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Biomedical subjects

M Hirokawa

Publications and source records attributed to M Hirokawa.

At least 235 records · Page 13Linked to original sources

Assessment of Palomo's operative method for infertile varicocele.

Palomo's operative method was employed in the surgical treatment of 58 cases with infertile varicocele, and the operative method and therapeutic results were assessed. With the lapse of time after operation, statistically significant improvement was achieved in the sperm density and sperm motility. The post-operative impregnation rate was 55.2%. When the pre-operative sperm motility index had been 20% or less, the post-operative impregnation rate was 23%, which was significantly lower than the overall rate of 55.2%. Thus, the pre-operative sperm motility index is a good indicator of the post-operative capacity for impregnation. Even in patients with severe oligozoospermia (< 5 x 10(6) ml-1), a post-operative impregnation rate of 45.5% was obtained. Thus, their prognosis is by no means hopeless. Study of the cross-sectional profile of the internal spermatic vessels revealed the possibility of overlooking small internal spermatic venous branches. Therefore, Palomo's method was concluded to be excellent as an approach performed under direct visual observation. Palomo's method did not cause any complication of testicular atrophy and improved the fertility potential.

Adult↗

Basement membrane material and tigroid background in a fine needle aspirate of clear cell adenocarcinoma of the cervix. A case report.

BACKGROUND: Although cytologic findings of clear cell adenocarcinoma of the female genital tract have been reported sporadically, the background on the smear has received little attention. CASE: A 16-year-old female had a large, necrotic mass in the cervix. As cervical brushing cytology and a punch biopsy of the mass could not make a definitive diagnosis, fine needle aspiration cytology was performed from the mass. The smears revealed loose, three-dimensional clusters and sheet arrangements of atypical cells. Dispersed atypical cells were also seen. The atypical cells were large and had abundant, weakly stained cytoplasm and round or oval nuclei with large nucleoli. There were a few tumor cells with clear cytoplasm and distinct cell borders in Papanicolaou-stained smears. The background in Diff-Quik-stained smears revealed a tigroid background and basement membrane material. CONCLUSION: The malignant tumor, revealing both a tigroid background and basement membrane material, seems to have been clear cell adenocarcinoma. Both features are diagnostic clues to clear cell adenocarcinoma in the female genital tract. Our case indicates that aspiration cytology is also an effective method of diagnosing a cervical tumor when the tumor is polypoid and the surface is extensively necrotic.

Adenocarcinoma, Clear Cell↗

Diagnostic value of hair shafts and squamous cells in peritoneal washing cytology.

OBJECTIVE: Little attention has been given to hair shafts and squamous cells in peritoneal fluid. To investigate their diagnostic value in peritoneal washing specimens, we reviewed peritoneal washing cytology preparations from 83 cases of ovarian tumors. STUDY DESIGN: We reviewed peritoneal washing specimens and histologic sections of 86 cases of ovarian tumors and tumorous conditions, including 22 teratomas, 16 serous adenocarcinomas, 10 clear cell adenocarcinomas, 9 endometrioid adenocarcinomas, 5 cases of endometriosis, 4 mucinous adenomas, 3 serous cystadenocarcinomas and 17 other tumors. RESULTS: We observed both squamous cells and hair shafts surrounded by inflammatory cells in 5 of the 22 cases of ovarian teratoma. Rupture of an ovarian teratoma was clinically and histologically found in one of the five cases. Hair shafts were not observed in the other tumors or in nonneoplastic conditions. The diameter of hair shafts in peritoneal washing specimens ranged from 10 to 28.8 microns (average, 16.6), and such hair shafts were present within an ovarian teratoma examined histologically. The diameter of hair shafts from six normal adults who were examined as controls ranged from 61.5 to 118.6 microns (average, 89.4). CONCLUSION: Hair shafts and squamous cells surrounded by inflammatory cells in peritoneal washing specimens are a diagnostic clue to ovarian teratoma and can be observed even when rupture of the tumor is not detected clinically or microscopically.

