Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-6bf8c574d5-9nwgx Total loading time: 0 Render date: 2025-02-18T18:42:10.876Z Has data issue: false hasContentIssue false
This chapter is part of a book that is no longer available to purchase from Cambridge Core

5 - Altered pan-epithelial functional activity

Edited by
Prabodh Gupta  and
Zubair Baloch
Prabodh Gupta
Affiliation:
University of Pennsylvania School of Medicine
Zubair Baloch
Affiliation:
University of Pennsylvania School of Medicine
Get access

Summary

GENERAL FEATURES

The normal (euplastic) nuclear pattern of epithelial and mesenchymal cells changes to reflect various adaptive activities. Most often, the cytoplasm is secondarily affected to express nuclear alterations resulting from prolonged stimulation, sustained degeneration (regression), and/or sudden irreversible death. It is important to examine the nuclear changes carefully when evaluating altered cells activity.

INCREASED FUNCTIONAL ACTIVITY (INCREASED ACTIVITY, REGENERATION, STIMULATION, REACTIVE ATYPIA)

Whenever stimulated and challenged in a slow and graduated fashion, tissues react and respond in two ways in growth activity: (i) hypertrophy, and (ii) hyperplasia. In the hypertrophic state there is an increase in the size of cells, while in hyperplasia there is an associated increase in the number of cells. In certain tissues, the two growth activities may occur simultaneously. For example, striated and cardiac muscles may react, enlarge and become hypertrophic. Epithelial cells such as those derived from endocervix, bronchial, and intestinal mucosa may respond by producing additional cells, i.e. hyperplasia. It must be realized that in most situations the cells represent a galaxy of changes occurring in the tissues being sampled, including regeneration, degeneration, “atypical”, and neoplastic alterations. Variable mitosis may be seen in the cells.

Cells as a whole

In cells derived from the cervical squamous epithelium, Papanicolaou recognized dyskaryosis (a state of abnormal nuclei) which, even though it has subsequently been greatly abused and confused, is a useful term and concept. Both the nuclei and cytoplasm of these dyskaryotic cells undergo morphologic changes which are good indicators of the quality and severity of the underlying processes.

