Table Of ContentDiagnostic
Cytopathology
Commissioning Editor: Michael Houston
Development Editor: Joanne Scott
Project Manager: Kerrie-Anne McKinlay
Design : Charles Gray
Editorial Assistant: Rachael Harrison
Illustration Manager: Merlyn Harvey
Illustrators : Richard Tibbitts/Paul Richardson /Martin Woodwerd
Marketing Managers (UK/USA): Ria Timmerman/Brenna Christensen
T h i r d E di t io n
Diagnostic
Cytopathology
Edited by
Winifred Gray, (retired), MB BS FRCPath
Consultant Cytopathologist/Histopathologist
John Radcliffe Hospital
Oxford
UK
Gabrijela Kocjan,
MB BS Spec Clin Cyt FRCPath
Senior Lecturer
Head of Diagnostic Cytopathology
University College Hospital
London
UK
an imprint of Elsevier Limited.
First edition 1995
Second edition 2003
Third edition 2010
© 2010, Elsevier Limited. All rights reserved.
The right of Winifred Gray and Gabrijela Kocjan to be identifi ed as authors of this work has been
asserted by them in accordance with the Copyright, Designs and Patents Act 1988.
No part of this publication may be reproduced or transmitted in any form or by any means, elec-
tronic or mechanical, including photocopying, recording, or any information storage and retrieval
system, without permission in writing from the publisher. Permissions may be sought directly from
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fax: ( (cid:2) 44) 1865 853333; e-mail: [email protected]. You may also complete your
request on-line via the Elsevier website at h ttp://www.elsevier.com/permissions .
ISBN: 978-0-7020-3154-0
British Library Cataloguing in Publication Data
Diagnostic cytopathology – 3rd ed.
1 . Cytodiagnosis.
I . Gray, W. (Winifred) II. Kocjan, Gabrijela.
616 ’ .07582-dc22
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notice
Medical knowledge is constantly changing. Standard safety precautions must be followed, but
as new research and clinical experience broaden our knowledge, changes in treatment and drug
therapy may become necessary or appropriate. Readers are advised to check the most current
product information provided by the manufacturer of each drug to be administered to verify the
recommended dose, the method and duration of administration, and contraindications. It is the
responsibility of the practitioner, relying on experience and knowledge of the patient, to deter-
mine dosages and the best treatment for each individual patient. Neither the Publisher nor the
author assume any liability for any injury and/or damage to persons or property arising from
this publication.
The Publisher
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Contents
Preface ix
List of Contributors xi
Dedication xv
Section 1 Introduction
Chapter 1 Cytopathology: the history, the present and the future direction 3
Ibrahim Ramzy and Amanda Herbert
Section 2 Respiratory System
Chapter 2 Respiratory tract 17
Thomas E. Giles, Julie McCarthy and Winifred Gray
Section 3 Serous Cavities
Chapter 3 Serous effusions 115
V inod B. Shidham and Mary Falzon
Section 4 Breast
C hapter 4 The breast 179
Torill Sauer and Derek Roskell
Section 5 Alimentary System
Chapter 5 Salivary glands 231
Gabrijela Kocjan and Ketan A. Shah
Chapter 6 Oral cavity 253
Phillip Sloan and Alfred B ö cking
Chapter 7 Oesophagus and gastrointestinal tract 265
Fernando Schmitt and Maria Helena Oliveira
Section 6 Hepatobiliary System and Pancreas
Chapter 8 Liver 287
Martha Bishop Pitman
Chapter 9 Gall bladder and extrahepatic bile ducts 319
Gabrijela Kocjan
v
Contents
Chapter 10 Pancreas 333
M artha Bishop Pitman
Section 7 Kidney and Urinary Tract
Chapter 11 Kidney and retroperitoneal tissues 367
Beatrix Cochand-Priollet
Chapter 12 Urine cytology 381
Stephen S. Raab
Section 8 Lymphoreticular System
Chapter 13 Lymph nodes 409
Lambert Skoog and Edneia Tani
Chapter 14 Other lymphoreticular organs 445
Edneia Tani and Lambert Skoog
S ection 9 Transplantation and Immunosuppression
Chapter 15 Organ transplantation 459
Eva von Willebrand and Irmeli Lautenschlager
Chapter 16 Immunosuppression 471
Martin Young and Robert Miller
Section 10 Endocrine System
Chapter 17 Thyroid gland 487
Ian D. Buley
Chapter 18 Other endocrine organs 513
Ian D. Buley
Section 11 Male Genital Tract
Chapter 19 Prostate gland 527
Aasmund Berner and Svante R. Orell
Chapter 20 Testis and scrotum: cytology of testicular and scrotal
masses and male infertility 537
Ika Kardum-Skelin and Paul J. Turek
Section 12 Female Genital Tract
Chapter 21 Vulva, vagina and cervix: normal cytology, hormonal and
infl ammatory conditions 555
Tanya Levine and Winifred Gray
Chapter 22 Cervical screening programmes 599
Karin J. Denton and Mina Desai
vi
Contents
Chapter 23 Cervical intraepithelial neoplasia and squamous cell carcinoma of the cervix 609
Peter A. Smith and Winifred Gray
Chapter 24 Glandular neoplasms of the cervix 645
Christine Waddell and Ashish Chandra
