DIAGNOSTIC CYTOLOGY
DIAGNOSTIC CYTOLOGY
Second Edition
Pranab Dey
MBBS MD MIAC FR CPath
Professor Department of Cytology Postgraduate Institute of Medical Education and Research Chandigarh, India
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Diagnostic Cytology
First Edition: 2014
Second Edition: 2018
9789352701209
Printed at:
Shree Shree Satyananda Giri
Rini
Madhumanti
and my mother Nisha Dey
In this second edition of the book, I have introduced two new chapters on round cell tumors and infections. The newer classifications of diseases and molecular genetics have been provided. In each chapter, I have added review questions along with multiple figures. Many old figures have been either replaced or deleted. Overall, I have changed many chapters. I am sure that this will help the readers significantly.
Pranab Dey
Preface to the First Edition
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
Acknowledgments
I am grateful to Mr Jitendar P Vij (Group Chairman) and Ms Chetna Malhotra Vohra (Associate Director—Content Strategy) of Jaypee Brothers Medical Publishers, for their great support and encouragement in writing the second edition of this book. Mr Subrata Adhikari (Commissioning Editor), Ms Kritika Dua (Development Editor) and the other members of the publishing team also provided me full support and advice during the preparation of the manuscript.
It is my great pleasure to express my thanks to Professor Arvind Rajwanshi, Head, Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. I am also thankful to my departmental colleagues for their routine support. My friend, Dr Suvradeep Mitra helped me to rethink in many aspects of general cytology. I am especially thankful to Dr Manish Rohilla. He thoroughly read the first edition of the book and corrected many chapters and gave me valuable suggestions. My friend, Dr Chandrasekaran Muralidharan taught me the principle of many newer techniques in cytology. My sincere thanks to Mr Ghanashyam Mahato, assistant librarian of Browser library, for helping me to provide many important references.
I am thankful to all my junior residents, senior residents and technical staffs in the Department of Cytology. My wife Rini and daughter Madhumanti provided me constant support and encouragement in writing this book.
Finally, I am grateful to God Almighty for His blessing to make this book successful.
Abbreviations
AIDS
Acquired immunodeficiency syndrome
ALL
Acute lymphoblastic leukemia
AML
Acute myeloblastic leukemia
ACC
Adenoid cystic carcinoma
APC
Adenomatous polyposis coli
ATP
Adenosine triphosphate
ACC
Adrenocortical carcinomas
APC
Allophycocyanin
AFP
Alpha fetoprotein
ACS
American Cancer Society
APC
Anaphase promoting complex
ALCL
Anaplastic large cell lymphoma
ALK
Anaplastic lymphoma kinase
AR
Androgen receptor
ABC
Aneurysmal bone cyst
AML
Angiomyolipoma
APAF
Apoptosis activating factor
AIF
Apoptosis inducing factor
AGNOR
Argyrophilic nucleolar organizer region
ANN
Artificial neural network
ADH
Atypical ductal hyperplasia
AGC
Atypical glandular cells
AGUS
Atypical glandular cells of undetermined significance
ALT
Atypical lipomatous tumor
ASC
Atypical squamous cell
ASC-H
Atypical squamous cell cannot exclude HSIL
ASC-US
Atypical squamous cell of undetermined significance
ATG
Autophagy related gene
BCG
Bacillus Calmette-Guérin
BE
Barrett't
BCA
Basal cell adenoma
BCC
Basal cell carcinoma
BBN
Bayesian belief network
BTA
Bladder tumor antigen
BAC
Bronchioloalveolar carcinoma
BAL
Bronchoalveolar lavage
BL
Burkitt lymphoma