Adolescent↗

Ectopic hamartomatous thymoma. Report of a case with fine needle aspiration biopsy findings.

BACKGROUND: Ectopic hamartomatous thymoma is a rare, benign tumor occurring exclusively in the supraclavicular and suprasternal regions. To the best of our knowledge, there are no English-language reports on its cytologic findings. CASE: A fine needle aspiration specimen from a mass in the suprasternal region in a 63-year-old male revealed epithelial cell nests, spindle cells, a cluster of mature adipocytes and a small number of lymphocytes. CONCLUSION: Although ectopic hamartomatous thymoma is very rare, fine needle aspiration cytology may contribute to the correct diagnosis in conjunction with the characteristic clinical findings.

Adipocytes↗

Cytologic findings in noninvasive intraductal papillary-mucinous carcinoma of the pancreas. A report of two cases.

BACKGROUND: Intraductal papillary-mucinous carcinoma of the pancreas is a new diagnostic term proposed by the 1996 World Health Organization classification of the exocrine pancreas. So far, there have been only a few reports concerning its cytologic findings, especially in noninvasive cases. CASES: The clinical and cytohistologic findings in two cases of noninvasive intraductal papillary-mucinous carcinoma of the pancreas were reviewed. Cytologic specimens were obtained from pure pancreatic juice in the dilated main pancreatic duct during the operation (case 1) and during endoscopic retrograde pancreatography (ERP) (case 2). Both cases showed three-dimensionally or individually scattered tumor cells with an increased nuclear/cytoplasmic ratio and prominent nucleoli. CONCLUSION: Our cases suggest that pancreatic juice cytology during ERP or surgery is useful in diagnosing pancreatic cancers and that it may detect noninvasive intraductal papillary-mucinous carcinoma of the pancreas.

Adenocarcinoma, Mucinous↗

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.

Biomarkers↗

Scrape cytology of elastofibroma. Report of a case with diagnostic cytologic features.

BACKGROUND: Elastofibroma is a benign, soft tissue tumor that occurs most frequently in the subscapular area in elderly people. To the best of our knowledge, in only two cases has the cytology been reported. The aim of this report is to describe the characteristic cytologic findings of elastofibroma and to discuss the usefulness of elastin stain in scrape smears. CASE: A 72-year-old female had bilateral masses in the lower subscapular area. Scrape smears from a cut surface of the resected masses revealed abundant, "wormlike" or "braidlike" material with central cores with Papanicolaou stain in an intraoperative consultation. Various-sized, petaloid or crystalloid globules were also present. Those elastic fibers were strongly positive for elastin stain in cytologic preparations. CONCLUSION: Elastofibroma can be diagnosed cytologically, and elastin-stained, scrape cytologic preparation is especially useful in such a case.

Aged↗

Calcium oxalate crystals in thyroid fine needle aspiration cytology.

OBJECTIVE: To determine the occurrence, distribution and location of calcium oxalate crystals (COCs) in thyroid fine needle cytology specimens. STUDY DESIGN: Thyroid tissues from 60 fine needle aspiration cytology specimens (31 benign and 29 malignant lesions) were reviewed. These lesions were also histologically examined, and their pathologic diagnosis was confirmed. The cytologic slides were examined by normal and polarized light microscopy to determine their size, shape, occurrence, distribution and location. RESULTS: The size and shape of COCs varied from case to case. The total incidence was 45% (benign diseases, 68%; malignant lesions, 21%). No significant relationship between age and occurrence of COCs was found. Benign diseases showed more multifocal than focal distribution of COCs, unlike malignant diseases. Twenty-three (85%) of 27 cases with COCs revealed background location of COCs, especially within thyroid colloid. CONCLUSION: The occurrence of COCs in thyroid fine needle cytology was lower than that in histologic specimens reported in the literature, and COCs were more often identified in benign than malignant lesions. The presence of COCs may be a clue to benign lesions if their distribution is taken into consideration.

