Pitfalls in Diagnostic Cytopathology With Key Differentiating Cytologic Features by Von G. Samedi & Thèrése Bocklage

Author:Von G. Samedi & Thèrése Bocklage
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

At the offset, in acutely or chronically ill patients, knowledge of any recent or concurrent injuries (e.g., pneumonia, respiratory distress, pulmonary infiltrates, radiation) to the lung should prompt caution during cytologic evaluation. If malignant cells are indeed present, two distinct cell populations, one malignant and one benign, should be identified.

Depending on the path of cytological specimen acquisition, Mesothelial Cells are not uncommon in percutaneous fine needle aspiration. Just like in fluid cytology, reactive mesothelial cells can mimic adenocarcinoma. The discriminating cytological features include knobby contours in cell clusters. The spaces between the cells “windows” would also be consistent with mesothelial cells (Fig. 7.23). Of course, as discussed in the fluid cytology chapter, the reactive changes include enlarged nuclei, multinucleation, cytoplasmic vacuolization, and mitotic figures (Fig. 7.24). If suspicion of heavy mesothelial cell contamination is present, obtaining a cell block followed by pertinent immunocytochemical staining will save the day. Mesothelial cells are immunoreactive for calretinin, WT1, D2-40, CK5/6, but negative for epithelial markers such as EMA, Claudin, and MOC-31.

Fig. 7.23 Mesothelial cells. Inadvertently sampled mesothelial cells with “windows” between the cells. The nuclei have smooth membranes with prominent nucleoli (Liquid-based, Papanicolaou)

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.