金子 千之

Helicobacter pylori (H. pylori) is a very important pathogenic bacteria associated with many upper gastrointestinal diseases including chronic active gastritis, chronic inactive gastritis, gastric and duodenal peptic ulcer disease, gastric MALT lymphoma, and gastric adenocarcinoma. There are no distinct endoscopic patterns of chronic H. pylori gastritis. The diagnosis of H. pylori gastritis is made by pathologic examination of gastric mucosal biopsies or by the detection of urease in mucosal specimens using the CLO test or urea breath test.  H. pylori infection has been diagnosed based on the histological laboratory procedure and indirectly from a background gastric-mucous-membrane view. Alcian Yellow Touidine Blue staining is available and useful as one of the diagnostic methods.

Objective: We previously reported that oral administration of the selective cyclooxygenase-2 (COX-2) inhibitor etodolac results in antitumor effects in endometrial cancer tissue. Herein, we investigated whether these antitumor effects could be assessed using endometrial cytological findings. Study Design: Etodolac (400 mg b.i.d. for 2 weeks) was administered preoperatively to 21 endometrial cancer patients: 16 had COX-2-positive disease and 5 had COX-2-negative disease. Twenty-one pairs of pre- and post-etodolac-treatment endometrial cytological samples were collected to review changes in the cytological features. Results: In the COX-2-positive patients, nuclear atypia was slightly decreased in 3 of the 16 cases, while the mitotic index was decreased in all cases. Cellular overlapping and tumor cell cluster outlines were somewhat affected in 6 and 8 cases, respectively. Nuclear/cytoplasmic ratio, anisokaryosis and hyperchromasia were also reduced in 6, 4, and 2 cases, respectively; however, tumor diathesis and nucleoli features were unchanged. In contrast, endometrial cytological features did not appear to be affected in the 5 COX-2-negative patients. Conclusions: We conclude that the antitumor effects observed in endometrial cancer tissues following oral administration of etodolac are reflected in and can be easily assessed by evaluating endometrial cytological features. Copyright (c) 2012 S. Karger AG, Basel

Objective: We previously reported that oral administration of the selective cyclooxygenase-2 (COX-2) inhibitor etodolac results in antitumor effects in endometrial cancer tissue. Herein, we investigated whether these antitumor effects could be assessed using endometrial cytological findings. Study Design: Etodolac (400 mg b.i.d. for 2 weeks) was administered preoperatively to 21 endometrial cancer patients: 16 had COX-2-positive disease and 5 had COX-2-negative disease. Twenty-one pairs of pre- and post-etodolac-treatment endometrial cytological samples were collected to review changes in the cytological features. Results: In the COX-2-positive patients, nuclear atypia was slightly decreased in 3 of the 16 cases, while the mitotic index was decreased in all cases. Cellular overlapping and tumor cell cluster outlines were somewhat affected in 6 and 8 cases, respectively. Nuclear/cytoplasmic ratio, anisokaryosis and hyperchromasia were also reduced in 6, 4, and 2 cases, respectively; however, tumor diathesis and nucleoli features were unchanged. In contrast, endometrial cytological features did not appear to be affected in the 5 COX-2-negative patients. Conclusions: We conclude that the antitumor effects observed in endometrial cancer tissues following oral administration of etodolac are reflected in and can be easily assessed by evaluating endometrial cytological features. Copyright (c) 2012 S. Karger AG, Basel

We present a case in which a primary cytodiagnosis of Langerhans cell histiocytosis (LCH) of the skull was made using squash preparations. The patient, a 25-year-old male, presented with raised intracranial pressure and decreased visual acuity. Magnetic resonance imaging revealed a large skull lesion with osteolytic features in the left frontal bone. The patient underwent surgical resection by the extended basal frontal epidural approach. The squash preparation smears were cellular and demonstrated a mixed population of small, mature lymphocytes, eosinophils, and a high histiocytes content. The histiocytes occurred as isolated or loosely cohesive and clustered. They possessed abundant cytoplasm with rounded cell shape and had characteristic nuclear features, composed of fine chromatin and delicate nuclear membranes. The cytologic features of these histiocytes were consistent with Langerhans cells (LCs). A final impression of LCH of the skull was rendered. Subsequent histopathology confirmed the diagnosis. LCs reacted with both S-100 protein and CD1a immunohistochemically. The demonstration of Birbeck granules on electron microscopic study was also noted. Whenever squash preparation yields a mixed population of mature lymphocytes, eosinophils, and histiocytes, the cytologists should be aware of and consider LCH as a diagnostic possibility.

The cytologic appearance of endosalpingiosis in peritoneal fluid cytology smears has not been extensively described. We report a case of endosalpingiosis in a 29-year-old pregnant female who presented with peritoneal fluid. Dense papillary epithelial clusters with indistinct ciliated cells were found in the Papanicolaou-stained smears. However, long and delicate cilia were obvious in papillary cluster with scanning electron microscopy. Cell nuclei were oval, with finely dispersed chromatin and uniform nuclear membrane. Peritoneal fluid cytology with these findings may be helpful to suggest the probable preoperative diagnosis of endosalpingiosis or benign glandular inclusions involving the pelvic peritoneum. (C) 2004 Wiley-Liss, Inc.

