Detection of Treponema pallidum by immunocytochemistry of cervical smear: A case report.

Syphilis is an infectious disease caused by Treponema pallidum (T. pallidum). A cervical smear is useful when screening for sexually transmitted diseases; however, T. pallidum is not detected in the usual Papanicolaou smear. We report the detection of T. pallidum by immunocytological examination of a cervical smear. A 22-year-old woman presented with nephrotic syndrome. On admission, we performed screening tests for infections, and her serology was positive for syphilis. A Papanicolaou cervical smear (Thin-Prep) showed slight nuclear enlargement, nuclear irregularity, and mild hyperchromasia in the superficial cells, but no organism was detected. T. pallidum was detected in the remaining specimen using immunocytochemistry. We also detected the T. pallidum DNA in a cervical biopsy specimen by polymerase chain reaction (PCR). Our findings suggest that immunocytological examination and PCR assay examination are useful tests for syphilis diagnosis.

Cervical lymph node metastasis of ovarian dysgerminoma: A case report with fine needle aspiration cytology.

Dysgerminoma is a rare germ cell tumor, accounting for 1% to 2% of all malignant ovarian tumors. Here, we report a case of dysgerminoma diagnosed by aspiration cytology of a cervical lymph node. A 20-year-old woman presented with an abdominal mass and left cervical swelling. CT revealed a large pelvic tumor, along with a nodular lesion on the left side of neck. Fine needle aspiration (FNA) cytology of a cervical lymph node showed large atypical cells and small lymphocytes. Immunocytochemical staining on cell block material revealed that these large tumor cells were positive for placental alkaline phosphatase, D2-40, and c-kit. Dysgerminoma was suggested by FNA cytology. Furthermore, bilateral oophorectomy was performed, and histology confirmed the diagnosis of ovarian dysgerminoma. FNA cytology of metastatic lymph nodes along with immunocytochemistry is a useful tool for diagnosis of dysgerminoma.

A case of a pleomorphic hyalinizing angiectatic tumor of soft parts with intracytoplasmic hemosiderin pigment apparent upon fine-needle aspiration cytology.

Pleomorphic hyalinizing angiectatic tumors of soft parts are extremely rare low-grade mesenchymal lesions that frequently occur subcutaneously, especially in the lower extremity. The tumor is histologically characterized by sheets of plump, spindled or rounded cells, and clusters of ectatic blood vessels. It also has a number of previously characterized cytological features such as pleomorphic cells, intranuclear pseudoinclusion, and intracytoplasmic hemosiderin pigments. However, intracytoplasmic hemosiderin has not been carefully evaluated in cytology specimens. Here, we report the case of a 56-year-old Japanese man with an encapsulated pleomorphic hyalinizing angiectatic tumor of soft parts that included fine and coarse hemosiderin-laden tumor cells. The tumor was clinically followed up as a hematoma, but malignant tumors, including malignant melanoma, were suspected because aspiration cytology specimens contained pleomorphic cells with intracytoplasmic brown pigments. The tumor was closely associated with an intratumoral hematoma and a few microscopic satellite lesions. Pleomorphic hyalinizing angiectatic tumor of soft parts should be included in the differential cytological diagnosis of soft tissue tumors if the three cytological features described earlier are present. Enucleation therapy could facilitate local recurrence, as the tumor may have the potential to infiltrate surrounding soft tissue or form satellite lesions.