Eiichi Akaogi

Cytological Diagnosis of Bronchial Carcinoid by Bronchial Brushing Method

On five cases of bronchial carcinoid, cytological and histological findings were compared. Cytological materials were obtained by the preoperative bronchial brushing method. On resected cases, additional cytological smears were prepared from the freshly-cut surfaces of resected tumors.The conclusion reached by these examinations is that cytology diagnosed by the bronchial brushing method is useful for establishing preoperative diagnosis of bronchial carcinoid. Essential cytological manifestations of typical carcinoid are as follows;(1) Cytoplasm is foamy and lightly stained, (2) moderately increased chromatin granules are slightly coarse, (3) chromatinic rim is thin and regular and (4) nucleoli are moderately prominent.Aside from these typical findings, various aspects in cytology reflected histological patterns of carcinoid. For example, rosette formation and tubular arrangement appeared in the adenopapillary pattern and spindle-shaped nuclei were found in the smears from the case of spindle cell type. In a poor-prognostic case, nuclear pleomorphism, filled granular chromatin and multiple small nucleoli were found. This nuclear atypism suggests “potential malignancy” as has been suspected by the authors.

Cytologic studies of lung metastasis of renal carcinoma

Renal carcinomas often metastasize to the endobronchial wall with no symptoms, so they are liable to be mistaken for primary lung tumors.Three cases of lung metastasis of renal carcinomas gave the following characteristic cytological indings: abundant cytoplasm with numerous vacuoles, eccentric but round nuclei and prominent nucleoli.Differentiation of lung metastasis of renal carcinoma from primary lung tumors especially “clear cell” carcinoma or benign clear cell tumor of the lung is discussed.

A case of multiple myeloma of the rib and thoracic vertebrae

A case of multiple myeloma of the rib and thoracic vertebrae in a 75-year-old man is presented, together with the results of cytologic and light microscopic examinations.The specimens were obtained by needle aspiration biopsy from the bone marrow of the sternum and the lesion of the rib. The M-G stain of the specimen obtained from the bone marrow revealed that the tumor cells had the features of myeloma cells.The cytological findings of myeloma cells stained by the method of Papanicolaou have rarely been reported. The examination of the smears after Papanicolaou stain of the lesion of the rib in the present case revealed the following features ; the cells were round to oval; the cytoplasma was faintly stained by light green and had granules; the nuclei were all eccentric, and mostly had coarse granules and prominent nucleoli.

A Case Report of Pulmonary Hamartoma with False Positive in Cytology

A 62year-old man visited our institute with a coin lesion on chest film. By sputum cytology by Saccomannos method (modified by Sato) atypical cells in cluster were found with following characteristics; Abundant cytoplasm with vacuoles, large round nuclei which are deviated in part, lots of chromatin, and one round nucleoli. Also in the bronchial brushing smear, atypical cells were found in sheets.Right lower lobectomy under the diagnosis of lung cancer revealed that the lesion was pulmonary hamartoma. The pathological examination showed that the tumor was surrounded by the monolayer cuboidal epithelium. And atypical proliferation was noted in the epithelium.The origin of atypical cells was discussed in cytological and histological point of view.