Rinya Sato

Clinicopathologic relevance of asymptomatic endometrial carcinoma.

OBJECTIVE To assess whether screening asymptomatic women is significant for early detection of endometrial carcinoma. STUDY DESIGN We compared the clinicopathologic findings and prognoses of 21 asymptomatic patients with 427 symptomatic patients with endometrial carcinoma. RESULTS The incidence of asymptomatic endometrial carcinoma was 4.7%. Nineteen of 21 asymptomatic patients with endometrial carcinoma were found by cytologic screening for endometrial cancer. There was a statistical difference in the histopathology and depth of myometrial invasion between the asymptomatic and symptomatic groups. However, no statistical differences were found in tumor grade, lymph node metastasis, adnexal metastasis, cervical invasion, peritoneal cytology, surgical stage and patient age. Univariate analysis showed that the presence or absence of symptoms was not related to survival. CONCLUSION The detection of asymptomatic endometrial carcinoma is not related to a reduced mortality rate. Screening asymptomatic women for endometrial carcinoma is not recommended.

Primary squamous cell carcinoma of the endometrium.

A rare case of primary squamous cell carcinoma of the endometrium, probably originating from adenomyosis, is presented. A 58-year-old Japanese woman was referred to Kitasato Institution Medical Center Hospital to explore the cause of her postmenopausal bleeding. The endometrial cytology specimen obtained with the Endocyte (an device for endometrial check up) showed cells suggesting well differentiated squamous cell carcinoma. The patient underwent modified radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy, followed by postoperative radiation therapy. The dissected uterus revealed keratinizing-type squamous cell carcinoma localized in the fundal portion of the uterine body and invading deeply into the myometrium, coexistent with a large area of adenomyosis with a transitional area to carcinoma. The residual endometrium was atrophic. There was no atypical finding in the cervix. Human papilloma virus DNA was not detected. The carcinoma recurred 26 months after the surgery, and the patient died of the disease.

Androgen-producing ovarian tumors: a clinicopathological study of 3 cases.

The clinical course and pathological findings of 3 rare cases of androgen‐producing ovarian tumors are presented. The ages of the 3 patients (Cases 1, 2, and 3, respectively) were 43, 34, and 57 years, respectively. Their preoperative serum testosterone levels were 506, 491, and 231 ng/dl, respectively. The pathological diagnoses of Cases 1, 2, and 3 were a Sertoli‐stromal cell tumor of intermediate differentiation, a stromal tumor containing Leydig cells, and a stromal tumor with minor sex cord elements, respectively. Patient 1 experienced a recurrence, of a lesion at the vaginal stump 1 year and 2 months after the initial surgery. The clinical courses of Cases 2 and 3 have been non‐contributory.

Secondary acute leukemia following chemotherapy for ovarian cancer: report of five cases

Abstract Five patients who developed leukemia after chemotherapy for ovarian cancer are reported. All patients received the platinum analogue cyclophosphamide, a known leukemogen. In two patients, the leukemia was diagnosed after second-line chemotherapy with carboplatin, cyclophosphamide, and pirarubicin hydrochloride following intraperitoneal chemotherapy that included etoposide. Four patients had acute nonlymphocytic leukemia. The latency period was 16–63 months. Chromosomal analysis was performed in four patients and partial deletion of the long arm of chromosome 6, partial deletion of the long arm of chromosome 7, and multiple abnormalities were observed in all four. Remission of leukemia was not experienced; three patients died of leukemia and two died of primary ovarian cancer.

Ovarian stromal Leydig cell tumor with prominent crystalloids of Reinke. Report of a case.

多数のReinke crystalを有する卵巣間質性ライディク細胞腫を経験したので, その組織所見と捺印細胞所見を報告する.組織学的には, 線維腫様の腫瘍組織の中に, 好酸性の豊富な細胞質と多数のReinke crystalを有するライディク細胞が, 島状に増生していた. また, 小範囲の粘液性腺腫を合併していた. 捺印細胞診標本上に出現した細胞は,(1) 結合性が粗で, N/C比の高い長円形の核を有する紡錘状の細胞,(2) ライトグリーンのやや豊富な細胞質と類円形の核を有し, 重積性ある集塊を形成する細胞,(3) 核が偏在し, 柵状配列を示す細胞, の3種類である.(2) の細胞集塊の中にオレンジGに好染する細長い結晶 (Reinke crystal) が多数出現していた.