Diagnostic Cytology Pranab Dey
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1Diagnostic Cytology2
3Diagnostic Cytology
PRANAB DEY MBBS MD MIAC FRCPath Professor Department of Cytology Postgraduate Institute of Medical Education and Research Chandigarh India
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Diagnostic Cytology
First Edition: 2014
9789351520665
Printed at
5Dedicated to
Shree Shree Satyananda Giri, Rini, Madhumanti, and my mother
6
7PREFACE
Cytology is an integral part of pathology curriculum and it is very important to have working knowledge in this area. I designed this book in four sections: general cytology, clinical cytology (exfoliative cytology), laboratory techniques in cytology and fine needle aspiration cytology. I hope that this present book will help immensely all the postgraduate students in pathology, students of cytology (both BSc and MSc), cytology practitioners and all others who are interested in clinical cytology. I have tried to explain various areas of cytology by simple language, tables and illustrations (both line diagrams and microphotographs). All the line diagrams are drawn by me. I hope that these figures are satisfactory. There are multiple boxes in this book which convey the essential and important messages. I will be glad if this book is helpful to the students, teachers and practitioners of cytology.
Pranab Dey
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9ACKNOWLEDGMENTS
I express my gratitude to Professor Yogesh Chawla, Director, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, for encouraging me to write more books on cytology.
I am proud to work in the Department of Cytology, PGIMER, Chandigarh, India. The excellent set up of this institution helped me a lot.
It is my great pleasure to thank my respected teachers Late Dr Subhash Kumari Gupta and Dr Arvind Rajwanshi, Head of Cytology, PGIMER, Chandigarh. They taught me cytology. I wish to express my sincere thanks to my departmental colleagues Dr Raje Nijhawan, Dr S Radhika and Dr Nalini Gupta with whom I nurture my experience and knowledge of cytology. I am grateful to Professor Kusum Joshi, Head, Department of Histopathology, whose guidance was always my constant support.
During writing this book, I received great support from various persons. Dr Uma Nahar Saikia gave her full cooperation and encouragement in many ways. She particularly helped me to take photography for this book. I am very much thankful to Professor Neelam Verma, Dr Anupam Lal, Dr Ritu Aggarwal, Dr Subhash Chandra Saha, Dr Saroj Sinha, Dr Uttam Mete and Dr Charan Singh Rayat. They donated me generously various photographs for this book.
I am thankful to all my junior residents, senior residents and technical staff in the Department of Cytology. My particular thanks to Dr Adarsh Barwad, who gave his full cooperation in every possible ways. I express my sincere thanks to Mr Rajinder Kumar, our Departmental Photographer, who helped me in taking microphotographs.
Truly speaking, the full credit of the concept of the book goes to my wife Rini Dey. She is the only person who actively encouraged me from the beginning to end of the manuscript preparation. In every step of this book, she helped me immensely.
Lastly, I must admit about the blessing of Great God, the great supreme power, without him a single word cannot be written.
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17ABBREVIATIONS Acquired immunodeficiency syndrome
AIDS
Acute lymphoblastic leukemia
ALL
Acute myleoblastic leukemia
AML
Adenoid cystic carcinoma
ACC
Adenomatous polyposis coli
APC
Adenosine triphosphate
ATP
Adrenocortical carcinomas
ACC
Allophycocyanin
APC
Alpha fetoprotein
AFP
American Cancer Society
Acs
Anaphase promoting complex
APC
Anaplastic large cell lymphoma
ALCL
Anaplastic lymphoma kinase
ALK
Androgen receptor
AR
Aneurysmal bone cyst
ABC
Angiomyolipoma
AML
Apoptosis activating factor
APAF
Apoptosis inducing factor
