Diagnostic Pathology: Cytopathology

SECTION 1: GYNECOLOGIC CYTOPATHOLOGY

OVERVIEW

Pap Test and Cervical Cancer Screening: History and
Reporting Terminology
Cytopreparation, Instrumentation, and Automated
Screening in Gynecologic Cytology
Specimen Adequacy in Cervicovaginal Cytology

BENIGN AND INFECTIOUS CONDITIONS

Normal Pap Test
Infectious and Other Organisms in Pap Tests
Nonneoplastic Findings, Mimics, and Artifacts

SQUAMOUS CELL ABNORMALITIES AND MIMICS

Low-Grade Squamous Intraepithelial Lesion and Mimics
High-Grade Squamous Intraepithelial Lesion and Mimics
Atypical Squamous Cells of Undetermined Significance
Atypical Squamous Cells, Cannot Exclude High-Grade Squamous Intraepithelial Lesion
Squamous Cell Carcinoma of Cervix

GLANDULAR CELL ABNORMALITIES

Endocervical Adenocarcinoma In Situ, Variants and Mimics
Endocervical HPV-Dependent Invasive Adenocarcinoma
Endocervical HPV-Independent Gastric Type Adenocarcinoma
Endometrial Cancers in Pap Tests
Atypical Glandular Cells: Endocervicals, Endometrials, and Glandulars, NOS
Endometrial Cells in Pap Test and Glandular Cells Status Post Hysterectomy

EXTRAUTERINE CARCINOMAS AND OTHER MALIGNANCIES OF FEMALE GENITAL TRACT

Extrauterine Cancers in Pap Tests
Neuroendocrine Carcinoma of Cervix
Other Uncommon Malignancies in Pap Tests

MOLECULAR TESTING IN GYNECOLOGIC CYTOLOGY

HPV and Other Molecular Testing in Gynecologic Cytology

DIRECTLY SAMPLED ENDOMETRIAL CYTOLOGY

Directly Sampled Endometrial Cytology

ANAL CYTOLOGY

Anal Cytology

SECTION 2: EXFOLIATIVE CYTOPATHOLOGY

GASTROINTESTINAL TRACT

Specimen Types in Gastrointestinal Cytology and Normal Cellular Components
Parasitic and Mycobacterial Infections of Gastrointestinal Tract
Viral Infections of Gastrointestinal Tract
Esophagitis and Barrett Esophagus
Esophageal Adenocarcinoma
Esophageal Squamous Cell Carcinoma
Gastritis and Intestinal Metaplasia
Gastric Adenocarcinoma
Gastric Lymphoma
Glomus Tumor
Ampulla/Bile Duct/Pancreatic Duct Reactive Changes
Ampulla/Bile Duct/Pancreatic Duct Adenocarcinoma and Intraampullary Tumors
Colorectal Adenoma/Carcinoma
Neuroendocrine Tumor/Carcinoma of Gastrointestinal Tract
Spindle Cell Neoplasms of Gastrointestinal Tract, Including Gastrointestinal Stromal Tumors

CEREBROSPINAL FLUID

Normal Cerebrospinal Fluid and Contamination by Normal Elements
Infectious Meningitis
Subarachnoid Hemorrhage
Aseptic and Mollaret Meningitis
Neurodegenerative Diseases
Primary Brain Tumors
Leukemia and Lymphoma in Cerebrospinal Fluid
Metastasis in Cerebrospinal Fluid

PLEURAL, PERITONEAL, PERICARDIAL, AND PELVIC FLUID AND WASHINGS

Normal Cellular Components, Reactive Mesothelial Proliferations, and Reporting Terminology
Infectious Conditions in Body Cavity Fluids
Autoimmune Diseases in Body Cavity Fluids
Mesothelioma in Effusions and Fine Needle Cytology
Malignant Effusion, Carcinomas
Metastatic Sarcomas in Effusions and Washings
Lymphoid Effusions and Secondary Involvement by Hematopoietic Neoplasms
Primary Effusion Lymphoma
Endometriosis and Endosalpingiosis
Ovarian Neoplasms

