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3 - Malignant cell morphology

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
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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
Cytohistology
Essential and Basic Concepts
 , pp. 66 - 94
Publisher: Cambridge University Press
Print publication year: 2000

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  • Malignant cell morphology
  • Edited by Prabodh Gupta, University of Pennsylvania School of Medicine, Zubair Baloch, University of Pennsylvania School of Medicine
  • Book: Cytohistology
  • Online publication: 17 February 2011
  • Chapter DOI: https://doi.org/10.1017/CBO9780511976001.004
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  • Malignant cell morphology
  • Edited by Prabodh Gupta, University of Pennsylvania School of Medicine, Zubair Baloch, University of Pennsylvania School of Medicine
  • Book: Cytohistology
  • Online publication: 17 February 2011
  • Chapter DOI: https://doi.org/10.1017/CBO9780511976001.004
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  • Malignant cell morphology
  • Edited by Prabodh Gupta, University of Pennsylvania School of Medicine, Zubair Baloch, University of Pennsylvania School of Medicine
  • Book: Cytohistology
  • Online publication: 17 February 2011
  • Chapter DOI: https://doi.org/10.1017/CBO9780511976001.004
Available formats
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