AIF
Argyrophilic nucleolar organizer region
AGNOR
Artificial neural network
ANN
Atypical ductal hyperplasia
ADH
Atypical glandular cells
AGC
Atypical glandular cells of undetermined significance
AGUS
Atypical lipomatous tumor
ALT
Atypical squamous cell
ASC
Atypical squamous cell cannot exclude HSIL
ASC-H
Atypical squamous cell of undetermined significance
ASC-US
Autophagy related gene
ATG
Bacillus Calmette-Guérin
BCG
Bacterial vaginosis
BV
Barrett's esophagus
BE
Basal cell adenoma
BCA
Basal cell carcinoma
BCC
Bayesian belief network
BBN
Bladder tumor antigen
BTA
Bromodeoxyuridine
BrDU
Bronchioloalveolar carcinoma
BAC
18Bronchoalveolar lavage
BAL
Burkitt lymphoma
BL
Carcinoembryonic antigen
CEA
CDK inhibitor
CKI
Cerebrospinal fluid
CSF
Cervical intraepithelial neoplasia
CIN
Chromosomal instability
ChIN
Chondrosarcoma
CHS
Chronic lymphocytic leukemia
CLL
Chronic myeloid leukemia
CML
Clear cell sarcoma of kidney
CCSK
Clinical Laboratory Improvement Amendments
CLIA
Cluster of differentiation
CD
Coenzyme A
CoA
Comparative genomic hybridization
CGH
Computerized tomography
CT
Conventional preparation
CP
CpG island methylator phenotype
CIMP
Cyclin-dependent kinase
CDK
Cytokeratin
CKI
Cytomegalovirus
CMV
Cystosarcoma phyllodes
CP
Dense fibrillar component
DFC
Deoxyribonucleic acid
DNA
Desmoplastic small round cell tumor
DSRCT
Diffuse large B cell lymphoma
DLBCL
Disseminated peritoneal adenomucinosis
DPAM
DNA methyltransferases
DNMT
Ductal crcinoma in situ
DCIS
Endodermal sinus tumor
EST
Endoplasmic reticulum
ER
Endoscopic retrograde cholangiopancreatography
ERCP
Endoscopic ultrasound guided FNAC
EUG FNAC
Eosin azure
EA
Epithelial growth factor
EGF
Epithelial membrane antigen
EMA
Epithelial mesenchymal transition
EMT
Epithelioid sarcoma
EST
Epstein-Barr virus
EBV
Estrogen receptor
ER
Ewing's sarcoma
EWS
Fas-associated death domain
FADD
Fibrillar center
FC
Fibrin degradation product
FDP
Fibroadenoma
FAD
Fibroblast growth factor
FGF
19Fibrocystic diseases
FD
Fine needle aspiration biopsy
FNAB
Fine needle aspiration cytology
FNAC
Fine needle sampling
FNS
Flow cytometry
FCM
Flow cytometry immunophenotyping
FCI
Fluorescein isothiocyanate
FITC
Fluorescence in situ hybridization
FISH
Focal nodular hyperplasia
FNH
Follicular adenoma
FA
Follicular carcinoma
FC
Follicular center cell lymphoma
FCC
Follicular lymphoma
FL
Follicular neoplasm
FN
Follicular variant of papillary carcinoma of thyroid
FVPTC
Food and drug administration
FDA
Forward light scatter
FCS
Gastrointestinal stromal tumor
GIST
Gastrointestinal tract
GIT
Giant cell tumor
GCT
Giant cell tumor of tendon sheath
GCTTS
Glial fibrillary acidic protein
GFAP
Glucose-transport protein-1
GLUT-1
Golgi complex
GC
G-protein-coupled receptors
GPCR
Granular components
GC
Granulomatous mastitis
GM
Guanosine diphosphate
GDP
Guanosine triphosphate
GTP
Hepatocellular carcinoma
HCC
Herpes simplex virus
HSV
Heterochromatin protein
HP
High grade squamous intraepithelial lesion
HSIL
High mobility group box 1
HMGB1
High power
HP
Histone deacetylase
HDAC
Histone methyltransferase
HMTase
Hodgkin's lymphoma
HL
Homogenously staining region
HSR
Human chorionic gonadotropin
hCG
Human herpes virus
HHV
Human immunodeficiency virus
HIV
Human leukocyte differentiation antigen
HLDA
Human papillomavirus
HPV
Hyaluronic acid
HA
Hybrid capture
HC
20Image cytometry
ICM
Immunocytochemistry
IC
Infiltrating duct carcinoma
IDC
Inner nuclear membrane
INM
Insular carcinoma
IC
Internal quality control
IQC
International Society of Urologic Pathologists
ISUP
Intranuclear pseudoinclusions
INI
Intrauterine contraceptive devices
IUCD
Invasive lobular carcinoma
ILC
Lactate dehydrogenase
LDH
Lamin B receptor
LBR
Lamina associated polypeptide
LAP
Langerhans cell histiocytosis
LCH
Large cell carcinoma
LCC
Laser scanning cytometry
LSC
Leiomyosarcomas
LMS
Liposarcoma
LPS
Liquid based cytology
LBC
Loss of heterozygosity
LOH
Low grade squamous intraepithelial
LSIL
Low power
LP
