Lung cancer and other malignant tumours

Carcinoma of the lung is one of the most common malignancies in both men and women. It accounts for about 16% of all cancers diagnosed (20% of male and 12% of female cancers) making it the commonest malignancy and third most common cause of death in the UK. Its incidence has increased over the past […]

Viral infections

Herpes simplex thacheobronchitis and pneumonitis usually affect immunocompromised patients. Multinucleated cells are commonly seen, usually with eosinophilic, intranuclear inclusions. The dignosis can be confirmed by immunoperoxidase studies. Cytomegalovirus often causes an opportunistic infection, with diffuse pulmonary infiltrates. Viral changes, which are the same as in other sites, are seen in bronchial cells or pneumocytes: the […]

Reporting terminology

As with other non-gynaecologic cytologic specimens, respiratory tract diagnoses are reported as “negative for malignant cells”, “positive for malignant cells”, “suspicious for malignancy” (in this case a comment is required to state whether reactive or neoplastic changes are favoured) or “unsatisfactory (non-diagnostic)”, followed by a description.

Fungal infections

Pulmonary fungal infections are readily diagnosed by cytology; they often arise in immunocompromised patients. They should be always suspected whenever granulomatous inflammation is present, sometimes together with neutrophils. Cell blocks can be used for silver or periodic acid-Schiff (PAS) stains. Many fungi have a characteristic structure that enables a specific diagnosis. Several fungal infections can […]

Normal cells – Respiratory tract

cartilage in BW FNA negative – macrophages FNA negative – macrophages Transbronchial aspiration – benign Bronchial brush – benign bronchial epithelium Bronchial brush – benign bronchial epithelium  

Pneumocystis carinii

The pneumonia by Pneumocystis carinii is common in immunocompromised patients (such as HIV-positive), usually presenting as bilateral pulmonary infiltrates on radiographs. The organisms can be demonstrated in BAL material, as well as in bronchial washings and induced sputum. With Papanicolaou stains, masses of organisms enmeshed in a proteinaceous material can be observed as green, foamy […]

Non-cellular elements and specimen contaminants

Non-cellular findings in respiratory material include those produced by the host, inhaled, formed as response to foreign material and introduced as laboratory contaminants. Curschmann`s spirals are coiled strand of mucus. On Papanicolaou stains, they appear as purple helices. They are a non-specific finding associated with chronic respiratory disorders.   Ferruginous bodies are mineral fibers (such […]

Echinococcosis (hydatid disease)

It is contracted by ingestion of Echinococcus granulosus or Echinococcus multilocularis cestode eggs, which hatch into embryos in the small intestine, enter the circulatory system and form hydatid cysts in many organs (such as the lung). In cytologic specimens, the laminated hydatid cystic wall (staining positive with PAS and methenamine silver) can be seen containing […]

Benign cellular changes

Squamous cell changes Bronchial cell changes Bronchial reserve cell hyperplasia Repair Tipe II pneumocytes hyperplasia Squamous cells Squamous cells from the upper respiratory tract often contaminate specimens from the lower tract. Inflammatory conditions of the mouth may exfoliate atypical squamous cells which should not be misdiagnosed as squamous cell carcinoma. Cancer involving head and neck […]

Lymphoma

Hodgkin and non-Hodgkin lymphomas occur as primary tumors of the lung, but spread from an extrapulmonary primary is more common. The most common primary lymphoma of the lung is low-grade extranodal marginal zone lymphoma (MALT lymphoma), followed by diffuse large B-cell lymphoma. Low grade lymphomas are typically incidental, solitary lung masses with an indolent clinical […]