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Respiratory Cytology
1. Benign and MalignantBenign and Malignant
Lesions in RespiratoryLesions in Respiratory
CytologyCytology
MISS SURUTTAYA CHINNAWONGMISS SURUTTAYA CHINNAWONG
2. Respiratory CytologyRespiratory Cytology
• Major role:
– Diagnosis of malignant neoplasms
involving lung both primary and
metastatic
• Minor role:
– Opportunistic infection
– Specific inflammatory process
– Benign neoplasms, some
7. Advantages of sputumAdvantages of sputum
• Noninvasive
• Reflect constituents from many regions of
lung
• Useful for centrally located malignancies
(Squamous cell/Small cell CA)
• High diagnostic yields: induced sputum, 3-5
samples continuously examined
• Chronic inflammations: Asthma, COPD
• Respiratory infections
8. Disadvantages of sputumDisadvantages of sputum
• Alveolar macrophages: lower respiratory
tract elements
• Localized lung lesion, peripheral lesion
• Adenocarcinoma, metastatic lesion,
lymphoma
• Benign tumor
9. Bronchial cytologyBronchial cytology
• Fiberoptic bronchoscopy
• Bronchoscope positions at the area
of abnormality
• Adequacy: large number of bronchial
epithelial cells and alveolar
macrophages
• Inadequate specimen: heavy oral
contamination, obscuring blood,
inflammatory process, dried artefact
33. Nonneoplastic lungNonneoplastic lung
diseasedisease
• Sarcoidosis
– Granulomatous inflammation of lung
parenchyma with hilar/mediastinal node
involement
– FNA diagnosis
– Diagnosis includes typical features of
nonnecrotizing granuloma and exclusion
of specific infectious etiology
– Culture and special stains needed
34. Noneoplastic lung diseaseNoneoplastic lung disease
• Pulmonary alveolar proteinosis
– BAL diagnosis
• Gross: cloudy/milky white with graular
debris
– Paucicellular sample of mononuclear
inflammatory cells
– Amorphous basophilic granular debris
– D/Dx: Pneumocystosis, Nocardia,
amyloidosis