Objective : Using the TACAS^TM method of liquid based cytology (LBC), we investigated the detection rate of cases requiring further detailed work-up, the diagnostic concordance rate between the TACAS^TM method and histological diagnosis, and the relationship between the results of human papillomavirus (HPV) testing and the cytological diagnoses.

Study Design : Of the 12158 cases screened for cervical cancer in fiscal year 2013, we conducted further analysis of cases with ASC-US or more severe lesions.

Results : The sole use of LBC increased the number of cases diagnosed as having ASC-US or more severe lesions from 1.7% to 3.2%. The concordance rate with the histological diagnosis was 76.2% for squamous epithelial abnormalities and 100% for glandular abnormalities. In regard to the results of HPV testing, 13 cases of ASC-US, 9 cases of LSIL, 3 cases of ASC-H, and 1 case of HSIL were HPV-positive.

Conclusion : An increase was observed in the diagnosis rate of cases with ASC-US or more severe lesions after transitioning to sole use of the TACAS^TM method, reflecting the improvement in specimen quality. Moreover, the detection of subtle cellular changes enabled by the use of the TACAS^TM method may contribute to the improved sensitivity of detection of early pathological changes.

Objective : Reports on liquid based cytology of thyroid nodules using LBC PREP2 are still rare. The aim of this report was to clarify the cytological findings and diagnostic accuracy of liquid based cytology of thyroid nodules using LBC PREP2.

Study Design : We studied 887 thyroid nodules by fine needle aspiration cytology at our hospital from June 2011 to May 2015. We washed the aspirated needles with LBC PREP2 fixative and prepared the material as directed.

Results : The sensitivity and specificity of LBC using LBC PREP2 for the correct diagnosis in 204 cases in whom the results were comparable with the histological results were 98.0% and 89.3%, respectively. Most of the red blood cells were hemolyzed and their debris appeared in the prepared specimens. The appearance of colloid was different from that in the cytology specimens processed using SurePath^TM. The basement membrane surrounding the follicular cluster was visualized in case of adenomatous goiter. Nuclear grooves and pseudoinclusions were more easily recognized than in the specimens prepared using ThinPrep^TM.

Conclusion : LBC using LBC PREP2 is at least as useful as the other known LBC methods for thyroid nodules. Some cytological features were different from those observed in the specimens processed by other LBC methods.

Background : We report a case of myoepithelial carcinoma of the parotid gland with containing rhabdoid cells.

Case : A 60- year-old man referred to us with a mass in the parotid region was diagnosed by computed tomography (CT) and magnetic resonance imaging (MRI) as having a tumor of the left parotid gland. Aspiration cytology showed a small number of clustered rhabdoid cells with abundant cytoplasm and eccentric nuclei in a necrotic background. Based on the histological and immunohistochemical findings, the tumor was definitively diagnosed as myoepithelial carcinoma.

Conclusions : Myoepithelial carcinoma with rhabdoid cells is a rare neoplasm of the salivary gland, that should be included in the differential diagnosis of salivary gland tumors in cases where the smears contain rhabdoid cells.

Background : Malignancy-associated pulmonary hypertension (PH) is a rare condition encountered in patients with cancers or hematological disorders. We present the findings of pulmonary blood aspiration cytology in two cases of PH associated with breast cancer and polycythemia vera, respectively.

Cases : Case 1 : A 59-year-old woman who had been treated for breast cancer 6 years earlier presented to us complaining of severe breathlessness. We performed right heart catheterization for PH and cytological examination of the pulmonary blood. Many cancer cells were detected in the blood smear and cell blocks, consistent with the diagnosis of pulmonary tumor-thrombotic microangiopathy. She was started on chemotherapy, but died of respiratory failure 7 months later.

Case 2 : A 72-year-old woman who had been diagnosed as having polycythemia vera and had been under treatment with an antimetabolite for 21 years presented to us with a history of exertional breathlessness. We performed pulmonary catheterization to confirm PH, and concomitant cytological examination. The blood smear showed megakaryocytes with platelet production and giant platelets. The patient was started on chemotherapy for myeloproliferative disorder, however, she died of respiratory failure after a year.

Conclusion : Patients with PH associated with malignancy cannot easily be treated by invasive approaches, and have a poor prognosis due to their often missing the chance for early treatment, as diagnosis, and consequently treatment, is often delayed. Therefore, heart catheterization with concomitant pulmonary blood aspiration cytology is safe and diagnostically useful for those patients.

Background : Granular cell tumor (GCT) is a rare, usually benign, neoplasm of the skin and soft tissue, and involves the vulva in approximately 15% of the cases.

Case : A 36-year-old female patient presented to us with the complaint of a slow-growing lump (4-cm size at presentation) on the left labium majus. We performed wide local excision of the mass. The gross specimen was a firm, solid white-yellow nodule, with no hemorrhage or necrosis. On microscopic examination, the tumor was composed of large polygonal cells with abundant granular eosinophilic cytoplasm, arranged in sheets and nests irregularly infiltrating between collagen bundles. Results of immunohistochemical staining for neural markers (neuron-specific enolase : NSE, S-100 proteins, and CD68) were positive. Touch smear of the vulvar tumor showed isolated large cells with abundant granular cytoplasm having small round or oval nuclei. Some tumor cells had nuclear grooves and showed mild nuclear atypia.

Conclusion : GCT of the vulva is a rare neoplasm of neural sheath origin. Although GCTs are mostly benign, the reported recurrence rates are about 2% with negative margins. Wide local excision is the treatment of choice and careful follow-up is recommended in patients with lesions larger than 4 to 5 cm in diameter.