Objectives : The aim of this survey was to identify effective means to promote academic research activities by cytotechnologists. Through this survey, we attempted to understand the attitudes of young cytotechnologists toward academic research, and based on the results of the survey, we propose appropriate activities for the future.

Study Design : The survey was conducted using a Google form, and responses were received between July 6, 2022 and August 3, 2022. The survey questions were formulated to gain an understanding of the current state of the research environments of cytotechnologists, and to determine appropriate means to promote academic research activities by cytotechnologists in the future.

Results : Many cytotechnologists have the desire to engage in academic research, but the work environment is not supportive. Therefore, creating support systems aligned with the academic research environment would be expected to increase engagement in academic research.

Conclusion : Provision of the knowledge and skills necessary for conducting academic research is required. Furthermore, it is necessary to provide an appropriate academic research environment for cytotechnologists, in the future.

Background : Lobular carcinoma in situ (LCIS) of the breast is rarely identified in cytology specimens so that little is known about its cytologic features. Herein, we report the cytologic findings in a case of LCIS of the breast diagnosed by histopathology.

Case : A woman in her 40 s noticed a mass in the EB portion of the right mammary gland. A fine-needle aspiration cytology specimen showed many crowding, overlapping, or sheet-like clusters of atypical epithelial cells. The cells had nearly uniform small-to medium-sized hyperchromatic nuclei and prominent nucleoli, some myoepithelial cells, and scattered single atypical epithelial cells. In the clusters or monolayered sheets of cells, the epithelial cells were non-cohesive, with slit-like spaces between them. Histopathologic examination of the resected specimen following right partial mastectomy revealed enlarged ductal and lobular glands filled with E-cadherin-negative uniform-sized tumor cells with comedo necrosis, which confirmed the diagnosis of florid LCIS.

Conclusion : Cytology smears prepared from invasive lobular carcinomas are usually sparse and have linear arrangements and the absence of these cytologic findings may help in distinguishing invasive lobular carcinoma from LCIS. Differentiating LCIS from ductal carcinoma is difficult, but the detection of slit-like spaces among the non-cohesive tumor cells arranged in monolayered sheets may be helpful for the diagnosis.

Background : Parotid gland secretory carcinoma is a low-grade tumor, and distant metastasis from this tumor is rare.

Case : The patient was a male in his 60 s. Computed Tomography showed a 40-mm-sized cervical mass around the lower pole of the left parotid gland and a 14-mm-sized right visceral pleural mass with effusion, suggesting the possibility of cervical lymph node metastasis from lung cancer. Fine-needle aspiration cytology (FNAC) of the left cervical mass showed tumor cells with oval nuclei and nuclear grooves arranged in sheets or in a partially papillary manner. The cytoplasm was relatively abundant and vacuoles were conspicuous. Secretory material showing focal metachromasia on Giemsa staining suggested the possibility of parotid gland secretory carcinoma. Immunohistochemical staining of the biopsy specimen showed diffusely positive reaction for S-100 protein, and partially positive reaction for mammaglobin. FISH revealed a positive result for the ETV6/NTRK3 break-apart signal, which led to the final diagnosis of parotid gland secretory carcinoma. Immunohistochemical staining of the cell block prepared from the right pleural fluid showed generally similar staining results as the cervical mass biopsy, and the patient was diagnosed as having pleural metastasis from a parotid gland secretory carcinoma.

Conclusion : Irrespective of the initial clinical diagnosis, careful analysis of the FNAC specimen, with further confirmation by FISH led us to make the final diagnosis of parotid gland secretory carcinoma. Following the diagnosis, the treatment proceeded smoothly under the supervision of a team of clinicians, pathologists, and cytotechnologists.

Background : Primary effusion lymphoma (PEL) is a rare B-cell lymphoma that is most often encountered in patients with human immunodeficiency virus infection. On the other hand, several cases of effusion-based lymphoma in Japan have been reported as being HHV-8-negative, leading to their classification as PEL-like lymphomas. Recently PEL-like lymphoma was recognized as an independent disease and named fluid overload-associated large B cell lymphoma (FO-LBCL).

Cases : Case 1. A man in his 70 s was admitted for worsening heart failure. Imaging studies showed massive pericardial effusion, but no mass lesions. Case 2. A man in his 70 s who had undergone surgery for lung cancer was admitted for heart failure. Pleural effusion was detected. Pericardial and pleural effusion cytology in the two cases, respectively, showed a large number of atypical cells. The cells showed weakly basophilic cytoplasm, marked nuclear atypia, and pleomorphism. Scattered giant cells with lobulated nuclei were observed. Immunocytochemical analysis of a cell block showed positive staining for CD20 and CD79a. Based on the findings, the patients were diagnosed as having diffuse large B cell malignant lymphoma. Enhanced CT showed neither tumor masses nor enlarged lymph nodes and the results of tests for HHV-8 and EBER-ISH were negative. Therefore, the patients were diagnosed as having FO-LBCL.

Conclusion : When cells suspicious for malignant lymphoma are found in body fluid, closer examination is necessary, including to rule out the possibility of PEL or FO-LBCL and secondary infiltration at other sites. Immunostaining and genetic analysis are essential for a definitive diagnosis.

Background : Embryonal rhabdomyosarcomas, which can originate in any part of the body, arise most commonly in the head and neck region and urogenital organs. We report a case of embryonal rhabdomyosarcoma arising in the paratesticular testis.

Case : The patient was a male in his 20 s who was referred to our hospital for detailed examination of an enlarged right scrotum ; the patient had presented with a 6-month history of a gradually enlarging right scrotum.

MRI showed a mass measuring 58×103×159 mm size in the right testicle. Under the suspicion of seminoma or some other type of testicular mass, a right high testicular resection was performed. Postoperative imprint cytology showed irregularly stacked atypical tumor cells with naked to elliptical nuclei that were enlarged and irregular in size and shape.

In addition, tumor cells with a snake-like morphology and abundant light green cytoplasm were observed in some parts, with cross striations in the cytoplasm. On histological examination, the irregularly proliferating tumor cells with vacuolated cytoplasm showed nuclear pleomorphism, with a high N/C ratio. Similar to the findings on cytology, the cells showed eosinophilic cytoplasm.

The diagnosis of embryonal rhabdomyosarcoma (ERMS) was confirmed by immunohistochemical analysis.

Conclusion : Cross striations are rarely seen on cytology in cases of RMS. Usually, the diagnosis is confirmed by immunohistochemical staining, electron microscopy, and/or genetic analysis. However, herein, we report a valuable case in which the presence of cross striations could be identified on cytological examination, which led us to suspect RMS.