Περιεχόμενα
1 Specimen Collection and Processing ……………………… 1
Specimen Collection ………………………………………………. 1
Sputum ……………………………………………………………… 3
Bronchoscopy Specimens ……………………………………. 3
Fine Needle Aspiration ……………………………………….. 4
Processing Pulmonary Specimens ……………………………. 5
Sputum ……………………………………………………………… 5
Bronchial Brush, Wash, and BAL Specimens ………… 6
Laser Capture Microdissection …………………………….. 6
Staining ………………………………………………………………… 6
Assessment of Specimen Adequacy …………………………. 7
Suggested Reading …………………………………………………. 9
2 Normal Components …………………………………………….. 13
Epithelial Elements ………………………………………………… 13
Tracheal and Bronchial Respiratory Epithelium …….. 13
Alveolar Epithelium ……………………………………………. 13
Nonepithelial Cellular Elements ………………………………. 16
Macrophages and Giant Cells ………………………………. 16
Siderophages ……………………………………………………… 19
Polymorphonuclear Leukocytes …………………………… 20
Lymphocytes ……………………………………………………… 20
Eosinophils ………………………………………………………… 21
Megakaryocytes …………………………………………………. 22
Miscellaneous Noncellular Elements ……………………….. 23
Curschmann Spirals ……………………………………………. 23
Charcot–Leyden Crystals …………………………………….. 24
Blue Bodies (Corpora Amylacea) …………………………. 24
Calcific and Psammoma Bodies …………………………… 25
Contaminants …………………………………………………….. 25
Suggested Reading …………………………………………………. 27
3 Hyperplasia, Reactive Changes, and Metaplasia ……. 29
Hyperplastic and Reactive Changes …………………………. 29
Goblet Cell Hyperplasia ……………………………………… 29
Reactive and Hyperplastic Bronchial Epithelium …… 31
Reactive Terminal Bronchial/Alveolar Epithelium …. 33
Reserve Cell Hyperplasia ……………………………………. 36
Ciliocytophthoria ……………………………………………….. 38
Creola Bodies …………………………………………………….. 39
Squamous Metaplasia and Atypia ………………………… 40
Therapy-Induced Changes ………………………………………. 43
Radiation Therapy ………………………………………………. 43
Chemotherapy ……………………………………………………. 45
Non-chemotherapeutic Drugs ………………………………. 46
Pulmonary Allograft Transplants ………………………….. 47
Pneumoconioses …………………………………………………….. 48
Asbestosis …………………………………………………………. 48
Other Pneumoconioses ……………………………………….. 50
Suggested Reading …………………………………………………. 50
4 Respiratory Infections ………………………………………….. 53
Viral Infections ……………………………………………………… 53
Herpes Simplex Infection ……………………………………. 54
Cytomegalovirus Infection ………………………………….. 56
Adenovirus Infection ………………………………………….. 58
Other Viral Infections …………………………………………. 58
Bacterial Infections ………………………………………………… 59
Mycobacterial Infections …………………………………….. 59
Legionella Infection ……………………………………………. 62
Actinomycosis and Nocardiosis …………………………… 63
Other Bacteria ……………………………………………………. 64
Mycotic Infections …………………………………………………. 64
Candidiasis ………………………………………………………… 64
Cryptococcosis …………………………………………………… 66
Aspergillosis………………………………………………………. 68
Zygomycosis (Phycomycosis) ……………………………… 72
Histoplasmosis …………………………………………………… 73
Blastomycosis ……………………………………………………. 74
Coccidioidomycosis and Paracoccidioidomycosis ….. 74
Sporotrichosis ……………………………………………………. 77
Pneumocystis Jiroveci (Carinii) Pneumonia …………… 77
Parasitic Infections …………………………………………………. 80
Strongyloidiasis………………………………………………….. 80
Paragonimiasis …………………………………………………… 82
Dirofilariasis ……………………………………………………… 82
Other Parasitic Infections ……………………………………. 83
Suggested Reading …………………………………………………. 83