Type
Chapter
Information
Cytohistology
Essential and Basic Concepts
 , pp. 127 - 147
Publisher: Cambridge University Press
Print publication year: 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agarwal, C. and Jain, M.. (2009). “Utility of fibronectin in immuocytochemical differentiation of reactive mesothelial cells from metastatic malignant cells in serous effusions”. Indian J Pathol Microbiol 52(1): 25–8.CrossRefGoogle Scholar
Ahmed, M. N., Lushpihan, A., et al. (1976). “Cytology of transitional cell carcinoma in situ of urinary bladder with extensive prostatic involvement”. Urology 7(5): 538–40.CrossRefGoogle Scholar
Aron, M., Mallik, A., et al. (2006). “Fine needle aspiration cytology of follicular variant of papillary carcinoma of the thyroid: morphologic pointers to its diagnosis”. Acta Cytol 50(6): 663–8.CrossRefGoogle Scholar
Arora, V. K., Singh, N., et al. (2003). “Significance of cytologic criteria in distinguishing small cell from non-small cell carcinoma of the lung”. Acta Cytol 47(2): 216–20.CrossRefGoogle Scholar
Atkinson, B. F. (2004). Atlas of Diagnostic Cytopathology. Philadelphia, PA, Saunders.Google Scholar
Atkinson, B. F. and Silverman, J. F.. (1998). Atlas of Difficult Diagnoses in Cytopathology. Philadelphia, PA, Saunders.Google Scholar
Baloch, Z. W. and LiVolsi, V. A.. (2002). “Etiology and significance of the optically clear nucleus”. Endocr Pathol 13(4): 289–99.CrossRefGoogle Scholar
Berner, H. S., Davidson, B., et al. (2000). “Differential expression of CD44s and CD44v3–10 in adenocarcinoma cells and reactive mesothelial cells in effusions”. Virchows Arch 436(4): 330–5.CrossRefGoogle Scholar
Bethwaite, P. B., Delahunt, B., et al. (1995). “Comparison of silver-staining nucleolar organizer region (AgNOR) counts and proliferating cell nuclear antigen (PCNA) expression in reactive mesothelial hyperplasia and malignant mesothelioma”. Pathology 27(1): 1–4.CrossRefGoogle Scholar
Boorjian, S., Ng, C., et al. (2004). “Abnormal selective cytology results predict recurrence of upper-tract transitional-cell carcinoma treated with ureteroscopic laser ablation”. J Endourol 18(9): 912–6.CrossRefGoogle Scholar
Bukovsky, A. (1986). “Multinucleation versus ‘cell-in-a-cell’ pattern”. Acta Cytol 30(2): 204–05.Google Scholar
Burja, I. T., Thompson, S. K., et al. (1999). “Atypical glandular cells of undetermined significance on cervical smears. A study with cytohistologic correlation”. Acta Cytol 43(3): 351–6.CrossRefGoogle Scholar
Cakir, E., Demirag, F., et al. (2009). “Cytopathologic differential diagnosis of malignant mesothelioma, adenocarcinoma and reactive mesothelial cells: a logistic regression analysis”. Diagn Cytopathol 37(1): 4–10.CrossRefGoogle Scholar
Chalon, J., Tang, C. K., et al. (1978). “Diagnostic and prognostic significance of tracheobronchial epithelial multinucleation”. Acta Cytol 22(5): 316–20.Google Scholar
Chen, G. L., El-Gabry, E. A., et al. (2000). “Surveillance of upper urinary tract transitional cell carcinoma: the role of ureteroscopy, retrograde pyelography, cytology and urinalysis”. J Urol 164(6): 1901–04.CrossRefGoogle Scholar
Chien, C. R., Ting, L. L., et al. (2005). “Post-radiation Pap smear for Chinese patients with cervical cancer: a ten-year follow-up”. Eur J Gynaecol Oncol 26(6): 619–22.Google Scholar
Cibas, E. S. and Ducatman, B. S.. (2009). Cytology: Diagnostic Principles and Clinical Correlates. Philadelphia, PA, Saunders Elsevier.Google Scholar
Copeland, J. N., Amin, M. B., et al. (2002). “The morphologic spectrum of metastatic prostatic adenocarcinoma to the lung: special emphasis on histologic features overlapping with other pulmonary neoplasms”. Am J Clin Pathol 117(4): 552–7.CrossRefGoogle Scholar
