PART TWO
Diagnostic Cytology
Table 13.2
Cancer Types Present in 28 Patients with Cytologic Diagnosis
of Atypical Squamous Metaplasia
Number
of patients
Percentage
of patients
Cancer primary in the lung
Squamous cell
carcinoma
9
32.2
Adenocarcinoma
5
17.8
Large-cell undifferen-
tiated carcinoma
5
17.8
Small-cell undifferenti-
ated carcinoma
5
17.8
Cancer metastatic to the lung
Mammary carcinoma
2
7.2
Squamous cell
carcinoma
1
3.6
Chondrosarcoma
1
3.6
Total
28
100
Reproduced with permission from Johnston WW. Cytologic correlations. In: Dail
DH, Hammar SP (eds)
Pulmonary Pathology.
New York: Springer-Verlag, 1987.
Table 13.3
A Profile of Signs and Diseases in 42 Patients without Cancer
but with Cytologic Diagnosis of Atypical Squamous Metaplasia
Disease
category
Number
of patients
Percentage of
patients
Pneumonia
12
28.6
Chronic obstructive
pulmonary disease
10
23.8
Granulomatous
disease
10
23.8
Chronic bronchitis
9
21.4
Smoking history
8
19.0
Hemoptysis
3
7.1
Abscess
3
7.1
Thromboemboli
3
7.1
Other
5
11.9
Reproduced with permission from Johnston WW. Cytologic correlations. In: Dail
DH, Hammar SP (eds)
Pulmonary Pathology.
New York: Springer-Verlag, 1987.
The exact nature, origin and diagnostic and prognostic
significance of the "Pap” cells has not as yet been established.
According to one view they are small squamous cells from the
upper portion of the respiratory tract. Another view supported
by good evidence is that they represent a squamous metaplastic
change of epithelial cells of the ciliated type.1
Atypical metaplastic cells have also been reported in the
sputum of patients with tracheostomies.110
Fig. 13.28 Atypical squamous metaplasia
from a young adult quadriplegic
with pneumonia and oxygen toxicity. Sputum (Papanicolaou x OI).
Fig. 13.29 Hyperplastic type II pneumocytes
in sputum from the same
case as in Fig. 13.28 (Papanicolaou x OI).
Fig. 13.30
Autopsy
lung specimen
from the case described in Figs. 13.28
and 13.29. Cells similar to those shown in sputum line the alveolar spaces
(H&E x MP).
314
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