Cytopathology of Infectious Diseases

405 Pages·2012·15.492 MB·English

by  Liron Pantanowitz, Pam Michelow, Walid E. Khalbuss (auth.)

Cytopathology of Infectious Diseases
ESSENTIALS IN CYTOPATHOLOGY
Dorothy L. Rosenthal, MD, FIAC, Series Editor
Editorial Board
Syed Z. Ali, MD
Douglas P. Clark, MD
Yener S. Erozan, MD
For further volumes:
http://www.springer.com/series/6996
Liron Pantanowitz, MD, MIAC
Pam Michelow, MBBCh, MSc (Med Sci)
Walid E. Khalbuss, MD, PhD, FIAC
Cytopathology
of Infectious Diseases
Including Chapters 2 & 14 Co-authored by:
Tanvier Omar, MB BCH, FC Path (S.A.)
Chapters 3, 9, 10 & 13 Co-authored by:
Sara E. Monaco, MD
Chapter 4 Co-authored by:
Gladwyn Leiman, MBBCh, FIAC, FRCPath
Lynne S. Garcia, MS, CLS, FAAM
Chapter 5 Co-authored by:
R. Marshall Austin, MD, PhD
Chapter 6 Co-authored by:
Rodolfo Laucirica, MD
Chapter 7 Co-authored by:
Robert M. Najarian, MD
Helen H. Wang, MD, PhD
Chapter 8 Co-authored by:
Anil V. Parwani, MD, PhD
and Chapter 15 Co-authored by:
Robert A. Goulart, MD
Rafael Martínez-Girón, MD, PhD
Liron Pantanowitz, MD, MIAC Pam Michelow, MBBCh,
Department of Pathology MSc (Med Sci)
University of Pittsburgh Department of Anatomical
Medical Center Pathology, University of the
Pittsburgh, PA 15232, USA Witwatersrand & National Health
[email protected] Laboratory Service
Johannesburg 2000, South Africa
Walid E. Khalbuss, MD, PhD, FIAC [email protected]
Department of Pathology
University of Pittsburgh
Medical Center
Pittsburgh, PA 15232, USA
[email protected]
ISSN 1574-9053 e-ISSN 1574-9061
ISBN 978-1-4614-0241-1 e-ISBN 978-1-4614-0242-8
DOI 10.1007/978-1-4614-0242-8
Springer New York Dordrecht Heidelberg London
Library of Congress Control Number: 2011932800
© Springer Science+Business Media, LLC 2011
All rights reserved. This work may not be translated or copied in whole or in part
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can accept any legal responsibility for any errors or omissions that may be made.
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Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
This book is dedicated to my wife Heidi and children
Joshua and Maya.
Liron Pantanowitz, MD, MIAC
To my husband Alan and children Gina, Matt, and Aaron.
Pam Michelow, MBBCh, MSc (Med Sci)
To my family, mentors, trainees, and friends
for their encouragement and support.
Walid E. Khalbuss, MD, PhD, FIAC
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Foreword
Although it is long overdue, finally there is a textbook developed
entirely to the cytology diagnosis of infectious diseases, despite
the fact that since the early twentieth century there were a number
of reports documenting the utility of cytology examination. Greig
and Gray were the first to describe fine needle aspiration (FNA)
cytology for the diagnosis of infectious disease in their 1904 report
of biopsies of lymph nodes from fifteen patients with sleeping sick-
ness. Proscher used FNA cytology of lymph nodes for the diagnosis
of spirochetal infections in 1907, along with other investigators
reporting the use of FNA cytology for the diagnosis of filariasis,
bubonic plague, and spirochetes in secondary syphilis. In 1921,
Guthrie reported FNA biopsy of lymph nodes using air-dried,
Romanowsky-stained smears in cases of syphilis, tuberculosis,
simple adenitis, and trypanosomiasis. Guthrie also reported the use
of special stains for organisms including Ziehl-Neelsen stain for
acid fast bacilli, along with dark field examination for spirochetes
and reported bacteria such as streptococci and staphylococci in
lymph node aspirates.
Despite these early successes in the use of cytology for the
diagnosis of infectious disease, beginning in 1925 at Memorial
Hospital in New York, FNA began to be used mainly to diagnose
neoplastic conditions, although infectious diseases such as tuber-
culosis, syphilis, and actinomyces were occasionally encountered.
However, the dynamic explosion of FNA cytology for the diag-
nosis of neoplastic disease initially took place in Scandinavia by
clinician/cytopathologists. Following their seminal contributions,
vii
viii Foreword
FNA cytology had a rebirth in the USA due to the contributions of
a number of outstanding cytopathologists.
It has been over 20 years since I have had the opportunity to
publish a text on FNA of infectious and inflammatory diseases and
other nonneoplastic disorders. Since that time, there has been a
renewed interest in the cytologic diagnosis of infectious disease
