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Syed Ali - Differential Diagnoses in Surgical Pathology: Cytopathology

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Syed Ali Differential Diagnoses in Surgical Pathology: Cytopathology

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For a concise, image-heavy guide to making accurate diagnoses from a range of cytopathology specimens, choose Differential Diagnoses in Surgical Pathology: Cytopathology, the latest addition to the renowned series. Compare similar entitiesor those with many common attributesand learn to spot the elements and details that can impact diagnosis. Like other volumes in the series the book presents material in a way that pathologists actually work, and is ideal as a quick-reference guide or for deep-dive research.
Features side-by-side comparisons of all the core elements of a diagnosis, including location, shape, morphology, prognosis, and treatment.
Covers common and rare disorders including conditions of the pulmonary and urinary tracts, as well as the kidney, liver, breast, and pancreas.
Sample diagnoses are presented in a succinct bulleted format with accurate, high-quality images for a helpful visual context.
Highlights clinical differences between lesions and the latest molecular alterations.
Follows the same structural format as the other volumes in the series, which cover the Breast, Head & Neck, Genitourinary System, Genitourinary Tract, and Pulmonary Pathology
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Differential Diagnoses in Surgical Pathology
Cytopathology
Christopher J. VandenBussche, MD, PhD
Associate Director, Division of Cytopathology
Associate Professor of Pathology and Oncology
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Syed Z. Ali, MBBS, MD
Director, Division of Cytopathology
Professor of Pathology and Radiology
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Series Editor
Jonathan I. Epstein, MD
Professor of Pathology, Urology and Oncology
The Reinhard Professor of Urological Pathology
Director of Surgical Pathology
The Johns Hopkins Medical Institutions
Baltimore, Maryland
Copyright Acquisitions Editor Keith Donnellan Development Editor Ariel S - photo 1
Copyright

Acquisitions Editor: Keith Donnellan

Development Editor: Ariel S. Winter

Editorial Coordinator: Julie Kostelnik

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Prepress Vendor: TNQ Technologies

Copyright 2020 Wolters Kluwer.

All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at (products and services).

987654321

Printed in China

Library of Congress Cataloging-in-Publication Data

ISBN-13: 978-1-975113-14-8

Cataloging in Publication data available on request from publisher.

This work is provided as is, and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work.

This work is no substitute for individual patient assessment based upon healthcare professionals examination of each patient and consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments.

Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturers package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work.

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Differential Diagnoses in Surgical Pathology Series
Series Editor: Jonathan I. Epstein
Differential Diagnoses in Surgical Pathology: Genitourinary System
Jonathan I. Epstein and George J. Netto, 2014
Differential Diagnoses in Surgical Pathology: Gastrointestinal System
Elizabeth A. Montgomery and Whitney M. Green, 2015
Differential Diagnoses in Surgical Pathology: Pulmonary Pathology
Rosane Duarte Achcar, Steve D. Groshong and Carlyne D. Cool, 2016
Differential Diagnoses in Surgical Pathology: Head and Neck
William H. Westra and Justin A. Bishop, 2016
Differential Diagnoses in Surgical Pathology: Breast
Jean F. Simpson and Melinda E. Sanders, 2016
Preface
The practice of cytopathology revolves around the creation of a differential diagnosis. Often, without the benefit of the level of architecture seen in histologic sections, the cytopathologist must use the smallest cytomorphologic cluesand even look beyond cells and into the surrounding backgroundto narrow the differential diagnosis or even arrive at a singular diagnosis.
This book compares similar entities that are often in the differential diagnosis together and focuses on those small details that can help favor one entity over another. In addition to high yield, bulleted cytomorphologic descriptions and representative images, the book also includes important clinical differences between lesions, as well as the latest molecular alterations associated with each entity, when known.
Some of the presented entities are common, while others are rare. This book may be used to learn about a given entity in more detail, to broaden a differential diagnosis, or eliminate less likely diagnoses from a differential. Whether used in a pinch or read from cover-to-cover, we hope this book will become a trusted reference for the reader when cytopathology specimens are encountered.

Christopher J. VandenBussche and Syed Z. Ali

Table of Contents
chapter 1
Gynecologic Cytopathology
1.1 Low-Grade Squamous Intraepithelial Lesion (LSIL) Versus High-Grade Squamous Intraepithelial Lesion (HSIL)
Low-Grade Squamous Intraepithelial Lesion (LSIL)High-Grade Squamous Intraepithelial Lesion (HSIL)
AgeAny age but more likely to be transient infection in younger womenAny age
LocationCervix (also vagina, anus, and vulva)Cervix (also vagina, anus, and vulva)
Signs and symptomsNone; detected on routine screening or on colposcopyNone; detected on routine screening or on colposcopy
EtiologyPremalignant lesion associated with both low- and high-risk HPVPremalignant lesion more commonly associated with high-risk HPV types
Cytomorphology
  • Squamous cells with enlarged nuclei ()
  • Irregular nuclear borders and/or raisinoid nucleus ()
  • Occasional binucleation ()
  • Koilocytes have, in addition to the above features, a well-defined polygonal perinuclear halo with sharp edges and central clearing ()
  • Cellular fragments and dispersed single cells ()
  • High N/C ratio due to increased nuclear size and decreased amounts of cytoplasm ()
  • Hyperchromatic nuclei without prominent nucleoli ()
  • Markedly irregular nuclear borders ()
  • Anisonucleosis may be present ()
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