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
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Differential Diagnoses in Surgical Pathology Series
Series Editor: Jonathan I. Epstein
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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
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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) |
Age | Any age but more likely to be transient infection in younger women | Any age |
Location | Cervix (also vagina, anus, and vulva) | Cervix (also vagina, anus, and vulva) |
Signs and symptoms | None; detected on routine screening or on colposcopy | None; detected on routine screening or on colposcopy |
Etiology | Premalignant lesion associated with both low- and high-risk HPV | Premalignant 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 ()
|