Difference between revisions of "mgh:cyto-1-7"

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__NOCACHE__{{DISPLAYTITLE:1-7 Respiratory Cytology: W.S. Black-Schaffer MD, Mary Rego CT}}{{:TOC}}
 
__NOCACHE__{{DISPLAYTITLE:1-7 Respiratory Cytology: W.S. Black-Schaffer MD, Mary Rego CT}}{{:TOC}}
 
== Lectures ==
 
== Lectures ==
* [mms://phsmghpatho.wm.internapcdn.net/phsmghpatho_vitalstream_com/Res%20Cytopathology%20Dr%20Black-Schafer.wmv Lecture: Respiratory cytology, part 1 by Dr. WS Black-Schaffer]
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* [https://web.microsoftstream.com/video/af91a85a-4326-4941-bc21-7b104a895178 Lecture: Respiratory cytology, part 1 by Dr. WS Black-Schaffer]
* [mms://phsmghpatho.wm.internapcdn.net/phsmghpatho_vitalstream_com/Res%20Cytopathology%20Dr%20Black-Schafer.wmv Lecture: Respiratory cytology, part 2. by Dr. W.S. Black-Schaffer]
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* [https://web.microsoftstream.com/video/aaed0c76-e865-4199-a092-9464eb494912 Lecture: Respiratory cytology, part 2. by Dr. W.S. Black-Schaffer]
  
 
* Indications for cytology examination
 
* Indications for cytology examination
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<br>
 
<br>
 
== Basic cytomorphology ==
 
== Basic cytomorphology ==
<br>
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{{collapsed|
 
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'''Cytology Respiratory Specimens –MN05-J8970'''|
'''Cytology Respiratory Specimens –MN05-J8970'''
 
 
* Sputum
 
* Sputum
 
* Bronchial washing and brushings
 
* Bronchial washing and brushings
 
* Bronchoalveolar lavage (BAL)
 
* Bronchoalveolar lavage (BAL)
 
* Fine needle aspirations (FNA)
 
* Fine needle aspirations (FNA)
<br>
+
|}}
 
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{{collapsed|
'''Normal Respiratory Cytology –MN05-X13303'''
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'''Normal Respiratory Cytology –MN05-X13303'''|
 
* Squamous cells (oral contamination)
 
* Squamous cells (oral contamination)
 
* Glandular cells
 
* Glandular cells
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* Pneumocytes
 
* Pneumocytes
 
* Alveolar macrophages
 
* Alveolar macrophages
<br>
+
|}}
 
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{{collapsed|
'''Alveolar macrophages –MN06-M2366'''
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'''Alveolar macrophages –MN06-M2366'''|
 
* Oval to bean shaped nuclei
 
* Oval to bean shaped nuclei
 
* Mononucleated or multinucleated
 
* Mononucleated or multinucleated
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* siderophages
 
* siderophages
 
* lipophages(associated with aspiration pneumonia)
 
* lipophages(associated with aspiration pneumonia)
<br>
+
|}}
 
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{{collapsed|
'''Granulomatous Inflammation –MN05-F5872'''
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'''Granulomatous Inflammation –MN05-F5872'''|
 
* Seen in pt’s with TB, Sarcoid and Rheumatoid Arthritis.
 
* Seen in pt’s with TB, Sarcoid and Rheumatoid Arthritis.
 
