Bronchial brushings: small cell carcinoma


Drs. Prolla and Diehl's INTERESTING CASE OF THE MONTH June 2003 case A

200x Pap staining, loose group of small round cells

500x Pap staining, same field as previous picture: notice small amount of cytoplasm, irregular chromatin

500x Pap staining, notice small amount of cytoplasm, irregular chromatin, nuclear molding

>500x Pap staining, salt and pepper chromatin

500x Pap staining, notice the dark blue apoptotic bodies, and the salt and pepper chromatin

500x Pap staining, notice the dark blue apoptotic bodies.



The smears show the typical features of small cell carcinoma: single small cells, with some loose groups showing nuclear molding, with scant or absent cytoplasm. The nuclei are oval or angulated, with "salt and pepper" chromatin, small or absent nucleoli ( a few nuclei have larger nucleoli).The main differential diagnosis is malignant lymphoma.
The bronchoscopic biopsies confirmed the diagnosis of small cell carcinoma.

Features of Small cell carcinoma

Cellular patterns:
Three-dimensional loose groups of small cells, with high N/C ratio
Cell within cell pattern
Occasional tandem or indian file cell pattern
Cytoplasm:
Small rim of basophilic cytoplasm or naked nuclei
Nucleus
Round or angular hyperchromatic, "oat cell" type
Few small or absent nucleoli
Some cases have a large nucleolus: "intermediate cell" type
"Salt and pepper" chromatin, with nuclear molding
Mitoses, karyorrhexis and apoptotic bodies("blue bodies") are frequent
DNA streaking or nuclear smudging








Case B June 2003 Case C June 2003 References List of cases Atlas
Hosted by www.Geocities.ws

1