CEA
Carcinoembryonic antigen
CKI
CDK inhibitor
CSF
Cerebrospinal fluid
CIN
Cervical intraepithelial neoplasia
CHS
Chondrosarcoma
CIN
Chromosomal instability
CLL
Chronic lymphocytic leukemia
CML
Chronic myeloid leukemia
CCSK
Clear cell sarcoma of kidney
CLIA
Clinical Laboratory Improvement Amendments
CDK
Cluster of differentiation
CGH
Comparative genomic hybridization
CT
Computerized tomography
CP
Conditional probability
CP
Conventional preparation
CIMP
CpG island methylator phenotype
CDK
Cyclin dependent kinases
CKI
Cytokeratin
CMV
Cytomegalovirus
CP
Cystosarcoma phyllodes
DFC
Dense fibrillar component
DNA
Deoxyribonucleic acid
DSRCT
Desmoplastic small round cell tumor
DLBCL
Diffuse large B cell lymphoma
DPAM
Disseminated peritoneal adenomucinosis
Dnmt
DNA methyl transferases
DCIS
Ductal crcinoma in situ
EST
Endodermal sinus tumor
ER
Endoplasmic reticulum
ERCP
Endoscopic retrograde cholangiopancreatography
EUG FNAC
Endoscopic ultrasound guided FNAC
EGF
Epithelial growth factor
EMA
Epithelial membrane antigen
EMT
Epithelial mesenchymal transition
EST
Epithelioid sarcoma
EBV
Epstein-Barr virus
ER
Estrogen receptor
EWS
Ewing'g sarcoma
FADD
Fas-associated death domain
FC
Fibrillar center
FDP
Fibrin degradation product
Fad
Fibroadenoma
FGF
Fibroblast growth factor
FD
Fibrocystic diseases
FNAB
Fine needle aspiration biopsy
FNAC
Fine needle aspiration cytology
FNS
Fine needle sampling
FCM
Flow cytometry
FCI
Flow cytometry immunophenotyping
FITC
fluorescein isothiocyanate
FISH
Fluorescence in situ hybridization
FNH
Focal nodular hyperplasia
FA
Follicular adenoma
FC
Follicular carcinoma
FCC
Follicular centre cell lymphoma
FL
Follicular lymphoma
FN
Follicular neoplasm
FVPTC
Follicular variant of papillary carcinoma of thyroid
FDA
Food and Drug Administration
GIST
Gastrointestinal stromal tumor
GIT
Gastrointestinal tract
GCT
Giant cell tumor
GCTTS
Giant cell tumor of tendon sheath
GFAP
Glial fibrillary acidic protein
GLUT-1
Glucose-transport protein 1
GC
Golgi complex
GPCR
G-protein-coupled receptors
GC
Granular components
GM
Granulomatous mastitis
GTP
Guanosine triphosphate
GDP
Gunasonsine diphosphate
HCC
Hepatocellular carcinoma
HSV
Herpes simplex virus
HP
Heterochromatin protein
HSIL
High grade squamous intraepithelial lesion
HMGB1
High mobility group box 1
HP
High power
HDAC
Histone deacetylases
HMTase
Histone methyltransferases
HL
Hodgkin lymphoma
HL
Hodgkin'n lymphoma
HSR
Homogenously staining region
HCG
Human chorionic gonadotropin
HHV
human herpes virus
HIV
Human immunodeficiency virus
HPV
Human papilloma virus
HA
Hyaluronic acid
HC
Hybrid capture
ICM
Image cytometry
IDC
Infiltrating duct carcinoma
INM
Inner nuclear membrane
IC
Insular carcinoma
IQC
Internal quality control
ISUP
International Society of Urologic Pathologists
INI
Intranuclear pseudoinclusions
IUCD
Intrauterine contraceptive devices
ILC
Invasive lobular carcinoma
LDH
Lactate dehydrogenase
LBR
Lamin B receptor
LAP
Lamina associated polypeptide
LCH
Langerhans cell histiocytosis
LCC
Large cell carcinoma
LSC
Laser scanning cytometry
LMS
Leiomyosarcomas
LPS
Liposarcoma
LBC
Liquid based cytology
LOH
Loss of heterozygosity
LSIL
Low grade squamous intraepithelial
LP
Low power
LE
Lupus erythematous
LBL
Lymphoblastic lymphoma
L & H
lymphocytic and/or histiocytic
LESA
Lymphoepithelial sialadenitis
LG
Lymphoglandular body
LPL
Lymphoplasmacytic lymphoma
MFH
Malignant fibrous histiocytoma
MM
Malignant mesothelioma
MPNST
Malignant peripheral nerve sheath tumor
MRCT
Malignant round cell tumor
MCL
Mantle cell lymphoma
MZL
