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Difference between revisions of "Head and neck cytopathology"
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*[http://commons.wikimedia.org/wiki/File:Adenoid_cystic_carcinoma_cytology.jpg Adenoid cystic carcinoma -cytology (WC)]. | *[http://commons.wikimedia.org/wiki/File:Adenoid_cystic_carcinoma_cytology.jpg Adenoid cystic carcinoma -cytology (WC)]. | ||
= | =Common= | ||
==Squamous carcinoma== | |||
{{Main|Squamous cell carcinoma}} | |||
*AKA ''squamous cell carcinoma''. | |||
===Cytopathology=== | |||
Features: | |||
*Mix of spindle cells/epithelioid cells, present in clusters, +/-small number of single cells. | |||
*Keratinization: | |||
**Orange/red staining on Pap stain. | |||
***Poorly differentiated SCC = not orange/red. | |||
**"Intense" (blue) staining of cells on rapid Romanowsky + pyknotic (small shriveled) nucleus.<ref>GS. 24 February 2010.</ref> | |||
*"Dense" appearing cytoplasm. | |||
**+/-Laminae (layers)/lines in the cytoplasm. | |||
*Nuclear features of malignancy (required for diagnosis): | |||
*#Irregular nuclear membrane, e.g. notches, sharp discontinuities. | |||
*#Nuclear hyperchromasia - "jet-black" nuclei on Pap stain '''key feature'''. | |||
*#Increased NC ratio. | |||
*#Variation of nuclear size from cell-to-cell. | |||
*#Granular chromatin. | |||
Notes: | |||
#One should see abnormal squamous cells to call it SCC. | |||
#Poorly differentiated SCC may look like [[adenocarcinoma]]. | |||
==Melanoma== | ==Melanoma== | ||
{{Main|Malignant melanoma}} | {{Main|Malignant melanoma}} | ||
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Notes: | Notes: | ||
#IHC stains are needed in many cases (S-100, HMB-45, Melan A). | #[[IHC]] stains are needed in many cases (S-100, HMB-45, Melan A). | ||
#The classic appearance of melanoma without pigment is closest to adenocarcinoma (which may have red nucleoli, large cells, abundant cytoplasm, occasional binucleation). | #The classic appearance of melanoma without pigment is closest to [[adenocarcinoma]] (which may have red nucleoli, large cells, abundant cytoplasm, occasional binucleation). | ||
#*Differentiating morphologic features: adenocarcinoma - 3-D clusters of cells, no spindle-shaped cells. | #*Differentiating morphologic features: adenocarcinoma - 3-D clusters of cells, no spindle-shaped cells. | ||
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*Epidermoid cyst. | *Epidermoid cyst. | ||
*Cystic squmaous cell carcinoma. | *Cystic squmaous cell carcinoma. | ||
=See also= | =See also= | ||