Chapter 25 Other tumours and lesions of cervix, vulva and vagina 667
John H. F. Smith
Chapter 26 Cytology of the body of the uterus 689
Tadao K. Kobayashi, Yoshiaki Norimatsu and Anna Maria Buccoliero
Chapter 27 Ovaries, fallopian tubes and associated lesions 721
Sanjiv Manek and Vesna Mahovlic´
Section 13 Skin, Soft Tissues and Musculoskeletal System
Chapter 28 Skin 739
Anna M. Bofi n and Eidi Christensen
Chapter 29 Soft tissue and musculoskeletal system 755
Henryk A. Domanski, M å ns Å kerman and Jan Silverman
Chapter 30 Synovial fl uid 809
Anthony J. Freemont and John Denton
Section 14 Central Nervous System
Chapter 31 Brain and cerebrospinal fl uid 821
Malcolm Galloway and Maria Thom
Chapter 32 Eyelids, orbit and eye 857
Pio Zeppa and Lucio Palombini
Section 15 Childhood Tumours
Chapter 33 Childhood tumours 873
Voichita Suciu, Monique Fabre, Jerzy Klijanienko,
Ziva Pohar-Marinsek and Philippe Vielh
Section 16 New Techniques
Chapter 34 New techniques 891
Victor Lee, Siok-Bian Ng and Manuel Salto-Tellez
Index 903
vii
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Preface
Cytopathology has seen major developments, opportunities the cytopathologist as a core member of the team has also been
and challenges in the fi rst decade of 21st century. At the time included at the end of each chapter. As active members of this
of writing for the second edition of Diagnostic Cytopathology, team, we can defi ne our role in the management pathway and
the human genome had only recently been elucidated, genom- thus bring the patient and the microscope together as never
ics and proteomics were budding sciences, molecular markers before.
were just coming into widespread use and vaccines for cervical The third edition of Diagnostic Cytopathology hopes to con-
cancer were still under investigation. tribute to all of these aspects of our working life. As editors, we
Today, the clinical value, diagnostic accuracy and cost have had the pleasure of seeking experts from around the world
effectiveness of a wide variety of applications of cytology are to update or rewrite each of the chapters, with particular attention
accepted by physicians and surgeons; in many cases a cyto- to the latest developments in their own fi eld. In some areas, the
logical diagnosis can serve as the basis for patient manage- complexity of the subject has necessitated putting together a team
ment without reliance on surgical procedures. Using molecular from different laboratories, a matter of slight trepidation, which
markers, so-called ‘ Personalised/Therapeutic Pathology ’ based fortunately was not ever justifi ed. We hope that readers will not
on material obtained by fi ne needle aspiration, mutations just fi nd the diagnostic answers they seek but will catch some of
diagnostic of a range of tumours, such as colorectal, lung or the dedication to cytopathology that has gone into the author-
breast cancer, can be identifi ed. Cervical screening still plays an ship of these chapters We would also like to think that the book
important part in prevention of cervical cancer, especially with will tempt would-be pathologists to embark on a training in
the use of liquid based cytology, but must now integrate with cytology – we believe that getting to know cells will be a necessary
papillomavirus sub-typing and with the emerging programme and enjoyable skill for many years to come.
of vaccination. As editors again, we would like to thank all of the chapter
The expectation of high standards of performance amongst authors for the huge amount of work that has gone into the
clinicians and the public has grown with each new develop- contributions they have made. We are also well aware that
ment. We are under an obligation therefore to maintain our none of us could have managed without the assistance of staff
expertise, to attract and train new recruits and to educate our within our laboratories, from secretaries, technical colleagues,
colleagues in the advantages and limitations of our speciality. photographers and fellow pathologists. We are very grateful
This edition stresses not just the diagnostic cytological features to our long-suffering families, too, for being so understanding
of the various conditions we encounter, but also the diagnostic and supportive throughout. And fi nally, we would never have
pitfalls and the grey areas between so as to enable the reader to managed without the editorial staff at Elsevier, who have been
give more evidence-based reports. encouraging, patient and pressing, according to need, so as to
In recognition of their rapid expansion, there are new ensure timely completion of the work of this third edition.
chapters on recent technological developments and on the
cytodiagnosis of childhood tumours. A special section on the Winifred Gray
importance of multidisciplinary team meetings that include Gabrijela Kocjan
2010
ix
