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Lung Cancers In Cytology |
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Uploaded: 2007-08-04, Updated: 2007-08-04 |
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Reactive Atypia |
Malignancy |
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Few atypical cells |
More cellular, many atypical cells, many single cells |
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Organized orderly clusters |
Crowed disorganized disorderly clusters |
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Spectrum from benign to high atypical cells |
Discrete population |
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Cohesive |
Dyscohesive |
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N/C ration in normal limits |
High N/C ratio |
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Enlarged nuclei, <4-6× |
Significantly enlarged nuclei, >4-6× |
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Smooth nuclear membrane |
Irregular nuclear membrane |
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Fine to coarse, but regular chromatin, uniform nucleoli |
Coarse, irregular chromatin |
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Cilia |
No Cilia |
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Regression with time |
Progress with time |
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Well-Differentiated SCC |
Poorly Differentiated SCC |
Adenocarcinoma |
Small Cell Carcinoma |
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Pattern |
More single cells |
More Groups |
Glands, cell ball, acini or papillae. Disorganized, crowed, palisading. |
Very cellular, isolated, syncytial aggregates, sheets, rosettes |
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Cell |
Marked pleomorphism, bizarre cells. Large, high N/C ratio |
More uniform, few bizarre cells. Higher N/C ratio. Distinct cell borders. |
Moderate pleomorphism. Columnar, N/C polarity. |
Relatively uniform. Molding, crush artifact. Indistinct cell borders. |
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Cytoplasm |
Dense cytoplasm. Diff-quick: dense blue or purple; Pap: yellow or orange. |
Relatively dense, well-defined. Diff-Quick: blue or purple; Pap: blue-green, or eosinophilic. |
Delicate, finely vacuolated |
Delicate, scant. Blue bodies. |
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Nuclei |
Irregular and angular |
Centrally located, irregular membrane. |
Large |
Hyperchromatic |
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Chromatin |
Coarse to pyknotic, hyperchromatic or ink dot-like |
Coarse and hyperchromatic, but more open. Irregular chromatin. |
More open, delicate, pale |
Fine chromatin |
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Nucleoli |
Inconspicuous |
More prominent |
Most prominent |
Inconspicuous |
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Background |
Keratin pearls. Large pleomorphic ghost cell, necrosis and granules. Granuloma. |
No keratin pearls. Granuloma. |
Mucin |
No inflammation |
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Mucinous BAC |
Nonmucinous BAC |
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Pattern |
3-dimensional clusters, honeycomb sheets, numerous cohesive |
Monolayered sheets, occasional papillae |
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Cell |
Large columnar cells, lower N/C ratio |
Smaller cuboidal cells, higher N/C ratio |
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Cytoplasm |
Abundant foamy to clear with terminal bar-like borders (microvilli) |
Scant finely granular, no terminal bar-like borders |
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Nuclei |
Bland basal, few intranuclear cytoplasmic invaginations |
Centered, atypical, intranuclear cytoplasmic invaginations (PAS±) |
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Mucin |
Positive |
Negative |
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Background |
No background, rare psammoma bodies |
Mild chronic inflammation, occasional psammoma bodies |
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Reference | |
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| Summarized by Zenggang Pan, MD, PhD | |