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Volume 54 (2015)
- Issue 6 Pages 351-
- Issue 5 Pages 285-
- Issue 4 Pages 233-
- Issue 3 Pages 187-
- Issue 2 Pages 103-
- Issue 1 Pages 1-
Volume 54, Issue 6
Displaying 1-9 of 9 articles from this issue
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Original Articles
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Azusa HANADA, Yasuo HIRAI, Kaoruko OKADA, Yuuko KIMURA, Yoshika AKIZAW ...2015 Volume 54 Issue 6 Pages 351-357
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSObjective : The aim of this study was to assess the adequacy of endometrial liquid-based cytology using the Beckton Dickinson SurePathTM method.
Study Design : A total of 1,097 endometrial samples were analyzed. The samples used for histological examination and cytological tests using conventional and SurePathTM methods, were collected simultaneously.
Results : The sensitivity of the samples containing more than 10 cell clumps of more than 50 cells was significantly higher than those containing less than 10 cell clumps (78.7% vs. 36.8%). In contrast, as for the difference between clumps having more than 50 cells and having more than 30 cells, no significant difference was detected in the sensitivity, specificity, PPV, or NPV.
Conclusion : In the SurePathTM specimens, the total number of clumps including small clumps is the most critical factor on which adequacy depends. Our study suggested that specimens containing more than 10 cell-clumps of more than 30 cells are adequate for examination with SurePathTM.View full abstractDownload PDF (899K) -
Kaori SASAMOTO, Yasushi YATABE, Jo KITAWAKI, Toru NAKANISHI2015 Volume 54 Issue 6 Pages 358-363
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSObjective : To investigate the clinicopathological characteristics of cases with endometrial cancer that could not be diagnosed by endometrial curettage.
Study Design : Between 1983 and 2012, we retrospectively analyzed the data of 12 cases in which endometrial cancer was detected by endometrial cytology but could not be diagnosed by endometrial curettage. We analyzed the clinical courses, cytological features, pathological findings, and outcomes of the cases.
Results : The false-negative rate of curettage for the diagnosis of endometrial cancer was 1.4% (12/880 cases). Histopathological examination showed that the cancer lesions in nearly half of the cases were localized on the endometrial surface ; 9 cases had stageⅠ disease, 2 had stageⅢ disease, and 1 had stageⅣ disease. The distribution of the histological types was as follows : endometrioid, 8 cases ; serous, 2 cases ; mucinous, 1 case ; carcinosarcoma, 1 case. Cytologically, well-differentiated endometrioid adenocarcinoma was composed of slightly atypical cells arranged in sheet-like clusters. By contrast, serous adenocarcinoma was composed of high-grade malignant cells arranged in papillary clusters. Of the total, 3 patients died of recurrent disease. The 5-year overall survival rate was 75%.
Conclusions : Endometrial cancer undiagnosed by curettage can be divided into two types, early-stage well-differentiated endometrioid adenocarcinoma and superficial serous adenocarcinoma potentially complicated by an extrauterine lesion. Endometrial cytology may be helpful for differentiating between the two types.View full abstractDownload PDF (1580K)
Clinical Articles
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Kumiko TAKAHASHI, Yasuyuki NAKAMURA, Hiroshi YAEGASHI, Akira KUROSE, T ...2015 Volume 54 Issue 6 Pages 364-371
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSBackground : Extracranial metastasis of brain tumors is rare. We present a postoperative case of gliosarcoma with tumor cells in a cell block specimen of pleural fluid.
Case : A male in his seventies was readmitted to our institution with loss of appetite and disturbed consciousness 4 months after undergoing an operation for gliosarcoma. Computed tomography revealed local recurrence, bilateral pleural fluid and multiple metastases in the lungs and liver. Immunocytochemical examination of a cell block specimen showed gliosarcoma cells in the pleural fluid.
Conclusion : Physicians should be aware of the possibility of tumor cells from a brain tumor appearing in ordinary extracranial cytology specimens.View full abstractDownload PDF (5548K) -
Toshitaka UEHARA, Daisuke KAWASHIMA, Sayaka SHIMODAI, Kanako INOUE, Is ...2015 Volume 54 Issue 6 Pages 372-376
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSBackground : Metastasis from breast cancer to the duodenum is rare. We report the cytological findings of a case with metastatic breast cancer.
Case : A woman in her 60’s presented with a mass in her left breast. A total mastectomy was performed. Histopathological examination of the resected specimen revealed the diagnosis of invasive ductal carcinoma of the breast. The patient presented 5 years later with jaundice, and a neoplasm was found in the papilla of the duodenum. Biliary brushing cytology, bile juice cytology, and biopsy of the neoplasm at the duodenal papilla were performed. On cytology, the distinction between atypical cells and benign cells was blurred. Therefore, a diagnosis of metastatic neoplasm rather than primary neoplasm was made. Biopsy of the duodenal neoplasm revealed the diagnosis of metastatic breast carcinoma. The results of immunocytochemistry corresponded to the results of immunohistochemistry of the primary breast cancer.
Conclusion : Recognition of the continuity between atypical cells and benign cells in bile juice and biliary brushing cytology is useful for diagnosing metastatic neoplasm. Immunocytochemistry is also useful for distinguishing between primary neoplasm and metastatic neoplasm.View full abstractDownload PDF (2994K) -
Tomonori KOZAKAI, Keiji IIZUKA, Kazuyo NISHIZAWA, Akiko ISHIDA, Hiroyo ...2015 Volume 54 Issue 6 Pages 377-382
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSBackground : Nested variants of urothelial carcinoma (NV-UC) are seen very rarely, and are histologically characterized by the formation of small nests of neoplastic cells with a deceptively bland morphology resembling Brunn’s nests. We describe herein a case of NV-UC.
