Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface
- 1 Historical perspective
- 2 Normal cell morphology – euplasia (cells in normal health and physiologic state)
- 3 Malignant cell morphology
- 4 Functional differentiation characteristics in cancer
- 5 Altered pan-epithelial functional activity
- 6 Fixation and specimen processing
- 7 Ancillary techniques applicable to cytopathology
- Index
- References
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3 - Malignant cell morphology
Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Preface
- 1 Historical perspective
- 2 Normal cell morphology – euplasia (cells in normal health and physiologic state)
- 3 Malignant cell morphology
- 4 Functional differentiation characteristics in cancer
- 5 Altered pan-epithelial functional activity
- 6 Fixation and specimen processing
- 7 Ancillary techniques applicable to cytopathology
- Index
- References
Summary
GENERAL PERSPECTIVE
The morphologic findings referred to in this chapter as “malignant criteria” are those changes which, when found together in a recognized pattern, have been most useful for identifying malignant cells in cytological material. It must be recognized that there is a constellation of morphologic changes that help in diagnosis. Most commonly, this interpretation is critically influenced by clinical and relevant information. There is no single cytologic feature which, by itself, unequivocally indicates malignancy; nor is there a cytologic change which, when absent, bespeaks benignancy.
One must be careful not to include a cellular finding as a malignant criterion only because it happens to be present in a cell known to be malignant. As far as possible, the criteria should exclusively be observed using malignant cells with minimal overlap with benign conditioning. It is necessary to employ an extremely conservative approach in malignancy diagnosis; specifically, is more important than specificity. To quote the late Dr. Frost,
It being my philosophy that we should strive for a cytologic unequivocal diagnosis of malignancy having the reliability of a tissue diagnosis. Only this unequivocally cancer group, do I call “Positive” in my own practice (0.8% of Gyn-Ob patients). To the normal or bizarre benign group, I refer as “Negative” (95.4%). Then there is the group containing the “shaded” lesions, (3.8%).
A malignant diagnosis is based upon the evaluation of multiple parameters. These include clinical history, relevant investigational studies, precise location of the lesion, manner of specimen collection, and processing.
- Type
- Chapter
- Information
- CytohistologyEssential and Basic Concepts, pp. 66 - 94Publisher: Cambridge University PressPrint publication year: 2000
References
, , et al. (2000). “Characterizing ‘blue blobs’. Immunohistochemical staining and ultrastructural study”. Acta Cytol 44(4): 547–50.CrossRefGoogle Scholar
, , et al. (1986). “Morphologic spectrum of hepatocellular carcinoma in fine needle aspiration biopsies”. Acta Cytol 30(3): 294–302.Google Scholar
and (1991). “Cytologic diagnosis of adenovirus bronchopneumonia”. Acta Cytol 35(2): 181–2.Google Scholar
and . (1976). “Bronchial brushing during fiberoptic bronchoscopy for the cytodiagnosis of lung cancer: comparison with sputum and bronchial washings”. Acta Cytol 20(5): 446–53.Google Scholar
and (1974). “Studies on the composition of the thyroid psammoma bodies of chronically iodine-deficient rats”. Endocrinology 95(3): 651–9.CrossRefGoogle Scholar
and (1985). “Psammoma bodies in the aspiration cytology smears of an acinic-cell tumor”. Acta Cytol 29(2): 191–2.Google Scholar
, , et al. (2003). “Cytologic criteria of cystic papillary carcinoma of the thyroid”. Acta Cytol 47(4): 590–4.CrossRefGoogle Scholar
, , et al. (1987). “A critical evaluation of bronchoalveolar lavage. Criteria for identifying unsatisfactory specimens”. Acta Cytol 31(5): 599–605.Google Scholar
, , et al. (2004). “Three-dimensional cytomorphology in fine needle aspiration biopsy of subacute thyroiditis”. Acta Cytol 48(2): 155–60.CrossRefGoogle Scholar
