Cytopathology has seen major developments, opportunities and challenges in the first decade of 21st century. At the time of writing for the second edition of Diagnostic Cytopathology, the human genome had only recently been elucidated, genomics and proteomics were budding sciences, molecular markers were just coming into widespread use and vaccines for cervical cancer were still under investigation.
Today, the clinical value, diagnostic accuracy and cost effectiveness of a wide variety of applications of cytology are accepted by physicians and surgeons; in many cases a cytological diagnosis can serve as the basis for patient management without reliance on surgical procedures. Using molecular markers, so-called ‘Personalised/Therapeutic Pathology’ based on material obtained by fine needle aspiration, mutations diagnostic of a range of tumours, such as colorectal, lung or breast cancer, can be identified. Cervical screening still plays an important part in prevention of cervical cancer, especially with the use of liquid based cytology, but must now integrate with papillomavirus sub-typing and with the emerging programme of vaccination.
The expectation of high standards of performance amongst clinicians and the public has grown with each new development. We are under an obligation therefore to maintain our expertise, to attract and train new recruits and to educate our colleagues in the advantages and limitations of our speciality. This edition stresses not just the diagnostic cytological features of the various conditions we encounter, but also the diagnostic pitfalls and the grey areas between so as to enable the reader to give more evidence-based reports.
In recognition of their rapid expansion, there are new chapters on recent technological developments and on the cytodiagnosis of childhood tumours. A special section on the importance of multidisciplinary team meetings that include the cytopathologist as a core member of the team has also been included at the end of each chapter. As active members of this team, we can define our role in the management pathway and thus bring the patient and the microscope together as never before.
The third edition of Diagnostic Cytopathology hopes to contribute to all of these aspects of our working life. As editors, we have had the pleasure of seeking experts from around the world to update or rewrite each of the chapters, with particular attention to the latest developments in their own field. In some areas, the complexity of the subject has necessitated putting together a team from different laboratories, a matter of slight trepidation, which fortunately was not ever justified. We hope that readers will not just find the diagnostic answers they seek but will catch some of the dedication to cytopathology that has gone into the authorship of these chapters We would also like to think that the book will tempt would-be pathologists to embark on a training in cytology – we believe that getting to know cells will be a necessary and enjoyable skill for many years to come.
Key Features
- Stresses not just the diagnostic cytological features of the various conditions encountered, but also the diagnostic pitfalls and the grey areas between.
- New chapters on recent technological developments and on the cytodiagnosis of childhood tumours.
- A special section on the importance of multidisciplinary team meetings that include the cytopathologist as a core member of the team.
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Contents
Section 1 - Introduction
CHAPTER 1 - Cytopathology: the history, the present and the future direction
- The early historical era
- Development and expansion of exfoliative cytology
- Consolidation of cytopathology as a discipline
- Responsibilities of cytology as a discipline
- Cytopathology in the twenty-first century
- Meeting new professional challenges
- Epilogue
Section 2 - Respiratory System
CHAPTER 2 - Respiratory tract
- Introduction
- Preparatory techniques and diagnostic applications
