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)
Bronchial material
Bronchial material A great improvement in sampling cells from the lower respiratory tract occurred with the development of the flexible bronchoscope in the late 1960s. The complications of bronchoscopy, including laryngospasm, bronchospasm, disturbances of cardiac conduction and sepsis, are very rare. Bronchoscopic methods are particularly good for diagnosing central lesions, on which a biopsy and […]
Transbronchial fine needle aspiration (FNA)
Transbronchial FNA is especially useful for the diagnosis of primary lung lesions lying beneath the bronchial surface and for staging lung cancer patients with mediastinal lymphadenopaty. The lesion is aspirated by a retractable needle (Wang needle) that is passed through a flexible catheter sent down the bronchoscope. Complications of transbronchial FNA are rare, including endobronchial […]
Transthoracic fine needle aspiration (FNA)
The indication for transthoracic FNA is the presence of a pulmonary mass. This method allows to spare many patients a more invasive surgical procedure. Indications to FNA also include subclassification of obvious malignant neoplasms and persistent lung infections. The most common complication is pneumothorax, requiring a drainage tube in 10% of the patients. FNA is […]
Liquid-based cytology (LBC)
Liquid-based cytology (LBC) has emerged as an alternative to conventional cytopreparatory methods. In particular, LBC has been extensively implemented in the cervical screening program, but it has found broader acceptance also in non-gynecologic cytologic preparations. LBC uses a specially devised instrument which allows a monolayer of cells to be obtained from a liquid sample. Most studies […]
Respiratory Tract
On completion of this section the cytotechnologist should Know: the anatomy and histology of the respiratory tract the role and indications of respiratory tract cytology the advantages and disadvantages of the different sampling methods the reporting terminology cytologic features of normal cells from the respiratory tract the non-cellular elements and contaminants which may appear in […]
Anatomy and histology of the respiratory tract
The respiratory tract can be divided into upper and lower compartments. The upper airway extends from the sino-nasal area to the larinx. The lower tract extends from trachea to the lungs and is the major focus of respiratory cytology. Cells of the upper airway are occasionally observed in the specimens from the lower tract. The […]