coinciding with increased incidence of common and unusual infec-
tions due to the AIDS epidemic, expansion of organ transplanta-
tion, and aggressive treatment of neoplastic diseases resulting in an
increasing population of immunocompromised patients.
Now stepping forward to fill the void are Pantanowitz, Michelow
and Khalbuss with their associates, who have written the first text
devoted entirely to the cytopathology of infectious diseases. The
authors’ format is user friendly, presenting in a very concise for-
mat the clinical, cytomorphologic features, differential diagnosis,
pitfalls, and ancillary studies of a wide range of infectious diseases
that can be appreciated in cytology specimens. I believe the reader,
whether in training or a practicing pathologist, will benefit from
the authors’ extensive experience in the cytologic diagnosis of
infectious agents that can be encountered both in developing and
industrial nations. It is with great pleasure to have this opportu-
nity to recognize the outstanding cytopathologists who share their
extensive experience in this much-needed cytology monograph.
Jan F. Silverman, MD
Pittsburgh, PA, USA
Series Preface
The subspeciality of cytopathology is over 60 years old and has
become an established and reliable discipline in medicine. As
expected, cytopathology literature has expanded in a remarkably
short period of time, from a few textbooks prior to the 1980s to a
currently substantial library of texts and journals devoted exclu-
sively to cytomorphology. The Essentials in Cytopathology Series
does not presume to replace any of the distinguished textbooks in
cytopathology. Instead, the Series has published generously illus-
trated and user-friendly guides for both pathologists and clinicians.
The Series has met with gratifying success, and we now present
volume 10, with more than five volumes scheduled to come.
Built on the amazing success of The Bethesda System for
Reporting Cervical Cytology, now in its second edition, the Series
has utilized a similar format, including minimal text, tabular criteria,
and superb illustrations based on real-life specimens. Essentials in
Cytopathology has, at times, deviated from the classic organiza-
tion of pathology texts. The logic of decision trees, elimination of
unlikely choices, and narrowing of differential diagnosis via a prag-
matic approach based on morphologic criteria are some of the strat-
egies used to illustrate principles and practice in cytopathology.
Most of the authors for Essentials in Cytopathology are faculty
members in The Johns Hopkins University School of Medicine,
Department of Pathology, Division of Cytopathology. They bring
to each volume the legacy of John K. Frost and the collective
experience of a preeminent cytopathology service. The archives
at Hopkins are meticulously catalogued and form the framework
for text and illustrations. Authors from other institutions have been
selected on the basis of their national reputations, experience,
ix
x Series Preface
and enthusiasm for cytopathology. They bring to the series,
complementary viewpoints and enlarge the scope of materials
contained in the photographs.
The editor and the authors are indebted to our students, past and
future, who challenge and motivate us to become the best that we
possibly can be. We share that experience with you through these
pages, and hope that you will learn from them as we have from
those who have come before us. We would be remiss if we did not
pay tribute to our professional colleagues, the cytotechnologists,
and preparatory technicians, who lovingly care for the specimens that
our clinical colleagues send to us. We are also grateful to Springer
and its production staff for their enthusiasm, responsiveness, and
patience.
And finally, we cannot emphasize enough throughout these vol-
umes the importance of collaboration with the patient care team.
Every specimen comes to us with questions begging answers.
Without input from the clinicians, complete patient history, results
of imaging studies, and other ancillary tests, we cannot perform
optimally. It is our responsibility to educate our clinicians about
their role in our interpretation, and for us to integrate as much
information as we can gather into our final diagnosis, even if the
answer at first seems obvious.
We hope you will find this Series useful and welcome your feed-
back as you place these handbooks by your microscopes and into
your book bags.
Dorothy L. Rosenthal
Baltimore, MD, USA
[email protected]