Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-06-27T10:39:26.665Z Has data issue: false hasContentIssue false
This chapter is part of a book that is no longer available to purchase from Cambridge Core

3 - Malignant cell morphology

Edited by
Prabodh Gupta  and
Zubair Baloch
Prabodh Gupta
Affiliation:
University of Pennsylvania School of Medicine
Zubair Baloch
Affiliation:
University of Pennsylvania School of Medicine
Get access

Summary

GENERAL PERSPECTIVE

The morphologic findings referred to in this chapter as “malignant criteria” are those changes which, when found together in a recognized pattern, have been most useful for identifying malignant cells in cytological material. It must be recognized that there is a constellation of morphologic changes that help in diagnosis. Most commonly, this interpretation is critically influenced by clinical and relevant information. There is no single cytologic feature which, by itself, unequivocally indicates malignancy; nor is there a cytologic change which, when absent, bespeaks benignancy.

One must be careful not to include a cellular finding as a malignant criterion only because it happens to be present in a cell known to be malignant. As far as possible, the criteria should exclusively be observed using malignant cells with minimal overlap with benign conditioning. It is necessary to employ an extremely conservative approach in malignancy diagnosis; specifically, is more important than specificity. To quote the late Dr. Frost,

It being my philosophy that we should strive for a cytologic unequivocal diagnosis of malignancy having the reliability of a tissue diagnosis. Only this unequivocally cancer group, do I call “Positive” in my own practice (0.8% of Gyn-Ob patients). To the normal or bizarre benign group, I refer as “Negative” (95.4%). Then there is the group containing the “shaded” lesions, (3.8%).

A malignant diagnosis is based upon the evaluation of multiple parameters. These include clinical history, relevant investigational studies, precise location of the lesion, manner of specimen collection, and processing.