URINARY CYTOLOGY

Normal Urinary Cytology, Specimen Types, and Reporting Terminology
Ileal Conduit Specimens
Noninfectious Benign Conditions in Urinary Cytology
Infectious Benign Conditions in Urinary Cytology
Reactive Urothelial Changes
Low-Grade Urothelial Lesions
Atypical Urothelial Cells
High-Grade Urothelial Cancer
Squamous Cell Carcinoma of Urinary Bladder
Adenocarcinoma of Urinary Bladder
Other Malignancies in Urinary Cytology
Renal Pelvic Cytology
Ancillary Testing, UroVysion, and Others

SECTION 3: FINE-NEEDLE ASPIRATION, SUPERFICIAL

OVERVIEW

Superficial Aspiration Technique

THYROID GLAND

Ultrasound-Guided Thyroid Fine-Needle Aspiration
Thyroid Fine-Needle Aspiration Reporting Terminology and Specimen Adequacy
Thyroid Follicular Nodular Disease
Chronic Lymphocytic/Hashimoto Thyroiditis
Granulomatous Thyroiditis
Graves Disease/Diffuse Toxic Goiter
Pigmented Thyroid Lesions and Crystals
Atypia of Undetermined Significance in Thyroid Fine-Needle Aspiration
Follicular Neoplasm in Thyroid Fine-Needle Aspiration
Oncocytic Follicular Neoplasm in Thyroid Fine-Needle Aspiration
Papillary Thyroid Carcinoma, Classic Subtype
Papillary Thyroid Carcinoma Subtypes
Medullary Thyroid Carcinoma
High-Grade Follicular Cell-Derived Non-Anaplastic Thyroid Carcinoma
Anaplastic Thyroid Carcinoma
Thyroid Lymphoma
Metastatic Carcinoma to Thyroid
Other Thyroid and Perithyroidal Lesions Encountered in Fine-Needle Aspiration

PARATHYROID GLAND

Parathyroid Cyst, Adenoma, and Carcinoma

LYMPH NODES

OVERVIEW

Lymph Node Aspiration: Indications, Techniques, and Reporting
FNA Sample Prep and Triage in Evaluating Suspected Lymphoma

BENIGN, INFECTIOUS, AND REACTIVE HYPERPLASIA

Inflammatory and Reactive Lymphoid Hyperplasia
Granulomatous Lymphadenitis, Infectious and Sarcoid
Rosai-Dorfman Disease

METASTATIC MALIGNANCIES

HPV-Mediated Carcinomas in Neck Lymph Nodes
Metastatic Melanoma
Other Metastatic Malignancies Encountered in Lymph Node Fine-Needle Aspiration

NODAL B-CELL LYMPHOMA

Small Lymphocytic Lymphoma
Lymphoplasmacytic Lymphoma
Mantle Cell Lymphoma
Nodal Marginal Zone Lymphoma
Follicular Lymphoma
Burkitt Lymphoma
Large B-Cell Lymphoma

EXTRANODAL B-CELL LYMPHOMA

Plasmacytoma
Mediastinal Large B-Cell Lymphoma
Plasmablastic Lymphoma

T-CELL LYMPHOMA

Peripheral T-Cell Lymphoma
Mycosis Fungoides
Nodal T-Follicular Helper Cell Lymphoma, Angioimmunoblastic Type
ALK (+) Anaplastic Large Cell Lymphoma
T-Cell Lymphoblastic Lymphoma

HODGKIN LYMPHOMA

Nodular Lymphocyte-Predominant Hodgkin Lymphoma
Classic Hodgkin Lymphoma

EYE

Approach to Ophthalmic Cytology
Infections in Ophthalmic Cytopathology
Neoplasms in Ophthalmic Cytopathology

SALIVARY GLAND

OVERVIEW

Approach to Interpretation of Salivary Gland Aspiration Biopsies and Reporting Terminology (Milan System)

BENIGN LESIONS

Normal Salivary Gland and Sialadenitis on Aspiration
Salivary Gland Cysts
Pleomorphic Adenoma
Warthin Tumor
Salivary Gland Oncocytoma
Salivary Gland Basal Cell Neoplasms
Salivary Gland Myoepithelial Neoplasms

