Case-based Approach in Exfoliative Cytology Pranab Dey
INDEX
Page numbers followed by f refer to figure and t refer to table
A
Acid fast bacilli 291
Acinic cell carcinoma 2
Actinomyces, presence of 115
Actinomycosis 75
Adenocarcinoma 64, 79, 81, 140, 147, 175t, 189, 241, 243, 244, 245, 246, 251, 255, 266, 321
cervix 83
extrauterine 83
Adrenocortical adenoma 2
Amorphous globules 3
Anaplastic
large cell 16
lymphoma kinase 190
Anemia 308, 314
Angiomyolipoma 2
Apocrine cells 22
Artifactual nuclear vacuolation 27
Aspergillosis 327
Aspergillus infection 134, 174
Atrophic smear 38, 63, 113, 339, 348
B
Bacille calmette-guerin 276
granuloma 325
Bacilli positive 351
Back pain 306
Bacterial vaginosis 41, 75
Barrett's esophagus 255
Basal cell 93
Bethesda system 94, 31
Bile duct, adenocarcinoma of 257
Bladder
stone in 282
tumor of 266
tumors, malignant 264
Bleeding gum 308, 314
Bone marrow 312
Brain
primary tumor of 311
tumor, primary 300, 305
Breast 159
carcinoma 313
metastatic 305, 313
of left 305
Burkitt's lymphoma 141
C
Calcium crystal 25
Calretinin 127
Cancer cells 3
Candida infection 133, 173
Candidal esophagitis 245
Candidal infection 75, 134, 253, 255, 327
Carcinoid tumors 2
Cell
adequate number of 32
arrangement 1, 124
basal types of 33
cannibalism 12, 26
clusters of 35, 294
malignant 295
cohesive group of 33, 105
discrete large 298
in urine 267
intermediate 36, 93
loose clusters of 298, 313
malignant 128, 147, 243, 270, 282, 311
morphology 1
polyhedral shaped 298
reactive atypical 270
round 297
to oval 313
shape 2
typical glandular arrangement of 295
with abundant cytoplasm 297
with scanty cytoplasm 314
Central nervous system 300
lymphoma 300
tumor 301, 308
Cerebrospinal fluid 300
Cervical
cytology 31
intraepithelial neoplasia 33
lesion 108f, 353f
section of 119f, 121f
lymph nodes 277
Chemotherapy changes 267, 290
Chest pain 315
Chondroid material 3
Chondromyxoid material 25
Chondrosarcoma 6
Chordoma 6
Chromatin 3
Coarse chromatin 103
Coarse granular chromatin 265, 292, 295
Cohesive clusters 314
Colposcopy 338
Columnar appearance 350
Columnar cell 1, 22
Condensed chromatin 297
Consistent with sarcoma 289, 299
Corn flakes cell 69, 112
Cough 311, 315
Cryptococcal infection 307, 345
Crystals in gout 25
Cystitis 269, 273, 274, 276, 279, 280
Cytology
normal 340
smear, normal 320
Cytoplasm 2, 34, 35, 124, 314
moderate 354
of cells contain sperm head 298
D
Detrusor muscle invasion 296
Discrete cells 294, 297, 313
Disseminated peritoneal adenomucinosis 179
Duct papilloma 318
Ductal carcinoma, metastatic 159, 336
Dysgerminoma 137, 139, 170
infiltration by 143
Dysplasia 244, 245
mild 246
of duct epithelium 257
Dysplastic cells 321
E
Eccentric nuclei 297
Embryonal rhabdomyosarcoma 141
Empyema 129, 130, 157, 172
Endocervical adenocarcinoma 35
Endocervical cells 36, 93, 113
Endocervical component 95
Endometrial
adenocarcinoma 35
cells 34, 36, 87, 93, 102, 113
Eosinophilic effusion 130, 131
causes of 173t
Epidermal growth factor receptor 189
Epithelioid cell granuloma 291, 294, 351
Esophagus 241
Ewing's tumor 3
Eye tumor 307
F
Fat necrosis of breast 24
Fever
high 302
low-grade 304
Fiber cells 34, 69, 107, 111, 112, 359
Fine chromatin 27, 312
Flow cytometry 28
Foamy macrophages 22
Follicular carcinoma of thyroid 2
Foreign body giant cells 69, 112
Fusarium 293
Fusarium
moniliforme 293
oxysporum 293
Fusarium solani 293
G
Gastritis 252
chronic 256
Gastrointestinal
carcinoma 266
stromal tumor 242, 251, 256
tract 148, 241, 300
Genetic profile 189
Germ cell tumors 2
Giant cell 8
multinucleated 123
tumor of bone 8, 24
Glandular arrangement 1
Glandular cell 34
abnormality 34
