Setsuo Sugishima

Scrape cytology of oral pemphigus. Report of a case with immunocytochemistry and light, scanning electron and transmission electron microscopy.

BACKGROUND Pemphigus vulgaris is a disseminated disease of the skin and mucous membranes characterized by recurrent vesicular and bullous lesions due to the autoantigen belonging to the cadherin type of cell adhesion molecules. The presence of acantholysis associated with immunoglobulins in the intercellular spaces and on the cell membrane are diagnostic features. However, the appearance of smears from the oral cavity by scanning (SEM) and transmission electron microscopic (TEM) study as well as immunocytochemistry of cadherin does not appear to have been previously reported. CASE A 67-year-old female developed erosion on her gingiva with severe pain. On oral examination, there were ulcerations on the palate, and the Nikolsky sign was positive. The characteristic cytologic findings from oral scrapes were high cellularity, a bloody background and a predominant cell population consisting of polygonal basal and parabasal cells with pronounced nucleoli. Also present were degenerative cell changes: e.g., cytoplasmic vacuoles and a homogeneous nuclear appearance. Immunocytochemical staining for IgG and cadherin gave a positive reaction in the intercellular spaces and on the cell membranes. The surface of cells in pemphigus vulgaris by SEM showed somewhat irregularly distributed microridges, and TEM revealed desmosomal attachments, degenerated tonofilaments with pronounced nucleoli and heterochromatin. As a result of cytodiagnosis, additional appropriate specimens were obtained at the time of the scraping for confirmatory immunocytochemistry for cadherin, SEM and TEM studies. CONCLUSION The results demonstrate that a precise diagnosis of pemphigus vulgaris can be rendered on cellular material and cadherin immunocytochemistry obtained by scrape from the oral mucosa.

Quantitative image analysis of nuclear chromatin distribution for cytological diagnosis.

Objective: We previously reported on the classification of the nuclear chromatin distribution into 3 types, that is peripheral (P), mixed (M) and central (C), which were related to the malignancy of cervical glandular lesions. However, the classification was subjective as it was performed by visual assessment. In the present study, quantitative assessment of nuclear chromatin distribution using image analysis by computer was applied for objective classification of cervical squamous epithelial lesions, which are the most common cervical lesions. Study Design: A total of 130 cells (44 cells of type P, 78 of type M and 8 of type C) from cytological specimens of cervical squamous epithelial lesions (dysplasia, squamous cell carcinoma) were analyzed. An image analysis program was developed as a plug-in macro program of an existing image processing software. The radial distribution (RD) value, which represents the gradient of the staining intensity from the center to the edge of a nucleus, was defined as an index of the chromatin distribution. Results: The RD values calculated in type P, type M and type C cells showed significant statistical differences as assessed by the t test (p < 0.001). Conclusions: Quantification of the nuclear chromatin distribution by image analysis is fast and highly objective. The RD value could be useful as an index for malignancy.

Endometrial metaplasia: correlation of histological and cytological specimens obtained from 103 cases undergoing hysterectomy for endometrial carcinoma

To assess the frequency of endometrial metaplasia in histological and cytological specimens from the same cases, and to determine the relationship between various types of metaplasia and clinicopathological findings.

Diagnostic value of squamous cell change associated with endometrial carcinoma: A cytopathologic approach.

To determine the frequency of squamous cell change associated with endometrial carcinoma, to evaluate the relationship between squamous cell change and clinicopathological features, and to assess cytological findings for squamous cells with and without nuclear atypia in endometrial smears.

Serum starvation induces abnormal spindle location, RhoA delocalization, and extension of intercellular bridge with the midbody

Abstract Serum starvation induces binucleation in HeLa cells, but the effects of serum starvation on mitosis and the significance of binucleation remain unknown. We investigated the effect of serum starvation on mitosis and analyzed the growth of binucleated cells. The frequency of binucleation caused by cytokinesis failure in DMEM without FBS (0% medium) was higher than that in DMEM with FBS (10% medium). In 0% medium, the metaphase spindle location was off-center, and RhoA localization significantly lacked symmetry. The frequency of the extension of intercellular bridge with the midbody in 0% medium was significantly higher than that in 10% medium. Moreover, all mononucleated mitotic cells caused bipolar mitosis and produced only mononucleated daughter cells, but binucleated cells produced various nucleated cells by multipolar mitosis in 0% medium. These results suggest that serum starvation may have various effects on mitosis, and binucleated cells may be related to formation of aneuploidy. RhoA localization in two different media.

Identification of intranuclear inclusions is useful for the cytological diagnosis of ovarian clear cell carcinoma

The aim of this study was to clarify the diagnostic significance of the presence of intranuclear inclusions in clear cell carcinoma (CCC).