- General respiratory tract findings
- Criteria for assessing adequacy of samples
- Non-Neoplastic Pulmonary Conditions
- Pulmonary Tumours
- Mediastinal Tumours
- Accuracy Of Cytology For Tumour Diagnosis And Management
Section 3 - Serous Cavities
CHAPTER 3 - Serous effusions
- Introduction
- Anatomy, histology and cytology
- Specimen types, collection and processing
- Interpretation of serous effusion cytopathology
- Ancillary techniques
- Immunocytochemistry of effusions
- Reactive conditions causing effusions
- Mesothelioma
- Metastatic carcinoma in effusion fluids
- Haematolymphoid disorders
- Metastatic sarcomas, melanoma and other neoplastic effusions
- Malignant effusions: evaluation of unknown primary
- Management role
Section 4 - Breast
CHAPTER 4 - The breast
- Introduction
- The normal breast
- Inflammatory conditions
- Breast cysts and fibrocystic change
- Benign tumours and tumour-like lesions
- Epithelial hyperplasias and tumour-like lesions
- Borderline epithelial and stromal lesions
- Malignant breast tumours
- Other malignant tumours
- Radiation-induced changes in the breast
- FNA in the management strategies of symptomatic and screening detected abnormalities
Section 5 - Alimentary System
CHAPTER 5 - Salivary glands
- Introduction
- Aspiration technique
- Normal salivary gland components
- Ectopic salivary glands
- Non-neoplastic conditions
- Miscellaneous conditions
- Tumours of the salivary gland
- Role of FNA in the management of salivary gland lesions
- Diagnostic accuracy
- Approach to salivary gland cytology
CHAPTER 6 - Oral cavity
- Introduction
- Normal oral mucosa
- Oral precursor lesions
- Oral and oropharyngeal cancers
- Infections
- Vesiculo-bullous disorders
- Pigmented lesions
- Jaw cysts
- Oral submucosal swellings
- Role of cytology in the management of oral cancer and precursor lesions
CHAPTER 7 - Oesophagus and gastrointestinal tract
- Introduction
- Normal anatomy and histology
- Cytology sampling methods and preparation
- General principles
- Pitfalls
- Oesophagus
- Stomach
- Duodenum
- Colon
- Anal canal
Section 6 - Hepatobiliary System and Pancreas
CHAPTER 8 - Liver
- Introduction
- Tumour classification
- Normal morphology
- Non-neoplastic conditions
- Benign neoplasms
- Malignant neoplasms – primary
- Malignant neoplasms – metastatic
CHAPTER 9 - Gall bladder and extrahepatic bile ducts
- Introduction
- Endoscopic techniques
- Complications and contraindications
- Normal cytology
- Benign conditions
- Dysplasia
- Adenocarcinoma
- Special tumour types
- Diagnostic pitfalls
- The role of cytology in management of diseases of hepatobiliary ducts
- Diagnostic accuracy
- The future
CHAPTER 10 - Pancreas
- Introduction: technical aspects
- Normal histology and cytology
- Reactive and inflammatory processes
- Solid malignant neoplasms
- Metastatic tumours
- Pancreatic cysts
- The role of FNA in the management of pancreatic lesions
Section 7 - Kidney and Urinary Tract
CHAPTER 11 - Kidney and retroperitoneal tissues
- Introduction
- Indications and contraindications for FNA of kidney
- FNA technique
- The unsatisfactory specimen
- Malignant tumours of kidney
- Benign primitive renal tumours
- Cystic neoplasms
- Ancillary techniques
- The retroperitoneum
- Idiopathic retroperitoneal fibrosis
- The role of the cytopathologist in clinical management
CHAPTER 12 - Urine cytology
- Introduction
- Specimen types
- Specimen processing
- Diagnostic categories
- Cytomorphological criteria of benign and neoplastic urinary tract specimens
- Malignancy and its pitfalls
- High-grade urothelial carcinoma
- Low-grade urothelial carcinoma
- Squamous cell carcinoma
- Adenocarcinoma
- Other malignancies
- Urinary biomarkers
- Quality assurance and improvement
- The role of the cytopathologist in patient management
Section 8 - Lymphoreticular System
CHAPTER 13 - Lymph nodes
- Introduction
- The role of cytology in lymph node diagnosis
- Technical aspects
- Normal lymph node histology and cytology
- Reactive lymphadenopathy
- Acute infective lymphadenopathy
