Orell and Sterrett's fine needle aspiration cytology

Cover......Page 1
Orell and Sterrett's Fine Needle Aspiration Cytology: Expert Consult......Page 2
ISBN: 9780702031519......Page 4
Copyright......Page 5
Preface......Page 6
List of contributors......Page 10
Acknowledgements......Page 12
FNAC as a tool in clinical investigation......Page 13
Advantages and limitations......Page 14
The practice of FNAC......Page 15
The aims of the book......Page 16
The challenge ahead......Page 17
References......Page 18
Syringes and syringe holder......Page 20
FNB with aspiration (Figs. 2.1 and 2.2)......Page 21
Fine needle sampling without aspiration (Figs 2.3 and 2.4)......Page 22
Failure to obtain a representative sample......Page 23
Direct smearing (Figs 2.7–2.12)......Page 24
Indirect smearing......Page 26
Fixation and staining......Page 27
Special stains......Page 29
Electron microscopy32–38......Page 30
Immunocytochemistry37,40–43......Page 31
Standardized/simplified approaches to FNB for radiologists......Page 33
Image analysis......Page 34
Molecular cytopathology (Table 2.6)......Page 35
References......Page 36
3 Imaging methods for guidance of aspiration cytology......Page 40
Maintaining sterility......Page 41
CT scanning......Page 42
Breast biopsy and carbon marking for localization of clinically occult lesions......Page 43
Carbon localization of nonpalpable breast lesions......Page 44
Risks and complications......Page 46
Pitfalls in aspiration biopsy technique......Page 48
References......Page 49
Accuracy of diagnosis......Page 50
The place of FNA in the investigative sequence......Page 51
Branchial cyst (Fig. 4.1)32,33......Page 52
Other non-neoplastic cysts......Page 53
Squamous cell carcinoma (Figs 4.2 and 4.6)......Page 54
Nasopharyngeal carcinoma (NPC) (Figs 4.8, 4.9, and 5.59)44–47......Page 55
Carcinoma of sinonasal tract......Page 56
Olfactory neuroblastoma (Fig. 4.15)49,56,57......Page 57
Tumors of the orbit......Page 58
Intraocular tumors......Page 59
Tumors of soft tissues and bone......Page 60
Sialadenosis (Fig. 4.21)87,88......Page 61
Sialadenitis (Figs 4.25, 4.26)......Page 62
Pleomorphic adenoma (PA) (Figs 4.29–4.35)14,104,105......Page 65
Basal cell and canalicular adenoma (Figs 4.36–4.40)117,118......Page 68
Warthin’s tumor (Figs 4.41–4.44)1,13......Page 69
Oncocytoma (Fig. 4.45)13,22,123......Page 71
Acinic cell carcinoma (Figs 4.48–4.50)129,130......Page 72
Mucoepidermoid carcinoma (Figs 4.51–4.56)17,133–135......Page 74
Polymorphous low-grade adenocarcinoma (Figs 4.57–4.59)138–140......Page 76
Epithelial-myoepithelial carcinoma (Figs 4.60–4.62)113,141–144......Page 77
Adenoid cystic carcinoma (Figs 4.63–4.68)15,147,148......Page 78
Salivary duct carcinoma (Figs 4.71–4.73)157–161......Page 80
Adenocarcinoma of no special type (Figs 4.74, 4.75)163......Page 82
Other malignant neoplasms......Page 83
References......Page 84
The place of FNA in the investigative sequence......Page 89
Accuracy of diagnosis......Page 90
Technical considerations......Page 91
Cytological findings......Page 92
The reactive node (Figs 5.4–5.16)......Page 93
Granulomatous lymphadenitis (Figs 5.17–5.20)......Page 97
Metastatic malignancy......Page 100
Indicators of the primary site......Page 101
Non-Hodgkin lymphoma9,10,11,38,41,54,55,58,60,68–70,84,141–145......Page 103
B-Cell neoplasms......Page 105
Plasmacytoma (Figs 5.35, 5.36)9,69,146,147......Page 106
Follicular lymphoma (FL) (Figs 5.37–5.39)69......Page 107
Diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS)69......Page 110
Plasmablastic lymphoma (Fig. 5.47)69,158......Page 113