Type
Chapter
Information
Cytohistology
Essential and Basic Concepts
 , pp. 66 - 94
Publisher: Cambridge University Press
Print publication year: 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdulla, M., Hombal, S., et al. (2000). “Characterizing ‘blue blobs’. Immunohistochemical staining and ultrastructural study”. Acta Cytol 44(4): 547–50.CrossRefGoogle Scholar
Ali, M. A., Akhtar, M., et al. (1986). “Morphologic spectrum of hepatocellular carcinoma in fine needle aspiration biopsies”. Acta Cytol 30(3): 294–302.Google Scholar
Bayon, M. N. and Drut, R. (1991). “Cytologic diagnosis of adenovirus bronchopneumonia”. Acta Cytol 35(2): 181–2.Google Scholar
Bedrossian, C. W. and Rybka, D. L.. (1976). “Bronchial brushing during fiberoptic bronchoscopy for the cytodiagnosis of lung cancer: comparison with sputum and bronchial washings”. Acta Cytol 20(5): 446–53.Google Scholar
Berthezene, F. and Greer, M. A. (1974). “Studies on the composition of the thyroid psammoma bodies of chronically iodine-deficient rats”. Endocrinology 95(3): 651–9.CrossRefGoogle Scholar
Bottles, K. and Lowhagen, T. (1985). “Psammoma bodies in the aspiration cytology smears of an acinic-cell tumor”. Acta Cytol 29(2): 191–2.Google Scholar
Castro-Gomez, L., Cordova-Ramirez, S., et al. (2003). “Cytologic criteria of cystic papillary carcinoma of the thyroid”. Acta Cytol 47(4): 590–4.CrossRefGoogle Scholar
Chamberlain, D. W., Braude, A. C., et al. (1987). “A critical evaluation of bronchoalveolar lavage. Criteria for identifying unsatisfactory specimens”. Acta Cytol 31(5): 599–605.Google Scholar
Chang, T. C., Lai, S. M., et al. (2004). “Three-dimensional cytomorphology in fine needle aspiration biopsy of subacute thyroiditis”. Acta Cytol 48(2): 155–60.CrossRefGoogle Scholar
Crabtree, W. N. and Murphy, W. M.. (1980). “The value of ethanol as a fixative in urinary cytology”. Acta Cytol 24(5): 452–5.Google Scholar
Crapanzano, J. P. and Zakowski, M. F. (2001). “Diagnostic dilemmas in pulmonary cytology”. Cancer 93(6): 364–75.CrossRefGoogle Scholar
Das, D. K. (2004). “Fine-needle aspiration (FNA) cytology diagnosis of small round cell tumors: value and limitations”. Indian J Pathol Microbiol 47(3): 309–18.Google Scholar
Das, D. K. (2005). “Intranuclear cytoplasmic inclusions in fine-needle aspiration smears of papillary thyroid carcinoma: a study of its morphological forms, association with nuclear grooves, and mode of formation”. Diagn Cytopathol 32(5): 264–8.CrossRefGoogle Scholar
Las Casas, L. E., Hoerl, H. D., et al. (2001). “Utility of urinary cytology for diagnosing human polyoma virus infection in transplant recipients: a study of 37 cases with electron microscopic analysis”. Diagn Cytopathol 25(6): 376–81.CrossRefGoogle Scholar
Dreyer, T., Knoblauch, I., et al. (2001). “Nuclear texture features for classifying benign vs. dysplastic or malignant squamous epithelium of the larynx”. Anal Quant Cytol Histol 23(3): 193–200.Google Scholar
Goellner, J. R. and Johnson, D. A.. (1982). “Cytology of cystic papillary carcinoma of the thyroid”. Acta Cytol 26(6): 797–808.Google Scholar
Gondos, B. (1974). “Cell degeneration: light and electron microscopic study of ovarian germ cells”. Acta Cytol 18(6): 504–09.Google Scholar
Gupta, S. K., Rajwanshi, A. K., et al. (1985). “Fine needle aspiration cytology smear patterns of malignant melanoma”. Acta Cytol 29(6): 983–8.Google Scholar
Hashi, A., Yuminamochi, T., et al. (2008). “Intranuclear cytoplasmic inclusion is a significant diagnostic feature for the differentiation of lobular endocervical glandular hyperplasia from minimal deviation adenocarcinoma of the cervix”. Diagn Cytopathol 36(8): 535–44.CrossRefGoogle Scholar
Hsu, C., Choo, Y. C., et al. (1984). “Exfoliative cytology in the evaluation of interferon treatment of cervical intraepithelial neoplasia”. Acta Cytol 28(2): 111–7.Google Scholar
Hunt, J. L. and Barnes, E. L.. (2003). “Non-tumor-associated psammoma bodies in the thyroid”. Am J Clin Pathol 119(1): 90–4.CrossRefGoogle Scholar
Jenkins, D. M. and Goulden, R. (1977). “Psammoma bodies in cervical cytology smears”. Acta Cytol 21(1): 112–3.Google Scholar