Marginal zone lymphoma
MAR
Matrix attachment region
MGG
May Grunwald Giemsa
MDC1
Mediator of DNA damage checkpoint 1
MP
Medium power
MCL
Medullary carcinoma
m-RNA
Messenger RNA
miRNA
Micro RNA
MN
Micronucleus
MSI
Microsatellite instability
MT
Mitochondria
MCN
Mucinous cystic neoplasia
MEC
Mucoepidermoid carcinoma
MALT
Mucosa associated lymphoma
M-FISH
Multicolor FISH
MEN
Multiple endocrine neoplasia
MLS
Myxoid liposarcoma
NPC
Nasopharyngeal carcinoma
NHS UK
National Health Service, United Kingdom
NKT
Natural killer T
NILM
Negative for intraepithelial lesion or malignancy
NB
Neuroblastoma
NSE
Neuron specific enolase
NLPHL
Nodular lymphocytic predominant HL
NHL
Non-Hodgkin lymphoma
NTM
Non-tuberculous mycobacteria
NMP
Nuclear matrix proteins
NPC
Nuclear pore complex
N/C
Nucleocytoplasmic
NOR
Nucleolar organizing regions
NA
Numerical aperture
OI
Oil immersion
ORF
Open reading frames
OCP
Oral contraceptive pill
OG
Orange G
ORC
Origin recognition complex
ONM
Outer nuclear membrane
53BP1
p53 binding protein 1
PET
Pancreatic endocrine tumor
PUNLMP
Papillary neoplasia of low malignant potential
PTC
Papillary thyroid carcinoma
PAS
Periodic Acid Schiff'f
PNET
Peripheral neuroectodermal tumor
PTCL
Peripheral T cell lymphoma
PMCA
Peritoneal mucinous carcinomatosis
PI3P
Phosphatidylinositol 3-phosphate
PtdSer
Phosphatidylserine
PE
Phycoerythrin
PT
Phyllodes tumor
PLAP
Placental alkaline phosphatase
PCM
Plasma cell myeloma
PDGF
Platelet derived growth factor
PA
Pleomorphic adenoma
p-CEA
Polyclonal carcinoembryonic antigen
PCR
Polymerase chain reaction
PLGA
Polymorphous low grade adenocarcinoma
pre-RC
pre replicative
pre-miRNA
Precursor miRNA
PEL
Primary effusion lymphoma
PMLBCL
Primary mediastinal large B-cell lymphoma
pri-miRNA
Primary miRNA
PNET
Primitive neuroectodermal tumor
PR
Progesterone receptor
PCD
Programmed cell death
PCNA
Proliferating cell nuclear antigen
PBD
Proliferative breast disease
PSA
Prostate specific antigen
PB
Psammoma bodies
RMS
Rhabdomyosarcoma
RLH
Reactive lymphoid hyperplasia
RS
Reed-Sternberg'g
RCC
Renal cell carcinoma
RLF
Replication licensing factors
Rb
Retinoblastoma
RT-PCR
Reverse transcriptase PCR
RM
Rhabdomyoma
RMS
Rhabdomyosarcoma
RNA
Ribonucleic acid
rRNA
Ribosomal RNA
RFBP
Ring finger binding protein
RER
Rough endoplasmic reticulum
SR
Scavenger receptors
SC
Sebaceous carcinoma
SSCP
Single strand conformation polymorphism
SHML
Sinus histiocytosis with massive lymphadenopathy
SCC
Small cell carcinoma
SLL
Small lymphocytic lymphoma
SER
Smooth endoplasmic reticulum
STS
Soft tissue sarcoma
SCPN
Solid and cystic papillary neoplasm
SKY
Spectral karyotyping
SAC
Spindle assembly check point
SQC
Squamous cell carcinomas
SIL
Squamous intraepithelial lesion
SOP
Standard operating protocol
SS
Synovial sarcoma
SCAP
Syringocystadenoma papilliferum
SLE
Systemic lupus erythematosus
TBP
TATA binding protein
TRAP
Telomeric repeat amplification protocol
TUNEL
Terminal deoxynucleotidyl transferase mediated dUTP Nick End Labeling
TBS
The Bethesda System
TSH
Thyroid stimulating hormone
TSI
Thyroid stimulating immunoglobulin
TTF
Thyroid transcription factor
TBNA
Transbronchial fine needle aspiration cytology
tRNA
Transfer RNA
TCC
Transitional cell carcinoma
TV
Trichomonas vaginalis
TNF-receptors
Tumor necrosis factor-receptors
USG
Ultrasonography
URR
Upstream regulatory region
UC
Urothelial carcinoma
VEGF
Vascular endothelial growth factor
VPF
Vascular permeability factor
VIA
Visual inspection of cervix with acetic acid
WT
Wilms’ tumor
WHO
World Health Organization