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Volume 53 (2014)
- Issue 6 Pages 419-
- Issue 5 Pages 337-
- Issue 4 Pages 251-
- Issue 3 Pages 169-
- Issue 2 Pages 89-
- Issue 1 Pages 1-
Volume 53, Issue 4
Displaying 1-13 of 13 articles from this issue
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Original Articles
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Naoko TAKESAWA, Atsuhiko SAKAMOTO, Kyouko KOMATSU, Junzo FUJIYAMA, Nor ...2014 Volume 53 Issue 4 Pages 251-256
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSObjective : We aimed to evaluate the clinical significance of new categories, namely AUS/FLUS and FN/SFN, which have appeared in The Bethesda System for Reporting Thyroid Cytopathology.
Study Design : We used 1,606 thyroid fine needle aspiration cytology (FNAC) specimens obtained from patients of the Cancer Institute Hospital, Tokyo, for 3 years from 2010 to 2012. All the specimens were reviewed and classified by The Bethesda System, and the results were then compared with each histological diagnosis of the surgically removed materials.
Results : A total of 88.6% of the patients with AUS/FLUS was given a final diagnosis of malignancy after surgery. Among these malignant tumors, papillary carcinomas were predominant (71.4%), followed by follicular carcinomas, malignant lymphomas and medullary carcinomas. Among the patients with FN/SFN, the percentage of malignant tumors was 72.7%.
Conclusion : When The Bethesda System is adopted in Japan in the near future, we need to have actual knowledge of typical diseases including the histological types of each category in addition to their exceptions.View full abstractDownload PDF (691K) -
Ayana SUZUKI, Mitsuyoshi HIROKAWA, Miyoko HIGUCHI, Naoki YAMAO, Nami T ...2014 Volume 53 Issue 4 Pages 257-263
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSObjectives : To clarify a significance of “benign” in the Thyroid Bethesda System (TBS), we compared benign lesions based on the TBS and the Japanese Reporting System (JRS).
Study Design : We reviewed the aspiration cytology findings of 10333 thyroid nodules encountered in Kuma Hospital from January to December 2011.
Results : The incidence of “benign” was 73.0% according to the JRS and 67.8% according to the TBS. This difference was because cystic lesions without follicular cells (“cyst fluid”) were classified as “benign” according to the JRS and as “inadequate” according to the TBS. The re-aspiration rates were 1.6% according to both reporting systems. In most of the re-aspiration cases, the ultrasonographic findings were considered as “indeterminate” or “suspicious for malignancy” . The resection rates for “benign” nodules diagnosed according to the JRS and TBS and “cyst fluid” were 8.1%, 8.2% and 6.5%, respectively. The risk rates of malignancy in the three groups were 1.2%, 1.1% and 1.7%.
Conclusion : There were no significant differences in the incidences of re-aspiration rates, resection rates or risks of malignancy between “benign” lesions diagnosed by JRS and TBS. As the results were within the ranges recommended by the TBS, it is considered that the TBS can be accepted without any concerns in Japan. We recommend that cystic lesions without follicular cells be managed as “benign”.View full abstractDownload PDF (692K) -
Miyoko HIGUCHI, Mitsuyoshi HIROKAWA, Eiji SASAKI, Junko MARUTA, Takash ...2014 Volume 53 Issue 4 Pages 264-270
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSObjective : The aim of this report is to establish an algorithm for cytological diagnosis of thyroid follicular lesions and to propose a new reporting system.
Study Design : We reviewed the preoperative fine needle aspiration cytology findings of 78 cases of follicular adenoma and 40 cases of follicular carcinoma resected in Kuma Hospital from January to December 2011.
Results : The incidences of overlapping follicles, three-dimensional small follicles accounting for more than 50% of the small ones, trabecular pattern, nuclei more than twice in size than that of the neutrophils and hyperchromasia were statistically significantly higher in the follicular carcinoma cases than in the follicular adenoma cases. Of the follicular carcinoma cases, 32.0% showed one of the above findings, 60.9% showed two, 42.9% showed three, 62.5% showed four and 100% showed all five of the above findings.
