By Sudha R. Kini MD
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Additional resources for Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology
6A to H. A: Round; spherical and monomorphic. B: Anisonucleosis; variations in size and shape of the nucleus. C: Oval; eggshaped (arrows) and oblong: greater length than breadth (arrowheads). , smooth muscle cell nucleus). E: Spindle. Slender rod, broader in the middle. F: Bipolar; two poles equidistant from the center. G: Comma; curved, broad at one end, tapered at the other (arrows). , a histiocyte). Note the notch in the nuclear membrane (arrows). (continued) I J K L M N P O Figs. 6I to P. (continued) I: Molded; flattening of portion of nuclear membrane by another nucleus (arrows).
All the above events contributed immensely to lowering the incidence of cervical cancer and related deaths in the Western world. However, the success of the tremendously useful test was overshadowed by some instances of missed diagnoses of cervical cancers and the publicity it received in media. The reasons given in many cases of missed diagnoses were inadequate sampling or a lack of diagnostic cells. Yet, the issue of specimen adequacy had never received enough attention. As the knowledge base regarding cervical neoplasia was being widened, gynecologic cytology experienced several modifications of classifications for precursor changes from Papanicolaou’s class system to Reagen’s classification of dysplasia (mild, moderate, severe) and carcinoma in situ, and Richart’s classifi cation of cervical intraepithelial neoplasia grade I to III.
To be of diagnostic importance, a psammoma body must be incorporated in a tissue fragment. The size of an abnormal cell and its nucleus are important parameters. Cells are often referred to as small, medium, or large. , a red blood cell, an entire neutrophil, a lymphocyte, a histiocytic nucleus, an intermediate squamous cell nucleus, or an endocervical glandular cell nucleus). Compared to the size of a resting lymphocyte, a small cell is roughly three to three and a half times as large, while a medium-sized cell is three to six times as large, and a large cell is six to 10 times as large.
Color Atlas of Differential Diagnosis in Exfoliative and Aspiration Cytopathology by Sudha R. Kini MD