Case : An 80-year-old man presented with urodynia and abdominal pain. Computed tomography revealed an irregular thickening of the bladder wall. Histological analysis of a transurethral resection of the urinary bladder lesion demonstrated neoplastic cells forming small nests infiltrating into the muscularis propria. A diagnosis of NV-UC was made. Peritoneal lavage cytology showed the presence of both single neoplastic cells and those in small clusters. Catheterized urine cytology revealed neoplastic cells arranged as nested groups with irregular stratification. Although most neoplastic cells contained uniform nuclei of medium size, a few with large atypical nuclei were also observed.
Conclusion : The observation of nested cell clusters with irregular stratification and the presence of large atypical nuclei despite an overall bland nuclear morphology are key diagnostic points of NV-UC in urinary specimens. Because NV-UC shows an aggressive clinical course, this diagnosis should be kept in mind for patients showing tightly packed nests with cytologic atypia following cytological examination.View full abstractDownload PDF (2632K) -
Nobuo HOSHI, Kimiko NAKANO, Kaori UETA, Yukiko OGURA, Kaoru HIRABAYASH ...2015 Volume 54 Issue 6 Pages 383-388
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSBackground : Mammary myofibroblastomas (m-MFBs) are uncommon benign mesenchymal tumors, occurring in middle-aged to elderly men and women. The cytopathological diagnosis of m-MFBs is often difficult because of their various cytological features. Herein we report on a case of m-MFB in an elderly man.
Case : The patient in his 70s suffered a bruise on his chest and a fractured rib in an accident. When he underwent a physical examination in the hospital, a well-defined tumor was indicated below his right nipple on imaging studies. Partial mastectomy was undertaken, during which a tan to white-colored tumor was detected in his right breast. In imprint cytology samples, oval to spindle tumor cells with scant or abundant cytoplasm consisted of fascicular cell clusters with loose cell-to-cell attachment. We identified nuclear grooves and intranuclear cytoplasmic bodies in some tumor cells and observed stromal collagen in some cell clusters. Histological specimens revealed proliferation of spindle cells with a fascicular or epithelioid pattern, immunohistochemistry revealed that the tumor cells were positive for desmin, CD34, vimentin, SMA, estrogen receptor and progesterone receptor but were negative for CK (AE1/3), EMA, p63, and S-100 protein.
Conclusion : m-MFB should be considered as one of the differential diagnoses when we investigate cytological specimens for a spindle cell tumor of the breast.View full abstractDownload PDF (8736K) -
Miwa SUZUKI, Ryoichi TANAKA, Madoka TAKAHASHI, Seiro SATOHISA, Mizue T ...2015 Volume 54 Issue 6 Pages 389-393
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSBackground : Primary malignant melanomas of the cervix is a rare tumor. Although there is no consensus as to a comprehensive treatment, complete radical surgery is generally the treatment cornerstone in the same manner as for melanomas in other organs. We summarized herein 2 cases of uterine cervical melanoma.
Cases : Our patients presented with vaginal bleeding. Case 1, a 76 year-old-woman, was initially considered as having a poorly differentiated squamous cell carcinoma. Although she had undergone irradiation, the original lesion had grown larger. A biopsy was taken and sent for histopathological examination, which revealed melanoma of the cervix, confirmed by immunohistochemistry. She was diagnosed as having stageⅠB1 cervical melanoma. She underwent a radical hysterectomy and pelvic lymph node dissection. The patient was under surveillance for 108 months of follow up without evidence of local or distant disease. In case 2, a 58 year-old-woman, a 5 cm tumor was identified in the cervix. Pap smear revealed the presence of pigmented malignant melanoma cells and she was also diagnosed as having stageⅣB cervical melanoma. She underwent an operation and chemotherapy, but died because her disease continued to progress rapidly.
Conclusions : Malignant melanoma should be considered in the differential diagnosis of cervical malignancies. Early diagnosis with cytology and pathology is essential in order to decide a therapeutic strategy.View full abstractDownload PDF (2825K)
Brief Notes
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Dai SONODA, Shinobu SAKAGUCHI, Hiroyasu NAKASHIMA, Tsutomu YOSHIDA, Yu ...2015 Volume 54 Issue 6 Pages 394-395
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSA 73-year-old female underwent distal pancreatectomy in 2009. In 2011, chest CT revealed a nodular lesion. Based on the suspicion of primary lung cancer, right lower lobectomy was performed. Cytology of the tumor stump showed atypical cell clusters showing palisading and formation of tubular structures. The tumor cells had comparatively small and elliptic nuclei and were elliptical in shape cytoplasm. Histologically, the lesion was a metastatic tumor in the lung from primary pancreatic cancer. In addition to the past history, the presence of a solitary lung nodule composed of cylindrical cells forming tubular structures led to the presumptive diagnosis of a pulmonary metastasis from primary pancreatic cancer.View full abstractDownload PDF (1595K) -
Naoki HAYASHI, Manami NOVATA, Mieko NAKAI, Makoto ITO, Takashi KOSHIKA ...2015 Volume 54 Issue 6 Pages 396-397
Published: 2015
Released on J-STAGE: December 10, 2015
JOURNAL FREE ACCESSA case of nodular fasciitis occurring in the left breast region in a middle-aged woman is reported. Fine-needle aspiration cytology showed pleomorphic spindle cells with occasional multinucleated giant cells, superficially mimicking sarcomatous neoplasms. The diagnosis of nodular fasciitis was established by core needle biopsy. In order to obviate unnecessary surgical resection of this benign self-limited lesion, the initial cytologic evaluation is essential to rule out malignant mesenchymal tumors arising from the breast.View full abstractDownload PDF (1349K)
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