PART TWO
Diagnostic Cytology
Fig. 8.121 Adenosquamous cancer showing poorly differentiated adenocarcinoma and nonkeratinizing squamous cancer components (H&E x MP).
Fig. 8.122 Adenosquamous cancer. Cells with characteristics of squamous cell cancer (A) occurring together with cells consistent with poorly differentiated
adenocarcinoma (B) (Papanicolaou x OI).
Fig. 8.123 Small-cell cancer. Large masses of tumor cells with minimal
cytoplasm separated by small strands of stromal cells (H&E x OI).
the tumor cells are relatively small and have large nuclei and
scanty cyanophilic cytoplasm, causing a high nucleocytoplas-
mic ratio (Fig. 8.124). Nuclei may be round to oval but more
often are irregular and have a hyperchromatic, coarsely granular
chromatin. Nucleoli are usually present but may be obscured by
the dense chromatinic material.
Key features of small cell carcinoma
• Small round-to-oval cells predominantly arranged in
syncytial aggregates;
• Within the syncytia cells show great variation in size;
• Cells have scant often indistinct cyanophilic cyto-
plasm;
• Round-to-oval nuclei with considerable variation in
size;
• N/C high;
• Unevenly distributed, coarsely granular, densely hyper-
chromatic chromatin;
• Micronucleoli are present but frequently obscured by
hyperchromatic nuclear chromatin.
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