By Syed Z. Ali MD, Yener S. Erozan MD, Ralph H. Hruban MD
Scientific and radiologic examinations can't reliably distinguish benign or inflammatory pancreatic illness from carcinoma. The elevated use of pancreatic high quality needle aspiration (FNA) in addition to advances in imaging concepts and the advent of endoscopic ultrasound assistance have ended in a lot better detection and popularity of pancreatic lots. hence, pancreatic cytopathology is necessary to exact pre-operative prognosis, but it's a demanding diagnostic quarter with various strength pitfalls and ???„????look-alike???„???? lesions. Skillful reputation and an wisdom of the constraints of the method are crucial in warding off misdiagnosis of those risky lesions. Atlas of Pancreatic Cytopathology with Histopathologic Correlations fills a void in present pathology literature. With 450 high-resolution photographs, together with photos of histopathologic and radiologic positive factors, this sensible atlas offers an built-in method of diagnostic cytopathology that may aid health professional cytopathologists, cytotechnologists, and pathologists steer clear of capability pitfalls and ""look-alike"" lesions. Written by way of famous specialists within the box, the broad high-resolution colour photos of the attribute beneficial properties of pancreatic ailment are provided with designated descriptions that disguise vintage positive aspects, diagnostic clues, and power pitfalls. Atlas of Pancreatic Cytopathology with Histopathologic Correlations is a necessary source for the professional cytopathologist, common and surgical pathologists, pathology trainees, and cytotechnologists.
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Extra info for Atlas of Pancreatic Cytopathology with Histopathologic Correlations
Numerous fragments of glandular epithelium, fibrous tissue, and marked background chronic inflammation give this smear a hypercellular appearance. The polymorphous cellular composition clearly favors a benign reactive process in this case. 12 — Chronic pancreatitis. Two fragments of “atypical” columnar epithelium are present. Note nuclear enlargement and marked disorganization of the architecture with loss of nuclear polarity. Although not diagnostic, an adenocarcinoma cannot be entirely excluded in this case.
The enhancement within the lesion is more pronounced in the arterial phase. A small hypervascular hepatic metastasis is seen in the arterial phase (arrowhead in A) and this mass in the liver becomes isoattenuating to the liver parenchyma in the venous phase (B). There has been a left nephrectomy. 1 — Chronic pancreatitis. Cross section of a pancreas with marked chronic pancreatitis. The normal tan-yellow lobular parenchyma is replaced by firm white bands of fibrosis. A few ducts remain, and most of them, as is often seen in alcoholic chronic pancreatitis, contain large calculi.
Lack of any cytologic atypia and presence of a significant lymphocytic population will rule out a carcinoma. 31 — Lymphoepithelial cyst. A thick aggregation of lymphocytes and histiocytes corresponding possibly to germinal center differentiation in a hyperplastic lymphoid follicle in the cyst wall is noted. Lack of squamous cells in such cases will make the diagnosis of a lymphoepithelial cyst extremely difficult. 32 — Lymphoepithelial cyst. This thick pasty looking aspirate (grossly) contains innumerable anucleate squames and keratinaceous debris admixed with scant crushed lymphocytes.