With a variety of non-malignant diseases of respiratory cytology research thorough, the understanding of these changes on cytology of lung cancer diagnosis and differential diagnosis has also been important.
1 Respiratory cytology of benign lesions. Ciliated columnar epithelial cells:
(1) multinucleated ciliated columnar epithelial cells: ciliated columnar epithelium and sometimes there may be multi-core, multi-core nucleus of ciliated columnar epithelium less the same size, usually but not nucleoli. The number of its nuclear can be for a few, dozens or even more.
(2) increased nuclear columnar epithelial cells: in the bronchial brush core chip can be seen sometimes significantly increased the columnar epithelial cells, the nuclear diameter than the other cells of 1-fold or more increase in nuclear chromatin, thicker, nuclear Jen sometimes be increased. The volume of the cells can be normal, can also be increased. This increases the cell nucleus is ciliated columnar epithelium response to various stimuli, such as bronchoscopy after intubation is more common after anesthesia; Second bronchitis, pneumonia, lesions were occasionally can be seen. The cells and tumor cells is the major difference between the existence of cilia or end plate.
(3) ciliated columnar epithelial cells: in chronic bronchitis, bronchiectasis, or asthma, bronchial epithelial hyperplasia. These proliferating cells can be detached groups, appears in the smear. Shape was usually round, oval, irregular shaped or curled up into a "Caterpillar"-like cell population, small groups of cells, see the cytoplasm, nuclear size consistent, which saw a small nucleolus. Overlapping three-dimensional structure of cells. Marginal price of cell populations of cells, and have a clear cytoplasm, and sometimes you can still see the Department of cilia or cilia attached to the end boards, this important sign of healthy cells. Such as cell populations within the goblet cells, mucus secretion in the visible edge of the cavity, which is adenocarcinoma, especially bronchioloalveolar carcinoma like, pay attention to identify. The differential point is: the proliferation of ciliated columnar epithelial cell surface may or end plate, columnar cell arrangement rules, nucleolar sizes.
Cytology of benign respiratory tract 2. Basal cell hyperplasia: basal cell conical or polygonal, arranged along the basement membrane does not reach the cavity surface. Basal cell hyperplasia can be a single layer, that is, basement membrane slightly increased basal nucleus, closely arranged in palisade layer; also can be stratified, that is, basal cell; wall had two layers, superficial ciliated columnar epithelial cells remains . Basal cell hyperplasia is a special reaction in chronic bronchitis, bronchiectasis, tuberculosis and other chronic disease (such as fungal infections, chronic pneumonia), the may appear. The proliferation of basal cells, small cell carcinoma should be noted that the phase difference between the same, especially the nuclear size is inconsistent, should pay attention.
Benign lesions of the respiratory tract cytology 3. Squamous metaplasia: squamous metaplasia is a chronic bronchial stimulation by a kind of adaptive changes occur. Case of squamous metaplasia, ciliated metaplasia local – and the carriage of liquid systems fear loss. Scales of the cells are usually shed into the film, was paving type arrangement, nuclear slightly increased, but the same size; cytoplasm less polygonal cells, squamous metaplasia is often not fully mature cells, so cells smaller, less cytoplasm, and off in groups. Non-keratinized squamous cells of squamous cell, keratosis if the phenomenon may be a change to the abnormal differentiation of squamous cell carcinoma of the letter.
Cytology of benign airway 4. Shaped shaped squamous metaplasia: squamous metaplasia, also known as atypical squamous cells of the throat, that is a precancerous lesion. Histologically atypical squamous metaplasia, the squamous cell disorder, significantly increased the cellular level, nuclear sizes, and sometimes do not see the typical keratinized. Cytology were as follows: atypical squamous cells of groups often fall off, nuclear sizes, low staining, the cytoplasm of cells in less than a simple scale, more eosinophilic stained. According to nuclear atypia, the typical scale is divided into mild, moderate and severe levels. Severe atypical squamous cells of squamous cell carcinoma is very similar. If there is such a typical squamous cells of a single abnormal cells to be highly suspected mad scales, and the follow-up observation, in order to avoid delaying diagnosis.