We examined diagnostic variation of flat intraurothelial lesions with comparison with immunohistochemical and fluorescence in situ hybridization (FISH) analyses. Nine uropathologists diagnosed 23 biopsy samples from the urinary bladder. The samples were analyzed by immunohistochemical expression of cytokeratin 20, high-molecular-weight cytokeratin, Ki-67, p53, and p16(INK4a), and multicolor FISH using the UroVysion probe set (Vysis, Abbott, Des Plaines, IL). Diagnostic agreement for each classification and for nonneoplastic or neoplastic lesions was obtained in 8 (35%) and 16 (70%) of 23 lesions, respectively. The preference ratio of neoplasia to nonneoplasia (0.9 to 4.8) or carcinoma in situ to dysplasia (0.2 to 4.0) also varied among the pathologists. In 6 ancillary analyses, the majority of neoplastic lesions with diagnostic agreement indicated more than 2 aberrant results, whereas the majority of lesions without diagnostic agreement showed no or only 1 aberrant result. The molecular and immunohistochemical analyses can discriminate between neoplastic and nonneoplastic lesions; however, they cannot reliably solve diagnostic variation of flat intraepithelial lesions.

The authors confirmed the presence of endocrine cells for the first time in a normal breast as well as in a non cancerous lesion of the breast. One hundred and eighty eight blocks of normal breast tissues in 44 cases and 74 blocks of non cancerous lesions in 35 cases were examined. Argyrophil cells were found in one block from a normal breast and in one block from a phyllodes tumor. Argyrophil cells in the normal breast showed positive reaction to anti‐endocrine granule constituent (EGC) antibody with immunohistochemical method. Argyrophil cells found in the phyllodes tumor gave positive reaction to both anti EGC and anti‐serotonin antibodies. The present study is thought to be the first report in the literature of serotonin‐positive cells in a non‐cancerous breast lesion, a phyllodes tumor. Acta Pathol Jpn 41: 874‐878, 1991.

Normal endometrium from one hundred normal cases were examined histologically, using sections stained with the Grimelius method. Endocrine cells were demonstrated in 4 cases. Immunohistochemically, these cells were positive for anti-serotonin and anti-somatostatin antisera. Argyrophil granules were also observed in supranuclear or subnuclear regions of glandular cells in 17 cases, and argyrophilia was present in the apical region including the brush borders or microvilli of glandular cells in 6 cases. In these latter 23 cases argyrophilia seemed to be nonspecific, having no relation to endocrine type secretory granules, judging from the electronmicroscopic observations on the silver-impregnated sections. The presence of endocrine cells and the pattern of argyrophilia in glandular cells were similar to those found previously in endometrial glandular adenocarcinomas with argyrophil cells. This is the first report on the occurrence of endocrine cells in normal endometrial glands.

The cytologic features of ascitic fluid in a case of malignant fibrous histiocytoma (MFH) of the colon are described. At autopsy, two solid tumor masses were found around the ascending and transverse colon, accompanied by about 3,000 ml of ascites. Tumor cells had infiltrated diffusely into the outer layers of almost all of the gastrointestinal wall, simulating peritonitis carcinomatosa. Cytologic examination of the ascites revealed various kinds of tumor cells; short spindle‐like cells, multinucleated giant cells, and round cells with an invaginated nuclear margin, forming small clusters. These cytologic findings were considered to be very useful in the diagnosis of MFH, especially in cytologic examinations of ascites. ACTA PATHOL JPN 38: 921 ∼ 928, 1988.

Urachal adenocarcinoma, normal urachus, and urinary bladder were studied by histochemichal methods and electron microscopy. Many argyrophil cells were found in urachal adenocarcinoma and urachal epithelium. Autofluorescence and immunoperoxidase examinations showed that the argyrophil cells possessed serotonin, glucagon, and secretin. Some of the carcinoma cells and urachal epithelial cells contained fairly large amount of mucosubstances. On the other hand, only a few argyrophil cells and very weakly PAS positive cells were observed in the urinary bladder mucosa. This study showed that there were close similarities in the histochemical and electron microscopical features between the urachal carcinoma and urachal epithelium, and suggested that the undifferentiated stem cells were able to differentiate to both glandular and endocrine cells.