Conclusion : We have proposed an algorithm for cytological diagnosis of thyroid follicular lesions and a reporting system. As it is cytologically difficult to distinguish, between follicular adenoma and follicular carcinoma, we think that the goal in the reporting of thyroid follicular lesions is not the histological diagnosis, but the recommendation for clinical management.View full abstractDownload PDF (594K) -
Misa ISHIHARA, Chie AWATA, Minoru NISHIDA, Mika MANABE, Rie NAKAMOTO, ...2014 Volume 53 Issue 4 Pages 271-279
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSObjective : Solid papillary carcinomas (SPCs) of the breast, the disease unit newly added in the revision of the WHO classification of 2012, are classified as one of the intraductal papillary lesions. We examined the cytological findings of SPCs and compared with those of intraductal papillary carcinomas (IPCs) also an intraductal papillary malignant lesion, and studied whether it would be possible to make a preoperative cytological diagnosis.
Study Design : We examined 6 patients who had been histologically diagnosed as having SPCs for cell imaging of fine-needle aspiration cytology (FNA). We also made a comparative study of the FNA findings of 5 patients who had been diagnosed as having IPCs.
Result : Our findings suggested that the diagnostic clues of SPCs which can distinguish them from IPCs in FNA findings are the presence mucinous substance, fine delicate capillary vessels, discohesive small clusters of cells and numerous single cells, and cuboidal and polygonal cells.
Conclusion : A reliable cytological differential diagnosis of SPCs versus IPCs can be possible through recognizing some characteristic findings of SPCs through FNA findings.View full abstractDownload PDF (1614K) -
—Comparison with one-step nucleic acid amplification assay—Kiyofumi UEDA, Kanako MORI, Ayaka KOBAYASHI, Yuko TESHIMA, Chikoto DOB ...2014 Volume 53 Issue 4 Pages 280-285
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSObjective : To examine the superiority of immunocytochemistry (ICC) to Papanicolaou (Pap.) staining in touch imprint cytology for detecting sentinel lymph node metastases in patients with breast cancer.
Study Design : We analyzed 79 samples that were rated as positive by the One-step nucleic acid amplification (OSNA) assay. Each of the samples was sectioned serially and evaluated by touch imprint cytology with Pap. staining or ICC staining, and the results were compared with those of the OSNA assay.
Results : There was a statistically significant difference in the concordance rate of cytology between Pap. staining and ICC staining with the results of the OSNA assay for the detection of micrometastases (p<0.001), although there was no significant difference in the concordance rate of cytology between Pap. staining and ICC staining with the results of the OSNA assay for the detection of macrometastases.
Conclusion : Imprint cytology with ICC yields a significantly higher positivity rate than imprint cytology with Pap. staining. Imprint cytology with ICC is practicable for intraoperative evaluation of sentinel lymph node metastases and useful for institutions without facilities for the OSNA assay.View full abstractDownload PDF (673K) -
—Analysis of a preprocessing process removing a specimen unsatisfactory factor—Ayana HORIGUCHI, Takashi UMEZAWA, Tomomi ASHIKAWA, Sachiko TSUCHIYA, M ...2014 Volume 53 Issue 4 Pages 286-291
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSObjective : BD SurePath is the specimen manufacture system which standardized a preliminary preprocessing process removing mucus, blood, debris. We added blood in a BD SurePath and clarify performance of a preprocessing process.
Study Design : We collected squamous cells and we adjusted it to about 40 squamous cells numbers in 40× high-power fields per (HPF) one slide. We added blood to 100-3000μl in above vials, and we made a BD SurePath specimen, and a field counted squamous cells 10 in 40× HPF, and the specimen calculated mean.
Results : As for the squamous cells average count number, In 0μl (53.3), 100μl (48.2), 500μl (39.5), 1,000μl (39.1), 2,000μl (22.1), 3,000μl (10.8), there is preprocessing process.
Conclusions : A preprocessing process standardized on a BD SurePath collects an important cell in elimination and a diagnosis of an unsatisfactory specimen by blood and contributes to detection improvement of cervix lesion.View full abstractDownload PDF (591K)
Clinical Articles
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Hideo OKAMOTO, Hiroshi URAMOTO, Yuko MIMURA, Yoshihiko HOSHIDA2014 Volume 53 Issue 4 Pages 292-297
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSBackground : Worms of the genus Paragonimus enter the human body through consumption of undercooked freshwater crabs or wild boar. The recent social globalization of human diets has resulted in an increase in the number of cases of paragonimiasis. Herein, we report two cases of paragonimiasis that were confirmed by the detection of eggs of the genus Paragonimus in sputum cytology specimens.
Cases : Case 1 : A Chinese woman in her 40 s living in Osaka presented with cough and sputum, and was diagnosed as having a pneumothorax. Partial pulmonary resection was performed. The resected lung contained numerous organisms of the genus Paragonimus. Several golden eggs of the genus Paragonimus were retrospectively confirmed on examination of sputum cytology specimens obtained prior to surgery.
