Eri Ishii

Fine needle aspiration cytology of an intraductal papilloma originating in a sublingual gland : A case report

BACKGROUND Intraductal papilloma of the salivary gland is a very rare tumor; only eight cases have been reported to date. Only histopathology has been used to investigate this tumor to our knowledge. There has not been any reported case of this tumor in a sublingual gland. CASE A 3-cm oral floor mass with a lanulalike lesion in a 72-year-old female was aspirated. The cytologic features included various cellular smears containing compact clusters of papillary, radial, palisading, trabecular, tubular and buddinglike projected patterns; monomorphic columnar cells with oval-to-spindle nuclei basally located; abundant, finely vacuolar cytoplasm; indistinct nucleoli; and no squamous differentiated cells. A sublingual glandectomy was performed. Cytology, histology, immunohistochemistry and electron microscopy were performed with standard methods. The intraductal papilloma seems to have arisen within an excretory duct and differentiated into acinar cells. CONCLUSION The cytologic findings of intraductal papilloma are unique and may allow its specific diagnosis on fine needle aspiration.

Cytological features of atypical carcinoid combined with adenocarcinoma of the uterine cervix

Neuroendocrine tumors of the uterine cervix (UC) are rare, and atypical carcinoid (AC) combined with adenocarcinoma of the uterine cervix (ACAUC) is particularly rare. Only the histopathology has been investigated in the English literature. A 49‐year‐old female with a polypoid lesion of the UC visited Yamanashi Prefectural Central Hospital. Scraping cytology, biopsy, and hysterectomy was performed. EC smears showed solid, rosette, honeycomb, true tubular, and trabecular clusters. Solid clusters were oval, thin edge, delicate, small‐large nuclei, pale, granular, scant, nothing, and well‐preserved (though ill‐defined border) cytoplasm. Rosette clusters were eccentric, oval nuclei, mixture of coarsely granular chromatin and euchromatin, and cyanophilic luminal content. Solid and rosette clusters impress AC. Honeycomb clusters involved a clearly defined border and translucent mucin. True tubular clusters were oval nuclei of fine chromatin or euchromatin, thick cytoplasm, and orange luminal content. Honeycomb and true tubular clusters suspected adenocarcinoma. Trabecular clusters were fusiform, columnar, cuboidal, and polygonal cell shapes of small, monotonous nuclei, and contained coarsely granular chromatin with occasionally intracytoplasmic translucent mucin and were difficult to differentiate typical carcinoid and adenocarcinoma. Histology was AC combined with adenocarcinoma. The aim of this study was to investigate the cytological characteristics of ACAUC. Diagn. Cytopathol. 2012.

Case of myoepithelioma originating from the palate: Collagenogenesis in myoepithelial tumor cells

We report a case of myoepithelioma of the palate in a 53‐yr‐old man. Myoepithelioma cells consisting of both plasmacytoid type and spindle type were obtained. A reticular pattern composed of a mosaic arrangement of hyaline‐like abundant cytoplasm, and scant matrix and considerable fiber formation were characteristic features of the plasmacytoid type; granular cytoplasm and a snake‐like shape were characteristic features of the spindle type. These are important points in differentiating this tumor from cellular type pleomorphic adenoma. The present study shows that tumorous myoepithelial cells can synthesize and secrete extracellular components such as proteoglycans, basal lamina, collagen fibers, and elastic fibers. Diagn Cytopathol 1996;15:415–420.

Differential diagnosis of well-differentiated squamous cell carcinoma from non-neoplastic oral mucosal lesions: New cytopathologic evaluation method dependent on keratinization-related parameters but not nuclear atypism: KERATINIZATION IN ORAL CANCER CYTOLOGY

The cytology of oral squamous cell carcinoma (SCC) is challenging because oral SCC cells tend to be well differentiated and lack nuclear atypia, often resulting in a false negative diagnosis. The purpose of this study was to establish practical cytological parameters specific to oral SCCs.

Cytologic study of pancreatic mucinous cystadenocarcinoma.

膵の粘液性嚢胞腺癌を1例経験し, その細胞像を検討した. 症例は35歳女性, 主婦. 左季肋部痛, 左背部痛出現. 超音波検査にて膵尾部に中心低エコー領域を示す大きな腫瘤があった. エコー下吸引細胞診では出現パターンが多彩で, シート状, 柵状, 乳頭状配列があり, これらは相互に移行していた. すなわち, シート状配列は密で1～6層の円柱状細胞からなり, 表面に細網状の赤色物質がみられた. また小型で良性にみえる細胞からなるシート状集団もあった. 柵状配列は淡緑色の高円柱状細胞からなり, 核偏在や核の重畳化がみられた. 乳頭状配列は細胞境界が明瞭で, 核のくびれや陥入像が顕著であった. 以上の細胞像および画像所見より粘液性嚢胞腺癌の診断のもとに膵体尾部脾切除術施行. 摘出腫瘍は11×10×8cmで, 組織学的には粘液性嚢胞腺癌であった. 術後10年経過の現在まで再発はない. また本例のような粘液性嚢胞腺癌と膵管内乳頭腺癌や粘液産生が目立つ管状腺癌との鑑別についても考察した.

A case of polymorphous adenocarcinoma originating from parotid gland. A cytological study.

耳下腺原発のpolymorphous adenocarcinomaの1例を報告する.症例は57歳男性で左耳下部に腫瘤を触知し, その後急速に増大し, 腫瘤を摘出するも再発を繰り返し肺転移を併発して死亡した.術中の細胞診では円-卵円および紡錘形の核からなる多数の腫瘍細胞が孤立散在性または集団で出現し, 孤立性の細胞はすべて裸核状であり, 紡錘形核の細胞は束状に配列していた.細胞質の保たれているところでは腺管形成と粘液様球体が認められた.核はいずれも小型から中型で約10μ 前後と大小不同に乏しく, 核形の不整も認められなかったが, 明瞭なnuclear clearingと赤い円形核小体がみられ, 悪性が示唆された.病理組織学的には明るい細胞質と円-卵円形核の腫瘍細胞が充実性に増殖し, その中に腺管-小嚢胞形成や肉腫様の配列がみられpolymorphous adenocarcinomaと診断された.

A cytological study on two cases of meningioma with chest metastasis.

2例の髄膜腫の頭蓋外転移巣を臨床細胞学的に検討した. 症例1は髄膜上皮型髄膜腫, Grade I で肺転移を伴っているものの, 細胞学的には渦紋状の配列を示す腫瘍細胞が集団をなしてみられ, 核には悪性細胞としての特徴に乏しかった. 症例2は髄膜上皮型髄膜腫, Grade III (狭義の悪性髄膜腫) で胸壁に転移を伴っていた. 細胞学的に, 腫瘍細胞は多面形または紡錘形で細胞質に富み, N/C比はあまり高くないものの, 核が大きく, 核小体も顕著であり, 悪性の非上皮性腫瘍が疑われた. 本例は再発を繰り返し, 発症から13年後に全身転移をきたし, 死亡した. 以上の2症例はいずれも頭蓋外の胸部に転移を伴った髄膜上皮型髄膜腫であるが臨床的に, また臨床細胞学的に相違が認められた.