5 Other Non-neoplastic Conditions ………………………….. 87
Bronchial Asthma ………………………………………………….. 87
Differential Diagnosis …………………………………………. 88
Sarcoidosis ……………………………………………………………. 89
Differential Diagnosis …………………………………………. 91
Pulmonary Alveolar Proteinosis ………………………………. 92
Differential Diagnosis …………………………………………. 93
Lipid Pneumonia ……………………………………………………. 94
Differential Diagnosis …………………………………………. 95
Amyloidosis ………………………………………………………….. 95
Pulmonary Infarcts …………………………………………………. 97
Differential Diagnosis …………………………………………. 98
Suggested Reading …………………………………………………. 99
6 Benign Neoplasms ………………………………………………… 101
Pulmonary Hamartoma …………………………………………… 101
Inflammatory Myofibroblastoma ……………………………… 104
Differential Diagnosis …………………………………………. 107
Solitary Fibrous Tumors …………………………………………. 107
Differential Diagnosis …………………………………………. 109
Pneumocytoma ………………………………………………………. 109
Differential Diagnosis …………………………………………. 112
Other Benign Tumors …………………………………………….. 112
Suggested Reading …………………………………………………. 113
7 Primary Epithelial Malignancies …………………………… 115
Squamous Cell Carcinoma ……………………………………… 116
Well-Differentiated Squamous Cell Carcinomas …….. 119
Poorly Differentiated Squamous Cell Carcinomas ….. 122
Immunohistochemistry of Squamous
Cell Carcinoma ………………………………………………….. 123
Differential Diagnosis: Benign Conditions
Mimicking Squamous Cell Carcinoma ………………….. 123
Pre-invasive Squamous Lesions ………………………………. 128
In Situ Squamous Cell Carcinoma and Dysplasia …… 128
Adenocarcinoma ……………………………………………………. 131
Adenocarcinoma with Lepidic Pattern
(Bronchioloalveolar Carcinoma) ………………………….. 139
Immunohistochemistry of Adenocarcinomas …………. 141
Differential Diagnosis of Adenocarcinomas ………….. 143
Large Cell Carcinoma (LCC)/Non-Small Cell
Carcinoma, Not Otherwise Specified (NOS) …………….. 148
Differential Diagnosis …………………………………………. 152
Small Cell Carcinoma …………………………………………….. 153
Differential Diagnosis …………………………………………. 158
Neuroendocrine Neoplasms …………………………………….. 163
Carcinoid Tumors ………………………………………………. 164
Differential Diagnosis …………………………………………. 169
Salivary Gland-Like Tumors …………………………………… 171
Adenoid Cystic Carcinoma ………………………………….. 171
Mucoepidermoid Carcinoma ……………………………….. 173
Suggested Reading …………………………………………………. 175
8 Primary Nonepithelial Malignancies …………………….. 181
Lymphomas …………………………………………………………… 181
Cytopathology ……………………………………………………. 181
Differential Diagnosis …………………………………………. 184
Sarcomas ………………………………………………………………. 184
Cytopathology ……………………………………………………. 185
Differential Diagnosis …………………………………………. 186
Suggested Reading …………………………………………………. 187
9 Metastatic Tumors ……………………………………………….. 189
Differential Diagnosis: General Considerations …………. 190
Adenocarcinoma ……………………………………………………. 191
Adenocarcinomas with Acinar Pattern ………………….. 192
Adenocarcinomas with Mucinous/Signet Ring
Cell Pattern ……………………………………………………….. 193
Carcinomas with Papillary Pattern …………………………… 196
Carcinomas with Solid Nest or Diffuse Pattern ……… 197
Tumors with Clear Cells ……………………………………… 200
Squamous and Transitional Cell Carcinoma ……………… 201
Spindle Cell and Miscellaneous
Nonepithelial Neoplasms ………………………………………… 203
Pleural Metastases ………………………………………………….. 208
Concluding Remarks ………………………………………………. 208
Suggested Reading …………………………………………………. 210
Index …………………………………………………………………………. 211