* Can see giant cells
 
* Can see giant cells
 
* Nodular collections of epithelioid histiocytes
 
* Nodular collections of epithelioid histiocytes
 
* Cells with elongated nuclei with pale chromatin and tiny nucleoli
 
* Cells with elongated nuclei with pale chromatin and tiny nucleoli
<br>
+
|}}
 
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{{collapsed|
'''Chondroid Hamartoma–C03-C14116'''
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'''Chondroid Hamartoma–C03-C14116'''|
 
* Cartilage
 
* Cartilage
 
* mature - homogenous, waxy
 
* mature - homogenous, waxy
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* small bland bronchial cells
 
* small bland bronchial cells
 
* Respiratory Infection –MN08-F9275 and N12-9869
 
* Respiratory Infection –MN08-F9275 and N12-9869
<br>
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|}}
 
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{{collapsed|
'''Candida and Actinomyces from oral contamination'''
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'''Candida and Actinomyces from oral contamination'''|
 
* Aspergillus
 
* Aspergillus
 
* 45º angle branching of true septate
 
* 45º angle branching of true septate
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* broad, irregular ribbon-like hyphae
 
* broad, irregular ribbon-like hyphae
 
* folding of hyphae
 
* folding of hyphae
<br>
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|}}
 
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{{collapsed|
'''Squamous Cell Carcinoma –C92-8306 and MN06-324'''
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'''Squamous Cell Carcinoma –C92-8306 and MN06-324'''|
 
* Keratinizing (Well-Diff)/ Nonkeratinizing(Mod to poorly Diff)
 
* Keratinizing (Well-Diff)/ Nonkeratinizing(Mod to poorly Diff)
 
* Bizarre cell shapes
 
* Bizarre cell shapes
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* Coarsely granular and/or opaque nucleus
 
* Coarsely granular and/or opaque nucleus
 
* Nucleoli possible
 
* Nucleoli possible
<br>
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|}}
 
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{{collapsed|
'''Bronchogenic adenocarcinoma –C00-A43961'''
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'''Bronchogenic adenocarcinoma –C00-A43961'''|
 
* 3-D balls, single cells, syncytia
 
* 3-D balls, single cells, syncytia
 
* Lacy, fine, vacuolated cytoplasm
 
* Lacy, fine, vacuolated cytoplasm
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* Finely granular irregular chromatin
 
* Finely granular irregular chromatin
 
* Nucleoli
 
* Nucleoli
<br>
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|}}
 
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{{collapsed|
'''Bronchioloalveolar Carcinoma –C01-W33204'''
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'''Bronchioloalveolar Carcinoma –C01-W33204'''|
 
* 3-D balls, papillary growth
 
* 3-D balls, papillary growth
 
* Finely granular to clear cytoplasm
 
* Finely granular to clear cytoplasm
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* Intranuclear cytoplasmic invaginations
 
* Intranuclear cytoplasmic invaginations
 
* Psammoma bodies may be seen
 
* Psammoma bodies may be seen
<br>
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|}}
 
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{{collapsed|
'''Small Cell Carcinoma –C03-T32870 and MN04-G5451'''
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'''Small Cell Carcinoma –C03-T32870 and MN04-G5451'''|
 
* Single and syncytial
 
* Single and syncytial
 
* Nuclear molding
 
* Nuclear molding
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* Crush artifact ( nuclear DNA streaming)
 
* Crush artifact ( nuclear DNA streaming)
 
* One to four times the size of a lymphocyte
 
* One to four times the size of a lymphocyte
<br>
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|}}
 
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{{collapsed|
'''Carcinoid –C02-M34743'''
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'''Carcinoid –C02-M34743'''|
 
* Uniform cuboidal cells
 
* Uniform cuboidal cells
 
* Scant to moderate cytoplasm
 
* Scant to moderate cytoplasm
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* Small nucleoli possible
 
* Small nucleoli possible
 
* Small blood vessels in background
 
* Small blood vessels in background
<br>
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|}}
 
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{{collapsed|
'''Metastatic malignancy –MN07-T9423, MN07-T9423 and C97-B18744'''
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'''Metastatic malignancy –MN07-T9423, MN07-T9423 and C97-B18744'''|
 
* Compare the metastatic with the primary lesion
 
* Compare the metastatic with the primary lesion
 
* Usually no tumor diathesis     
 
* Usually no tumor diathesis     
 
* Presence of multiple nodules and a history of morphologically compatible cancer strongly favor metastasis
 
