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Volume 55, Issue 1
Displaying 1-10 of 10 articles from this issue
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Original Articles
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Shigeru TSUCHIDA, Akane OBOKATA, Yumiko HIGUCHI, Seiji TSURUTA, Marie ...2016 Volume 55 Issue 1 Pages 1-6
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSObjective : The Bethesda System 2001 sets standard values for accuracy management in cervical cytology. We examined whether or not these values are applicable as reference values for medical centers.
Study Design : We compiled reports on cervical cytology from 9 medical centers and 1 laboratory that was intended only for screenings, and compared the accuracy management items between the clinical facilities and screening facility.
Results : The rate of ASC was higher in the clinical facilities than at the screening facility, although the rates of ASC-H (ASC-H/ASC rate) and ASC/SIL were similar among the ASC reports from the two types of facilities. However, the ASC-H/ASC rate was higher than the standard values at the clinical facilities. We calculated the rate of SIL as a percentage of the total cases, and divided the study centers into 2 groups : centers with a high SIL rate and those with a low SIL rate. However, no significant difference of the accuracy management items was noted between the 2 groups.
Conclusion : For accuracy management of cervical cytology performed at medical centers, there is a need to set standard values that are different from those used for screening.View full abstractDownload PDF (669K) -
Madoka MIYAKE, Akihiko KAWAHARA, Mayuko KAWAHARA, Eiji SADASHIMA, Junk ...2016 Volume 55 Issue 1 Pages 7-12
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSObjective : The aim of this study was to examine the effectiveness of combined use of liquid based cytology (LBC) and conventional cytology (conventional) in fine-needle aspiration biopsy of Warthin’s tumors.
Study Design : We investigated 28 specimens of Warthin’s tumor using paired conventional cytology and LBC preparations. The conventional cytology and LBC preparations were compared in relation to the following : 1) number of cases with oncocytic cells and cytological findings, 2) number of oncocytic cells and clusters, and 3) the background material.
Results : Oncocytic cells were observed in both LBC and conventional cytology preparations in 20 cases (71.4%), and in the LBC preparation alone in 6 cases (21.4%). In terms of the cytological findings of the oncocytic cells, in the LBC preparation, the tumor cells showed granular cytoplasm, with nuclear pyknosis and prominent nucleoli. There was a significant difference between LBC and conventional cytology in the number of high columnar oncocytic cells or oncocytic cell clusters (p<0.05). The background material was decreased, and degeneration of the lymphocytes was observed in the LBC preparation.
Conclusion : In the diagnosis of Warthin’s tumor, an adequate number of oncocytic cells is clearly obtainable by LBC. The LBC method is considered to be useful for qualitative diagnosis of salivary gland tumors showing cystic changes.View full abstractDownload PDF (9658K)
Clinical Articles
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Akira SATO, Tomoe MIYANISHI, Tomoko YOKOYAMA, Naomi YASUMO, Noriko KAN ...2016 Volume 55 Issue 1 Pages 13-19
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSBackground : Ductal adenoma of the breast is often overdiagnosed, because aspiration cytology often shows numerous atypical apocrine cells. A large amount of mucin obtained on fine-needle aspiration cytology (FNAC) of ductal adenoma is extremely rare.
Case : A woman in her 60s was found to show an inner lower-quadrant category-3 tumor on mammography carried out as part of a health examination. FNAC showed tumors arranged in solid and tubular clusters or sheets, and numerous isolated tumor cells in a background of a large amount of mucin with foamy macrophages and cell debris. A few tumor cells were also seen arranged in cribriform and low-papillary patterns. Most of the tumor cells, with monotonous oval nuclei and a relatively low nuclear/cytoplasmic ratio showed orange G-stained intracellular mucin. Additionally, goblet cells were also seen. Based on the cytological findings, mucinous carcinoma was suspected. The histological diagnosis was ductal adenoma with mucinous metaplasia and mucinous cysts.
Conclusion : Although it was difficult to differentiate between mucinous carcinoma and mucocele-like tumor in our case, it is important to recognize that intracytoplasmic and extracellular mucin may be characteristic cytological findings of ductal adenoma.View full abstractDownload PDF (21280K) -
—A case report—Nobuo SATAKE, Mari SHIGEKI, Junko YAMADA, Eiji KUDO2016 Volume 55 Issue 1 Pages 20-25
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSBackground : Benign multicystic mesothelioma (BMM) is a rare mesothelial proliferative lesion characterized by multilocular cysts in the pelvis and abdominal cavity. Approximately 130 cases of BMM have been documented in the literatures, but reports of the cytopathological features are few. We report herein on a case of BMM in the pelvic peritoneum.
