, Kunih ...2013 Volume 52 Issue 6 Pages 606-607
Published: 2013
Released on J-STAGE: January 15, 2014
JOURNAL FREE ACCESSManson’s sparganosis, which can affect any of various sites of the body, was recognized as a breast mass in a 66-year-old woman. The infection manifested as a breast mass measuring 13 mm in diameter detected by ultrasonography and mammography. Breast cancer was suspected initially and the microbe was detected by fine needle aspiration. Hematological and immunoserological examinations revealed no significant abnormalities. Since this disease is generally transmitted by the intake of unboiled water or raw meats, including of snakes, chickens, etc., the dietary history is useful for the diagnosis. In our patient reported here, the route of infection could not be ascertained, because she gave no history of drinking unboiled water or consuming raw meat.View full abstractDownload PDF (302K)
Erratum
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2013 Volume 52 Issue 6 Pages 628
Published: 2013
Released on J-STAGE: January 29, 2014
JOURNAL FREE ACCESSDownload PDF (130K)
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