Objective : The prognostic significance of positive peritoneal cytology in patients with early-stage endometrial cancer (Stage 1A) is controversial and unclear. The aim of this study was to investigate the influence of positive peritoneal cytology on survival in patients who had undergone laparoscopic surgery.

Study Design : Eighty-two cases of endometrial cancer Stage 1A treated with laparoscopic hysterectomy, salpingo-oophorectomy, and selective lymphadenectomy were retrieved and peritoneal cytology specimens were reviewed.

Results : Among the 82 patients, five (6.1%) had positive peritoneal cytology. Two of these five patients received adjuvant chemotherapy, and they did not have any recurrence. The remaining three patients did not receive adjuvant chemotherapy, and had recurrence.

Conclusion : This study demonstrates that positive peritoneal cytology in cases of early-stage endometrial cancer is a significant risk factor for recurrence.

Objective : Primary cytologic screening has been regularly performed in Japan. In our clinic, a combination of cytology and a human papillomavirus (HPV) test (COM) has been performed since 2015. The primary HPV screening with cytological triage (pHPV) has been mainly done since 2017. We examined the distribution and frequency of abnormal cytology by both COM and pHPV during the last four years.

Study Design : Six hundred and sixty-nine patients comprised 404 cases with COM and 265 cases with pHPV, with 14 cases being excluded. Liquid-based cytology (SurePath) and an HPV test (cobas^® 4800) were used for sampling.

Results : Between the COM and pHPV groups, the percentage of abnormal cytology of HPV positive cases among all 669 patients was almost similar, with 63.6% and 66.0%, respectively. The percentage of abnormal cytology was 78.6% with HPV positive cases in the pHPV group. On the other hand, 8.9% among the cases in the COM group with HPV negative in 458 cases were evaluated with both methods.

Conclusion : We concluded that pHPV would be an alternative to COM. Further studies are mandatory with a recall system for patients with no regular visit and both a post-screening algorithm and an accurate triage system is required for cases who show any discrepancy between the cytology and HPV test.

Background : Canalicular adenoma is a benign tumor that typically arises from the minor salivary glands, but is also known to rarely originate from the major salivary glands. While its characteristic histopathological features are well-known little is known about its cytological features. Thus, cytological diagnosis of this tumor can be challenging. Herein, we report a case of canalicular adenoma.

Case : The patient was a 70-year-old woman with a submandibular lump. Fine-needle aspiration cytology revealed the presence of multiple clusters of small-to-medium-sized cylindrical cells. Most of the cells were not atypical, and the cells in the periphery of the clusters were arranged in a palisade. Based on these findings, we suspected that the mass was a basal cell adenoma. However, we reported it as suspicious cytology, because it was difficult to exclude the possibility of adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma. We subsequently performed excision of the left submandibular gland, and based on the characteristic histopathological and immunohistochemical features, the tumor was diagnosed as a canalicular adenoma.

Conclusion : In this case, the cytological features consisted of monotonous cylindrical cells, fragmented tubular cell clusters, palisade arrangement of the cells around the cluster, multiple glandular cavities, and dense connectivity of the cells.

Background : Adult granulosa cell tumors (AGCTs) are a rare low-grade ovarian malignancy. This type of tumor is notorious for its tendency for late recurrence. We herein report on an autopsy case of late recurrent AGCT, in which ascitic and imprint tumor cytologies at autopsy were found to be useful for the definitive diagnosis.

Case : A 75-year-old woman underwent a diagnostic laparoscopy with a clinical diagnosis of probable peritoneal carcinoma. Histologically, the peritoneal nodules revealed a malignancy, not otherwise specified. Ten months later, her history of oophorectomy for AGCT 17 years prior was disclosed. Chemotherapy with paclitaxel was started with a clinical diagnosis of recurrent AGCT, but she died and an autopsy was performed. Ascitic and tumor imprint cytologies showed uniformly oval and naked tumor nuclei with obvious grooves. Call-Exner bodies were absent. A molecular analysis of the tumor revealed a FOXL2 c.402C>G mutation.

Conclusion : This is a case of a late recurrent, molecularly proven AGCT, representing a case of difficulty in the histological diagnosis of AGCT without knowledge of crucial past medical history of AGCT. However, cytomorphologies, particularly nuclear grooves, were retained even in the late recurrent tumor and were of great help in the definitive diagnosis.

Background : Paraganglioma is a rare tumor derived from the paraganglia, a neuroendocrine organ closely associated with the autonomic nervous system. Herein, we report a case of retroperitoneal paraganglioma with intranuclear cytoplasmic inclusions in the giant tumor cells.

Case : An 80-year-old woman was referred to our hospital because of an abdominal tumor detected by CT. Since a malignant lymphoma was suspected, a diagnostic excisional biopsy was performed.

Imprint cytology findings : The tumor cells were distributed singly or in loosely cohesive clusters, and showed anisokaryosis. Intranuclear cytoplasmic inclusions were also seen in some tumor cells.

Histopathological and immunohistochemical findings : The tumor cells showed a characteristic pattern of “Zellballen,” and positive staining for synaptophysin, chromogranin A, and CD56. Based on the findings, we diagnosed the tumor as a paraganglioma.

Conclusion : Paraganglioma is difficult to diagnose by cytology. We think that the presence of intranuclear cytoplasmic inclusions is one of the important markers to support the diagnosis of paraganglioma.

We present a case of goiter with ectopic bone formation and extramedullary hematopoiesis in the thyroid, diagnosed by fine-needle aspiration cytology (FNAC). A 43-year-old female patient with a calcified thyroid nodule underwent ultrasound (US) -guided FNAC. Microscopic examination showed mature megakaryocytes with multilobulated nuclei and abundant granular cytoplasm, and myeloid and erythroid cells in various stages of development in a background of benign thyroid follicular epithelial cells. Adipose tissue and fragmented bone materials were also found. Presence of hematopoietic cells in the thyroid gland is an unusual finding ; moreover, detection of giant cells in FNAC of the thyroid could lead to the mistaken diagnosis of thyroid anaplastic carcinoma.

We report herein on a case of anaplastic large cell lymphoma with Charcot-Leyden crystals (CLCs). The patient was a male in his 30 s. Large lymphoma cells were found in an imprint specimen, and eosinophils and CLCs were observed in the background. The CLC formation involves ETosis (extracellular trap cell death) of eosinophils. The CLCs appeared with granular material associated with eosinophil disintegration. There have been no previous reports published on a lymphoma with CLCs, and the cause of the ETosis in the tumorous lesion is unknown. In the future, it will be necessary to examine various cases with CLCs with many different approaches.