Case : A-30-year old woman with the chief complaint of pain in the lower left quadrant was referred to our hospital. Transvaginal ultrasonography, CT and MRI detected a mass with a multilocular cystic tumor in the pelvis. Cytologically, sheets of monomorphous mesothelial cells and papillary or ball-like clusters of mesothelial cells were observed in the intracystic fluid smear. The patient subsequently underwent an excision of the tumor. The pathological and cytopathological examination of the tumor revealed BMM in the pelvic peritoneum.
Conclusion : Cytology of the touch preparation and the intracystic fluid smear provided useful information for a pathological diagnosis in our case.View full abstractDownload PDF (41233K) -
—Correlation of the cytological appearances of the tumor cells with the histology—Tomohisa MACHIDA, Hitoshi ITOH, Nobuaki KATO, Suguru TOGUCHI, Hirotaka ...2016 Volume 55 Issue 1 Pages 26-31
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSBackground : We report a case of mixed adenoneuroendocrine carcinoma (MANEC) arising from the biliary tract with the finding of intermediate cells.
Cases : A-60s man old man presenting with jaundice was detected to have a nodule in the common bile duct, and brush sampling of the biliary tract was performed. Based on the preoperative cytological findings suggestive of adenocarcinoma, cholecystectomy with partial resection of the biliary tract was performed.
Cytology of the biliary tract revealed intermediate cells of between adenocarcinoma and neuroendocrime carcinoma (NEC), with large nuclei and a high N/C ratio. Exfoliative bile juice cytology revealed the diagnosis of adenocarcinoma. Large oval cells with high N/C ratios and a fine nuclear chromatin pattern were observed on intraabdominal lavage cytology performed during the surgery, indicative of NEC,
Histologically, small round-CD56 positive cell clusters with high N/C ratios were identified in the submucosa, associated with adenocarcinoma of the mucosal surface. Based on the findings, a final histopathological diagnosis of MANEC was made.
Conclusion : The cytological findings can differ depending on the cytological material examined and the method used to obtain it, depending on the depth histologic variation of MANEC from which the material is obtained. When intermediate cells showing overlapping features between adenocarcinoma and NEC are found, the possibility of MANEC should be borne in mind.View full abstractDownload PDF (19900K) -
Aya ISEKI, Sakae HATA, Katsuyuki KATO, Harumi KOBAYASI, Toshiaki HARA, ...2016 Volume 55 Issue 1 Pages 32-38
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSBackground : We have experienced a case of invasive lobular carcinoma of the signet-ring-cell type, and we report herein on the cytological findings and intracytoplasmic mucin.
Case : A female in her fifties consulted with a mass which had been discovered. The fine-needle aspiration (FNA) cytology revealed dissociated tumor cells with signet-ring-cell appearance including orange mucin. Histologically, small tumor cells grew in a linear manner together with a targetoid distribution. Approximately 20% of the tumor cells were recognized as signet-ring-cells which were strongly positive for PAS. Immunohistochemically, E-cadherin was negative and p120 was diffusely positive, so that the tumor comprised a lobular carcinoma with a component containing signet-ring-cell carcinoma. In the component of the classical type lobular carcinoma, the surrounding cell membranes were positive for MUC1. On the other hand, signet-ring-cell carcinoma component, not only were the cell membranes positive for MUC1, but the intracytoplasmic mucin also tested positive. Eighty percent of intracytoplasmic mucin was positive for GCDFP-15. MUC2, MUC5AC and MUC6 were negative in both types of cell.
Conclusions : Invasive lobular carcinoma of the signet-ring-cell type shows characteristic cytological features. MUC1 and GCDFP-15 showed positive for intracytoplasmic mucin whereas MUC2, MUC5AC and MUC6 were negative.View full abstractDownload PDF (74028K) -
—A case report—Ikuko NAGATA, Ai UEKUNI, Atsuko OKAMOTO, Kaita IMACHI, Yutaka DAIMARU, ...2016 Volume 55 Issue 1 Pages 39-45
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSBackground : We report the cytomorphologic features of primary intra-abdominal biphasic synovial sarcoma (SS) in cytology of peritoneal washings and tumor imprint cytology.
