This new edition examines the latest diagnostic techniques for the interpretation of a complete range of cytological specimens. It is concise, yet covers all of the organ systems in which the procedure is used, with the number of pages devoted to each body site proportional to the clinical relevance of cytology for that site. Inside, you'll find new information on ductal lavage cytology and expanded coverage of FNA performance, keeping you current with the newest procedures. Over 700 full-color illustrations provide you with a real-life perspective of a full range of cytologic findings. Each chapter includes a discussion of indications and methods, along with a section on differential diagnosis accompanied by ancillary diagnostic techniques such as immunohistochemistry and molecular biology, where appropriate. As an Expert Consult title, it includes online access to the complete text of the book, fully searchable-as well as all of the images downloadable for your personal use-at www.expertconsult.com. Offers comprehensive coverage of everyday diagnostic work in a concise format for a practical benchside manual. Covers every type of cytology-gynecology, non-gynecology, and FNA. Presents an in-depth differential diagnosis discussion for all major entities. Examines the role of special techniques such as immunohistochemistry, flow cytometry, and molecular biology in resolving difficulties in interpretation and diagnosis. Provides an in-depth analysis of common diagnostic pitfalls to assist with daily signing out and reporting. Features coverage of patient management in discussions of pertinent clinical features. Uses capsule summaries featuring easy-to-read bulleted text that provide a quick review of key differential diagnoses, diagnostic pitfalls, cytomorphologic features, and tissue acquisition protocols for specific entities. Includes over 700 full-color illustrations that provide you with a real-life perspective of a full range of cytologic findings. Features anytime, anywhere online access to the complete text of the book, fully searchable-as well as all of the images downloadable for your personal use-at www.expertconsult.com. Covers automated cytology and HPV testing in Cervical and Vaginal Cytology chapter, providing an up-to-date reference on the techniques used in today's labs. Offers new information on ductal lavage cytology and expanded coverage of FNA performance, keeping you current with the newest procedures. Discusses the implementation of proficiency testing and changes in laboratory inspection and accreditation. Includes recommendations from the 2008 National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. If the next edition is published less than one year after your purchase, you will be entitled to online access for one year from your date of purchase. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should access to the web site be discontinued.
Author(s): Edmund S. Cibas MD, Barbara S. Ducatman MD
Edition: 3
Publisher: Saunders
Year: 2009
Language: English
Pages: 536
Cover......Page 1
Preface to Third Edition......Page 4
Contributors......Page 5
Acknowledgments......Page 6
1. Cervical and Vaginal Cytology......Page 7
The History of the Pap Test......Page 8
Liquid-Based Cytology......Page 9
MonoPrep Pap Test......Page 10
FocalPoint Slide Profiler......Page 12
ThinPrep Imaging System......Page 13
Diagnostic Terminology and Reporting Systems......Page 14
Specimen Adequacy......Page 15
Interpretation and Results......Page 16
Squamous Cells......Page 17
Endocervical Cells......Page 19