Crapanzano, J. P. and Zakowski, M. F.. (2001). “Diagnostic dilemmas in pulmonary cytology”. Cancer 93(6): 364–75.CrossRefGoogle Scholar
Demay, R. M (2000). “Hyperchromatic crowded groups: pitfalls in pap smear diagnosis”. Am J Clin Pathol 114 (Suppl): S36–43.Google Scholar
DiBonito, L., Musse, M. M., et al. (1992). “Cytology of transitional-cell carcinoma of the urinary bladder: diagnostic yield and histologic basis”. Diagn Cytopathol 8(2): 124–7.CrossRefGoogle Scholar
Domanski, H. A., Akerman, M., et al. (2006). “Fine-needle aspiration of soft tissue leiomyosarcoma: an analysis of the most common cytologic findings and the value of ancillary techniques”. Diagn Cytopathol 34(9): 597–604.CrossRefGoogle Scholar
Ducatman, B. S., Wang, H. H., et al. (1993). “Tubal metaplasia: a cytologic study with comparison to other neoplastic and non-neoplastic conditions of the endocervix”. Diagn Cytopathol 9(1): 98–103; discussion 103–05.CrossRefGoogle Scholar
Elpek, G. O., Paksoy, N., et al. (1999). “Value of morphometry in distinguishing atypical reactive mesothelial and adenocarcinoma cells in pleural effusions”. Diagn Cytopathol 21(2): 148–50.3.0.CO;2-E>CrossRefGoogle Scholar
Finley, J. L., Silverman, J. F., et al. (1988). “Fine-needle aspiration cytology of pulmonary carcinosarcoma with immunocytochemical and ultrastructural observations”. Diagn Cytopathol 4(3): 239–43.CrossRefGoogle Scholar
Granter, S. R. and Cibas, E. S.. (1997). “Cytologic findings in thyroid nodules after 131I treatment of hyperthyroidism”. Am J Clin Pathol 107(1): 20–5.CrossRefGoogle Scholar
Guarda, L. A., Peterson, C. E., et al. (1991). “Anaplastic thyroid carcinoma: cytomorphology and clinical implications of fine-needle aspiration”. Diagn Cytopathol 7(1): 63–7.CrossRefGoogle Scholar
Hashi, A., Yuminamochi, T., 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
Hata, S., Mikami, Y., et al. (2002). “Diagnostic significance of endocervical glandular cells with ‘golden-yellow’ mucin on pap smear”. Diagn Cytopathol 27(2): 80–4.CrossRefGoogle Scholar
Henderson, D. W., Shilkin, K. B., et al. (1998). “Reactive mesothelial hyperplasia vs mesothelioma, including mesothelioma in situ: a brief review”. Am J Clin Pathol 110(3): 397–404.CrossRefGoogle Scholar
Hernandez, E. and Atkinson, B. F.. (1996). Clinical Gynecologic Pathology. Philadelphia, PA, W.B. Saunders.Google Scholar
Hoda, R. S. and Hoda, S. A.. (2007). Fundamentals of Pap Test Cytology. Totowa, NJ, Humana Press.CrossRefGoogle Scholar
Jhala, N., Siegal, G. P., et al. (2008). “Large, clear cytoplasmic vacuolation: an under-recognized cytologic clue to distinguish solid pseudopapillary neoplasms of the pancreas from pancreatic endocrine neoplasms on fine-needle aspiration”. Cancer 114(4): 249–54.CrossRefGoogle Scholar
Kapila, K., Nampoory, M. R., et al. (2007). “Role of urinary cytology in detecting human polyoma bk virus in kidney transplant recipients. A preliminary report”. Med Princ Pract 16(3): 237–9.CrossRefGoogle Scholar
Karakiewicz, P. I., Benayoun, S., et al. (2006). “Institutional variability in the accuracy of urinary cytology for predicting recurrence of transitional cell carcinoma of the bladder”. BJU Int 97(5): 997–1001.CrossRefGoogle Scholar
Kaur, J. and Dey, P.. (2010). “Micronucleus to distinguish adenocarcinoma from reactive mesothelial cell in effusion fluid”. Diagn Cytopathol 38(3): 177–9.Google Scholar
Khayyata, S., Barroeta, J. E., et al. (2008). “Papillary hyperplastic nodule: pitfall in the cytopathologic diagnosis of papillary thyroid carcinoma”. Endocr Pract 14(7): 863–8.CrossRefGoogle Scholar
Kim, T. J., Kim, H. S., et al. (1999). “Clinical evaluation of follow-up methods and results of atypical glandular cells of undetermined significance (AGUS) detected on cervicovaginal Pap smears”. Gynecol Oncol 73(2): 292–8.CrossRefGoogle Scholar
