Difference between revisions of "Pulmonary cytopathology"

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===Cytology===
===Cytology===
Features:
Features:
*Eccentric nucleus:
**+/-Nuclear grooves.
**+/-Nuclear pseudoinclusions.
*Nucleolus.
*Nucleolus.
**Good ones are visible with 10X objective (virtually excludes SCLC).
**Good ones are visible with 10X objective (virtually excludes SCLC).
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*Abundant cytoplasm - virtually excludes small cell carcinoma.
*Abundant cytoplasm - virtually excludes small cell carcinoma.
*Vacuoles with mucin (pink discolouration) - virtually diagnostic.
*Vacuoles with mucin (pink discolouration) - virtually diagnostic.
*Eccentric nucleus.
*Negatives: NO moulding.
**Important if no nucleolus visible.


Notes:
Notes:
*May be subtle, i.e. have minimal cytologic changes.  
*May be subtle, i.e. have minimal cytologic changes.  
*No nuclear moulding -esp. important if no nucleolus visible.


DDx:
DDx:
*[[Creola body]] - have cilia, may be subtle.
*Benign mesothelium (also sheets of cells).
*Benign mesothelium (also sheets of cells).
*Atypical adenomatous hyperplasia (AAH) - thought to be the precursor to adenocarcinoma.<ref name=pmid11235908>{{Cite journal  | last1 = Mori | first1 = M. | last2 = Rao | first2 = SK. | last3 = Popper | first3 = HH. | last4 = Cagle | first4 = PT. | last5 = Fraire | first5 = AE. | title = Atypical adenomatous hyperplasia of the lung: a probable forerunner in the development of adenocarcinoma of the lung. | journal = Mod Pathol | volume = 14 | issue = 2 | pages = 72-84 | month = Feb | year = 2001 | doi = 10.1038/modpathol.3880259 | PMID = 11235908 |url = http://www.nature.com/modpathol/journal/v14/n2/full/3880259a.html }}</ref>
*Atypical adenomatous hyperplasia (AAH) - thought to be the precursor to adenocarcinoma.<ref name=pmid11235908>{{Cite journal  | last1 = Mori | first1 = M. | last2 = Rao | first2 = SK. | last3 = Popper | first3 = HH. | last4 = Cagle | first4 = PT. | last5 = Fraire | first5 = AE. | title = Atypical adenomatous hyperplasia of the lung: a probable forerunner in the development of adenocarcinoma of the lung. | journal = Mod Pathol | volume = 14 | issue = 2 | pages = 72-84 | month = Feb | year = 2001 | doi = 10.1038/modpathol.3880259 | PMID = 11235908 |url = http://www.nature.com/modpathol/journal/v14/n2/full/3880259a.html }}</ref>
**AAH has a size criterion, ergo not really possible to diagnose on cytopathology specimen.
**AAH has a size criterion, ergo not really possible to diagnose on cytopathology specimen.
*[[Creola body]] - have cilia, may be subtle.


==Neuroendocrine tumours==
==Neuroendocrine tumours==
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