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Epithelial repair versus carcinoma in esophageal brush cytology
Author(s) -
Hoover Lola,
Berman Jules J.
Publication year - 1988
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.2840040308
Subject(s) - medicine , carcinoma , nuclear atypia , atypia , esophagus , pathology , cytopathology , malignancy , cytology , surgery , immunohistochemistry
The distinction between repair atypia and carcinoma in esophageal brushings is often difficult. To establish criteria for making this distinction, the cytologic smears from 121 consecutive esophageal brushings and the companion biopsies were reviewed. The most reliable criteria for malignancy included sharply angulated nuclear rims, a high nuclear/cytoplasmic ratio, and coarsely granular chromatin. Nuclei bearing these features were not numerous and had to be carefully sought. Nuclear pleomorphism was a more consistent feature, but it showed considerable overlap with epithelial repair. Cytologic features of multiple nucleoli, macronucleoli, and loss of polarity were common to both repair and carcinoma. Adherence to the criteria established in this study permits the distinction between repair atypia and carcinoma in almost all cases; however, there are lesions of the esophagus with such overlap between the features of repair and carcinoma that it may not be possible to reach a definitive diagnosis. Specific examples, with illustrations, are discussed as diagnostic guides.