대한세포병리학회지 (The Korean Journal of Cytopathology)

대한세포병리학회 (The Korean Society for Cytopathology)
권호 표지

객담과 기관지세척액에서 폐 샘암종과 유사한 병변의 세포소견 분석

Cytologic Evaluation of Adenocarcinoma and its Mimics in Sputum and Bronchial Washings

  • 박인서 (인하대학교 의과대학 병리학교실) ;
  • 최석진 (인하대학교 의과대학 병리학교실) ;
  • 김루시아 (인하대학교 의과대학 병리학교실) ;
  • 한지영 (인하대학교 의과대학 병리학교실) ;
  • 김준미 (인하대학교 의과대학 병리학교실) ;
  • 박정애 (인하대학교 의과대학 병리학교실) ;
  • 주영채 (인하대학교 의과대학 병리학교실)
  • Park, In-Suh (Department of Pathology, Inha University College of Medicine) ;
  • Choi, Suk-Jin (Department of Pathology, Inha University College of Medicine) ;
  • Kim, Lucia (Department of Pathology, Inha University College of Medicine) ;
  • Han, Jee-Young (Department of Pathology, Inha University College of Medicine) ;
  • Kim, Joon-Mee (Department of Pathology, Inha University College of Medicine) ;
  • Park, Jung-Ae (Department of Pathology, Inha University College of Medicine) ;
  • Chu, Young-Chae (Department of Pathology, Inha University College of Medicine)
  • 발행 : 2007.03.30
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초록

Objective : To identify key cytologic features for diagnosis of adenocarcinoma and morphologic differentiation from reactive/reparative respiratory epithelium. Study Design : The cytomorphologic features of 145 pulmonary cytology specimens (sputum and bronchial washing), which included 117 histologically proven adenocarcinomas and 28 non-neoplastic lesions, cytologically diagnosed as atypia and suspicious for malignancy (adenocarcinoma) were reviewed retrospectively. We analyzed 11 morphologic criteria in pulmonary cytologic specimens. Results: Over 110 of 117 cases of adenocarcinomas revealed nuclear membrane irregularities, non-cohesive cells, single atypical cells, moderate to markedly enlarged nuclei and an increased nuclear/cytoplasmic (N/C) ratio. Chromatin clearing, chromatin heterogeneity and hyperchromasia were seen in 102, 99 and 97 cases, respectively. All 28 cases involving non-neoplastic lesions revealed hyperplastic reactive pneumocytes, hyperplastic reactive bronchial epithelium, or degenerating macrophages. The non-neoplastic lesions revealed a small number of atypical cell clusters and paucity or absence of atypical single cells. Conclusion : The most important morphologic features for diagnosis of adenocarcinoma are nuclear membrane irregularities, non-cohesive cells, single atypical cell, moderate to markedly enlarged nuclei and increased N/C ratio. Chromatin clearing, chromatin heterogeneity and hyperchromasia were also helpful features, while pleomorphism and prominent nucleoli were less valuable.

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