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Volume 55 (2016)
- Issue 6 Pages 365-
- Issue 5 Pages 291-
- Issue 4 Pages 215-
- Issue 3 Pages 137-
- Issue 2 Pages 89-
- Issue 1 Pages 1-
Volume 55, Issue 2
Displaying 1-7 of 7 articles from this issue
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Clinical Articles
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Atsuko NASU, Kouichi ICHIMURA, Sakae HATA, Hiroyuki YANAI, Masaru FUJI ...2016 Volume 55 Issue 2 Pages 89-93
Published: 2016
Released on J-STAGE: May 10, 2016
JOURNAL FREE ACCESSBackground : Extranodal NK/T cell lymphoma, nasal type (ENKL), is a rare subtype of malignant lymphoma. We describe the cytological findings of ENKL cells that appeared in the aqueous humor.
Case : A male in his 5th decade of life who was diagnosed as having ENKL was referred to our hospital for systemic therapy. Ophthalmic examination revealed turbid aqueous humor in the anterior chamber of the left eye. A cytological specimen was prepared by the liquid-based cytology (LBC) method. Atypical lymphocytes with cleaved nuclei and elongated cytoplasm on one side were observed, appearing like “hand-mirror cells”. Immunocytochemical analysis showed positive staining of the tumor cells for CD3 and CD56. In situ hybridization (ISH) analysis of the cytological specimen revealed a positive result for EBER-1. These phenotypes were identical to those in the histopathology specimens.
Conclusion : Tumor cells of ENKL can appear as hand-mirror cells in cytological specimens. Immunocytochemistry and ISH are necessary to make a final diagnosis. We can perform these studies even in small-volume specimens obtained by the LBC method, as in this case.View full abstractDownload PDF (2365K) -
—A case report—Rira HOSHI, Noriko MOTOI, Noriyuki FURUTA, Kyouko KOMATSU, Noriko YANA ...2016 Volume 55 Issue 2 Pages 94-99
Published: 2016
Released on J-STAGE: May 10, 2016
JOURNAL FREE ACCESSBackground : Pulmonary artery sarcoma is rare, and diagnosis before surgery is difficult. The characteristic cytologic appearances have not been described yet.
Case : A man in the fifties was admitted to our hospital with a persistent cough. Computed tomographic examination revealed a pulmonary nodule in the lower left lung field. The lesion was suspected to be a primary pulmonary carcinoma and was resected with a left lower lobectomy. Imprint cytologic smears obtained from the resected specimen revealed clusters of small and uniform epithelioid cells, and small tumor cells with polygonal and thick cytoplasm. The nuclei of the cells were round and localized. The nuclei frequently showed irregularity, but without any conspicuous atypia. Intracytoplasmic and/or nuclear inclusions were prominent. No mitosis was seen. We therefore diagnosed them as atypical columnar cells, uncertain as to whether they were benign or malignant. Histologically, the tumor was diagnosed as an artery sarcoma combining the above data with an immunohistochemical examination.
Conclusion : Although the cytologic appearance of pulmonary artery sarcoma is similar to that of pulmonary adenocarcinoma, focusing on cytologic findings such as nuclear features and inclusion body structures may allow them to be distinguished.View full abstractDownload PDF (3542K) -
Daisuke NAGAYAMA, Yoshiki NAITO, Takahisa TSUKAMOTO, Sonoe ITO, Masami ...2016 Volume 55 Issue 2 Pages 100-106
Published: 2016
Released on J-STAGE: May 10, 2016
JOURNAL FREE ACCESSBackground : We experienced one case of intraductal papillary mucinous neoplasm (IPMN) with the appearance of signet ring cell-like cells. We examined the characteristic cell findings with touch smear cytology and we report our findings herein.
Case : A 63-year-old woman had a branch type IPMN identified eight years previously and was undergoing follow-up observation. Because increase of the cyst diameter and the expansion of the pancreatic duct were accepted, the patient underwent a pancreatic tail resection. Against the backdrop of inflammation and a small amount of mucus in the diagnosis tumor cell seal, signet ring cell-like cells containing prominent mucus was observed in loose coupling of isolated or sporadic formation. In the histopathological findings, signet ring cell-like cells were observed in the vicinity of the villous growth component. The pathological diagnosis was determined as intraductal papillary mucinous carcinoma, and it was diagnosed as the intestinal type because it was positive for MUC2 staining.
Conclusion : The appearance of signet ring cell-like cells should promote a diagnosis that assumes the intestinal type and gastric type of IPMN. It is possible to identify the subtypes by adding MUC staining.View full abstractDownload PDF (5846K) -
—A case report—Hideyuki ABE, Akihiko KAWAHARA, Yasuo SUGITA, Tomohiko YAMAGUCHI, Tomo ...2016 Volume 55 Issue 2 Pages 107-111
Published: 2016
Released on J-STAGE: May 10, 2016
JOURNAL FREE ACCESSBackground : Pineal parenchymal tumor of intermediate differentiation (PPTIDs) are rare brain tumor, and there are few cytological reports about this tumor. We report herein on a case of PPTID diagnosed on squash cytology.