B-lymphoblastic leukemia/ lymphoma (Fig. 5.51)9,69,145,162......Page 114
Mature T and NK-Cell neoplasms......Page 115
Anaplastic large cell lymphoma (ALCL), ALK positive (Fig. 5.55)69,85,86,171–173......Page 116
Hodgkin lymphoma (HL) (Figs 5.61–5.68)40,75–77,184,185......Page 120
References......Page 124
Clinical aspects......Page 130
Technical considerations......Page 131
Normal structures......Page 132
Simple colloid goiter......Page 133
Nodular goiter (Figs 6.4–6.7)......Page 134
Cystic nodules......Page 135
Graves’ disease (primary hyperplasia) (Figs 6.8 and 6.9)81,82......Page 136
Autoimmune thyroiditis (Hashimoto’s thyroiditis/lymphocytic thyroiditis) (Figs 6.10–6.13)81,86–89......Page 137
de Quervain’s thyroiditis (subacute thyroiditis; granulomatous thyroiditis) (Figs 6.14–6.17)42,81,87......Page 140
Follicular neoplasms (Figs 6.18–6.24)23,29,68,117–120......Page 141
Variants of follicular neoplasms......Page 145
Papillary carcinoma (Figs 6.30–6.47)159–162......Page 146
Oncocytic variant (Fig. 6.44A,B)......Page 152
Hyalinizing trabecular tumor (Fig. 6.48)167,209,210......Page 153
Medullary carcinoma (Figs 6.49–6.57)90,213–222......Page 155
C-cell hyperplasia......Page 157
Anaplastic carcinoma (Figs 6.58–6.63)42,67,213,223–225......Page 158
Lymphoma (Figs 6.64, 6.65)90,228,229......Page 159
Metastatic malignancies (Figs 6.29, 6.66 and 6.67)42......Page 160
Parathyroid neoplasms (Figs 6.68 and 6.69)136,240–242......Page 161
References......Page 162
Palpable lesions......Page 168
Accuracy of diagnosis in FNB and CNB......Page 169
Standardized reporting of FNB and CNB samples and quality assurance......Page 172
FNB for measurement of biological factors for diagnosis or prognostication......Page 173
Non-neoplastic glandular breast tissue......Page 174
Gynecomastia of the male breast96–98......Page 176
Main features......Page 177
Simple cyst (Figs 7.10–7.14)......Page 178
Common findings.......Page 179
Fat necrosis (Fig. 7.19)......Page 181
Fibroadenoma (Figs 7.20–7.28)......Page 182
Phyllodes tumor (Figs 7.29–7.32)117–123......Page 185
Adenomyoepithelioma (Fig. 7.33)......Page 186
Usual epithelial hyperplasia, and ADH......Page 188
Papillary lesions (Figs 7.40–7.45)111,146–148......Page 191
Common cytologic findings.93,150–153......Page 194
Mucocele-like lesions......Page 195
Benign mesenchymal lesions; rare lesions158......Page 196
Infiltrating ductal carcinoma of no special type (NOS) (Figs 7.54–7.56 and see Figs 7.2–7.4)......Page 197
Ductal carcinoma in situ (DCIS) (Figs 7.57, 7.58, and see Figs 7.36, 7.39)41,138,170–173......Page 199
Predicting invasion175–180......Page 200
Usual findings.......Page 201
Usual findings.......Page 202
Usual findings.......Page 204
Usual findings.......Page 205
Lobular carcinoma in situ/atypical lobular hyperplasia (LCIS, ALH) (Figs 7.74, 7.75)209–212......Page 207
Carcinoma with apocrine (oxyphil) differentiation (Figs 7.76A and 7.77)219,220......Page 208
Invasive micropapillary carcinoma (Fig. 7.80)226,227......Page 209
Secretory carcinoma (Fig. 7.82)230,231......Page 210
Metaplastic carcinoma (Figs 7.85 and 7.86)235,236......Page 211
Sarcoma......Page 212
Management summaries......Page 213
1. Tumors with central necrosis or sclerosis......Page 214
References......Page 215
The place of FNAC in the investigative sequence......Page 222
Obtaining material......Page 223
Immunocytochemistry......Page 224
Chest wall and pleura......Page 225
Normal structures (Figs 8.1–8.3)......Page 226
Common findings......Page 227
Granulomatous inflammation (Figs 8.5–8.7)98–103,170–176......Page 228
Other specific infections......Page 230
Pulmonary infarct......Page 231