atypical 34, 85, 89, 116
Glial fibrillary acidic protein 301
Glomeruloid body 25
Granulomatous inflammation 325
Granulosa cell tumor 2
Ground glass nuclei 123
Gum bleeding 302, 312
H
Headache 303, 304, 308, 310, 314
Hematological malignancies 126
Hemogram 312
Hepatocellular carcinoma 2, 132
Herpes simplex virus 110
Histoplasma infection 133, 169
Hodgkin lymphoma 7, 23
HPV infection 6, 23
Human immunodeficiency virus 312
Hyperchromasia 265, 294
moderate 291, 292
Hyperchromatic
enlarged nuclei 298
nuclei 290, 298
Hyper-eosinophilia 129
I
Immature cells
abundant 312
discrete 314
Inflammation
acute 129, 131, 134, 172, 306
chronic 246, 248, 254, 277, 319
Inflammatory cells 296
Intranuclear inclusion 3, 27, 123
Irregular clumped chromatin 3, 265
Irregular nuclear margin 26, 103, 290, 298, 312, 355, 359
Irregular nuclear membrane 265, 292, 295, 314
K
Koilocytes 123
Koilocytosis 33, 71, 355
L
Large cell 298
anaplastic tumor 191
carcinoma 191
neuroendocrine carcinoma 190
Leiomyoma 251
Leiomyosarcoma
case of 299
history of 296
Leishmania donovani 133
body 30
Leptomeninges, infective conditions of 300
Leucocyte common antigen 28
Leukemia 300
acute 169, 302, 304, 309, 312, 319
Lipoma, atypical 2
Liposarcoma 6
Liquid based cytology 32, 34, 96
Lobular carcinoma
metastatic 155, 159
of breast 2
Lung 191t, 311
left upper lobe of 311
tumors, classification of 188
Lymphoblastic lymphoma 17
Lymphocyte 302, 305, 312
rich effusion 128, 129, 130, 135, 141, 149, 158, 165, 167, 336
Lymphocytosis 303, 304, 306, 307, 308, 309, 312
Lymphoid
cells 3, 17, 294
hyperplasia, reactive 252
Lymphoma 158, 256, 300, 303, 305, 307, 310, 342
infiltration by 143
M
Mature lymphocytes 155
Medulloblastoma 301, 309, 314
Melanin containing cells 11, 25, 26
Mesothelial cell 22, 36, 93, 175t
Mesothelial proliferation, reactive 336
Metastatic adenocarcinoma 125, 128, 132, 135, 150, 152, 153, 157, 161, 164, 167, 174, 282, 296, 323, 342
Metastatic carcinoma 129, 130, 148, 158, 169, 302, 304, 306, 311, 323, 341, 345
Metastatic squamous cell carcinoma 152
Metastatic tumor 125, 300
Mitosis 3, 125
Monomorphic cells 1
Monomorphic lymphoid cells 294
Monomorphic nuclei 297
Mucinous 3
adenocarcinoma 137
carcinoma of breast 2
Mucormycosis 327
infection 134
Mucosa, normal 247
Muscle, normal smooth 251
Myeloid leukemia, acute 308, 314
Myeloma, multiple 306
N
Neoplastic causes of effusion 124
Neuroendocrine tumors 191t
Neurological symptoms 306
Non-Hodgkin lymphoma 132, 139, 145, 155, 170, 246, 252, 254, 277, 294, 300, 304, 341, 345
Nuclear
chromatin, clearing of 3
enlargement, mild 101
hyperchromasia 265, 295, 355
margin 2
pleomorphism 2, 294
Nucleocytoplasmic ratio, high 292
Nucleoli, absent 292
Nucleus 2, 125
O
Oval cells 296
P
Paget's disease 320
Painless hematuria 275, 279
Pancreas, adenocarcinoma of 254
Pancreatic adenocarcinoma 250
Pancreatic neuroendocrine tumor 250, 254
Pancreatitis, chronic 250
Papillary
clusters 2
of cells 2
neoplasm 320
Papilloma, inverted 280
Parabasal cell 93
Paraganglioma 2
Pepper 3, 27
Peripheral neuroectodermal tumor 145
Peritoneal implants 165
Peritoneal mucinous carcinomatosis 179
Plasma cell 3, 312, 313
atypical 313
neoplasm 136, 175
tumor 306, 313
Pleomorphic cell 34
Pleomorphic hyperchromatic nuclei 359
Pleomorphic lipoma 2
Pleomorphic nuclei 297, 314, 357
large moderately 313
mild to moderately 292
moderate 295
Pleomorphic nucleoli 291
Pleomorphic sarcoma 24
Pneumocystis carinii 340
Polygonal squamous cells 96
Prominent nucleoli 259, 350
Prostate specific antigen 280
Prostatic carcinoma, metastatic 161
Psammoma body 3, 26
Pseudomyxoma 168
peritonei 126, 147, 164, 331
R
Rectal carcinoma 296