* Presence of multiple nodules and a history of morphologically compatible cancer strongly favor metastasis
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|}}
 
{{:mgh:cytology-footer}}
 
{{:mgh:cytology-footer}}

Latest revision as of 13:17, July 6, 2020

Lectures

  • Indications for cytology examination
  • Procuring the specimen
  • Test platforms/specimen processing and triage
  • Report


Basic cytomorphology

Cytology Respiratory Specimens –MN05-J8970
  • Sputum
  • Bronchial washing and brushings
  • Bronchoalveolar lavage (BAL)
  • Fine needle aspirations (FNA)
Normal Respiratory Cytology –MN05-X13303
  • Squamous cells (oral contamination)
  • Glandular cells
  • ciliated columnar
  • mucous goblet cells
  • Pneumocytes
  • Alveolar macrophages
Alveolar macrophages –MN06-M2366
  • Oval to bean shaped nuclei
  • Mononucleated or multinucleated
  • Foamy cytoplasm
  • Phagocytic cells
  • carbon histiocytes
  • siderophages
  • lipophages(associated with aspiration pneumonia)
Granulomatous Inflammation –MN05-F5872
  • Seen in pt’s with TB, Sarcoid and Rheumatoid Arthritis.
  • Can see giant cells
  • Nodular collections of epithelioid histiocytes
  • Cells with elongated nuclei with pale chromatin and tiny nucleoli
Chondroid Hamartoma–C03-C14116
  • Cartilage
  • mature - homogenous, waxy
  • immature - fibrillar texture
  • Epithelium
  • small bland bronchial cells
  • Respiratory Infection –MN08-F9275 and N12-9869
Candida and Actinomyces from oral contamination
  • Aspergillus
  • 45º angle branching of true septate
  • Pneumocystis
  • foamy alveolar casts
  • GMS- stain cell wall of cyst black
  • cysts are 4 to 8 um
  • Zygomycetes-(Mucor)
  • broad, irregular ribbon-like hyphae
  • folding of hyphae
Squamous Cell Carcinoma –C92-8306 and MN06-324
  • Keratinizing (Well-Diff)/ Nonkeratinizing(Mod to poorly Diff)
  • Bizarre cell shapes
  • Cytoplasm is dense or hard with defined cell borders
  • Heavy keratinization(seen in Keratinizing SCC)
  • Coarsely granular and/or opaque nucleus
  • Nucleoli possible
Bronchogenic adenocarcinoma –C00-A43961
  • 3-D balls, single cells, syncytia
  • Lacy, fine, vacuolated cytoplasm
  • Cuboidal cells, eccentric nuclei
  • Finely granular irregular chromatin
  • Nucleoli
Bronchioloalveolar Carcinoma –C01-W33204
  • 3-D balls, papillary growth
  • Finely granular to clear cytoplasm
  • Eccentric nuclei
  • Pale to moderately hyperchromatic chromatin
  • Intranuclear cytoplasmic invaginations
  • Psammoma bodies may be seen
Small Cell Carcinoma –C03-T32870 and MN04-G5451
  • Single and syncytial
  • Nuclear molding
  • Scant cytoplasm
  • Oval to angulated nuclei
  • Nucleoli not prominent
  • Dense chromasia (salt and pepper chromatin)
  • Crush artifact ( nuclear DNA streaming)
  • One to four times the size of a lymphocyte
Carcinoid –C02-M34743
  • Uniform cuboidal cells
  • Scant to moderate cytoplasm
  • Small round to oval nuclei
  • Stippled granular chromatin
  • Small nucleoli possible
  • Small blood vessels in background
Metastatic malignancy –MN07-T9423, MN07-T9423 and C97-B18744
  • Compare the metastatic with the primary lesion
  • Usually no tumor diathesis
  • Presence of multiple nodules and a history of morphologically compatible cancer strongly favor metastasis

Cytology service page