CT Non-Gynecologic Cytology 1 — Questions and Answers
Question 1: Which type of lung carcinoma is most commonly identified in sputum cytology specimens due to its central airway location?
- Adenocarcinoma
- Squamous cell carcinoma (Correct answer)
- Small cell carcinoma
- Large cell carcinoma
Correct answer: Squamous cell carcinoma
Squamous cell carcinoma arises centrally near major bronchi and sheds cells into sputum more readily than peripheral tumors like adenocarcinoma.
Question 2: Creola bodies found in respiratory cytology specimens are clusters of ciliated bronchial epithelial cells most associated with which condition?
- Pulmonary adenocarcinoma
- Squamous cell carcinoma
- Asthma (Correct answer)
- Pulmonary infarction
Correct answer: Asthma
Creola bodies are tight clusters of bronchial epithelial cells with visible cilia shed due to airway inflammation, classically associated with asthma.
Question 3: Which cytomorphologic feature is MOST characteristic of small cell carcinoma in bronchial brushing specimens?
- Abundant cytoplasm with prominent nucleoli
- Nuclear molding and salt-and-pepper chromatin (Correct answer)
- Intracytoplasmic mucin vacuoles
- Keratin pearls and intercellular bridges
Correct answer: Nuclear molding and salt-and-pepper chromatin
Small cell carcinoma displays nuclear molding, scant cytoplasm, finely granular neuroendocrine 'salt-and-pepper' chromatin, and frequent apoptotic bodies.
Question 4: Ferruginous bodies (asbestos bodies) identified in sputum cytology indicate prior exposure to which agent?
- Silica dust
- Coal dust
- Asbestos fibers (Correct answer)
- Beryllium
Correct answer: Asbestos fibers
Ferruginous bodies are asbestos fibers coated with an iron-protein complex, forming golden-brown beaded rods visible in sputum from exposed individuals.
Question 5: Which cytologic feature BEST distinguishes reactive type II pneumocytes from pulmonary adenocarcinoma cells in BAL specimens?
- Large nuclei with prominent nucleoli
- Vacuolated cytoplasm
- Cohesive flat sheets with uniform nuclei (Correct answer)
- Single cells with nuclear membrane irregularity
Correct answer: Cohesive flat sheets with uniform nuclei
Reactive type II pneumocytes form cohesive, flat honeycombed sheets with relatively uniform nuclei, whereas adenocarcinoma shows disorganized clusters with nuclear atypia.
Question 6: In bronchoalveolar lavage (BAL) specimens, what percentage of hemosiderin-laden macrophages (HLMs) is considered significant for pulmonary hemorrhage?
- >5%
- >20% (Correct answer)
- >40%
- >60%
Correct answer: >20%
Greater than 20% hemosiderin-laden macrophages in BAL is the accepted threshold indicating clinically significant pulmonary hemorrhage.
Question 7: A sputum specimen shows elongated, anucleate squamous cells with dense orange cytoplasm on Pap stain. What is the most likely interpretation?
- Squamous cell carcinoma
- Reactive bronchial epithelium
- Curschmann spirals
- Anucleate squames (oral contamination) (Correct answer)
Correct answer: Anucleate squames (oral contamination)
Anucleate keratinized squames with orange cytoplasm in sputum represent oral cavity contamination from superficial squamous epithelium, not a malignant finding.
CT Non-Gynecologic Cytology 1
Which type of lung carcinoma is most commonly identified in sputum cytology specimens due to its central airway location?