Case : A woman in her 60’s visited a nearby hospital complaining of headache. A mass was found in the pineal body with magnetic resonance imaging and she underwent an operation at Kurume University Hospital. Squash cytological smears showed a loose cluster of tumor cells with bland cytological findings against the neuropil background. Individual tumor cells showed coarse to granular chromatin, like that seen in neuroendocrine tumors. On immunocytochemistry, Ki67 labeling index was observed in 5% of the tumor cells. Histologically, the tumor showed a monotonous appearance with scant cytoplasm. No distinct necrosis or mitosis was seen, whereas an increase of cellularity was observed. On immunohistochemistry the tumor cells were positive for neurofilament, and Ki67 labeling index was observed in 4% of the tumor cells.
Conclusion : Cytological findings of PPTID were characterized by coarse chromatin and the neuropil background. It is important for accurate diagnosis of PPTID to identify the Ki67 labeling index based on the characteristic cytological findings.View full abstractDownload PDF (3850K) -
—A case report—Atsuko NASU, Sakae HATA, Masaru FUJITA, Toyoko YAMAUCHI, Satoko NAKAMU ...2016 Volume 55 Issue 2 Pages 112-116
Published: 2016
Released on J-STAGE: May 10, 2016
JOURNAL FREE ACCESSBackground : We report herein on a case of a mammary analogue secretory carcinoma in a parotid gland.
Case : A 60-year-old man noticed swelling of his left neck. Ultrasound imaging showed a left parotid gland mass 30 mm in diameter. Fine needle aspiration cytology was undertaken. Against the background of macrophages appeared a large papillary cluster. The cells constituting the clusters were round to oval shaped, and hard large eosinophilic nucleoli. The loosely cohesive cells had abundant cytoplasm which atained faintly light green, and most of the cells had a oval nucleus pushed to the periphery of the cell. In the cytoplasm of the tumor cells constituting the clusters or in the areas surrounded by tumor cells, proteinous secretory material, which showed metachromasia on Hema-color® staining, was found. The parotid gland tumor was diagnosed as a mammary analogue secretory carcinoma (MASC).
Conclusion : The differentiation between an acinic cell carcinoma and an adenocarcinoma is difficult, but this parotid gland tumor was a rare histological type. When an acinic cell cancer-like cell is recognized, we recommend that careful cytological diagnosis is essential, taking MASC into consideration.View full abstractDownload PDF (3059K) -
Shogo IMAMURA, Yuki OTAZAWA, Akiko ODA, Tadashi MIYAHISA, Naoko NISHIY ...2016 Volume 55 Issue 2 Pages 117-122
Published: 2016
Released on J-STAGE: May 10, 2016
JOURNAL FREE ACCESSBackground : Thymic primary atypical carcinoids are relatively rare tumor to be classified as an intermediate-grade neuroendocrine epithelial neoplasm. We report herein on a case of an atypical carcinoid that was difficult to distinguish from small cell carcinoma in the pleural lavage cytology.
Case : A 6×5×3 cm mass was found in the right mediastinum of a male in the sixties on chest computed tomography. Intraoperative pleural lavage cytology showed small and large clusters, and relatively loose clusters of atypical cells with scant cytoplasm and rough chromatin. Rosette-like and molding-like arrangement were also seen. According to these features, a small cell carcinoma or a neuroendocrine carcinoma was suspected. Histopathological study confirmed the diagnosis of an intermediate-grade neuroendocrine epithelial neoplasm (atypical carcinoid) in the thymus, by the presence of small amount of necrosis and 3-5mitoses per 2 mm2 (10 HPF).
Conclusion : Careful observation of the cytological findings, such as the appearance of clusters and chromatin pattern are useful for the discrimination between an atypical carcinoid and a small cell carcinoma.View full abstractDownload PDF (6461K) -
—A case report—Shogo SHIGETA, Hideki TOKUNAGA, Keita TSUJI, Satoshi OKAMOTO, Hitoshi ...2016 Volume 55 Issue 2 Pages 123-128
Published: 2016
Released on J-STAGE: May 10, 2016
JOURNAL FREE ACCESSBackground : Sertoli-Leydig cell tumors (SLCTs) are a rare ovarian tumor usually localized in the unilateral ovary. There are few reports describing the positive cytological findings in the ascites. We report herein on a case of advanced SLCT with positive peritoneal cytology.
Case : A 58 year-old woman, 3 gravida, 1 para, visited a local hospital with lower abdominal pain and abdominal distention. A large pelvic mass was detected and the preoperative examination suggested advanced ovarian carcinoma with peritonitis carcinomatosa. Bilateral salpingo-oophorectomy and partial omentectomy were performed at our hospital. The pathological diagnosis was SLCT with heterologous elements. Besides atypical Sertoli cells, in peritoneal cytology, there were cells considered to be derived from heterologous elements but no obvious Leydig cells. The tumor was resistant to chemotherapy and the patient died of the disease about 11 months after surgery.
Conclusion : In cytology, it can be difficult to distinguish atypical Sertoli cells from epithelial ovarian cancer cells. The presence of the cells representing the heterologous element or retiform pattern may help differential diagnosis. Further, immunocytochemistry is considered to be useful.View full abstractDownload PDF (7576K)
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