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Difference between revisions of "Pulmonary cytopathology"
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Pulmonary cytopathology (view source)
Revision as of 14:14, 16 February 2011
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This article deals only with pulmonary cytopathology (FNAs, sputum samples). An introduction to cytopathology is in the ''[[cytopathology]]'' article. An introduction to lung pathology is in the ''[[lung]]'' article. | This article deals only with pulmonary cytopathology (FNAs, sputum samples). An introduction to cytopathology is in the ''[[cytopathology]]'' article. An introduction to lung pathology is in the ''[[lung]]'' article. | ||
==Normal== | =Introduction= | ||
==Normal cytology== | |||
*Cells with cilia = good. | *Cells with cilia = good. | ||
*Cells with "terminal bar" (apical red band-like region associated with cilia) = good. | *Cells with "terminal bar" (apical red band-like region associated with cilia) = good. | ||
== | ==Specimen types== | ||
#Bronchial brushings. | #Bronchial brushings. | ||
#Bronchial washing (contain airway cells). | #Bronchial washing (contain airway cells). | ||
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#Endobronchial ultrasongraphic transbronchial needle aspiration (EBUS-TNA). | #Endobronchial ultrasongraphic transbronchial needle aspiration (EBUS-TNA). | ||
==Adequacy== | ==Adequacy criteria== | ||
*Want to see pulmonary macrophages (large cells with bubbly green/brown cytoplasm, eccentric reniform nucleus). | *Want to see pulmonary macrophages (large cells with bubbly green/brown cytoplasm, eccentric reniform nucleus). | ||
**Ciliated cells may be from the nasopharynx - not proof of lung parenchymal tissue. | **Ciliated cells may be from the nasopharynx - not proof of lung parenchymal tissue. | ||
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There is no generally accepted standard for pulmonary specimens. An in-house standard is:<ref>UHN PCY50001.08 P.11.</ref> | There is no generally accepted standard for pulmonary specimens. An in-house standard is:<ref>UHN PCY50001.08 P.11.</ref> | ||
*Sputum: >= 10 pulmonary macrophages. | *Sputum: >= 10 pulmonary macrophages. | ||
=Infection= | =Infection= | ||
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*[http://commons.wikimedia.org/wiki/File:Melanoma_-_cytology_field_stain.jpg Bug-eyed monster cell in melanoma - Field stain (WC)]. | *[http://commons.wikimedia.org/wiki/File:Melanoma_-_cytology_field_stain.jpg Bug-eyed monster cell in melanoma - Field stain (WC)]. | ||
=Other= | |||
==Asthma== | ==Asthma== | ||
{{Main|Asthma}} | {{Main|Asthma}} | ||
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*''Curschmann's spirals'' are a non-specific finding; they may be seen in a range of conditions in including chronic bronchitis, asymptomatic smokers and lung cancer.<ref name=pmid9812228/> | *''Curschmann's spirals'' are a non-specific finding; they may be seen in a range of conditions in including chronic bronchitis, asymptomatic smokers and lung cancer.<ref name=pmid9812228/> | ||
==See also | ==Pulmonary hamartoma== | ||
===General=== | |||
*Non-neoplastic growth - see ''[[hamartoma]]''. | |||
===Microscopic=== | |||
Features: | |||
*No cytologic features of malignancy. | |||
*Fat. | |||
==Non-specific inflammation== | |||
*A very common finding in BALs. | |||
Types: | |||
*Eosinophilia | |||
**If you notice eosinophils... you probably have eosinophilia. | |||
***One in several HPFs (40x obj. with 22 mm eye piece) is enough. | |||
*Acute - neutrophils. | |||
**~10/HPF (40xo 22mm ep). | |||
*Chronic - lymphocytes + occ. plasma cells. | |||
**~5 small lymphocytes/HPF (40xo 22 mm ep). | |||
*Mixed acute & chronic inflammation. | |||
=See also= | |||
*[[Cytopathology]]. | *[[Cytopathology]]. | ||
*[[Basics]]. | *[[Basics]]. | ||
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*[[Lung cancer]]. | *[[Lung cancer]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
=External links= | |||
*[http://www.cytology-asc.com/cec/respiratory/respneopl.htm Respiratory cytopathology (Australian Society)]. | *[http://www.cytology-asc.com/cec/respiratory/respneopl.htm Respiratory cytopathology (Australian Society)]. | ||
[[Category:Cytopathology]] | [[Category:Cytopathology]] | ||