Red cytoplasmic granules 97
Reinke's crystal 3
Renal cell carcinoma 2, 296
Respiratory
cytology 188
epithelial cell 22
Retinoblastoma 307, 314, 319
history of 314
Retroperitoneal lymph node 294
Rhabdomyosarcoma 7, 23, 145
Round cell tumor, metastatic 141
S
Salivary gland, carcinoma of 2
Sarcoma, metastatic 296
Schistosoma hematobium infection 266
Schwannoma, ancient 2
Seminal vesicle cells 267, 288, 290, 298
Sertoli cell tumor 3
Serum electrophoresis 306
Sex cord tumor 15
Signet ring
carcinoma, metastatic 149
cell carcinoma 163, 316
Single cells 1
Skeletal muscle 16
Small cell carcinoma 125, 190, 241, 266, 284, 297
metastatic 136, 150, 151, 153
Small immature atypical cells 102
Small inconspicuous nucleoli 291
Small nucleoli 34
Soft tissue
Ewings’ tumor 145
tumor 16
Sperm 322
head within cell 298
Spermatozoa 298
Spindle cell
abundant 296
tumor 283, 296
Spindle shaped pleomorphic nuclei 296
Squamous cell 22
abnormality 33
carcinoma, diagnosis of 294
adequacy of 94
atypical 33, 38, 42, 100, 105
insufficient 94
superficial 36, 93
carcinoma 7, 23, 34, 48, 61, 125, 189, 241, 243, 244, 245, 247, 253, 255, 266, 278, 287, 294, 298, 334, 339
Squamous intraepithelial lesion
high-grade 33, 42
low-grade 33, 42
Squamous metaplastic cells 102
Squamous pearl 71
Stomach 241
adenocarcinoma of 6, 23
Synaptophysin 266
Syncytial aggregates of cells 33
Synovial fluid 25
T
Tadpole cells 34, 107
Taenia solium 30
T-lymphoblastic lymphoma 141
Trichomonas vaginalis 30, 38, 41, 75, 95, 97, 322
Tubal metaplasia 59, 69, 112, 335
Tubal metaplastic cells 113
Tuberculosis 131, 139, 269, 291, 303, 310, 311, 315
Tuberculous effusion 163, 316
Tumor
cells 313, 314, 315
abundant dissociated 295
clusters of 34
discrete 299
diathesis 34, 71, 107, 111, 354, 359
dispersed 180
low risk 242
metastatic malignant 124
metastatic solid 300
U
Umbrella cells 267, 290
Urinary
bladder
adenocarcinoma of 285, 297
cancers of 264
fusariosis 293
Urine
cytological 277
cytology 264, 269
Urothelial carcinoma 296
Urothelial cell 22, 265, 267, 290, 295
atypia 268, 290
carcinoma
high-grade 265, 268
low-grade 265
atypical 265, 267, 278, 285, 290
cytomorphology of 294
discrete 295
high-grade 295
low-grade 295
normal 278
carcinoma 7, 23, 264, 274, 278, 280, 282, 287, 291, 292, 341
Urothelial neoplasm, classification of 264
V
Vesicular chromatin 3
Vimentin 127
Viral infection 61, 65, 243, 302, 309, 310, 312, 319
Visual inspection 338
W
World Health Organization 188
Wuchereria bancrofti, microfilaria of 30
Y
Yolk sac tumor 137, 170, 176
×
Chapter Notes

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FM1Case-based Approach in Exfoliative CytologyFM2
FM3Case-based Approach in Exfoliative Cytology
Pranab Dey MBBS MD MIAC FRCPath Professor Department of Cytology and Gynecologic Pathology Postgraduate Institute of Medical Education and Research Chandigarh, India
FM4
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© 2018, Jaypee Brothers Medical Publishers
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Case-based Approach in Exfoliative Cytology
First Edition: 2017
9789386261892
FM5Dedicated to
Shree Satyananda Giri, Rini and Madhumanti
FM7PREFACE
In this book I have discussed many classical and interesting cases of exfoliative cytology. The book is written in the form of multiple choice questions (MCQs); and, therefore, it will help the students and the cytology practitioners to learn and self-evaluate. In each case I have discussed the diagnostic points and differential diagnosis along with salient immunocytochemistry. I hope that this case-based approach will be very effective in learning exfoliative cytology.
