Our visit to Japan

The Johns Hopkins University

American Society of Cytopathology

Japanese Society of
Clinical Cytology Joint Meeting

Keio University, Tokyo Japan Dec 14-15, 2019

Through the good offices our past President, Dr. Syed Ali, we were fortunate enough to be invited to participate in the first joint meeting of the Japanese Society of Cytopathology, Johns Hopkins University and the American Society of Cytopathology. The meeting was a thoroughly enjoyable event organized by Dr. Ali and Dr. Takayuki Enomoto. As you would expect, the content of the talks was at an excellent academic level and would be very familiar to the our membership. Presentations covered a wide range of topics in cytopathology seeking to advance understanding of modern diagnostic systems, advances in models of disease and molecular technologies. Dr. Ali discussed recent advances in thyroid cytopathology including the cautions introduced into The Bethesda System for Reporting Thyroid Cytopathology about Non-Invasive Follicular Thyroid neoplasm with Papillary like features (NIFTP). He also discussed the Milan System for Reporting Salivary Gland Cytopathology and some aspects of gynecology cytology. Dr. Peter Illei (Hopkins) spoke to the cytology of lung and about immunochemistry. I had the opportunity to present my approach to atypia in gynecologic cytopathology and an overview of the Paris System for Reporting Urinary Cytopathology. We all presented unknown sessions. Our hosts from the Japanese Society of Clinical Cytology gave the bulk of the presentations. Dr. Robert Osamura, past president of the International Academy of Cytology (IAC), talked about molecular advances and testing in cytology. Dr. Kayoko Higuchi, an author in the Milan System, shared her expertise in salivary gland pathology and explained the Japanese take on Milan. Of note, Japanese versions of both the Milan System and Paris System are available. I have copies and given a couple of years, I might be able to translate a portion back to English. Our Japanese partners proved to be among the best hosts on the planet and we cannot thank them enough for the kindnesses shown. Everyone involved would like to see the meeting repeated.

Touring Japan

Keio University and the Keio Plaza hotel are in Shinjuku, northwest of the center of Tokyo. It is electric – neon lit and active with large entertainment, business and shopping areas. During our meals at the Keio University Hospital, we could look out at the New National Stadium built for the 2020 Olympics. Unlike many of the other Olympic venues, Japan is ready to receive the world, long before an Olympic event starts. We were close to the Shinjuku Rail Station that handles more than two million passengers every day. From there you can, for the most part, easily reach any site in Tokyo and get access to bullet trains (Shinkansen) to travel to the rest of the country. Getting around Japan is relatively easy for English speakers. There is always someone official in the stations that has a good grasp of English and many of the signs and announcements in the trains are in English. Certain rules of etiquette maintain. It is considered rude to use your cell phone on a train, but ok to quietly play a video game or listen to music with headphones. A few words are especially useful. Summimasen (Sue•me•mass•sen) means either pardon me, I’m sorry… or get’s a waiter’s attention. Domo arrigatou gozaiimasu (Dome•oh•ah• rig•gatoe•go•zie•ee•mas) is a polite form of “thank you”. There is no tipping. In fact, offering a tip is considered a bit of an insult for people who are doing the job that they have pride in doing well.


Kaimono (Kaii•mo•no) or shopping is an adventure. Everything is available. A single major Departo (deh•part•to) (department store) will have floors for food, clothing, electronics, toys and a selection of restaurants. Sections will have specialty items, but each shopping center, mall or Depato will contain everything one needs to sustain a modern lifestyle. Buildings styled as a “Camera Store” will have only a portion of a store dedicated to selling cameras. The rest of the place will offer video games, toys, computers, health product and home appliances. The density of products per unit area of shelf space far exceeds what we usually expect in the US. I was disappointed that I could not think of a way to get hobby equipment, like: saws, drills, miniature fixtures, airbrushes, and plastic parts into my luggage.

Japanese Food

The small restaurants or Izakaya (izz•ah•kay•ah) of Japan were marvelous. There are a range of styles from varieties of ramen shops, patisseries or traditional Japanese home cooking like Omrice (scrambled egg covering rice in a tomato sauce). By the way, what you get in a real ramen shop is usually a far cry from the 25 cent freeze dried convenience store pack, or a pack of noodles that fit into a college student’s budget. Izakaya ramen is a flavorful hearty soup, often with homemade noodles and fresh ingredients. The inability to speak Japanese is usually not a problem in the larger cities. Many of the shops provide English (Eigo, ehh•go) menus. A great number have plastic representations of their offerings in the front window or pictures on the menu and you can order by number. Curries are especially nice. I am quite fond of Okonomiyaki, a dish usually called a Japanese pancake, but really more like an omelet with flour, eggs, cabbage, pork, shrimp and sauce. My whole family enjoyed Yakiniku (barbeque) where you cook thin sliced meat and vegetables over a charcoal or electric brazier located in the middle of your table. Rest assured that yakiniku restaurants have appropriate ventilation.

Cultural Visits

Five hours of Kabuki, a once in a lifetime experience, everything is beautiful, a necessary cultural experience… Oh, I did say five hours….Luckily, the Minamazi Theater in Kyoto will provide radios that translate the action and give background to what is happening on stage. They run it like an airline replete with stewardesses, but you bring your own small lunch. They will seat you, collect the trash and deal with any problems. The costuming and sets are elaborate and follow schemes that are centuries old. An image from the poster of the presentation is shown below.

There are beautiful shrines everywhere, and the melding of Buddhist and Shinto disciplines can be more than somewhat confusing to a westerner. A very simplistic approach is that Buddism has to do with compassion, alleviation of suffering and passing from this life; while Shinto deals with celebrations, numerous festivals, daily living and the animating spirits that exist in everything.

Christmas in Kyoto.

The Colonel is a thing…really. Turkeys are not a part of the economy….. so KFC for Christmas. We went to a Mall and got the holiday pack for the family. Given that my mother’s family comes from Corbin, Ky.. the home of Harlan Sanders… I can testify.. it was the real article. Another thing, Christmas is different. The icons of Christmas are there, the trees, the lights and tinsel, but there is a romantic focus to the season. It is the time that young men are supposed to propose and come across with the ring. Yes, there are presents and commerce is supported, but the focus is social rather than religious. In our hotel we were greeted by a six-foot tall Santa who was a little thin by our standards, and had a significant accent to his ho-ho-ho, but he was very gracious and jolly.

As seems obvious from the above, I’m recommending a trip to Japan. With a little planning, you will be well taken care of and have one of the more memorable vacations of your life.