A rapid and simple cytologic screening technique for fresh urine specimens stained with toluidine blue is described. As to the validity and description of cell structure, the accuracy of urine cytology with this procedure is very similar to that of the Papanicolaou technique. Utilizing this technique, a hospital population was screened for urinary tract cancer from specimens sent for routine urinalysis. In this study of 16,062 fresh urine sediments selected at random from nonurologic patients, a total of three cases of histologically proven bladder cancer were detected, corresponding to a rate of one bladder cancer in 5,000 individuals. The results emphasize the usefulness of this simple screening technique in combination with clinical urinalysis and cytology for early detection of urinary tract malignancy.
A 66-year-old womanwith an altered mental status caused by hypoglycemia was referred to Akita City Hospital. Abdominal ultrasonography (US) and endoscopic US revealed an isoechoic mass measuring 25 mmin the head of the pancreas. Endoscopic retrograde cholangiopancreatography (ERCP) revealed that the main pancreatic duct and its branches were displaced around the mass in the head of the pancreas. On arteriography, a poorly vascularized tumor was observed. Dynamiccontrast-enhanced computed tomography (CT) showed a low-attenuation mass in the head of the pancreas. A pylorus-preserving pancreaticoduodenectomy was performed. Microscopically, the diagnosis was malignant insulinoma. (Internal Medicine 40: 28-31, 2001)
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