- Malignant lymphomas
- Metastatic lymph node disease
CHAPTER 14 - Other lymphoreticular organs
- Introduction
- Waldeyer’s ring
- Thymus and mediastinum
- Spleen
- Mucosa associated lymphoid tissue (MALT)
- Diagnostic value of FNA in assessment of extranodal lymphoid tissue
Section 9 - Transplantation and Immunosuppression
CHAPTER 15 - Organ transplantation
- Introduction
- Kidney transplant cytology
- Liver transplant cytology
- The role of the cytopathologist in patient management
CHAPTER 16 - Immunosuppression
- Introduction
- Technical aspects
- Opportunistic infection
- Neoplastic disease
- Associated conditions and pitfalls: immunosuppression due to miscellaneous conditions
- The role of cytology in management of the immunosuppressed patient
Section 10 - Endocrine System
CHAPTER 17 - Thyroid gland
- Anatomy and physiology
- Historical perspective
- Clinical indications for FNA of thyroid nodules, the influence of thyroid imaging and mode of FNA guidance
- Technique
- Contraindications and complications
- Normal cytological findings
- Developmental abnormalities
- Acquired non-neoplastic conditions
- Thyroid neoplasms
- Specimen adequacy and diagnostic accuracy
- Integrated management schemes for thyroid cytology
CHAPTER 18 - Other endocrine organs
- The parathyroid glands
- The adrenal glands
- Other paraganglionomas including carotid body tumours
Section 11 - Male Genital Tract
CHAPTER 19 - Prostate gland
- Introduction
- Diagnostic procedure
- Causes of prostatic enlargement
- Adenocarcinoma
- Neuroendocrine (small cell) carcinoma
- Transitional cell carcinoma
- Rare epithelial tumours
- Non-epithelial neoplasms
- The role of cytology in management of prostate cancer
CHAPTER 20 - Testis and scrotum: cytology of testicular and scrotal masses and male infertility
- Introduction
- Diagnostic work-up of testicular and scrotal masses
- Benign lesions of the scrotum
- Tumours of the testis
- Testicular cytology for infertility
- Role of FNA cytology in testicular and scrotal lesions and male infertility
- Summary of testis FNA and male infertility
Section 12 - Female Genital Tract
CHAPTER 21 - Vulva, vagina and cervix: normal cytology, hormonal and inflammatory conditions
- Introduction
- Gross and microscopic anatomy
- Cytological identification of epithelial cells
- Other epithelial and inflammatory cells in cervical and vaginal smears
- Cells other than inflammatory and epithelial cells
- Assessment of quality of smears
- Influence of sex hormones on squamous epithelium
- Other hormonal effects
- Inflammation and infection of the vagina and cervix
- Special types of cervicitis and vaginitis
- Bacterial microorganisms of the vagina and cervix
- Protozoa
- Fungi
- Viruses
- Iatrogenic lesions
CHAPTER 22 - Cervical screening programmes
- Introduction
- Principles of screening
- History of cervical screening in the UK
- The UK cervical screening programmes
- Quality assurance and governance
- Litigation
- Comparison with other national cervical screening programmes
- New methods in cervical screening
- Summary
- The future
CHAPTER 23 - Cervical intraepithelial neoplasia and squamous cell carcinoma of the cervix
- Introduction
- Clinical features of invasive carcinoma of the cervix
- Histological classification
- Aetiology and pathogenesis of carcinoma of the cervix
- The relationship between CIN and cervical cancer
- Screening for prevention of carcinoma of the cervix
- Cytological terminology of cervical pre-cancer
- The cytology of CIN and invasive squamous cell carcinoma
- Low-grade (formerly mild) dyskaryosis, including koilocytosis: CIN 1
- High-grade dyskaryosis (incorporating moderate and severe dyskaryosis): CIN 2 and CIN 3
- Invasive squamous cell carcinoma
- Borderline nuclear changes
- The cervical cytology test in pregnancy
- Accuracy of cervical cytology
- Management of the patient with abnormal cytology
CHAPTER 24 - Glandular neoplasms of the cervix
- Introduction
- Epidemiology
- Endocervical adenocarcinoma precursor lesions
- Invasive adenocarcinoma of the cervix
