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 […]
Inflammation
The cytologic features of common inflammatory processes, such as organizing pneumonia, bronchiolitis obliterans obstructing pneumonia and diffuse alveolar damage, are considerably overlapping. Inflammatory cells are observed, such as macrophages, neutrophils, eosinophils and lymphocytes. Reactive pneumocytes are especially common in organizing pneumonia and diffuse alveolar damage. The lung is the most common site of sarcoidosis, which […]
Respiratory infections
Cytology plays an important role in diagnosing infectious diseases in immunocompromised patients. Conventional inflammatory response may be much reduced, absent or greatly altered in these patients. Viral infections Bacterial infections Fungal infections Pneumocystis carinii Echinococcosis (hydatid disease)
Bacterial infections
Bacterial infections present as pneumonias or abscesses. Acute pneumonia and lung abscesses are characterized by a neutrophilic exudate. Many bacteria, but not all, can be seen with Routine stains as well as with Gram stain. A specific identification of Legionella pneumophila can be made in BAL samples by immunofluorescent antibody staining. Infection by Mycobacterium tuberculosis […]
Preneoplastic changes of respiratory epithelium
Squamous cell carcinoma of the lung is preceded by precursor lesions, with a progression from benign squamous metaplasia, through dysplasia, to invasive cancer. Most authors acknowledge degrees (mild, moderate, severe) of dysplasia. The risk of developing bronchogenic carcinoma increases with the degree of atypia. Preinvasive lesions Squamous dysplasia Carcinoma in situ Atypical adenomatous hyperplasia Diffuse […]