Objective : We compared the diagnostic accuracy and cytomorphologic features of thyroid lesions in fine needle aspiration biopsy between the ThinPrep^® and conventional smear methods (TP and CS, respectively).

Study Design : In this study, we compared the results and cytomorphologic features in 358 CS preparations and 308 TP preparations. We also compared the results obtained with TP and the corresponding surgical findings with those obtained using CS.

Results : The insufficient material rates for CS and TP were 18.7% and 9.7%, respectively, being significantly lower for TP as compared to CS. The diagnostic sensitivity of CS was 92.5%, and that of TP was 86.7%. The specificity was 100% for both CS and TP. In comparison to CS, a clean background, fragmentation of cell clusters and colloids, and obvious chromatin features were observed in TP. Nuclear grooves and pseudoinclusions could be easily visualized in the TPs of papillary thyroid carcinoma.

Conclusion : The TP method showed a similar diagnostic accuracy to CS, but with the advantage of reduced sample insufficiency rates. It is important to be aware of the cytological differences observed between CS and TP ; however, overall, TP seems to be at least as useful as CS.

Objective : The aim of this study was to clarify the cytological characteristics of deep-layer squamous cells by cytological classification the cytologic diagnosis and to quantify of subjective diagnosis in screening. We performed analysis of the cytological images and consider the cytological characteristics by cytological classification the cytologic diagnosis.

Study Design : The subjects of this study were oral cytology specimens obtained from the lateral tongue of 384 subjects at Nihon University Hospital at Matsudo, between January and December 2016. The cytological images were analyzed using an image analysis software to quantitatively measure the cell area, nuclear area, N/C ratio, nuclear irregularity and hyperchromasia.

Results : Deep-layer squamous cells were seen in 27 cases [8.6% (27/314)] of negative for intraepithelial lesion or malignancy (NILM), 1 case [2.0% (1/50)] of squamous intraepithelial lesion or dysplasia, 8 cases [40.0% (8/20)] of squamous cell carcinoma (SCC). The average nuclear area was 66.0μm² (34.8) in cases of NILM and 82.6μm² (43.7) in cases of SCC. The average nuclear irregularity index was 1.25 (0.08) in cases of NILM and 1.29 (0.09) in cases of SCC. A significant difference was found in the nuclear area (p=0.042) and nuclear irregularity index between NILM and SCC (p=0.028).

Conclusion : The nuclear area and nuclear irregularity index of the deep-layer squamous cells were higher in cases of SCC as compared to cases of NILM. These findings are suggested as being potentially helpful in oral cytological diagnosis.

Objective : We investigated the nucleic acid quality and stability of protein expression in sodium alginate formalin-fixed paraffin-embedded (FFPE) cell blocks (CB) produced under different formalin fixing conditions.

Study Design : Cell lines were fixed in two types of formalin solutions for various lengths of time, and FFPE CBs were prepared using sodium alginate. The DNA integrity number was investigated to assess the DNA quality. The FFPE CBs were then evaluated with regard to stainability.

Results : The DNA quality deteriorated in the samples fixed in both formalin solutions, in a time-dependent manner. The DNA in the cell lines fixed in 10% neutral buffered formalin (NBF) for 3 and 6 hours was of higher quality than that in the cell lines fixed in the same solution for 24 hours or more. In regard to immunostaining for cytokeratin, cell lines fixed in both types of formalin solutions for 3 and 6 hours showed good staining. Furthermore, the Ki-67 labeling index of the cell lines fixed in formalin solution for 24 hours or more was lower than that observed after the cell lines had been fixed for 3 and 6 hours.

Conclusion : Our data show that comparatively higher quality DNA and stable protein expression can be obtained from cytological samples fixed in 10% NBF for 3 to 6 hours in the sodium alginate FFPE CB method.

Background : Tuberculosis (TB) of the breast is very rare, as the breast tissue is known to be relatively resistant to tubercular infection. Herein, we report a case of breast TB that was initially suspected as a case of breast carcinoma based on the imaging findings.

Case : A women aged in her 70 s presented with a lump in her right breast. Ultrasonography showed several nodular lesions in both breasts. The largest lesion was an intracystic papilloma-like lesion, measuring 11×11mm in size, located in the B area of the right breast. It was judged as being mammography category 3 and magnetic resonance imaging category 5, suggestive of carcinoma. Fine-needle aspiration cytology (FNAC) showed granulomatous cells (epithelioid cells, multinucleated giant cells, fine granular necrosis), although, because of the presence also of some atypical spindle cells, we could not make a definitive diagnosis. Excisional biopsy was performed, and histological examination confirmed the features of TB. Retrospective immunohistochemical analysis and immunocytochemical analysis for CD68 suggested the possibility of the spindle cells being of histiocytic origin.

Conclusion : TB of the breast is a rare benign disease, but the imaging findings can mimic those of breast carcinoma. Therefore, FNAC would be indicated for obtaining the diagnosis in these patients. Pathologists examining breast FNAC specimens should bear in mind the possibility, even though rare, of breast TB.

Background : Cytological differentiation between a hydatidiform mole and choriocarcinoma is challenging. Herein, we describe a case of histopathological diagnosis of a complete hydatidiform mole after hysterectomy.

Case : A 53-year-old woman (G5P3) presented to us with a history of irregular genital bleeding. Uterine cancer was suspected from the markedly elevated serum hCG levels and CT findings. Endometrial cytology revealed villi and mildly atypical intermediate trophoblasts, suggestive of hydatidiform mole. Histopathological diagnosis of the resected uterus confirmed it as complete hydatidiform mole with exaggerated placental site.

Conclusion : Endometrial cytology could be useful for the diagnosis of molar diseases and also for differentiating hydatidiform mole from choriocarcinoma.

Background : Adenoid cystic carcinoma (AdCC) is the most commonly encountered malignant tumor of the minor salivary glands. Herein, we report a case of AdCC, in which differential diagnosis from a basaloid-like tumor was achieved by liquid-based cytology (LBC) of oral brushings.

Case : A male patient in his 60's was referred to our hospital by his family dentist. A tumor was identified by endoscopy in the upper right palate, and oral brushing LBC was performed, which showed clusters of small round cells with basaloid features. However, the presence of tumor clusters consisting of monotonous cells led to the suspicion of AdCC, and immunocytochemistry was performed. The tumor cell nuclei showed strongly positive staining for MYB protein, and we made the diagnosis of AdCC. Biopsy revealed nests and sheets of small round, basaloid cells, and identifiable atypical double-layered ductal structures in the solid nests which were predominant. The tumor cells showed strongly positive staining for MYB. FISH analysis revealed MYB split signals (68%) in the tumor cells. Based on these findings, the patient was diagnosed as having AdCC.

Conclusion : Although differential diagnosis from a basaloid-like tumor was required in this case, histological diagnosis of AdCC was possible by comprehensive analysis of the clinical information, cytological findings and results of MYB staining.