Squamous cell carcinoma (Figs 8.16 and 8.17)......Page 232
Adenocarcinoma, including BAC (Figs 8.18–8.24)......Page 234
Small cell carcinoma (Figs 8.25–8.29)32,35,36,79,82,83......Page 237
Usual findings......Page 241
Usual findings......Page 242
Primary pulmonary salivary-type neoplasms......Page 244
Other bronchial gland tumors......Page 245
Usual findings......Page 246
Other metastatic tumors......Page 247
Inflammatory myofibroblastic tumor (Fig. 8.44)57,316–320......Page 249
Pulmonary hamartoma (Figs 8.45–8.51)64,75,90–93,321......Page 250
Lymphoid lesions in lung and pleura (Fig. 8.53)55,56,302–305......Page 252
Other rare benign tumors276,332–334......Page 254
Usual findings......Page 255
Peripheral primitive neuroectodermal tumor/Ewing’s sarcoma (PNET, Askin tumor)42,347–349......Page 256
References......Page 257
Accuracy of diagnosis......Page 266
Ancillary testing (Table 9.1)......Page 267
Thymoma (Figs 9.1–9.6)18,25–35,59–63......Page 269
Neuroendocrine neoplasms66,79–86 (see also Chapter 8)......Page 272
Hodgkin lymphoma38,39,98,102......Page 273
Large cell lymphoma (± sclerosis) (Fig 9.9)106......Page 274
Teratoma (mature cystic)110......Page 275
Embryonal carcinoma109,112–117......Page 276
Other neoplasms......Page 277
References......Page 279
Accuracy of diagnosis......Page 283
Technical considerations......Page 284
Diffuse parenchymal disease (Figs 10.2–10.9)......Page 285
Congenital (developmental) cysts......Page 287
Abscess (Fig. 10.11)......Page 288
Hepatobiliary cystadenoma......Page 289
Hepatocellular carcinoma (Figs 10.14–10.27)......Page 290
Cholangiocarcinoma......Page 295
Malignant lymphoma183,184......Page 296
Other mesenchymal tumors......Page 297
Metastatic malignancy (Figs 10.31 and 10.32)......Page 298
Technical considerations......Page 299
Others......Page 300
Metastases......Page 301
References......Page 302
The place of FNAC in the investigative sequence......Page 309
Technical considerations......Page 310
Normal structures (Figs 11.1–11.3)......Page 311
Cysts......Page 312
Serous cystadenoma (microcystic/glycogen-rich adenoma) (Fig. 11.6)......Page 313
Solid-psedopapillary neoplasm (Figs 11.7 and 11.8)......Page 314
Adenocarcinoma (Figs 11.9–11.11)......Page 315
Intraductal papillary mucinous and mucinous cystic neoplasms (Figs 11.12–11.14)......Page 316
Other variants of pancreatic cancer......Page 318
Islet cell tumours (Figs 11.18–11.20)......Page 319
Pancreatoblastoma......Page 320
Intra-abdominal tumors......Page 321
References......Page 323
The place of FNAC in the investigative sequence......Page 328
Normal structures; cortical pseudotumor (Figs 12.1 and 12.2)3......Page 329
Cystic nephroma (multilocular renal cyst) (Figs.12.4, 12.5)......Page 330
Xanthogranulomatous pyelonephritis3,54......Page 331
Angiomyolipoma of kidney (Figs 12.7–12.11)55–58......Page 332
Clear cell renal cell carcinoma (Figs. 12.12–12.16)......Page 333
Papillary renal cell carcinoma......Page 334
Chromophobe renal cell carcinoma......Page 336
Uncommon variants of renal cell carcinoma......Page 337
Renal oncocytoma (Fig. 12.23)......Page 338
Wilms’ tumor (Figs 12.27 and 12.28)103–105......Page 339
Transitional cell carcinoma (Figs 12.29–12.31)106,107......Page 340
Non-neoplastic lesions......Page 341
Primary adrenal cortical tumors17–19,120,121......Page 342
Pheochromocytoma (Figs 12.36, 12.37)128–131......Page 343
Retroperitoneum proper......Page 344
Extra-adrenal paraganglioma (Fig. 12.40)133,134......Page 345
Retroperitoneal lymph nodes......Page 346
References......Page 347
The place of FNA in the investigative sequence......Page 351
