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Ebook Atlas of pulmonary cytopathology: Part 2

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Nội dung chi tiết: Ebook Atlas of pulmonary cytopathology: Part 2

Ebook Atlas of pulmonary cytopathology: Part 2

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2ace of this papilloma show human papillomavirus cytopathic effect, with koilocytosis and nuclear hypctchromasia with ’raisinoid" features. High grade

dysplasia in a papilloma, associated with human papillomavirus-16 and -18. is associated with partial or failed maturation, and is graded according to Ebook Atlas of pulmonary cytopathology: Part 2

the World Health Organization classification of preinvasive lesions.Figure 5.2a — Pulmonary Hamartoma, Fine Needle Aspiration [Pap Stain: Medium Powe

Ebook Atlas of pulmonary cytopathology: Part 2

r]. Pulmonary hamartoma is the most common benign neoplasm of the lung. Most are solitary, incidental findings, but multiple lesions have been describ

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2eading to their description as a “coin" lesion. When present radiographically, speckled (so-called "popcorn") calcifications are diagnostically useful

. Hyaline-type cartilage and adipose tissue are the two most common components ol hamartomas, and as seen here cartilage may be abundant, or minimal i Ebook Atlas of pulmonary cytopathology: Part 2

n amount, as seen in the next image.Figure 5.2b — Pulmonary Hamartoma, Fine Needle Aspiration [Dift-Quik Stain: High Power]. Most hamartomas are 3 cm

Ebook Atlas of pulmonary cytopathology: Part 2

or less in diameter, though larger lesions have been reported. Cellulariry is variable and can Ik dispersed in loose or tight clusters and as single c

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2bility of low-grade malignancy such as carcinoid tumor. Ihesc cells arc derived from bronchiolar or alveolar cells anil typically lack cilia. A concen

trated search for a mesenchymal component usually allows for a specific diagnosis. In contrast to the prior image, only a small wispy fragment of chon Ebook Atlas of pulmonary cytopathology: Part 2

dromyxoid stroma is present in this case.84Atluở ụj i UI/IIUHUIy \~'Vii>i>muunjỊỊỵFigure 5-2c — Pulmonary Hamartoma, Fine Needle Aspiration (Diff-Quik

Ebook Atlas of pulmonary cytopathology: Part 2

Stain; High Power]. This image shares all three components of a pulmonary hamartoma: mature adipose tissue (most noticeable on the right), a cluster

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2martomas, and more myxoid or myxohyaline in peripheral lesions.Figure 5-3(a. b) — Hamartoma. Fine Needle Aspiration : Diff-Quik Stain; Medium Power).

The smears show abundant magenta-colored, fibrillary matrix material surrounding bland-appearing epithelioid cells with a thin rim of blue cytoplasm. Ebook Atlas of pulmonary cytopathology: Part 2

If this were taken from the salivary gland, it would be strongly suggestive of a pleomorphic adenoma, lhere is also significant overlap with chondrosa

Ebook Atlas of pulmonary cytopathology: Part 2

rcoma (discussed in Chapter 7). Examination of other fields or fine needle aspiration passes may reveal secondary components more suggestive of hamart

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2of acellular magenta-colored. fibr illary matrix that has the quality of matrix material seen in a pleomorphic adenoma. Given that this sampling was t

aken from a hamartoma. the matrix material is likely chondroid in origin. Chondroid matrix material can have many different appearances. 'Illis highli Ebook Atlas of pulmonary cytopathology: Part 2

ghts the challenge of definitively identifying the origin of background material. For instance, the misidentification of mucinous material as chondrom

Ebook Atlas of pulmonary cytopathology: Part 2

vxoid could lead one far down the incorrect diagnostic path.Figure 5-3d — Hamartoma, Fine Needle Aspiration [Pap Stain; High Power]. 'Ihis fragment of

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2ilaginous material, given the presence of Swiss cheese-like holes within the matrix. If seen on a separate pass from the same lesion as in the previou

s images, this would cause one to consider a hamartoma rather than a pleomorphic adenoma. Unfortunately, this could also represent contamination from Ebook Atlas of pulmonary cytopathology: Part 2

the normal cartilage if the needle has passed through a large airway, in which case the differential diagnosis remains between hamartoma and pleomorph

Ebook Atlas of pulmonary cytopathology: Part 2

ic adenoma.Figure 5.4a — Hamartoma. Fine Needle Aspiration [Pap Stain; Medium Power]. Ihis colorful field demonstrates intermixed lipid and myxoid mat

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2 entrapped respiratory or alveolar epithelium that has undergone metaplasia and/or hyperplasia. Hamartomas contain a variable mixture of components an

d the fine needle aspiration findings are representative of the components present, as well as which components arc sampled.86Atlui Ifj I uưiiunuiV ì~ Ebook Atlas of pulmonary cytopathology: Part 2

ỵn>i>iuuiHUỊỊỵFigure 5.4b — Hamartoma, Biopsy [H&E Stain: Low Power]. Ar low power, the characteristic lobulated architecture of hamartoma is apparent

Ebook Atlas of pulmonary cytopathology: Part 2

. Nodules of adipose tissue and myxoid stroma are separated by entrapped bronchiolar epithelium. Although disorganized, the histomorphology is otherwi

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2mixed with fibrous and adipose tissue. Ihc epithelium at the lower left represents entrapped bronchiolar epithelium. Other examples may contain varyin

g proportions of a range of mesenchymal elements, including bone, smooth muscle, and myxoid stroma. Hamartomas are distinguished from benign pulmonary Ebook Atlas of pulmonary cytopathology: Part 2

soft tissue tumors by the presence of two or more mesenchymal components. Carney Triad-associated chondromas are encapsulated and lack entrapped epit

Ebook Atlas of pulmonary cytopathology: Part 2

helium; osseous metaplasia is often present. Primary or metastatic sarcoma should be considered if significant nuclear atypia is present.Figure 5'5 —

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2 adjacent to small bronchioles. Ihe component cells may be round, oval, or spindled, and have a moderate amount of eosinophilic cytoplasm; salt and pe

pper-type chromatin is characteristic. Tumorlets are usually an incidental finding in abnormal lungs biopsied or resected for a wide variety of chroni Ebook Atlas of pulmonary cytopathology: Part 2

c lung diseases. A diagnosis of “diffuse idiopathic pulmonary neuroendocrine cell hyperplasia’ is appropriate when tumorlets are numerous and diffuse

Ebook Atlas of pulmonary cytopathology: Part 2

throughout the lungs. In small biopsies, tutnorlcts may mimic meningothclial nodules (EMA- and PR-positive, negative for neuroendocrine markers) and g

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

Ebook Atlas of pulmonary cytopathology: Part 2erature; most likely they arc rarely sampled due to their small size.

Benign LungNeoplasms81Chapter 5: Benign Lung NeoplasmsFigure 5.Id — Papillomatosis, Resection [H&E Stain; High Power]. Ihc maturing cells at the surfa

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