Case 2 : A Japanese woman in her 40 s with a history of travel to Guam and Okinawa presented with cough and bloody sputum. A chest radiograph showed the presence of abnormal nodules. A laboratory examination revealed eosinophilia, elevated serum IgE, and a positive result for the presence of serum antibodies to Paragonimus westermanii. The presence of eggs in the sputum cytology specimens confirmed the diagnosis. Then, a concentration method was employed for detailed observation of the structure.
Conclusion : These instructive cases illustrate the importance of applying clinical information and thorough knowledge about this parasite in the daily practice of cytology.View full abstractDownload PDF (975K) -
Saki KAWAGUCHI, Hideyuki SHIMAZAKI, Tomohiro ODA, Hiromi TAKAHASHI, Hi ...2014 Volume 53 Issue 4 Pages 298-302
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSBackground : Myelolipoma is a rare benign tumor-like lesion of the adrenal glands.
Case : We reported the case of a 38-year-old woman who had follow-up after resection of a mucoepidermoid carcinoma in the tongue. Computed tomography for follow-up revealed a large tumor in the left adrenal gland. Aspiration cytology of the resected adrenal tumor revealed myeloid cells, megakaryocytes, and erythroid cells, but no adipocytes, suggesting a diagnosis of myelolipoma.
Conclusion : Cytologists have few opportunities to see a case of myelolipoma, but it should be kept in mild as a candidate for differential diagnosis informed by cytologic examination of tumors of the adrenal gland.View full abstractDownload PDF (675K) -
Yuki TERAMOTO, Mitsuhiro TACHIBANA, Tatsuo UENO, Tamae SONE, Yumi HASH ...2014 Volume 53 Issue 4 Pages 303-307
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSBackground : Orthokeratotic dysplasia (OKD), a variant of epithelial dysplasia, is a precancerous condition of the oral mucosa. OKD is defined histopathologically as an oral mucosal condition that shows hyperorthokeratosis, hypergranulosis, and a cytokeratin (CK) 10 positive immunoprofile. We report herein on two cases of OKD diagnosed by oral scraping cytology.
Case : Case 1 : A 52-year-old man presented with leukoplakia of the palate. The cytological findings showed keratinized anucleated squamous cells comprised a large proportion of the collected cells. Immunocytochemically, these cells were positive for CK10, and negative for CK13. Histological specimens showed hyperorthokeratosis and hypergranulosis of oral mucosa. On immunohistochemical examination, the lesion was CK10 (+)/CK13 (−)/CK17 (−). These findings supported the diagnosis of OKD.
Case 2 : A 65-year-old man presented with two torose leukoplakia lesions on the left upper gum. On cytology, keratinized anucleated squamous cells accounted for 80 percent of collected cells, and CK10 (+)/CK13 (−) immunocytochemically. Histopathologically, both lesions were diagnosed as OKD.
Conclusion : OKD is a new entity of the oral mucosa related to squamous cell carcinoma. However, very few cytologists are currently familiar with OKD. It is important to keep OKD in mind as one of the differential diagnoses and use immunocytochemical staining for CK10 or CK13, when we encounter many keratinized anucleated squamous cells in the scraping cytology of oral leukoplakia.View full abstractDownload PDF (738K) -
Kana KATOH, Tetsuji KUROKAWA, Akiko SHINAGAWA, Naoyo HORIE, Hideki MAE ...2014 Volume 53 Issue 4 Pages 308-312
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSBackground : The severe adverse effects of intra-uterine contraceptive devices (IUDs) can include pelvic inflammatory disease caused by Actinomyces israelii, the pre-treatment diagnosis of which is extremely difficult. Almost all diagnoses have been made based on the post-operative pathological examination. Nevertheless, some reports describe the possibility of a pre-operative diagnosis using cytology or culture. Cytology might be superior to culture examination for diagnosis because it enables a convenient and rapid diagnosis.
Case : A 46-year-old gradiva 2 para 2 female was admitted for lower abdominal pain with fever. She had used the same IUD for 10 years. We removed the IUD and treated her with antibiotics. After 40 days, she presented with lower abdominal pain. Magnetic resonance imaging revealed a large abscess in the pelvic cavity. Laparotomy showed a swollen right adnexal lesion, which resembled actinomycosis. Review of the stamp cytology taken from the IUD confirmed actinomycosis.