and . (1980). “The value of ethanol as a fixative in urinary cytology”. Acta Cytol 24(5): 452–5.Google Scholar
and (2001). “Diagnostic dilemmas in pulmonary cytology”. Cancer 93(6): 364–75.CrossRefGoogle Scholar
. (2004). “Fine-needle aspiration (FNA) cytology diagnosis of small round cell tumors: value and limitations”. Indian J Pathol Microbiol 47(3): 309–18.Google Scholar
(2005). “Intranuclear cytoplasmic inclusions in fine-needle aspiration smears of papillary thyroid carcinoma: a study of its morphological forms, association with nuclear grooves, and mode of formation”. Diagn Cytopathol 32(5): 264–8.CrossRefGoogle Scholar
, , et al. (2001). “Utility of urinary cytology for diagnosing human polyoma virus infection in transplant recipients: a study of 37 cases with electron microscopic analysis”. Diagn Cytopathol 25(6): 376–81.CrossRefGoogle Scholar
, , et al. (2001). “Nuclear texture features for classifying benign vs. dysplastic or malignant squamous epithelium of the larynx”. Anal Quant Cytol Histol 23(3): 193–200.Google Scholar
and . (1982). “Cytology of cystic papillary carcinoma of the thyroid”. Acta Cytol 26(6): 797–808.Google Scholar
(1974). “Cell degeneration: light and electron microscopic study of ovarian germ cells”. Acta Cytol 18(6): 504–09.Google Scholar
, , et al. (1985). “Fine needle aspiration cytology smear patterns of malignant melanoma”. Acta Cytol 29(6): 983–8.Google Scholar
, , et al. (2008). “Intranuclear cytoplasmic inclusion is a significant diagnostic feature for the differentiation of lobular endocervical glandular hyperplasia from minimal deviation adenocarcinoma of the cervix”. Diagn Cytopathol 36(8): 535–44.CrossRefGoogle Scholar
, , et al. (1984). “Exfoliative cytology in the evaluation of interferon treatment of cervical intraepithelial neoplasia”. Acta Cytol 28(2): 111–7.Google Scholar
and . (2003). “Non-tumor-associated psammoma bodies in the thyroid”. Am J Clin Pathol 119(1): 90–4.CrossRefGoogle Scholar
, , et al. (1996). “Studies on intranuclear inclusions and nuclear grooves in papillary thyroid cancer by light, scanning electron and transmission electron microscopy”. Acta Cytol 40(3): 417–22.CrossRefGoogle Scholar
, , et al. (1986). “Carcinoid tumors of the lung: cytologic differential diagnosis in fine-needle aspirates”. Diagn Cytopathol 2(4): 343–6.CrossRefGoogle Scholar
, , et al. (1980). “Cytopathology of papillary carcinoma of the thyroid by fine needle aspiration”. Acta Cytol 24(6): 511–21.Google Scholar
. (2000). “Utility of liquid-based cytology for cervical carcinoma screening”. Cancer 90(1): 67–9.3.0.CO;2-M>CrossRefGoogle Scholar
, , et al. (2006). Koss' Diagnostic Cytology and its Histopathologic Bases. Philadelphia, PA, Lippincott Williams & Wilkins.Google Scholar
, , et al. (2008). “Prospective study of urine cytology screening for BK polyoma virus replication in renal transplant recipients”. Cytopathology 19(6): 385–8.CrossRefGoogle Scholar
, , et al. (2006). “Pitfalls in the diagnosis of herpes simplex infection in respiratory cytology”. Acta Cytol 50(6): 617–20.CrossRefGoogle Scholar
and . (1992). “Thyroid fine-needle aspiration: intranuclear inclusions, nuclear grooves and psammoma bodies – paraganglioma-like adenoma of the thyroid”. Diagn Cytopathol 8(1): 82–3; discussion 83–4.CrossRefGoogle Scholar
and (1987). “Cytology and immunocytochemistry of bronchioloalveolar carcinoma”. Acta Cytol 31(6): 717–25.Google Scholar
, , et al. (2002). “Diagnosing endometrial carcinoma with cervical involvement by cervical cytology”. Acta Cytol 46(2): 284–90.CrossRefGoogle Scholar
, , et al. (1989). “Intracytoplasmic eosinophilic inclusion bodies in breast cyst fluids are giant lysosomes”. Acta Cytol 33(1): 99–103.Google Scholar
, , et al. (1981). “Evaluation of collection and preservation techniques for urinary cytology”. Acta Cytol 25(3): 327–33.Google Scholar
, , et al. (1989). “Undifferentiated small round-cell tumors of childhood: the immunocytochemical demonstration of myogenic differentiation in fine-needle aspirates”. Diagn Cytopathol 5(2): 194–9.CrossRefGoogle Scholar
