Cytologic Evaluation of Adenocarcinoma and its Mimics in Sputum and Bronchial Washings.
- Author:
Young Chae CHU
1
;
In Suh PARK
;
Suk Jin CHOI
;
Lucia KIM
;
Jee Young HAN
;
Joon Mee KIM
;
Jung Ae PARK
Author Information
1. Department of Pathology, Inha University College of Medicine, Incheon, Korea. ycchu@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Adenocarcinoma;
Lung;
Cytology
- MeSH:
Adenocarcinoma*;
Chromatin;
Diagnosis;
Epithelium;
Lung;
Macrophages;
Nuclear Envelope;
Pneumocytes;
Population Characteristics;
Respiratory Mucosa;
Retrospective Studies;
Sputum*
- From:Korean Journal of Cytopathology
2007;18(1):36-45
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To identify key cytologic features for diagnosis of adenocarcinoma and morphologic differentiation from reactive/reparative respiratory epithelium. STUDY DESIGN: The cytomorphologic features of 145 pulmonary cytology specimens (sputum and bronchial washing), which included 117 histologically proven adenocarcinomas and 28 non-neoplastic lesions, cytologically diagnosed as atypia and suspicious for malignancy (adenocarcinoma) were reviewed retrospectively. We analyzed 11 morphologic criteria in pulmonary cytologic specimens. RESULTS: Over 110 of 117 cases of adenocarcinomas revealed nuclear membrane irregularities, non-cohesive cells, single atypical cells, moderate to markedly enlarged nuclei and an increased nuclear/cytoplasmic (N/C) ratio. Chromatin clearing, chromatin heterogeneity and hyperchromasia were seen in 102, 99 and 97 cases, respectively. All 28 cases involving non-neoplastic lesions revealed hyperplastic reactive pneumocytes, hyperplastic reactive bronchial epithelium, or degenerating macrophages. The non-neoplastic lesions revealed a small number of atypical cell clusters and paucity or absence of atypical single cells. CONCLUSION: The most important morphologic features for diagnosis of adenocarcinoma are nuclear membrane irregularities, non-cohesive cells, single atypical cell, moderate to markedly enlarged nuclei and increased N/C ratio. Chromatin clearing, chromatin heterogeneity and hyperchromasia were also helpful features, while pleomorphism and prominent nucleoli were less valuable.
