Kiyomi Terayama

Solitary fibrous tumor of the spinal cord : Report of a case with scrape cytology

BACKGROUND Solitary fibrous tumor is a rare spindle cell tumor and has been forced at a variety of sites. To the best of our knowledge, only two cases of solitary fibrous tumor arising in the spinal cord have been reported; no cytologic findings were documented. CASE A 62-year-old male presented with a spinal cord tumor. A scrape smear of the resected tumor revealed naked, spindle-shaped nuclei. Some nuclei were twisted or had long spindles. In the background, abundant, thin and thick collagen fibers were present. Immunohistochemically, the spindle cells were positive for CD34 and negative for S-100 protein and alpha-smooth muscle actin. Histologic diagnosis of the tumor was benign solitary fibrous tumor. CONCLUSION Our case indicates that solitary fibrous tumor can occur in the spinal cord and should be differentiated from other benign spindle cell tumors, such as meningioma and schwannoma. The key cytologic features of solitary fibrous tumor may be the presence of abundant thin and thick collagen fibers in scrape specimens.

Sarcomatoid renal cell carcinoma with chromophobe cell foci

We report a case of sarcomatoid renal cell carcinoma with chromophobe cell foci. The patient was a 57‐year‐old Japanese woman with a renal mass measuring 12×8×8 cm in diameter. Histologically, the tumor was composed predominantly of sarcomatoid renal cell carcinoma with foci of chromophobe cell carcinoma. The patient died of multiple metastases 2 months after operation. To the best of our knowledge, there have been only two reports of the coexistence of sarcomatoid renal cell carcinoma and chromophobe renal cell carcinoma in the literature. Our case indicates that chromophobe cell carcinoma may be connected with sarcomatoid renal cell carcinoma. In such a case, the prognosis may be related to the latter component.

Sclerosing lipogranuloma of the scrotum : Report of a case with fine needle aspiration biopsy findings

BACKGROUND Sclerosing lipogranuloma of the scrotum is a rare granulomatous lesion of the subcutis. To the best of our knowledge, there have been no English-language reports dealing with its cytologic findings. CASE A fine needle aspiration specimen from a mass in the scrotum in a 62-year-old male showed epithelioid cells, multinucleated giant cells and fibroblasts, which were suggestive of sclerosing lipogranuloma. The diagnosis was confirmed by histology of the resected specimen. CONCLUSION Fine needle aspiration cytology is useful for the diagnosis of sclerosing lipogranuloma. It is important, however, to interpret the fine needle aspiration cytology specimen in conjunction with the clinical information.

Macrofollicular variant of papillary thyroid carcinoma. Report of a case with fine needle aspiration biopsy findings.

BACKGROUND Macrofollicular variant of papillary thyroid carcinoma is defined as a combination of numerous macrofollicles occupying 50% of the tumor and foci of the conventional follicular variant of papillary carcinoma. To the best of our knowledge, there have been no English-language reports on its cytologic findings. CASE A fine needle aspiration specimen from a mass of the thyroid in a 59-year-old female showed a large collection of dense, inspissated colloid and a few sheets of tumor cells with nuclei characteristic of papillary carcinoma. There were no three-dimensional, branching papillae with fibrovascular cores. CONCLUSION Although macrofollicular variant of papillary carcinoma is very rare, fine needle aspiration cytology may contribute to its correct diagnosis.

Nasal NK/T cell lymphoma presenting as transverse myelopathy

Abstract A case of nasal NK/T cell lymphoma with central nervous system (CNS) involvement is reported. A 56-year-old man presented with eyelid edema and transverse myelopathy. Cerebrospinal fluid examination revealed atypical lymphoid cells with azurophilic granules, which were positive for CD2, CD8, and CD56, and negative for CD3 and CD5 by flow cytometry. Because a tumor mass was found involving the ethmoid and maxillary sinuses, CNS involvement was considered to have resulted from local invasion by the nasal lymphoma. In spite of intensive chemotherapy including intrathecal infusion, the patient died 6 months after the initial diagnosis. Autopsy revealed that lymphoma cells were positive for cytotoxic molecules, granzyme B and TIA-1, and EB virus-encoded RNA-1 (EBER-1), and they showed no rearrangement of TCR-β, -γ, or -δ genes, suggesting an NK-cell origin of the lymphoma cells. They showed an angiocentric and angiodestructive pattern in the subarachnoid space, focally extending to the cerebral cortex and cranial and spinal nerve roots. Marked demyelination was found in the lateral and posterior funiculi of the spinal cord. Thus, the pathogenesis of this spinal demyelination might be attributed to ischemia secondary to angiocentric and angiodestructive infiltration by lymphoma cells.

Sertoli cell tumor of the testis. Report of a case with imprint cytology findings.

BACKGROUND Sertoli cell tumor of the testis is a relatively rare neoplasm, and few reports concerning its cytologic findings have been previously documented. CASE A 41-year-old male had Sertoli cell tumor in the left testis. An imprint smear revealed tumor cells showing a less cohesive or singly dispersed cell pattern. The cytoplasm was faintly stained, and most tumor cells were naked. The nuclei were oval or short and spindle in shape, and some of them showed coffee bean nuclei or nuclear indentation. CONCLUSION Coffee bean nuclei can be observed in Sertoli cell tumor.

Sarcomatoid renal cell carcinoma with chromophobe cell component.

色素嫌性腎細胞癌成分を伴った肉腫型腎細胞癌の1例を報告する. 患者は57歳の女性で, 右腎臓に12×8×8cm大の腫瘤が認められたため, 腎摘除術が行われた. 摘出された腫瘤の捺印細胞診では, 異型性に富む紡錘形細胞と核周囲明量や明瞭な細胞境界を特徴とする多稜形細胞の二種類の腫瘍細胞が観察された. 組織学的には腫瘍のほとんどは肉腫型の腎細胞癌で占められており, 一部に色素嫌性腎細胞癌の成分が存在した. 患者は腎摘除術から2ヵ月後に多発性の転移と癌性腹膜炎のため死亡した. 他の組織型よりも予後良好といわれている色素嫌性腎細胞癌が予後不良の肉腫型腎細胞癌に合併した症例の細胞像に関する報告はわれわれの調べた限りなく, 本例はきわめてまれな症例である.

A Proposed Methodology for Evaluating Secondary Screening (Rescreening) Instruments for Gynecologic Cytology

The potential benefit of these devices is that they may increase the overall sensitivity of any one gynecologic cytology screening event by detecting the presence of possible abnormal cells missed upon primary screening. Because primary screening (i.e., first-time examination of a slide) is not 100% sensitive, rescreening is used to detect these false negatives. Secondary screening devices are intended to focus manual rescreening on slides that are more likely to harbor missed abnormalities than on slides selected randomly. Secondary screening instruments may be used in place of or in addition to secondary manual rescreening.