Exfoliated Endometrial Cells......Page 20
Trophoblastic Cells and Decidual Cells......Page 22
Lactobacilli......Page 24
Shift in Flora Suggestive of Bacterial Vaginosis......Page 25
Actinomyces......Page 27
Herpes Simplex......Page 28
Cytomegalovirus......Page 29
Benign Squamous Changes......Page 30
Benign Endocervical Changes......Page 31
Repair......Page 32
Radiation Changes......Page 33
Other Benign Changes......Page 34
Squamous Intraepithelial Lesions......Page 35
Grading Squamous Intraepithelial Lesions......Page 36
Low-Grade Squamous Intraepithelial Lesion......Page 37
High-Grade Squamous Intraepithelial Lesion......Page 38
Avoiding Overdiagnosis of Low-Grade Squamous Intraepithelial Lesions......Page 42
Squamous Cell Carcinoma......Page 43
Atypical Squamous Cells......Page 46
Atypical Squamous Cells of Undetermined Significance......Page 47
Atypical Squamous Cells, Cannot Exclude High-Grade Squamous Intraepithelial Lesion......Page 49
Endocervical Adenocarcinoma
in Situ......Page 50
Endocervical Adenocarcinoma......Page 52
Endometrial Adenocarcinoma......Page 54
Differential Diagnosis of Adenocarcinoma......Page 57
Atypical Endometrial Cells......Page 58
Malignant Melanoma......Page 59
Metastatic Tumors......Page 60
Endometrial Cells in Women Older than 40 Years of Age......Page 61
References......Page 64
2. Respiratory Tract......Page 70
Normal Anatomy, Histology, and Cytology of the Respiratory Tract......Page 71
Bronchial Aspirations and Washings......Page 72
Transbronchial Fine-Needle Aspiration......Page 73
Percutaneous Fine-Needle Aspiration......Page 74
Benign Squamous Cell Changes......Page 75
Repair......Page 76
Noncellular Elements and Specimen Contaminants......Page 77
Adenovirus......Page 79
Bacterial Pneumonias......Page 80
Coccidioidomycosis......Page 81
Sporotrichosis......Page 82
Echinococcosis (Hydatid Disease)......Page 83
Sarcoidosis......Page 84
Pulmonary Alveolar Proteinosis......Page 85
Inflammatory Myofibroblastic Tumor......Page 86
Preneoplastic Changes of the Respiratory Epithelium......Page 87
Lung Cancer......Page 88
Squamous Cell Carcinoma......Page 89
Adenocarcinoma......Page 91
Large Cell Carcinoma......Page 94
Sarcomatoid Carcinoma......Page 96
Typical Carcinoid......Page 97
Small Cell Carcinoma......Page 98
Sarcomas......Page 100
Lymphomas and Leukemias......Page 101
Metastatic Cancers to the Lung......Page 102
References......Page 103
3. Urine and Bladder Washings......Page 109
Upper Tract Washings and Brushings......Page 110
Urine......Page 111
Normal Elements......Page 113
Infections......Page 115
Noninfectious Findings and Conditions......Page 116
Effects of Radiation and Chemotherapy......Page 117
Urothelial Neoplasms......Page 118
Papillary Urothelial Neoplasm of Low Malignant Potential and Low-Grade Urothelial Carcinoma......Page 119
High-Grade Urothelial Carcinoma and Carcinoma in Situ......Page 121
Squamous Cell Carcinoma......Page 123
Diagnosing Difficult or BoRderline Specimens: Common Patterns......Page 124
Ancillary Techniques......Page 127
References......Page 128
Specimen Collection, Preparation, and Reporting Terminology......Page 132
Accuracy......Page 133
Benign Elements......Page 134
Acute Serositis......Page 135
Rheumatoid Pleuritis......Page 136
Other Non-Neoplastic Conditions......Page 137
Malignant Effusions......Page 138
Diffuse Malignant Mesothelioma......Page 139
Mesothelioma versus Reactive Mesothelial Cells......Page 140
Mesothelioma versus Adenocarcinoma......Page 141
Mesothelioma versus Squamous Cell Carcinoma......Page 143
Primary Effusion Lymphoma......Page 144