, , et al. (2002). “Intranuclear inclusions in fine needle aspirates of bronchial low grade mucoepidermoid carcinoma with clear cell change: a report of two cases”. Acta Cytol 46(1): 57–60.CrossRefGoogle Scholar
, , et al. (1987). “Psammoma bodies in neuroendocrine carcinoma of the uterine cervix”. Acta Cytol 31(6): 791–5.Google Scholar
, , et al. (1994). “Localization of double, roentgenographically occult lung cancer. Cytologic findings from selective brushing of all segmental and subsegmental bronchi”. Acta Cytol 38(3): 392–7.Google Scholar
and . (2000). “Cystic degeneration in phyllodes tumor. A source of error in cytologic interpretation”. Acta Cytol 44(2): 163–8.CrossRefGoogle Scholar
and (1989). “The significance of paravacuolar granules of the thyroid. A histologic, cytologic and ultrastructural study”. Acta Cytol 33(6): 929–33.Google Scholar
, , et al. (1989). “Cytopathology of neoplasms of the central nervous system in specimens obtained by the Cavitron Ultrasonic Surgical Aspirator”. Acta Cytol 33(5): 576–82.Google Scholar
and . (1991). “Fine-needle aspiration biopsy of malignant melanoma: a cytologic and immunocytochemical analysis”. Diagn Cytopathol 7(4): 380–6.CrossRefGoogle Scholar
and . (1976). “Small-cell carcinoma of the lung. Cytological, roentgenologic, and clinical findings in a consecutive series diagnosed by fine-needle aspiration biopsy”. Radiology 121(2): 269–74.CrossRefGoogle Scholar
, , et al. (1999). “Intranuclear cytoplasmic inclusions and nuclear grooves in pleomorphic adenoma of parotid gland”. Diagn Cytopathol 21(6): 435–6.3.0.CO;2-0>CrossRefGoogle Scholar
, , et al. (2003). “Diagnosis of hepatocellular carcinoma by fine needle aspiration cytology. Cellular features”. Acta Cytol 47(4): 581–9.CrossRefGoogle Scholar
, , et al. (1979). “The diagnostic value of cell-nuclear DNA determination in aspiration cytology of benign and malignant lesions of the breast”. Anal Quant Cytol 1(1): 29–36.Google Scholar
, , et al. (2009). “High-grade neuroendocrine carcinoma of the lung: comparative clinicopathological study of large cell neuroendocrine carcinoma and small cell lung carcinoma”. Pathol Int 59(8): 522–9.CrossRefGoogle Scholar
, , et al. (1984). “Cytomorphology of primary small-cell (Merkel-cell) carcinoma of the skin in fine needle aspirates”. Acta Cytol 28(3): 290–6.Google Scholar
and (1988). “Carcinoids, atypical carcinoids, and small-cell carcinomas of the lung: differential diagnosis of fine-needle aspiration biopsy specimens”. Diagn Cytopathol 4(1): 1–8.CrossRefGoogle Scholar
, , et al. (1982). “Viability of intraperitoneal free cancer cells in patients with gastric cancer”. Acta Cytol 26(5): 681–7.Google Scholar
, , et al. (1986). “Cytologic diagnosis of bronchioloalveolar carcinoma by fine-needle aspiration biopsy”. Cancer 57(8): 1565–70.3.0.CO;2-J>CrossRefGoogle Scholar
, , et al. (1992). “Bronchoalveolar lavage. Influence of cytologic methods on the cellular picture”. Acta Cytol 36(5): 680–6.Google Scholar
, , et al. (2008). “Microcalcifications and psammoma bodies in thyroid tumors”. Thyroid 18(9): 1017–8.CrossRefGoogle Scholar
, , et al. (2002). “Cytologic features of metastatic papillary thyroid carcinoma in cervical lymph nodes”. Acta Cytol 46(6): 1043–8.CrossRefGoogle Scholar
, and . (1977). “Psammoma bodies of benign endometrial origin in cervicovaginal cytology”. Acta Cytol 21(4): 550–2.Google Scholar
, , et al. (1995). “Computer-derived nuclear features distinguish malignant from benign breast cytology”. Hum Pathol 26(7): 792–6.CrossRefGoogle Scholar
. (1995). “Mixed small cell/large cell carcinoma of the lung. Report of a case with cytologic features and ultrastructural correlation”. Acta Cytol 39(6): 1175–81.Google Scholar
, , et al. (1980). “The morphometry of the Sudan-III-positive granules in the cytoplasm of the human amniotic epithelium”. Acta Cytol 24(1): 44–8.Google Scholar
. (2004). “Viral cytopathic changes in urine cytology of ileal conduit attributed to adenovirus: report of a case”. Diagn Cytopathol 30(4): 284–7.CrossRefGoogle Scholar
and . (1976). “Cyanophilic bodies in cervico-vaginal smears”. Acta Cytol 20(4): 340–2.Google Scholar