Tadashi Yabana

Adenocarcinoma arising in a tailgut cyst: report of a case.

We report herein the unusual case of a 66-year-old woman found to have adenocarcinoma arising in a tailgut cyst. The patient had been observed for 6 months following the discovery of a presacral cystic mass measuring 10×9 cm for which she had refused surgery. The serum tumor marker, carcinoembryonic antigen, became slightly elevated, and diagnostic imaging distinctly revealed a tumorous lesion with papillary projection into the cyst lumen. The cystic mass was then excised through the transsacral approach. The pathological findings were compatible with moderately differentiated adenocarcinoma arising in a tailgut cyst. This entity is extremely rare, and only six cases, including our own, have been reported in the English literature. Early complete excision is advised because it is almost impossible to determine for certain whether presacral cystic masses are benign or malignant prior to surgery.

A case of mixed acinar-endocrine carcinoma of the pancreas discovered in an asymptomatic subject.

SummaryA 50-yr-old Japanese man was found to have a hypoechoic mass 3 cm in diameter in the pancreatic head on an ultrasonography (US) examination without symptoms. A computed tomography (CT) scan demonstrated a 3-cm solid mass in the pancreatic head, and it was more clearly delineated as a low-density area on enhanced CT. Angiography showed a tumorlike stain, 3 cm in size, in the pancreatic head. The preoperative diagnosis was “special type of pancreatic tumor such as acinar cell carcinoma or non-functioning islet cell tumor.” The patient was treated by pylorus-preserving pancreatoduodenectomy. Histological, immunohistochemical, and electron-microscopic studies of the surgical specimen led to a definitive diagnosis of a mixed acinar-endocrine carcinoma. The patient is currently well, with no signs of tumor recurrence, 18 mo after the operation. Our search of the Japanese and English-language literature retrieved only 15 welldocumented cases of mixed acinar-endocrine carcinoma. Imaging in the reported cases revealed features of either acinar cell carcinoma or islet cell tumor, or both, which can may be detected even in small tumors more easily than conventional invasive ductal carcinoma of the pancreas because the detectability of this rare tumor on US and CT seems to be good.

Reliability of Cytological Grading of Prostatic Carcinoma Compared with Histological Grading

Thirty prostatic carcinomas diagnosed simultaneously by fine needle aspiration cytology and punch biopsy were graded into three groups according to their cytological and histological appearances. Among them 23 carcinomas were graded equally by both methods. Cytological examination appears to be suitable for grading prostatic carcinoma, thus being a possible indicator of the patients prognosis and response to hormonal therapy. In addition to the results obtained here, fine needle aspiration cytology has many advantages such as simplicity, quickness and safety. With increase of attention of urologists and pathologists to fine needle aspiration cytology, this evaluation will become comparable to the histological examination not only as a routine diagnostic tool.

Epithelia in both seminal vesicles and ejaculatory ducts as a pitfall in the cytologic diagnosis of prostatic carcinoma.

前立腺穿刺吸引細胞診で偽陽性の原因のひとつである精嚢上皮系の細胞について検討した.材料は前立腺穿刺吸引細胞診31症例, 術中迅速細胞診1症例および剖検時精嚢塗抹細胞診47症例を使用した.40歳以上の症例における精嚢上皮系細胞は, 核の大小不同が顕著で, クロマチン量が多く, クロマチンは粗顆粒状で, 核内に不均等に分布する細胞がみられるが, 同時に細胞質内色素顆粒・核内細胞質封入体, 核形不整, 核皺襞形成がみられ, 核小体は不明瞭なことが多い.前立腺腺癌細胞には細胞質内色素顆粒や核内細胞質封入体は認められないので, 異型細胞を注意深く観察すると, これら両者の鑑別は可能と考えられ, 精嚢上皮系細胞の混入に起因した偽陽性や疑陽性率の低下が期待される.