Biomedical subjects

N Takeshima

Publications and source records attributed to N Takeshima.

59 records · Page 4Linked to original sources

PubMedDate not supplied

Müllerian adenosarcoma of the uterus: report of a case with imprint cytology.

BACKGROUND: Müllerian adenosarcoma is a rare morphologic variant of uterine sarcoma that, although well described histologically, is scarcely mentioned in the cytologic literature. CASE: A 75-year-old female was suspected of having atypical endometrial hyperplasia on an endometrial smear. However, subsequent imaging techniques revealed the presence of a bulky, polypoid mass filling the uterine cavity. On pathologic examination of the hysterectomy specimen, the polypoid tumor was diagnosed as mullerian adenosarcoma, homologous, with sarcomatous overgrowth, in which the sarcomatous component was compatible with high grade endometrial stromal sarcoma. Imprint smears of the tumor consisted of two morphologic patterns, sarcomatous and glandular. The sarcomatous tumor cells, with coarse chromatin and relatively scant cytoplasm, formed small aggregates or appeared alone. These cells were semiround or oval and had conspicuous nucleoli. In addition to these observations, small and large clusters of glandular cells with mild atypism were interspersed with the sarcomatous cells. CONCLUSION: Cytologic examination of müllerian adenosarcoma well reflects its pathologic features.

Adenosarcoma↗

PubMedDate not supplied

Identification of a high-risk subgroup in cytology-positive stage IIIA endometrial cancer.

OBJECTIVE: To identify a high-risk subgroup among patients with cytology-positive stage IIIA endometrial cancer. STUDY DESIGN: Fifty-four stage IIIA endometrial cancer patients who were positive only on peritoneal cytology were divided into two groups based on the cytologic pattern of their peritoneal smears. In group A, malignant cell clusters had well-defined edges, while the tumor cell clusters had scalloped edges in group B. The prognostic significance of these findings was investigated. RESULTS: The five-year disease-free survival rate was 97.5% in group A (n=40) versus 50% in group B (n = 14). Multivariate analysis confirmed that the cytologic pattern had an independent influence on survival. CONCLUSION: Positive peritoneal cytology composed of malignant cell clusters with well-defined edges has no impact on survival. Only endometrial cancer patients who show tumor cell clusters with scalloped edges in peritoneal smears are worth considering for upstaging.

Adenocarcinoma↗

PubMedDate not supplied

Peripheral primitive neuroectodermal tumor of the vulva: report of a case with imprint cytology.

BACKGROUND: Peripheral primitive neuroectodermal tumor (PNET) of the vulva is an extremely rare disease, and, to our knowledge, only two cases have been previously reported. CASE: A 45-year-old woman presented with a mass in the right labium major. Three years after removal of the tumor, she noticed a new lesion in the same place and underwent a partial vulvectomy. The imprint cytology of the recurrent tumor showed a monomorphic appearance, composed of small round cells with scant cytoplasm against a hemorrhagic background. These tumor cells were loosely connective, but rosettelike structures were observed focally. On pathologic examination, the neoplasm was composed of small round tumor cells showing sinusoidal, diffuse or micropapillary growth. Immunohistochemically, the neoplastic cells stained positively for neuron-specific enolase, vimentin and HBA 71 and negatively for cytokeratin, HBA 45 and muscle-specific actin. The morphologic characteristics of the disease were well expressed in the imprint cytology, and this influenced the selection of immunohistochemical studies. CONCLUSION: Cytologic examination for vulvar tumors, even imprint cytology, can be a useful tool in obtaining an accurate pathologic diagnosis of a rare disease, such as peripheral PNET.

Antigens, Neoplasm↗

PubMedDate not supplied

Morphologic analyses of positive peritoneal cytology in endometrial carcinoma.

OBJECTIVE: To investigate the relationship between the morphologic features of endometrial adenocarcinoma cells in peritoneal fluids (effusions and washings) and macroscopic intraabdominal adenocarcinoma at laparotomy as well as prognosis. STUDY DESIGN: Seventy-one patients with endometrial adenocarcinoma who showed positive peritoneal cytology at laparotomy were clinically divided into three groups: 25 patients with macroscopic neoplastic seeding in the peritoneal cavity (type 1), 38 patients without macroscopic peritoneal metastasis who survived with no evidence of disease (type 2) and 8 patients without macroscopic peritoneal metastasis who later developed recurrence of adenocarcinoma (type 3). Morphologic features of the adenocarcinoma cells in smears of peritoneal fluids were examined. RESULTS: Most of the smears from type 1 patients showed moderate to high cellularity, scalloped edges of cell clusters and isolated adenocarcinoma cells, whereas these features were seldom observed in type 2 patients. Although not all type 3 patients demonstrated these three features, patients in the series whose specimens exhibited none of the three features did not show any peritoneal lesions or have a recurrence of their disease. CONCLUSION: The finding of endometrial adenocarcinoma cells exhibiting high cellularity, scalloped edge of cell clusters and isolated cells in smears of peritoneal fluid is associated with the presence of intraabdominal macroscopic metastatic lesions and could be regarded as a risk factor for intraabdominal recurrence of carcinoma.

Adenocarcinoma↗

PubMedDate not supplied

Clinical usefulness of endometrial aspiration cytology and CA-125 in the detection of fallopian tube carcinoma.

OBJECTIVE: To determine the clinical usefulness of endometrial aspiration cytology and CA-125 in the detection of fallopian tube carcinoma. STUDY DESIGN: Positive rates of gynecologic cytology and serum levels of CA-125 were examined in 20 consecutive patients with primary fallopian tube carcinoma before any treatment. RESULTS: The positive rates were 25% (5/20) for cervicovaginal smears and 50% (10/20) for endometrial aspiration smears in the absence of endometrial invasion. The positivity of endometrial aspiration cytology was not influenced by clinical staging or tumor differentiation. The presence of disease in all asymptomatic patients (4/4) was suspected by abnormal endometrial cytology. The features of endometrial cytology were consistent with those of extrauterine adenocarcinoma, from which ovarian carcinoma was unable to be differentiated. Serum levels of CA-125 increased with clinical staging. The positive rate for CA-125 was 20% in stage I, 75% in stage II, 88.9% in stage III, 100% in stage IV and 70% (14/20) in all cases. Eighty-five percent (17/20) of cases exhibited either positive endometrial cytology or elevated CA-125 levels. CONCLUSION: The series suggests that the use of endometrial cytology combined with determination of serum CA-125 levels covers most cases of fallopian tube carcinoma and is a potent aid in the detection of this rare disease.

Adenocarcinoma↗