cytology of adenocarcinoma

the cytological appearances of adenocarcinoma are complicated by the heterogeneity
of this group of tumors. diagnosis is based on overall architecture
and individual cellular details (fig. 22. 12). cytological
specimens may show groups of cells with glandular, papillary,
or bronchioloalveolar patterns but as noted previously, diagnosis
of specific subtypes of adenocarcinoma is not possible
by cytological examination alone. cell aggregates may form
monolayer sheets, three-dimensional cell balls, papillary structures,
or flat groups with a central lumen. cytoplasm may be vacuolization or may be granular and is usually translucent.
nuclei are eccentrically placed and have prominent
nucleoli that may be misshapen rather that perfectly rounded.
micropapillary adenocarcinomas, a variant with poor prognosis
and egfr association reported by miyoshi et al. 279 as
mentioned previously, are recognizable in cytology preparation
by their micropapillary structures. these are composed
of tumor cell aggregates without central fibrovascular tufts.
adenocarcinomas are only infrequently detected in sputum
and because the majority of adenocarcinomas are more peripheral
tumors. transthoracic fna is most likely to yield
a diagnosis especially in peripheral nodules 2. 0 cm with a
sensitivity and specificity of 0. 9 and 0. 97, respectively. 6