Lung Cancers In Cytology

 

 

Uploaded: 2007-08-04, Updated: 2007-08-04

 

Reactive Atypia

Malignancy

Few atypical cells

More cellular, many atypical cells, many single cells

Organized orderly clusters

Crowed disorganized disorderly clusters

Spectrum from benign to high atypical cells

Discrete population

Cohesive

Dyscohesive

N/C ration in normal limits

High N/C ratio

Enlarged nuclei, <4-6×

Significantly enlarged nuclei, >4-6×

Smooth nuclear membrane

Irregular nuclear membrane

Fine to coarse, but regular chromatin, uniform nucleoli

Coarse, irregular chromatin

Cilia

No Cilia

Regression with time

Progress with time

 

 

Well-Differentiated SCC

Poorly Differentiated SCC

Adenocarcinoma

Small Cell Carcinoma

Pattern

More single cells

More Groups

Glands, cell ball, acini or  papillae. Disorganized, crowed, palisading.

Very cellular, isolated, syncytial aggregates, sheets, rosettes

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.

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.

Nuclei

Irregular and angular

Centrally located, irregular membrane.

Large

Hyperchromatic

Chromatin

Coarse to pyknotic, hyperchromatic or ink dot-like

Coarse and hyperchromatic, but more open. Irregular chromatin.

More open, delicate, pale

Fine chromatin

Nucleoli

Inconspicuous

More prominent

Most prominent

Inconspicuous

Background

Keratin pearls. Large pleomorphic ghost cell, necrosis and granules. Granuloma.

No keratin pearls. Granuloma.

Mucin

No inflammation

 

 

Mucinous BAC

Nonmucinous BAC

Pattern

3-dimensional clusters, honeycomb sheets, numerous cohesive

Monolayered sheets, occasional papillae

Cell

Large columnar cells, lower N/C ratio

Smaller cuboidal cells, higher N/C ratio

Cytoplasm

Abundant foamy to clear with terminal bar-like borders (microvilli)

Scant finely granular, no terminal bar-like borders

Nuclei

Bland basal, few intranuclear cytoplasmic invaginations

Centered, atypical, intranuclear cytoplasmic invaginations (PAS±)

Mucin

Positive

Negative

Background

No background, rare psammoma bodies

Mild chronic inflammation, occasional psammoma bodies

 

Reference

 
  • The art and science of cytopathology. Richard M Demay, MD. 1996

  Summarized by Zenggang Pan, MD, PhD