Diagnostic 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 Elsevier’s Rights Department: phone: ( (cid:2) 1) 215 239 3804 (US) or ( (cid:2) 44) 1865 843830 (UK); 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 This page intentionally left blank 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
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