Kaneko, C., Shamoto, M., et al. (1996). “Studies on intranuclear inclusions and nuclear grooves in papillary thyroid cancer by light, scanning electron and transmission electron microscopy”. Acta Cytol 40(3): 417–22.CrossRefGoogle Scholar
Kim, K., Mah, C., et al. (1986). “Carcinoid tumors of the lung: cytologic differential diagnosis in fine-needle aspirates”. Diagn Cytopathol 2(4): 343–6.CrossRefGoogle Scholar
Kini, S. R., Miller, J. M., et al. (1980). “Cytopathology of papillary carcinoma of the thyroid by fine needle aspiration”. Acta Cytol 24(6): 511–21.Google Scholar
Koss, L. G. (2000). “Utility of liquid-based cytology for cervical carcinoma screening”. Cancer 90(1): 67–9.3.0.CO;2-M>CrossRefGoogle Scholar
Koss, L. G., Melamed, M. R., et al. (2006). Koss' Diagnostic Cytology and its Histopathologic Bases. Philadelphia, PA, Lippincott Williams & Wilkins.Google Scholar
Koukoulaki, M., O'Donovan, M., et al. (2008). “Prospective study of urine cytology screening for BK polyoma virus replication in renal transplant recipients”. Cytopathology 19(6): 385–8.CrossRefGoogle Scholar
Lapkus, O., Elsheikh, T. M., et al. (2006). “Pitfalls in the diagnosis of herpes simplex infection in respiratory cytology”. Acta Cytol 50(6): 617–20.CrossRefGoogle Scholar
LiVolsi, V. A. and Gupta, P. K.. (1992). “Thyroid fine-needle aspiration: intranuclear inclusions, nuclear grooves and psammoma bodies – paraganglioma-like adenoma of the thyroid”. Diagn Cytopathol 8(1): 82–3; discussion 83–4.CrossRefGoogle Scholar
Lozowski, W. and Hajdu, S. I. (1987). “Cytology and immunocytochemistry of bronchioloalveolar carcinoma”. Acta Cytol 31(6): 717–25.Google Scholar
Morimura, Y., Nishiyama, H., et al. (2002). “Diagnosing endometrial carcinoma with cervical involvement by cervical cytology”. Acta Cytol 46(2): 284–90.CrossRefGoogle Scholar
Nagy, G. K., Jacobs, J. B., et al. (1989). “Intracytoplasmic eosinophilic inclusion bodies in breast cyst fluids are giant lysosomes”. Acta Cytol 33(1): 99–103.Google Scholar
Pearson, J. C., Kromhout, L., et al. (1981). “Evaluation of collection and preservation techniques for urinary cytology”. Acta Cytol 25(3): 327–33.Google Scholar
Pettinato, G., Swanson, P. E., et al. (1989). “Undifferentiated small round-cell tumors of childhood: the immunocytochemical demonstration of myogenic differentiation in fine-needle aspirates”. Diagn Cytopathol 5(2): 194–9.CrossRefGoogle Scholar
Romagosa, C., Morente, V., et al. (2002). “Intranuclear inclusions in fine needle aspirates of bronchial low grade mucoepidermoid carcinoma with clear cell change: a report of two cases”. Acta Cytol 46(1): 57–60.CrossRefGoogle Scholar
Russin, V. L., Valente, P. T., et al. (1987). “Psammoma bodies in neuroendocrine carcinoma of the uterine cervix”. Acta Cytol 31(6): 791–5.Google Scholar
Sagawa, M., Saito, Y., et al. (1994). “Localization of double, roentgenographically occult lung cancer. Cytologic findings from selective brushing of all segmental and subsegmental bronchi”. Acta Cytol 38(3): 392–7.Google Scholar
Shet, T. and Rege, J.. (2000). “Cystic degeneration in phyllodes tumor. A source of error in cytologic interpretation”. Acta Cytol 44(2): 163–8.CrossRefGoogle Scholar
Sidawy, M. K. and Costa, M. (1989). “The significance of paravacuolar granules of the thyroid. A histologic, cytologic and ultrastructural study”. Acta Cytol 33(6): 929–33.Google Scholar
Silverman, J. F., Jones, F. D., et al. (1989). “Cytopathology of neoplasms of the central nervous system in specimens obtained by the Cavitron Ultrasonic Surgical Aspirator”. Acta Cytol 33(5): 576–82.Google Scholar
Simmons, T. J. and Martin, S. E.. (1991). “Fine-needle aspiration biopsy of malignant melanoma: a cytologic and immunocytochemical analysis”. Diagn Cytopathol 7(4): 380–6.CrossRefGoogle Scholar
Sinner, W. N. and Sandstedt, B.. (1976). “Small-cell carcinoma of the lung. Cytological, roentgenologic, and clinical findings in a consecutive series diagnosed by fine-needle aspiration biopsy”. Radiology 121(2): 269–74.CrossRefGoogle Scholar
Sironi, M., Claren, R., et al. (1999). “Intranuclear cytoplasmic inclusions and nuclear grooves in pleomorphic adenoma of parotid gland”. Diagn Cytopathol 21(6): 435–6.3.0.CO;2-0>CrossRefGoogle Scholar