Kitazume, H., Kitamura, K., et al. (2000). “Cytologic differential diagnosis among reactive mesothelial cells, malignant mesothelioma, and adenocarcinoma: utility of combined E-cadherin and calretinin immunostaining”. Cancer 90(1): 55–60.3.0.CO;2-P>CrossRefGoogle Scholar
Koss, L. G. (2005). “Cytological criteria for the diagnosis of intraductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma of the breast”. Diagn Cytopathol 33(3): 219.CrossRefGoogle Scholar
Koss, L. G. (2007). “Of tissues, cells, and molecules: reminiscences of an old pathologist”. Hum Pathol 38(10): 1447–53.CrossRefGoogle Scholar
Koss, L. G. (2008). “Atypical urothelial cells”. Anal Quant Cytol Histol 30(1): 61–2.Google ScholarPubMed
Koss, L. G., Melamed, M. R., et al. (2006). Koss' Diagnostic Cytology and its Histopathologic Bases. Philadelphia, PA, Lippincott Williams & Wilkins.Google Scholar
Koukoulaki, M., O'Donovan, M., 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
Lachman, M. F. (1994). “Morphometric comparison of a metastatic transitional cell carcinoma simulating squamous metaplasia in sputum cytology. A case report”. Acta Cytol 38(3): 407–09.Google Scholar
Lee, A., Baloch, Z. W., et al. (2000). “Mesothelial hyperplasia with reactive atypia: diagnostic pitfalls and role of immunohistochemical studies – a case report”. Diagn Cytopathol 22(2): 113–6.3.0.CO;2-6>CrossRefGoogle Scholar
Lee, M. W. and Nguyen, G. K.. (2007). “Cytology of papillary low-grade transitional cell carcinoma of the cervix in pap smear”. Diagn Cytopathol 35(9): 615–7.CrossRefGoogle Scholar
Leslie, K. K., Walter, S. A., et al. (2007). “Effect of tamoxifen on endometrial histology, hormone receptors, and cervical cytology: a prospective study with follow-up”. Appl Immunohistochem Mol Morphol 15(3): 284–93.CrossRefGoogle Scholar
Logani, S., Gupta, P. K., et al. (2000). “Thyroid nodules with FNA cytology suspicious for follicular variant of papillary thyroid carcinoma: follow-up and management”. Diagn Cytopathol 23(6): 380–5.3.0.CO;2-0>CrossRefGoogle Scholar
Malik, S. N., Wilkinson, E. J., et al. (2001). “Benign cellular changes in Pap smears. Causes and significance”. Acta Cytol 45(1): 5–8.CrossRefGoogle Scholar
Murugan, P., Siddaraju, N., et al. (2008). “Significance of intercellular spaces (windows) in effusion fluid cytology: a study of 46 samples”. Diagn Cytopathol 36(9): 628–32.CrossRefGoogle Scholar
Owens, C. L. and Ali, S. Z.. (2005). “Atypical squamous cells in exfoliative urinary cytology: clinicopathologic correlates”. Diagn Cytopathol 33(6): 394–8.CrossRefGoogle Scholar
Papanicolaou, G. N. (1960). Atlas of Exfoliative Cytology. Cambridge, MA, published for the Commonwealth Fund by Harvard University Press.Google Scholar
Pereira, T. C., Saad, R. S., et al. (2006). “The diagnosis of malignancy in effusion cytology: a pattern recognition approach”. Adv Anat Pathol 13(4): 174–84.CrossRefGoogle Scholar
Renshaw, A. A. (2005). Aspiration Cytology. Philadelphia, PA, Elsevier Saunders.Google Scholar
Ribotta, M., Donna, A., et al. (1992). “Quantitative analysis of nucleoli and nucleolar organizer regions in cultured primary human normal, reactive and malignant mesothelial cells”. Pathol Res Pract 188(4–5): 536–40.CrossRefGoogle Scholar
Saad, R. S., Kanbour-Shakir, A., et al. (2006). “Cytomorphologic analysis and histological correlation of high-grade squamous intraepithelial lesions in postmenopausal women”. Diagn Cytopathol 34(7): 467–71.CrossRefGoogle Scholar
Sakuma, N., Kamei, T., et al. (1999). “Ultrastructure of pleural mesothelioma and pulmonary adenocarcinoma in malignant effusions as compared with reactive mesothelial cells”. Acta Cytol 43(5): 777–85.CrossRefGoogle Scholar