背景:子宮頸部癌としてはきわめてまれな組織型である明細胞腺癌を経験したので報告した.<BR>症例:77歳, 女性. 4年前に不正出血を認め当院産婦人科を受診したが, 異常所見はみられなかった. その後, 再び不正出血を認め再受診. 初診時, 子宮口にポリープ状の腫瘤を認め, 擦過細胞診が行われた. 細胞診標本には大型明瞭な核小体を有する腫瘍細胞が立体的集塊 (ミラーボール状, 棍棒状) あるいは花弁様小集塊を形成して観察された. また, この細胞集塊内部および中心部にはライトグリーン好性の無構造物質が認められた. 以上の所見から悪性 (子宮頸部明細胞腺癌) と診断された. 入院後, 準広汎子宮全摘術およびリンパ節廓清術が施行され, 組織学的に子宮頸部明細胞腺癌と診断された.<BR>結論:乳頭状増殖を主体とする明細胞腺癌では集塊内部にライトグリーン好性の無構造物質 (基底膜様物質) を有する立体的集塊 (ミラーボール状, 棍棒状), あるいは花弁様小集塊など本型の増殖形態を推定可能な集塊が認められた. したがって, このような集塊がみられた場合は明細胞腺癌を組織型推定する必要があると思われた.

Our objective was to determine the applicability of the cell transfer and cell block methods using Mount Quick (Daido Sangyo, Saitama, Japan) mounting medium (MQ) for hematoxylin-eosin (H & E) and immunohistochemical staining of several limited amounts of biological materials in slide preparations. The materials investigated were histopathologically confirmed malignant mesotheliomas (pleural effusions) and malignant lymphomas, a malignant melanoma, and an amelanotic melanoma in sealed slides. Monoclonal antibodies against carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), cancer antigen 125 (CA-125), vimentin, thrombomodulin (TM), cytokeratin, UCHL-1, L-26, melanoma-specific antigen (HMB45), and S-100 protein (S-100) were applied in the investigation. The malignant melanoma and amelanotic melanoma materials stained strongly for HMB45 and S-100. Cell transfer employing MQ is a suitable approach for immunohistochemical investigations of limited materials. In addition, cell blocks derived from MQ-embedded smears can be used for both H & E and immunohistochemical staining. (C) 2000 Wiley-Liss, Inc.

OBJECTIVE: To determine the significance of the presence of mast cells in Warthin's tumor by evaluating the occurrence of these cells in cellular and immunohistochemical preparations. STUDY DESIGN: Specimens derived from five cases of FNAC were examined. A total of four slides fi om five cases were prepared from each: two air-dried smears were stained with May-Grunwald-Giemsa (MGG) stain and two with Hansel's stain. The other two were alcohol fixed and stained using the Papanicolaou method. The smears were evaluated for the presence of mast cells, especially associated with oxyphilic cells. In order to investigate the location of mast cells, we also counted those using cells by means of immunohistochemistry using anti-mast cell monoclonal antibody AA1. RESULTS: The Hansel-stained cellular sample from Warthin's tumor contained numerous mast cells, associated mainly with large, oxyphilic cell sheets. The number of AA1-positive cells (mast cells) stained with immunohistochemistry was greater in epithelial component than in lymphoid stroma. CONCLUSION: Mast cells in a salivary gland aspirate might be indicative of Warthin's tumor; therefore, MGG-stained slides offer the advantage of ease of preparation, particularly when the typical cytologic features are not present.

OBJECTIVE: To study the cytomorphologic features of bar-shaped chromatin in conjunctival samples and assess logic similarities between nuclear grooves seen in thyroid papillary carcinoma and bar-shaped chromatin. STUDY DESIGN: A total of 10 conjunctival samples from five volunteers were studied cytologically. Of the 10 samples, 2 showed bar-shaped chromatin. This chromatin was studied using a light microscope, scanning electron microscope (SEM) and transmission electron microscope (TEM). RESULTS: On SEM, bar-shaped chromatin tons ob shaped chromatin existed both in the center of the nuclei and in the nuclear membrane and cytoplasm. It was surrounded by outer and inner membranes. CONCLUSION: It seems that bar-shaped chromatin is formed by the nuclear membrane and that these changes are essentially the same configuration as cytoplasmic invaginations commonly present ii? papillary carcinoma of the thyroid.

Although the presence of nuclear grooving in papillary carcinomas of the thyroid has been well-described, so far the attention paid to similar structures in endometrial cell samples has been limited. In order to investigate the occurrence of nuclear grooves in endometrial specimens from patients with various pathologic conditions of the endometrium, we compared their appearance with papillary thyroid cancers. A total of 10 cases was studied (age range, 40-72 yr), all cases demonstrating nuclear grooves. In each case, 10 random high-power fields (HPFs) were investigated, and the numbers of fields in which nuclear grooving could be seen were recorded. Nuclear grooves were observed in 3-36 of each HPFs and were more often observed in atypical endometrial cells than in their normal-appearing counterparts; however, these nuclear alterations were thought to be nonspecific findings. (C) 1998 Wiley-Liss, Inc.