Adenocarcinoma......Page 145
Squamous Cell Carcinoma......Page 148
Melanoma......Page 149
Non-Hodgkin Lymphoma......Page 150
Hodgkin Lymphoma......Page 152
Germ Cell Tumors......Page 153
References......Page 154
Specimen Collection, Preparation, and Reporting Terminology......Page 157
The Normal Peritoneal Washing......Page 158
Endosalpingiosis and Similar Benign Proliferations......Page 160
Endometriosis......Page 161
Ovarian Cancer......Page 162
Endometrial Cancer......Page 165
Cervical Cancer......Page 167
Other Malignancies......Page 169
Monitoring Response to Treatment (“Second-Look Procedures”)......Page 170
References......Page 171
Obtaining and Preparing
the Specimen......Page 173
Reporting Terminology......Page 174
Normal Elements......Page 175
Abnormal Inflammatory Cells......Page 177
Acute Bacterial Meningitis......Page 178
Aseptic Meningitis......Page 180
Toxoplasmosis......Page 181
Neoplasms......Page 182
Carcinoma of the Lung......Page 183
Carcinoma of the Breast......Page 184
Acute Lymphoblastic Leukemia......Page 185
Acute Myeloid Leukemia......Page 186
Chronic Myeloproliferative Diseases......Page 187
Primary Central Nervous
System Lymphoma......Page 188
Medulloblastoma......Page 190
Astrocytomas and Glioblastoma......Page 191
Ependymoma......Page 192
Choroid Plexus Tumors......Page 193
Germ Cell Tumors......Page 194
References......Page 195
Better Recognition of Lymphoid Cells......Page 198
Sample Collection......Page 199
Accuracy......Page 200
Infections......Page 201
Epithelial Repair......Page 202
Barrett’s Esophagus......Page 203
Dysplasia in Barrett’s Esophagus......Page 204
Adenocarcinoma of the Esophagus......Page 205
Squamous Cell Carcinoma of
the Esophagus......Page 206
Dysplasia and Gastric Adenomas......Page 208
Adenocarcinoma of the Stomach......Page 210
Endocrine Tumors (Including Carcinoid Tumor)......Page 211
Non-Hodgkin Lymphoma......Page 212
Gastrointestinal Stromal Tumor......Page 213
Infections......Page 215
Colon......Page 216
References......Page 217
Nipple Discharge, Nipple Aspiration, and Ductal Lavage......Page 222
Fine-Needle Aspiration Cytology......Page 225
Reporting Terminology......Page 226
Evaluation of the Specimen......Page 227
Nonproliferative Fibrocystic Changes......Page 228
Proliferative Fibrocystic Changes......Page 229
Fibroadenoma......Page 230
Pregnancy and Lactational Changes......Page 232
Fat Necrosis......Page 233
Radiation Change......Page 234
Gynecomastia......Page 235
Papillary Neoplasms......Page 236
Phyllodes Tumor......Page 237
Invasive Ductal Carcinoma......Page 238
Invasive Lobular Carcinoma......Page 240
Mucinous (Colloid) Carcinoma......Page 242
Tubular Carcinoma......Page 243
Metaplastic Carcinomas......Page 244
Apocrine Carcinoma......Page 245
Adenoid Cystic Carcinoma......Page 246
Sarcoma......Page 247
Metastatic Tumors......Page 248
References......Page 249
9. Thyroid......Page 256
Aspiration Technique and Slide Preparation......Page 257
Terminology for Reporting Results......Page 258
Evaluation of the Specimen......Page 259
Benign Follicular Nodules......Page 260
Subacute (de Quervain) Thyroiditis......Page 265
Black Thyroid......Page 267
Radiation Changes......Page 268
Suspicious for a Follicular Neoplasm......Page 269
Suspicious for a Huumlrthle Cell Neoplasm......Page 270
Papillary Carcinoma......Page 272
Undifferentiated (Anaplastic) Carcinoma......Page 276
Medullary Thyroid Carcinoma......Page 278
Lymphoma......Page 280
Parathyroid Tumors......Page 282
References......Page 283
Rationale, Indications, and Technical Considerations......Page 286