Saleh, H. A., El-Fakharany, M., et al. (2009). “Differentiating reactive mesothelial cells from metastatic adenocarcinoma in serous effusions: the utility of immunocytochemical panel in the differential diagnosis”. Diagn Cytopathol 37(5): 324–32.CrossRefGoogle Scholar
Saleh, H. A., Haapaniemi, J., et al. (1998). “Bronchioloalveolar carcinoma: diagnostic pitfalls and immunocytochemical contribution.”Diagn Cytopathol 18(4): 301–06.3.0.CO;2-N>CrossRefGoogle Scholar
Sandhyamani, S., Kartha, C. C., et al. (1984). “Reactive mesothelial nodule of the pericardium”. Indian Heart J 36(3): 169–72.Google Scholar
Schaefer, F. V., Custer, R. P., et al. (1983). “Induction of squamous metaplasia: requirement for cell multiplication, and competition with lobuloalveolar development in cultured mammary glands”. Differentiation 25(2): 185–92.CrossRefGoogle Scholar
Schulte, E. (1986). “Air drying as a preparatory factor in cytology: investigation of its influence on dye uptake and dye binding”. Diagn Cytopathol 2(2): 160–7.CrossRefGoogle Scholar
Selvaggi, S. M. and Haefner, H. K.. (1997). “Microglandular endocervical hyperplasia and tubal metaplasia: pitfalls in the diagnosis of adenocarcinoma on cervical smears”. Diagn Cytopathol 16(2): 168–73.3.0.CO;2-K>CrossRefGoogle Scholar
Silverberg, S. G. and DeLellis, R. A.. (2006). Silverberg's Principles and Practice of Surgical Pathology and Cytopathology. Edinburgh, Churchill Livingstone/Elsevier.Google Scholar
Soosay, G. N., Griffiths, M., et al. (1991). “The differential diagnosis of epithelial-type mesothelioma from adenocarcinoma and reactive mesothelial proliferation”. J Pathol 163(4): 299–305.CrossRefGoogle Scholar
Stanley, M. W., Henry-Stanley, M. J., et al. (1992). “Hyperplasia of type II pneumocytes in acute lung injury. Cytologic findings of sequential bronchoalveolar lavage”. Am J Clin Pathol 97(5): 669–77.CrossRefGoogle Scholar
Ueda, J., Iwata, T., et al. (2006). “Comparison of three cytologic preparation methods and immunocytochemistries to distinguish adenocarcinoma cells from reactive mesothelial cells in serous effusion”. Diagn Cytopathol 34(1): 6–10.CrossRefGoogle Scholar
Vrtacnik Bokal, E., Rakar, S., et al. (2005). “Human papillomavirus infection in relation to mild dyskaryosis in conventional cervical cytology”. Eur J Gynaecol Oncol 26(1): 39–42.Google Scholar
Wang, N., Emancipator, S. N., et al. (2002). “Histologic follow-up of atypical endocervical cells. Liquid-based, thin-layer preparation vs. conventional Pap smear”. Acta Cytol 46(3): 453–7.CrossRefGoogle Scholar
Wiatrowska, B. A., Krol, J., et al. (2001). “Large-cell neuroendocrine carcinoma of the lung: proposed criteria for cytologic diagnosis”. Diagn Cytopathol 24(1): 58–64.3.0.CO;2-O>CrossRefGoogle Scholar
Willen, R., Bruce, T., et al. (1976). “Squamous epithelial cancer in metaplastic pleura following extrapleural pneumothorax for pulmonary tuberculosis”. Virchows Arch A Pathol Anat Histol 370(3): 225–31.CrossRefGoogle Scholar
Williams, S. K., Denton, K. J., et al. (2008). “Correlation of upper-tract cytology, retrograde pyelography, ureteroscopic appearance, and ureteroscopic biopsy with histologic examination of upper-tract transitional cell carcinoma”. J Endourol 22(1): 71–6.CrossRefGoogle Scholar
Ylagan, L. R., Edmundowicz, S., et al. (2002). “Endoscopic ultrasound guided fine-needle aspiration cytology of pancreatic carcinoma: a 3-year experience and review of the literature”. Cancer 96(6): 362–9.CrossRefGoogle Scholar
Zusman-Harach, S. B., Harach, H. R., et al. (1991). “Cytological features of non-small cell carcinomas of the lung in fine needle aspirates”. J Clin Pathol 44(12): 997–1002.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×