MALIGNANT NEOPLASMS

Adenoid Cystic Carcinoma
Acinic Cell Carcinoma
Mucoepidermoid Carcinoma
Carcinoma Ex-Pleomorphic Adenoma
Adenocarcinoma, NOS
Polymorphous Adenocarcinoma
Salivary Duct Carcinoma
Salivary Gland Secretory Carcinoma
Metastasis to Salivary Gland
Primary and Metastatic Nonepithelial Tumors

BREAST

OVERVIEW

Role of Fine-Needle Aspiration of Breast, Techniques and Triple Test

BENIGN BREAST LESIONS

Inflammatory and Granulomatous Conditions
Fat Necrosis
Nonproliferative and Proliferative Changes in Breast
Radial Scar/Complex Sclerosing Lesion
Gynecomastia
Mucocele-Like Lesion

BENIGN NEOPLASMS

Fibroadenoma
Granular Cell Tumor of Breast
Papillary Neoplasms
Myofibroblastoma, Mammary

MALIGNANT NEOPLASMS

Ductal Carcinoma and Variants of Invasive Mammary Carcinoma
Lobular Carcinoma
Phyllodes Tumor
Angiosarcoma and Other Sarcomas
Lymphomas and Metastatic Tumors

SKIN AND SUBCUTANEOUS CYTOLOGY

Cutaneous and Adnexal Cytology
Fat Pad Aspiration for Amyloid

SECTION 4: FINE-NEEDLE ASPIRATION, DEEP ORGANS AND TISSUES

OVERVIEW

Techniques and Modalities of Deep Aspiration Biopsies
Techniques and Modalities of Bronchoscopic Aspiration and Small Biopsies
Techniques and Modalities of Gastrointestinal Endoscopic Aspiration and Small Biopsies

RESPIRATORY TRACT

Specimen Types in Respiratory Cytology and Adequacy Criteria
Benign and Reactive Changes
Fungal Yeasts and Hyphal Organisms
Pneumocystis Pneumonia
Parasitic Organisms
Viral Infections (Cytomegalovirus, Herpesvirus, and Others)
Mycobacteria and Other Bacterial Infections
Sarcoidosis and Other Immune-Related Conditions
Pulmonary Alveolar Proteinosis and Mimics
Miscellaneous Findings, Including Contaminants
Adenocarcinoma of Lung
Squamous Cell Carcinoma of Lung
Small Cell Carcinoma of Lung
Large Cell Neuroendocrine Carcinoma of Lung
Carcinoid and Atypical Carcinoid of Lung
Rare Benign and Low Malignant Potential Tumors
Rare Malignant Tumors
NUT Carcinoma
SMARCA4-Deficient Undifferentiated Tumor
Pulmonary Lymphoma
Pulmonary Metastasis

MEDIASTINUM

OVERVIEW

Anatomic Compartments and Constituent Tumors

NONNEOPLASTIC LESIONS

Mediastinal Cysts and Inflammatory Lesions

NEOPLASMS

Thymoma
Thymic Carcinoma
Germ Cell Tumors
Mediastinal Neurogenic Tumors
Metastatic Tumors of Mediastinum

LIVER

OVERVIEW

Cytology of Normal Liver
Inflammatory and Infectious Conditions of Liver

BENIGN HEPATIC NEOPLASMS

Hepatocellular Adenoma
Focal Nodular Hyperplasia
Hemangioma and Other Vascular Tumors of Liver

MALIGNANT NEOPLASMS

Hepatocellular Carcinoma
Hepatoblastoma
Liver Metastasis

KIDNEY

OVERVIEW

Cytology of Normal Kidney

INDOLENT NEOPLASMS AND BENIGN LESIONS

Renal Cysts
Clear Cell Papillary Renal Cell Tumor
Angiomyolipoma
Renal Oncocytoma and Other Indolent Oncocytic Tumors
Metanephric Adenoma
Metanephric Stromal Tumor
Xanthogranulomatous Pyelonephritis/Malakoplakia