Conclusion : This case suggests that cytology using stamp preparation from an IUD might be useful for the pretreatment diagnosis of actinomycosis.View full abstractDownload PDF (750K) -
Akiko YAMAMOTO, Rira HOSHI, Maki MATODA, Kohei OMATSU, Kazuyoshi KATO, ...2014 Volume 53 Issue 4 Pages 313-317
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSBackground : Primary fallopian tube carcinoma is considered a relatively rare tumor arising in the female genital tract. We report herein on a case of non-invasive adenocarcinoma in the bilateral fallopian tubes occurring after tubal ligation, which was preoperatively detected only by endometrial cytology.
Case : A 57-year-old postmenopausal woman, gravida 2 para 2, presented with abnormal genital bleeding. Endometrial cytology revealed atypical glandular cells detected though endometrial biopsy and MRI did not show any evidence of a malignant tumor in the pelvis.
A hysterectomy and bilateral salpingo-oophorectomy were undertaken under the suspected diagnosis of minute carcinoma in the genital tracts. Grossly, we found a tumor of 3 mm in diameter in the left tube. Microscopically serous non-invasive adenocarcinoma was observed in both fallopian tubes.
Conclusion : Serous adenocarcinoma tumor cells are easily released from the primary focus. Even after tubal ligation, tumor cells can pass through the recanalized fallopian tube. Our results indicate that tubal serous adenocarcinoma cells can be successfully detected with endometrial cytology.View full abstractDownload PDF (673K) -
Hidetaka NOMURA, Akiko ABE, Akiko YAMAMOTO, Maki MATODA, Kohei OMATSU, ...2014 Volume 53 Issue 4 Pages 318-322
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSBackground : Estrogen is involved in the development of breast and endometrial cancers, and tamoxifen, an antiestrogen, is associated with an increased risk of development of endometrial cancer. Recently, tamoxifen use has been suggested to be associated with the development of endometrial tumors. We present a case of atypical endometrial hyperplasia arising in an endometrial polyp in a tamoxifen-treated breast cancer patient in whom endometrial cytology was negative for cancer.
Case : A 43-year-old woman, para 2, was referred to us for hypermenorrhea. She had been treated by tamoxifen for four years. Transvaginal ultrasonography revealed an endometrial polyp, and endometrial cytology was negative for cancer. Transcervical resection was performed for the endometrial polyp. Histological examination confirmed the diagnosis of atypical endometrial hyperplasia in the endometrial polyp. Thereafter, we performed laparoscopic vaginal hysterectomy and bilateral salpingoophorectomy.
Conclusion : Patients using tamoxifen are at a high risk of development of endometrial neoplasms. Atypical endometrial hyperplasia can arise inside an endometrial polyp. Thus, care must be exercised in patients with endometrial polyps even if the endometrial cytology is negative.View full abstractDownload PDF (662K) -
Makiko OMORI, Tetsuo KONDO, Akihiko HASHI, Yoshio ISHII, Kumiko NAKAZA ...2014 Volume 53 Issue 4 Pages 323-328
Published: 2014
Released on J-STAGE: September 25, 2014
JOURNAL FREE ACCESSBackground : Transitional cell tumors of the ovary are uncommon histologic subtypes, and include the following : Brenner tumor (BT), borderline Brenner tumor, malignant Brenner tumor (mBT), and transitional cell carcinoma (TCC). A few studies about their cytological findings have been reported. The present study aimed at demonstrating the differences among the cytological findings of these subtypes to evaluate the usefulness of intraoperative imprint cytology of ovarian tumors.
Cases : Two cases of BT, two cases of mBT and one case of TCC received intraoperative imprint cytology at our hospital. Their cytological findings were evaluated.
Cytological findings of BT showed a clean background, many stromal cells and mature urothelial-like tumor cells. mBT and TCC showed a background with necrosis and poor stromal cells. BT showed a defined cytoplasmic border, fine granular chromatin, and many tumor cells with grooved, “coffee bean” nuclei. TCC showed an ill-defined cytoplasmic border, coarse granular chromatin, and scant “coffee bean” nuclei. mBT showed variable cytological findings with mixtures of clusters resembling BT and TCC.
Conclusion : There were differences in the ratio of the count of stromal cells to tumor cells, nuclear atypia, and the count of “coffee bean” nuclei among the three tumors. Knowledge of these distinct cytological features is useful as an adjunct to the intraoperative diagnoses of ovarian tumors.View full abstractDownload PDF (1123K)
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