Diagnostic Overview......Page 287
The Normal Aspirate......Page 289
Acute and Chronic Sialadenitis......Page 290
Lymphoepithelial Sialadenitis......Page 292
Squamous-Lined Cysts......Page 293
Mucin-Containing Cysts......Page 295
Pleomorphic Adenoma......Page 296
Myoepithelioma......Page 297
Basal Cell Adenoma......Page 300
Warthin Tumor......Page 302
Oncocytoma......Page 303
Mucoepidermoid Carcinoma......Page 304
Acinic Cell Carcinoma......Page 306
Adenoid Cystic Carcinoma......Page 307
Salivary Duct Carcinoma......Page 310
Epithelial-Myoepithelial Carcinoma......Page 311
Clear Cell Carcinoma, Not Otherwise Specified......Page 312
Squamous Cell Carcinoma......Page 313
Lymphoma Involving the Salivary Gland......Page 314
References......Page 315
11. Lymph Nodes......Page 320
Reporting Terminology and Accuracy......Page 321
Ancillary Studies......Page 322
Flow Cytometry......Page 323
Molecular Genetic Studies......Page 324
Reactive Hyperplasia......Page 325
Miscellaneous Benign Lymphadenopathies......Page 327
Bacterial and Fungal Lymphadenitis......Page 328
Cat Scratch Disease......Page 329
Mycobacterial Lymphadenitis......Page 330
Rosai-Dorfman Disease (Sinus Histiocytosis with Massive Lymphadenopathy)......Page 331
Infectious Mononucleosis......Page 332
Neoplasms......Page 333
Hodgkin Lymphoma......Page 334
Non-Hodgkin Lymphoma......Page 336
Mantle Cell Lymphoma.......Page 337
Marginal Zone Lymphoma.......Page 338
Lymphoplasmacytic Lymphoma.......Page 340
Differential diagnosis of small cell lymphomas......Page 341
Burkitt Lymphoma.......Page 345
T-cell Lymphomas.......Page 346
Peripheral T-cell lymphoma, unspecified......Page 347
Anaplastic large cell lymphoma......Page 348
Post-Transplant Lymphoproliferative Disorders.......Page 349
Differential Diagnosis of Large Cell Lymphomas......Page 351
Malignant Melanoma......Page 353
Seminoma or Germinoma......Page 354
References......Page 355
Normal Liver......Page 359
Other Infections......Page 361
Cirrhosis......Page 362
Liver Cell Adenoma......Page 363
Bile Duct Hamartoma and Adenoma......Page 364
Angiomyolipoma......Page 365
Hepatocellular Carcinoma......Page 366
Cholangiocarcinoma (Bile Duct Carcinoma)......Page 372
Epithelioid Hemangioendothelioma......Page 374
Metastatic Tumors......Page 375
References......Page 380
Sampling Techniques......Page 385
Sample Preparation and Reporting Technology......Page 386
Cyst Fluid Analysis......Page 387
Normal Pancreas and Bile Duct......Page 388
Pancreatitis and Reactive Changes......Page 389
Ductal Adenocarcinoma......Page 390
Variants of Ductal Adenocarcinoma......Page 392
Acinar Cell Carcinoma......Page 393
Pancreatic Endocrine Neoplasms......Page 394
Serous Cystadenoma......Page 397
Mucinous Cystic Neoplasm and Intraductal Papillary Mucinous Neoplasm......Page 398
Secondary Pancreatic Neoplasms......Page 399
References......Page 400
The Kidney......Page 403
Adequacy......Page 404
Glomeruli and Tubular Cells......Page 405
Oncocytoma......Page 406
Metanephric Adenoma......Page 408
Cystic Nephroma......Page 410
Renal Infarct......Page 411
Renal Cysts......Page 412
Renal Cell Carcinoma......Page 413
Clear Cell Renal Cell Carcinoma......Page 414
Papillary Renal Cell Carcinoma......Page 415
Sarcomatoid Renal Cell Carcinoma......Page 418
Translocation-Associated Renal Cell Carcinoma......Page 419
Urothelial Carcinoma......Page 420
Metastatic Tumors......Page 421
The Adrenal Gland......Page 422
Adrenal Cortical Neoplasms......Page 423
Pheochromocytoma......Page 425
Metastatic Tumors......Page 426