A study of cluster configuration in breast tumor of aspiration cytology.

目的: 乳腺穿刺吸引細胞診において良悪性の鑑別を正確に行うために良性および悪性腫瘍のおのおのの細胞集塊形の特徴について検討した.対象: 乳頭腺管癌16例 (356 clusters), 線維腺腫15例 (251 clusters) の乳腺穿刺吸引細胞標本を用いた.成績:細胞異型の乏しい乳頭腺管癌の集塊の縦横比は1に近く, 形状は多分岐状で, 個々の細胞の突出による凹凸を有する輪郭を形成していた. 細胞重積性による半島状に突出した複雑形状となるものもみられた. 一方, 線維腺腫の細胞集塊形状は直線的に長いものと滑らかな曲線からなり, 円形に近いものがみられた. 集塊形は集塊内の細胞重積性の有無とその分布と関連し, 複雑な輪郭を来たす機序が異なっていた. 線維腺腫では集塊の辺縁部に重積性を伴い, 核間距離の不整が多くみられた. 一方, 乳頭腺管癌では細胞集塊の中心部から辺縁部にかけて重積性がみられたが, 辺縁部においては比較的重積性は少なく個々の細胞の結合性の不均一性から生じた, 複雑な輪郭を形成していた.結論: 今回の検討により, 良性ならびに悪性腫瘍細胞集塊形状に特徴があることが明らかになり, 乳頭腺管癌では細胞集塊の大きさに依存しない集塊形状が明らかになった.細胞異型の乏しい乳腺腫瘍の細胞診の診断に際しては, 個々の細胞の所見に加え, 細胞集塊形状に注意を払うことにより, より正診率を高めることが期待できる.

A case of basal cell epithelioma of the breast cytologically suspected ductal carcinoma.

乳腺の穿刺吸引細胞診にて乳管癌が疑われた乳房部原発基底細胞上皮腫の1例の細胞像について報告した.症例は65歳, 女性, 右乳房C領域に1.5×1.5cmの腫瘤が認められ10年来大きさは不変であった.Mammography, 超音波などの画像診断にて乳管癌が疑われ外来受診時に穿刺吸引細胞診が施行された.細胞診所見は出血像を背景に腫瘍細胞は大小の結合性の強い細胞集塊で出現し, 細胞の配列は不均等で細胞の重積性が認められた.核は類円形小型で核クロマチンの増量がみられ, 乳管癌も否定できず術中迅速病理組織診断が行われた.病理組織にて基底細胞上皮腫と診断された.基底細胞上皮腫の一般的な細胞学的所見としては大小の細胞集塊での出現, 細胞は小型類円形で大小不同性に乏しく, 細胞集塊の辺縁に柵状配列が認められることであると思われるが, 乳房部に発生する基底細胞上皮腫は非常にまれであり, 本症例では術前の穿刺吸引細胞診での確定診断は困難であった.

A case of the primary urethral malignant melanoma with an appearance of tumor cells in urine.

尿中に腫瘍細胞が出現した男子尿道原発悪性黒色腫について報告した.症例は64歳男性で尿道球部に発生した悪性黒色腫であった.尿細胞診では腫瘍細胞は孤立散在性に出現し, 一部疎な結合を示す集塊で出現した細胞では移行上皮癌細胞との鑑別が困難であったが, 少数の細胞には明らかなメラニン顆粒が認められた.これら尿中の腫瘍細胞は免疫組織化学染色においてS-100蛋白が陽性を示し, 摘出腫瘤の病理組織標本ではMasson-Fontana染色陽性, 鉄染色陰性, 免疫組織化学染色ではS-100蛋白陽性さらにNSE (Neuron-specifi cenorase) も陽性であった.また, 電顕にて腫瘍細胞の細胞質に多数のmelanosomeが確認された.

A case of pemphigus vulgaris diagnosed by cytology.

尋常性天庖瘡の1例を報告した. 症例は38歳男性で, 口腔粘膜の発赤・びらんを主訴とし, 臨床的に多形性滲出性紅斑が疑われ, 口腔粘膜擦過細胞診が施行された. 多数の労基底～ 中層細胞に類似した異型細胞が孤立散在性あるいは平面的な細胞集塊で出現し, 核の腫大, N/C比の増加と単～3, 4個の著明な核小体を特徴とした. しかし核内は明るく核クロマチンの増加は認められなかった. これらの細胞は尋常性天庖瘡に出現するいわゆるTzanck cell (Acantholytic cell) に相当する細胞と考えられた. また, 免疫螢光抗体直接法にて口腔粘膜表皮有棘細胞間にIgGの沈着が認められ, 血中のIgG, IgA値も軽度上昇していた.