MALIGNANT NEOPLASMS

Clear Cell Renal Cell Carcinoma
Papillary Renal Cell Carcinoma
Chromophobe Renal Cell Carcinoma
TFE3- and TFEB-Rearranged Renal Cell Carcinomas
Collecting Duct Carcinoma
Renal Medullary Carcinoma
Mucinous Tubular and Spindle Cell Carcinoma of Kidney
Renal Neuroendocrine Tumor
Primary Renal Sarcomas in Adults
Renal Lymphomas
Nephroblastoma (Wilms Tumor)
Clear Cell Sarcoma of Kidney
Congenital Mesoblastic Nephroma
Rhabdoid Tumor of Kidney
Metastatic Tumors to Kidney

TUMORS OF RENAL PELVIS

Urothelial Carcinoma

ADRENAL GLAND

OVERVIEW

Cytology of Normal Adrenal Gland

ADRENAL CORTICAL LESIONS

Adrenal Cortical Adenoma
Adrenal Cortical Carcinoma
Metastatic Tumors to Adrenal Gland

ADRENAL MEDULLARY LESIONS

Pheochromocytoma

PANCREAS

OVERVIEW

Cytology of Normal Pancreas
Pancreaticobiliary Cytology Reporting Terminology, Cyst Evaluation

NONNEOPLASTIC LESIONS

Pancreatitis
Lymphoepithelial Cyst of Pancreas
Intra- and Peripancreatic Splenules

NEOPLASMS

Serous Microcystic Adenoma
Mucinous Cystic Neoplasm
Intraductal Papillary Mucinous Neoplasm
Solid Pseudopapillary Neoplasm
Pancreatic Neuroendocrine Tumor
Pancreatic Ductal Adenocarcinoma
Unusual Variants of Ductal Carcinoma
Acinar Cell Carcinoma
Lymphoma and Secondary Tumors of Pancreas

BONE

OVERVIEW

Approach to Cytologic/Small Biopsy Diagnosis of Primary Bone Tumors

NEOPLASMS

Chondromas of Bone and Soft Tissue
Chondroblastoma
Giant Cell Tumor
Osteoblastoma
Adamantinoma
Langerhans Cell Histiocytosis
Chordoma
Osteosarcoma
Chondrosarcoma
Ewing Sarcoma
Bone Lymphoma
Metastatic Tumors of Bone

SOFT TISSUE

OVERVIEW

Approach to Cytologic/Small Biopsy Diagnosis of Primary Soft Tissue Lesions

ADIPOCYTIC TUMORS

Benign Adipose Tissue Tumors
Liposarcoma

FIBROBLASTIC/MYOFIBROBLASTIC LESIONS

Fibrosarcoma
Myofibroblastoma
Low-Grade Myofibroblastic Sarcoma
Low-Grade Fibromyxoid Sarcoma
Myxofibrosarcoma

TUMORS OF MUSCLE ORIGIN

Smooth Muscle Tumors
Skeletal Muscle Tumors

VASCULAR AND PERICYTIC TUMORS

Hemangioma, Soft Tissue
Epithelioid Hemangioendothelioma
Kaposi Sarcoma
Angiosarcoma

OTHER TUMORS

Other Reactive and Neoplastic Soft Tissue Entities
Intramuscular Myxoma
Giant Cell Tumor of Tendon Sheath
Nerve Sheath Tumors
Solitary Fibrous Tumor
Mesenchymal Chondrosarcoma
Synovial Sarcoma
Epithelioid Sarcoma
Alveolar Soft Part Sarcoma
Clear Cell Sarcoma of Soft Tissue
Desmoplastic Small Round Cell Tumor
Undifferentiated Pleomorphic Sarcoma

NEUROPATHOLOGY

Neuropathology Squash Preparations, Infectious
Neuropathology Squash Preparations, Glial Neoplasms
Neuropathology Squash Preparations, Nonglial Neoplasms

SECTION 5: MANAGEMENT AND ANCILLARY TESTING

CYTOPREPARATORY AND QUALITY MANAGEMENT

Cytopreparatory Techniques and Instrumentation in Nongynecologic Cytology
Quality Improvement and Laboratory Management for Cytopathology

ANCILLARY TESTING

Immunocytochemistry
Molecular Techniques