Technical considerations......Page 352
Prostatitis (Figs 13.3 and 13.4)4,36,37,39......Page 353
Adenocarcinoma of prostate (Figs 13.5–13.8)4,5,27,34,36,37,39......Page 354
Transitional cell carcinoma (Figs 13.16 and 13.17)9,37......Page 357
Rare tumors of the prostate9......Page 358
Accuracy of diagnosis......Page 359
The non-neoplastic testis (Figs 13.22 and 13.23)......Page 360
Miscellaneous......Page 362
Seminoma (Figs 13.30 and 13.31)14,50,57–63,65,66......Page 363
Spermatocytic seminoma (Fig. 13.32)14,64......Page 364
Tumors of more than one histologic type (mixed forms) (Figs 13.35 and 13.36)14,60,63,65......Page 365
Yolk sac tumor (Figs 13.37 and 13.38)14,53–56,59–61,63......Page 366
Teratoma (Fig. 13.40)14,59,63,66......Page 367
Hematopoietic tumors......Page 368
Other tumors......Page 369
Lower female genital tract......Page 370
Malignant tumors......Page 371
Non-neoplastic ovarian cysts......Page 373
Malignant neoplasms5,6,31......Page 374
Mucinous cystadenocarcinoma (Fig. 13.59)......Page 375
Metastatic carcinoma to ovary......Page 376
Granulosa cell tumor (Figs 13.62–13.65)135,136......Page 377
References......Page 378
Technical considerations......Page 382
Inflammatory processes......Page 383
Cysts and other non-neoplastic lesions......Page 384
Adenomatous tumors of sweat gland origin......Page 385
Pilomatricoma (calcifying epithelioma of Malherbe) (Fig. 14.11)37–40......Page 386
Squamous cell carcinoma (Fig. 14.13)......Page 388
Basal cell carcinoma (Fig. 14.14)8,45–48......Page 389
Merkel cell carcinoma (neuroendocrine carcinoma of skin) (Fig. 14.17, and see Fig. 5.23)61,62......Page 390
Histiocytoma/dermatofibroma (Figs 14.19 and 14.20)......Page 391
Malignant melanoma (Figs 14.23–14.28)......Page 392
References......Page 396
The place of FNAC in the investigative sequence......Page 399
Common characteristics......Page 400
Benign tumors......Page 401
Malignant tumors......Page 405
Benign tumors......Page 407
Malignant tumors......Page 408
Tumors of smooth muscle......Page 410
Malignant tumors......Page 411
Malignant tumors......Page 412
Benign tumors......Page 414
Malignant tumors......Page 417
Benign tumors......Page 418
Malignant tumors......Page 419
References......Page 421
Technical considerations......Page 424
Normal structures......Page 425
Metastatic carcinoma......Page 426
Solitary plasmacytoma; myeloma......Page 427
Giant cell tumor of bone......Page 428
Chondroma......Page 429
Chondromyxoid fibroma......Page 430
Osteosarcoma (conventional intramedullary osteosarcoma)......Page 431
Chondrosarcoma......Page 434
Chordoma......Page 435
Ewing’s family tumors......Page 436
References......Page 438
Obtaining and handling of specimens......Page 440
Ancillary techniques......Page 441
Neuroblastoma......Page 442
Wilms’ tumor (nephroblastoma)......Page 444
Ewing’s sarcoma/primitive neuroectodermal tumor (EWS/PNET)......Page 445
Rhabdomyosarcoma......Page 446
Malignant lymphoma......Page 447
Langerhans cell histiocytosis......Page 448
Hepatoblastoma......Page 449
Undifferentiated (embryonal) sarcoma of the liver......Page 450
Pancreas......Page 451
Gonads......Page 453
Lymph nodes......Page 454
Soft tissues and bone......Page 457
Pilomatrixoma......Page 458
References......Page 459
Specific sites......Page 463
Contraindications......Page 465
Clinical......Page 466
Specific infections......Page 471
Kaposi’s sarcoma......Page 473
References......Page 480
A......Page 482
C......Page 483
E......Page 485
G......Page 486
I......Page 487
L......Page 488
M......Page 489
O......Page 490
P......Page 491
S......Page 492
T......Page 493
Z......Page 494