Adolescent↗

Giant lamellar bodies in pulmonary MALT lymphoma. A case report.

BACKGROUND: Giant lamellar bodies are laminated, scroll-like whorls seen within alveolar spaces and have been occasionally observed in sclerosing hemangioma of the lung. However, to the best of our knowledge, the cytologic findings of giant lamellar bodies have not been reported. We describe cytologic findings of giant lamellar bodies associated with pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. CASE: A 72-year-old male had a pulmonary mass measuring 2.0 x 1.4 x 1.5 cm. Cytologic smears imprinted from a cut surface of the resected mass revealed a large number of concentrically laminated structures, giant lamellar bodies, measuring 15-40 microns in diameter. Necrotic cellular remnants were occasionally observed in the center of the structures. In the background, small to medium-sized lymphoid cells and plasmacytoid cells were observed. Histologic diagnosis of the tumor was IgG, kappa type, MALT lymphoma. An aggregate of giant lamellar bodies was observed within entrapped, dilated alveolar spaces lined with hypertrophied, type II pneumocytes. Immunohistochemically, the giant lamellar bodies were positive for KL-6. CONCLUSION: Giant lamellar bodies may be derived from surfactant and necrotic type II pneumocytes and may be observed cytologically in cases of pulmonary MALT lymphoma.

Aged↗

Collagenous crystalloids in a fine needle aspirate of a pleomorphic adenoma of the minor salivary gland. A case report.

BACKGROUND: Collagenous crystalloids were previously observed in histologic sections of pleomorphic adenoma. However, to the best of our knowledge, there have been no English-language reports dealing with collagenous crystalloids in fine needle aspirates. CASE: A fine needle aspiration specimen obtained from a mass in the hard palate of a 52-year-old female revealed collagenous crystalloids. The crystalloids were yellow to green, measured 30-50 microns in diameter and were radially arranged. CONCLUSION: This case indicates that collagenous crystalloids in salivary gland aspirates may be a clue to the diagnosis of pleomorphic adenoma.

Adenoma, Pleomorphic↗

Cytology of pigmented renal cell carcinoma. A case report.

BACKGROUND: Pigmented renal cell carcinoma is very rare, and there have been no reports on its cytologic findings. CASE: A 40-year-old female with pigmented renal cell carcinoma had cytologic findings similar to those of clear cell carcinoma except for the presence of melaninlike brown pigment. CONCLUSION: It is important to recognize that renal cell carcinoma may contain melaninlike brown pigment seen on cytologic examination of renal aspirates.

Adult↗

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.

Adipose Tissue↗

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.

Biopsy, Needle↗

Adenocarcinoma in situ of the fallopian tube. A case report.

BACKGROUND: So far only a few cases of carcinoma in situ of the fallopian tube have been reported, but its detailed clinical and pathologic findings, including cytology, have not been fully described. CASE: A 70-year-old female was admitted to our hospital because of irregular genital bleeding. Endometrial smear revealed a small number of atypical cells with a clear background. Hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. Grossly, a grayish white papillary tumor, measuring 1.5 x 1.0 cm, was observed within the lumen of the left fallopian tube. Microscopically, the diagnosis of papillary adenocarcinoma in situ of the left fallopian tube was made according to 1992 International Federation of Gynecologists and Obstetricians fallopian tube staging. CONCLUSION: Although endometrial brush cytology is not sensitive enough to detect a primary carcinoma of the fallopian tube, our case indicates that it may contribute useful information on extrauterine diseases and can detect a stage 0 cancer of the fallopian tube. Clinicians, as well as pathologists, should consider the possibility of fallopian tube cancer if cervical or endometrial cytology shows atypical cells with papillary patterns with a clear background but endometrial curettage cannot prove malignancy.

Adenocarcinoma↗

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.

Adult↗