Lupus erythematosus
LE
Lymphoblastic lymphoma
LBL
lymphocytic and/or histiocytic
L & H
Lymphoepithelial sialadenitis
LESA
Lymphoglandular body
LG
Lymphoplasmacytic lymphoma
LPL
Malignant fibrous histiocytoma
MFH
Malignant mesothelioma
MM
Malignant peripheral nerve sheath tumor
MPNST
Malignant round cell tumor
MRCT
Mantle cell lymphoma
MCL
Marginal zone lymphoma
MZL
Matrix attachment region
MAR
May-Grünwald Giemsa
MGG
Mediator of DNA damage checkpoint 1
MDC1
Medium power
MP
Medullary carcinoma
MCL
Messenger RNA
m-RNA
Micro-RNA
miRNA
Micronucleus
MN
Microsatellite instability
MSI
Mitochondria
MT
Mucinous cystic neoplasia
MCN
Mucoepidermoid carcinoma
MEC
21Mucosa associated lymphoma
MALT
Multicolor FISH
M-FISH
Multiple endocrine neoplasia
MEN
Myxoid liposarcoma
MLS
Nasopharyngeal carcinoma
NPC
National Health Service, United Kingdom
NHS UK
Natural killer T
NKT
Negative for intraepithelial lesion or malignancy
NILM
Neuroblastoma
NB
Neuron specific enolase
NSE
Nodular lymphocytic predominant HL
NLPHL
Non-Hodgkin lymphoma
NHL
Nontuberculous mycobacteria
NTM
Nuclear matrix proteins
NMP
Nuclear pore complex
NPC
Nucleocytoplasmic
N/C
Nucleolar organizing regions
NOR
Numerical aperture
NA
Oil immersion
OI
Open reading frames
ORF
Oral contraceptive pill
OCP
Orange G
OG
Origin recognition complex
ORC
Outer nuclear membrane
ONM
p53 binding protein 1
53BP1
Pancreatic endocrine tumor
PET
Papillary neoplasia of low malignant potential
PUNLMP
Papillary thyroid carcinoma
PTC
Periodic acid Schiff's
PAS
Peripheral neuroectodermal tumor
PNET
Peripheral T cell lymphoma
PTCL
Peritoneal mucinous carcinomatosis
PMCA
Phosphatidylinositol 3-phosphate
PI3P
Phosphatidylserine
PtdSer
Phycoerythrin
PE
Phyllodes tumor
PT
Placental alkaline phosphatase
PLAP
Plasma cell myeloma
PCM
Platelet derived growth factor
PDGF
Pleomorphic adenoma
PA
Polyclonal carcinoembryonic antigen
p-CEA
Polymerase chain reaction
PCR
Positive predictive value
PPV
Polymorphous low grade adenocarcinoma
PLGA
Pre-replicative
pre-RC
Precursor miRNA
pre-miRNA
22Primary effusion lymphoma
PEL
Primary mediastinal large B-cell lymphoma
PMLBCL
Primary miRNA
pri-miRNA
Primitive neuroectodermal tumor
PNET
Progesterone receptor
PR
Programmed cell death
PCD
Proliferating cell nuclear antigen
PCNA
Proliferative breast disease
PBD
Prostate specific antigen
PSA
Psammoma bodies
PB
Reactive lymphoid hyperplasia
RLH
Reed-Sternberg's
RS
Renal cell carcinoma
RCC
Replication licensing factors
RLF
Retinoblastoma
Rb
Reverse transcriptase PCR
RT-PCR
Rhabdomyoma
RM
Rhabdomyosarcoma
RMS
Ribonucleic acid
RNA
Ribosomal DNA
rDNA
Ribosomal RNA
rRNA
Ring finger binding protein
RFBP
Rough endoplasmic reticulum
RER
Scavenger receptors
SR
Sebaceous carcinoma
SC
Single strand conformation polymorphism
SSCP
Sinus histiocytosis with massive lymphadenopathy
SHML
Small cell carcinoma
SCC
Small lymphocytic lymphoma
SLL
Smooth endoplasmic reticulum
SER
Soft tissue sarcoma
STS
Solid and cystic papillary neoplasm
SCPN
Spectral karyotyping
SKY
Spindle assembly check point
SAC
Squamous cell carcinoma
SQC
Squamous intraepithelial lesion
SIL
Standard operating protocol
SOP
Synovial sarcoma
SS
Syringocystadenoma papilliferum
SCAP
Systemic lupus erythematosus
SLE
T cell receptor
TCR
TATA binding protein
TBP
Telomeric repeat amplification protocol
TRAP
Terminal deoxynucleotidyl transferase mediated dUTP nick end labeling
TUNEL
The Bethesda system
TBS
Thyroid stimulating hormone
TSH
23Thyroid stimulating immunoglobulin
TSI
Thyroid transcription factor
TTF
Transbronchial needle aspiration cytology
TBNA
Transfer RNA
tRNA
Transitional cell carcinoma
TCC
Trichomonas vaginalis
TV
Tumor necrosis factor-receptors
TNF-receptors
Ultrasonography
USG
Ultrasound-guided FNAC
USG FNAC
Upstream regulatory region
URR
Urothelial carcinoma
UC
Vascular endothelial growth factor
VEGF
Vascular permeability factor
VPF
Visual inspection of cervix with acetic acid
VIA
Wilms' tumor
WT
World Health Organization
WHO24