References......Page 427
15. Ovary......Page 432
Accuracy......Page 433
Cystic Follicle and Follicle Cyst......Page 434
Endometriotic Cyst......Page 436
Tubo-Ovarian Abscess......Page 437
Benign Mucinous Tumors......Page 438
Malignant Surface Epithelial-Stromal Tumors......Page 439
Serous Borderline Tumor and Adenocarcinoma......Page 440
Mucinous Borderline Tumor and Adenocarcinoma......Page 441
Germ Cell Tumors......Page 442
Mature Teratoma......Page 443
Embryonal Carcinoma and Other Malignant Germ Cell Tumors......Page 444
Adult Granulosa Cell Tumor......Page 445
Juvenile Granulosa Cell Tumor......Page 446
Metastatic Tumors......Page 447
References......Page 448
16. Soft Tissue......Page 450
Ancillary Studies......Page 451
Lipoma......Page 453
Hibernoma......Page 454
Spindle Cell Lipoma and Pleomorphic Lipoma......Page 455
Well-Differentiated Liposarcoma or Atypical Lipomatous Tumor......Page 456
Pleomorphic Liposarcoma......Page 457
Intramuscular Myxoma......Page 458
Myxofibrosarcoma, Low and High Grade (Myxoid Malignant Fibrous Histiocytoma)......Page 459
Low-Grade Fibromyxoid Sarcoma......Page 460
Myxoid or Round Cell Liposarcoma......Page 461
Myxofibrosarcoma-Like Dedifferentiated Liposarcoma......Page 462
Lipoblastoma......Page 463
Chordoma......Page 464
Leiomyosarcoma......Page 465
Schwannoma......Page 466
Malignant Peripheral Nerve Sheath Tumor......Page 468
Synovial Sarcoma......Page 469
Solitary Fibrous Tumor......Page 471
Dermatofibrosarcoma Protuberans......Page 473
Giant Cell Tumor of Tendon Sheath, Localized and Diffuse Types......Page 474
Extraosseous Ewing Sarcoma/Primitive Neuroectodermal Tumor......Page 476
Desmoplastic Small Round Cell Tumor......Page 478
Alveolar Rhabdomyosarcoma......Page 479
Epithelioid Sarcoma......Page 480
Clear Cell Sarcoma (Malignant Melanoma of Soft Tissues)......Page 481
Epithelioid Hemangioendothelioma......Page 482
Granular Cell Tumor......Page 483
Pleomorphic Neoplasms......Page 484
Undifferentiated High-Grade Pleomorphic Sarcoma (Pleomorphic Malignant Fibrous Histiocytoma)......Page 485
Idiopathic Retroperitoneal Fibrosis......Page 486
Elastofibroma......Page 487
References......Page 488
Centers for Medicare and Medicaid Services......Page 494
National Fire Protection Association......Page 495
Laboratory Personnel......Page 496
Cytotechnologist......Page 497
Workflow......Page 498
Billing......Page 499
Procedure Codes......Page 500
International Classification of Diseases (ICD)-9 Codes......Page 501
Coding Pap Tests......Page 502
The Screening (Routine) Pap Test......Page 503
The Diagnostic Pap Test......Page 504
Coding Nongynecologic, Non-Fine-Needle Aspiration Cases......Page 505
Coding Fine-Needle Aspirates......Page 506
Coding Consultation Cases......Page 508
Retrospective Rescreen (“5-Year Lookback”)......Page 509
Cytologic-Histologic Correlation......Page 510
Workload Records......Page 511
Proficiency Testing......Page 512
Measures of Cytotechnologist Performance......Page 513
Abnormal Rate.......Page 514
High-Risk Human Papillomavirus-Positivity Rates for Atypical Squamous Cells of Undetermined Significance......Page 515
Cytology/Biopsy Correlation......Page 516
Exposure Control......Page 517
OSHA Laboratory Standard......Page 518
National Fire Protection Association Standard on Fire Protection for Laboratories Using Chemicals......Page 519
References......Page 520
A......Page 522
B......Page 523
C......Page 524
E......Page 526
F......Page 527
H......Page 528
L......Page 529
M......Page 530
P......Page 532
R......Page 533
S......Page 534
T......Page 535
Z......Page 536