- Immunochemical and molecular markers in glandular neoplasia
- Management of women with cytological prediction of glandular abnormality
CHAPTER 25 - Other tumours and lesions of cervix, vulva and vagina
- Introduction
- Tumour-like conditions of the cervix
- Epithelial changes simulating neoplasia
- Uncommon tumours of the cervix
- Tumours of the vulva
- Tumours of the vagina
- The role of the cytopathologist in clinical management
CHAPTER 26 - Cytology of the body of the uterus
- Introduction
- Endometrial sampling and processing
- Cells present in endometrial samples
- Cytological findings in direct preparations using cytoarchitectural features
- Cytological findings in LBC preparations using cytoarchitectural features: non-neoplastic endometrium
- Hormone-dependent modifications
- Endometrial hyperplasia
- Endometrial glandular and stromal breakdown (EGBD)
- Papillary metaplastic change in endometrium
- Endometrial adenocarcinoma
- Malignant mixed mullerian tumour (carcinosarcoma)
- Trophoblastic tumours
- Non-endometrial tumours
- Immunocytochemistry using LBC
- Reporting format for endometrial cytodiagnosis based on cytoarchitectural criteria
CHAPTER 27 - Ovaries, fallopian tubes and associated lesions
- Introduction
- Obtaining cytological material
- Ovaries
- Fallopian tubes
- Pelvic serous carcinoma of the peritoneum
- Other pelvic cysts
- The role of peritoneal washings
- The role of cytology in management of ovarian lesions
Section 13 - Skin, Soft Tissues and Musculoskeletal System
CHAPTER 28 - Skin
- Introduction
- Normal skin
- Technical procedures
- Infections
- Bullous lesions
- Benign and malignant tumours of the surface epithelium
- Melanocytic naevi and malignant melanoma
- Tumours of the skin adnexae
- Cutaneous lymphomas
- Soft tissue lesions affecting the skin and subcutis
- Other conditions
- The role of skin cytology in clinical management
CHAPTER 29 - Soft tissue and musculoskeletal system
- Introduction
- Technical procedures
- Complications of FNA of soft tissue and bone tumours
- Cytological findings in normal and reactive soft tissues
- Cytological findings in normal and reactive bone
- Soft tissue tumours
- Benign soft tissue tumours
- Tumours of peripheral nerves
- Tumours of smooth muscle
- Tumours of striated muscle
- Tumours of blood vessels
- Tumours of uncertain histogenesis
- Malignant soft tissue tumours
- Malignant tumours of uncertain, unknown or debated origin
- Skeletal tumours/lesions
- Osteogenic tumours
- Notochordal tumours
- Neuroectodermal tumours
- Lymphohistiocytic lesions
- Inflammatory lesions of bone
- Metastatic tumours
- The role of FNA cytology in management of soft tissue lesions
CHAPTER 30 - Synovial fluid
- Introduction
- Synovial fluid cytology
- The cytocentrifuge preparation
- Cells
- Clinical applications of synovial fluid microscopy and the value of diagnostic algorithms
- The place of synovial fluid microscopy in clinical management
- Summary
Section 14 - Central Nervous System
CHAPTER 31 - Brain and cerebrospinal fluid
- Intraoperative Cytology Of The Central Nervous System
- The Cytology Of Cerebrospinal Fluid
CHAPTER 32 - Eyelids, orbit and eye
- Introduction
- Eyelids
- Conjunctiva
- Cornea
- Ocular globe
- Anterior segment
- Posterior segment
- Orbit
Section 15 - Childhood Tumours
CHAPTER 33 - Childhood tumours
- Introduction
- Role of the cytopathologist
- Main tumours
- Non-Hodgkin and Hodgkin lymphomas
- Neuroblastoma and nephroblastoma
- Rhabdomyosarcoma and other soft tissue tumours
- Ewing (sarcoma) family of tumours (pPNET)
- Other tumours
- Conclusion
Section 16 - New Techniques
CHAPTER 34 - New techniques
- Introduction
- Diagnostic molecular cytopathology
- Technological advances (non-molecular)
- The future of diagnostic molecular cytopathology
Product Details
- Hardcover: 954 pages
- Publisher: Churchill Livingstone; 3 edition (2011)
- Language: English
- ISBN-10: 0702031542
- ISBN-13: 978-0702031540
- Product Dimensions: 11.1 x 9 x 1.9 inches
List Price: $329.00