Soyuer, I., Ekinci, C., et al. (2003). “Diagnosis of hepatocellular carcinoma by fine needle aspiration cytology. Cellular features”. Acta Cytol 47(4): 581–9.CrossRefGoogle Scholar
Sprenger, E., Ulrich, H., et al. (1979). “The diagnostic value of cell-nuclear DNA determination in aspiration cytology of benign and malignant lesions of the breast”. Anal Quant Cytol 1(1): 29–36.Google Scholar
Sun, L., Sakurai, S., et al. (2009). “High-grade neuroendocrine carcinoma of the lung: comparative clinicopathological study of large cell neuroendocrine carcinoma and small cell lung carcinoma”. Pathol Int 59(8): 522–9.CrossRefGoogle Scholar
Szpak, C. A., Bossen, E. H., et al. (1984). “Cytomorphology of primary small-cell (Merkel-cell) carcinoma of the skin in fine needle aspirates”. Acta Cytol 28(3): 290–6.Google Scholar
Szyfelbein, W. M. and Ross, J. S. (1988). “Carcinoids, atypical carcinoids, and small-cell carcinomas of the lung: differential diagnosis of fine-needle aspiration biopsy specimens”. Diagn Cytopathol 4(1): 1–8.CrossRefGoogle Scholar
Tanida, O., Kaneshima, S., et al. (1982). “Viability of intraperitoneal free cancer cells in patients with gastric cancer”. Acta Cytol 26(5): 681–7.Google Scholar
Tao, L. C., Weisbrod, G. L., et al. (1986). “Cytologic diagnosis of bronchioloalveolar carcinoma by fine-needle aspiration biopsy”. Cancer 57(8): 1565–70.3.0.CO;2-J>CrossRefGoogle Scholar
Taskinen, E., Tukiainen, P., et al. (1992). “Bronchoalveolar lavage. Influence of cytologic methods on the cellular picture”. Acta Cytol 36(5): 680–6.Google Scholar
Triggiani, V., Guastamacchia, E., et al. (2008). “Microcalcifications and psammoma bodies in thyroid tumors”. Thyroid 18(9): 1017–8.CrossRefGoogle Scholar
Tseng, F. Y., Hsiao, Y. L., et al. (2002). “Cytologic features of metastatic papillary thyroid carcinoma in cervical lymph nodes”. Acta Cytol 46(6): 1043–8.CrossRefGoogle Scholar
Valicenti, J. F., , J r. and Priester, S. K.. (1977). “Psammoma bodies of benign endometrial origin in cervicovaginal cytology”. Acta Cytol 21(4): 550–2.Google Scholar
Wied, G. L. and Koss, L. G.. (1984). “Aspiration biopsy cytology”. Acta Cytol 28(3): 195–7.Google ScholarPubMed
Wolberg, W. H., Street, W. N., et al. (1995). “Computer-derived nuclear features distinguish malignant from benign breast cytology”. Hum Pathol 26(7): 792–6.CrossRefGoogle Scholar
Yang, G. C. (1995). “Mixed small cell/large cell carcinoma of the lung. Report of a case with cytologic features and ultrastructural correlation”. Acta Cytol 39(6): 1175–81.Google Scholar
Yoshimura, S., Nishimura, T., et al. (1980). “The morphometry of the Sudan-III-positive granules in the cytoplasm of the human amniotic epithelium”. Acta Cytol 24(1): 44–8.Google Scholar
Zaharopoulos, P. (2004). “Viral cytopathic changes in urine cytology of ileal conduit attributed to adenovirus: report of a case”. Diagn Cytopathol 30(4): 284–7.CrossRefGoogle Scholar
Ziabkowski, T. A. and Naylor, B.. (1976). “Cyanophilic bodies in cervico-vaginal smears”. Acta Cytol 20(4): 340–2.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Malignant cell morphology
  • Edited by Prabodh Gupta, University of Pennsylvania School of Medicine, Zubair Baloch, University of Pennsylvania School of Medicine
  • Book: Cytohistology
  • Online publication: 17 February 2011
  • Chapter DOI: https://doi.org/10.1017/CBO9780511976001.004
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Malignant cell morphology
  • Edited by Prabodh Gupta, University of Pennsylvania School of Medicine, Zubair Baloch, University of Pennsylvania School of Medicine
  • Book: Cytohistology
  • Online publication: 17 February 2011
  • Chapter DOI: https://doi.org/10.1017/CBO9780511976001.004
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Malignant cell morphology
  • Edited by Prabodh Gupta, University of Pennsylvania School of Medicine, Zubair Baloch, University of Pennsylvania School of Medicine
  • Book: Cytohistology
  • Online publication: 17 February 2011
  • Chapter DOI: https://doi.org/10.1017/CBO9780511976001.004
Available formats
×