Case : A Japanese woman in her 50’s underwent complete removal of a large intra-abdominal tumor measuring about 15 cm in size. Histologically, two components were observed : an epithelioid component, with the cells forming rounded nests, and a stromal component, with the cells arranged in sheets and fascicles. Immunohistochemistry revealed positive staining for EMA, AE1/AE3, CK7, vimentin and calretinin. Based on the findings, the tumor was diagnosed as a biphasic SS arising from the abdominal cavity ; the tumor was detected by RT-PCT as expressing the SYT-SSX1 fusion gene. In both cytology of the peritoneal washings and imprint cytology, two types of tumor cells were observed : scattered atypical spindle-shaped cells with cigar-shaped nuclei, nuclear infoldings and/or intra-nuclear inclusions, and atypical epithelioid cells with round nuclei, a high N/C ratio, nuclear moldings and paired cells.
Conclusion : The appearance of both atypical spindle-shaped and epithelioid cells in cytology of peritoneal washings and imprint cytology is useful for accurate diagnosis of biphasic SS. Immunohistochemistry and genomic analysis are necessary for diagnosing and distinguishing SS from other malignancies.View full abstractDownload PDF (57915K) -
Tomoya TAKEBUCHI, Hayato IKOTA, Yusuke GOTO, Yasunori KURIBARA, Junko ...2016 Volume 55 Issue 1 Pages 46-51
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSBackground : Ovarian carcinosarcoma and neuroendocrine carcinoma are rare tumors. Moreover, coexistence of these two neoplasm is extremely rare.Herein, we report a case of ovarian tumor containing both carcinosarcoma and neuroendocrine carcinoma components.
Case : A 69-year-old woman presented to us with a history of abdominal pain. Computed tomography revealed a right ovarian tumor measuring 98×87×87 mm in size.Intraoperative ascitic fluid cytology showed atypical cell with an increased nuclear/cytoplasmic ratio were arranged in irregular and trabecular clusters. The cells showed diffusely positive staining for CD56 and synaptophysin, and focally positive staining for chromogranin A. No atypical cells were found in liquid based cytology of the cervix uteri or endometrium. These cytological findings were suggestive of neuroendocrine carcinoma of the ovary. Histopathological examination of the resected specimen revealed a diagnosis of carcinosarcoma with a neuroendocrine carcinoma component.
Conclusion : Ovarian neuroendocrine carcinoma has an extremely poor survival prognosis. Detection of high-grade neuroendocrine tumors by cytology may contribute to early decision on the treatment strategy.View full abstractDownload PDF (8390K) -
Yuichiro MIYAMOTO, Satoshi OKADA, Mitsuya ISHIKAWA, Shunichi IKEDA, To ...2016 Volume 55 Issue 1 Pages 52-57
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSBackground : We report a case of rapidly growing ovarian cancer manifesting as positive uterine cytology alone, in which it was difficult to diagnose the tumor origin.
Case : The patient was a 49-year-old female with positive uterine endometrial cytology. CT and MRI showed no evidence of any tumor in the uterus or within the abdominal cavity. One month later, surgical operation was performed under the diagnosis of small uterine endometrial cancer or small ovarian cancer, however, intraoperative findings showed massive metastasis in the abdominal cavity. The pathological diagnosis was bilateral ovarian cancer, stage IIIc, with right Tubal Intraepithelial Carcinoma.
Conclusion : Ovarian high-grade serous adenocarcinoma with TIC may progress rapidly, with rapid spread of the tumor cells in the abdomen. Early detection of ovarian cancer is still a challenge, however, careful investigation of the uterine cytology could suggest the origin of mullerian malignancies and enable a decision on the appropriate surgical procedure.View full abstractDownload PDF (11108K)
Brief Note
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Yukari NISHIDA, Kazuhito HATANAKA, Kaori TAKESHITA, Kimiko MOUGI, Kazu ...2016 Volume 55 Issue 1 Pages 58-59
Published: 2016
Released on J-STAGE: February 16, 2016
JOURNAL FREE ACCESSWe report a case of secretory meningioma diagnosed in a 40-year-old woman. MRI revealed a 2.5-cm mass with the dural tail sign, and evidence of cerebral edema adjacent to the mass in the right frontal convexity. Crush cytology of the resected specimen showed tumor cell clusters arranged in sheets. The tumor cells had round nuclei, finely granular chromatin, and some cells showed PAS-positive intracytoplasmic inclusions (diastase resistant). Histologically and immunohistochemically, the tumor was confirmed to show the features of secretory meningioma. Besides clinical information, the characteristic cytologic features of secretory meningioma presented in this case may be helpful for the diagnosis.View full abstractDownload PDF (2557K)
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