Pranab Dey
FM9ACKNOWLEDGMENTS
This book should be considered the second part of the previous book Case-based Approach in Fine Needle Aspiration Cytology. I again honestly acknowledge that the main concept of the book belongs to Shri Jitendar P Vij (Group Chairman) and Mr Ankit Vij (Group President) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India.
I wish to express my gratitude to Late Professor Subhash Kumari Gupta, and Professor Arvind Rajwanshi, Head of Cytology and Gynecologic Pathology, who taught me cytology.
I am grateful to Professor Uma Nahar Saikia and Dr Suvradeep Mitra for their assistance. They provided me the histopathology microphotographs. Dr Suvradeep Mitra deserves special thanks as he helped me throughout in the preparation of this manuscript.
My wife Rini and Madhumanti always gave me encouragement and support, and without their support it would not be possible to write this book.
I am grateful to God Almighty as the entire work is done by His blessings only.
FM13ABBREVIATIONS AIDS
Acquired immunodeficiency disease
AGC
Atypical glandular cell
AGCUS
Atypical glandular cell of undetermined significance
ASC
Atypical squamous cell
ASCUS
Atypical squamous cell of undetermined significance
ASC-H
Atypical squamous cell high-grade SIL cannot be excluded
BCG
Bacillus Calmette-Guerin
BAL
Bronchoalveolar lavage
CSF
Cerebrospinal fluid
CIN
Cervical intraepithelial neoplasia
CD
Cluster differentiation
CK
Cytokeratin
CMV
Cytomegalovirus
DPAM
Disseminated peritoneal adenomucinosis
ERCP
Endoscopic retrograde cholangiopancreatectography
EUS TBNA
Endoscopic ultrasound guided transbronchial needle aspiration
EGFR
Epithelial growth factor receptor
EMA
Epithelial membrane antigen
FNAC
Fine needle aspiration cytology
FCM
Flow cytometry
GI
Gastrointestinal
GIST
Gastrointestinal stromal tumor
GLUT 1
Glucose transporter member 1
GM CSF
Granulocyte-macrophage colony stimulating factor
HSV
Herpes simplex virus
HSIL
High-grade squamous intraepithelial lesion
HPF
High power filed
HL
Hodgkin lymphoma
HIV
Human immunodeficiency virus
HPV
Human papilloma virus
HCG
Hyperchromatic crowded group
LC
Langerhans cell
LCC
Large cell carcinoma
LD body
Leishmania Donovani body
LCA
Leucocyte common antigen
FM14LBC
Liquid based cytology
LSIL
Low-grade squamous intraepithelial lesion
MGG
May Grunwald Giemsa
NSE
Neuron specific enolase
NHL
Non-Hodgkin lymphoma
N/C
Nucleocytoplasmic ratio
PAS
Periodic Acid-Schiff
PMCA
Peritoneal mucinous carcinomatosis
PCP
Pneumocystis pneumonia
PMP
Pseudomyxoma peritonei
PAP
Pulmonary alveolar proteinosis
PLCH
Pulmonary Langerhans cell histiocytosis
R-S cell
Reed Sternberg cell
SCC
Small cell carcinoma
SQC
Squamous cell carcinoma
TdT
Terminal deoxynucleotidase
TBS
The Bethesda system
TTF
Thyroid transcription factor
TV
Trichomonas vaginalis
USG
Ultrasonograph
UCC
Urothelial cell carcinoma
WHO
World Health Organization
ZN
Ziehl Neelsen stain