Hyperchromatic crowded groups hcgs in the pap test. In this study, we specifically defined hcg as dark crowded cell groups with more. Thinprep small groups with radial arrangement of the cells with occasional feathering. Hyperchromatic crowded groups pitfalls in pap smear diagnosis.
Colgan 2006 hyperchromatic crowded groups in cervical cytologydiffering appearances and interpretations in conventional and thinprep preparations. The discrimination of hyperchromatic crowded cell groups hccgs in cervical cytology is a difficult and error. Hyperchromatic crowded groups hcg hyperchromatic crowded groups differential diagnosis. A problem in the diagnosis of papanicolaou smearsthe interpretation of hyperchromatic crowded groups hcgsis identified and analyzed. Hyperchromatic crowded groups term introduced by dr. Distinction between moderate and severe dyskaryosis.
Walts and bose proved positive staining 50% for proex c in paget cells, in all cases of pagets disease irrespective of tissue site extramammary, mammary, albeit it appeared that the immunostaining could be unrelated to hpv 46. A cell that contains more than the normal number of chromosomes and hence stains more densely. From 2009 to 2011, cells were collected from 82,218 individuals and the. Glandular abnormalities misdiagnosed as severe squamous dyskaryosis. Cytoplasm of the cells as seen in figure 2d was abundant and feathery. Hyperchromatic crowded groups in cervical cytologydiffering. Hyperchromatic crowded cell groups may also fall into this category if there is insufficient fine cellular detail to allow accurate assessment. Demay noted that although hyperchromatic crowded groups are usually benign and include such entities as endometrial cells and severe atrophy. Ais cells aggregate in hyperchromatic crowded groups. Nonkeratinizing squamous cell carcinoma cells occur singly or in syncytial aggregates with poorly. Hyperchromatic crowded groups are smaller, denser, and more threedimensional with smoother, sharper margins pseudostratified strips of cells may be the most prominent architectural feature architectural features of peripheral feathering, rosettes, and cell strips have a more subtle presentation. It has a nucleus that is usually to 12 of the size of the cell. Hyperchromatic groups and cell blocks in cervical cytology.
Configuration loose cell groups, acini, papillae nuclei round, vesicular nucleoli multimacro cytoplasm scant, cyanophilic background diathesis. They are commonly found in liquidbased cytology lbc samplesin almost 80% according to one study and are easily detected at lowpower magnification. Hyperchromatic crowded groups hcgs, also known as microbiopsies are defined as threedimensional aggregates of crowded cells with hyperchromatic nuclei. There is nuclear size and shape variation with some cells dissociating from the group. Instead, squamous cell atypia with a dispersed cell pattern was more prevalent in lbps. Hyperchromatic article about hyperchromatic by the free. The advantages of incorporating liquidbased cytology. Nuclear clarity and small groups morphology in lbc. Squamous cell carcinomas scc are epithelial tu1 welldifferentiated tumors. Indeed, although hyperchromatic groups of cells classified as. Detecting and interpreting glandular lesions in cervical. Methods we evaluated consecutive liquidbased surepath pap tests from 601 women age 1774 years, mean age 29. A study from the college of american pathologists interlaboratory comparison program in cervicovaginal cytology. Report of a case, diagnostic cytopathology on deepdyve, the largest online rental service for scholarly research with thousands of academic.
Hyperchromatic crowded syncytial groups are well known to be difficult to categorize in conventional papanicolaou tests. Read tennis racket cells in severe dyskaryosis in hyperchromatic crowded cell groups of surepath tm cervical samples, cytopathology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available. Abstract abstract objective hyperchromatic crowded groups hcg, a term first introduced into the cytology literature by demay in 1995, are commonly observed in pap tests and may rarely be associated with serious but difficult to interpret lesions. Jan 22, 2007 hyperchromatic crowded groups, termed hcg by demay, are a frequent occurrence in pap tests. The usefulness of using lbc in mass screening for cervical cancer was examined. Hcgs usually represent benign entities such as endometrial cells, syncytial aggregates in severe atrophy, or fragments of endocervical tissue, the latter being seen with increasing frequency due to. Evaluation and significance of hyperchromatic crowded. Features of endocervical glandular differentiation in these groups include the following. Hyperchromatic crowded groups are smaller, denser, and more threedimensional with smoother, sharper margins pseudostratified strips of cells may be the most prominent architectural feature architectural features of peripheral feathering, rosettes, and. Hyperchromatic crowded groups hcg, a term first introduced into the cytology literature by demay in 1995, are commonly observed in pap tests and may rarely be associated with serious but difficult to interpret lesions. Cytomorphological features of hyperchromatic crowded groups in. Hyperchromatic crowded groups hcg, a term first introduced into the cytology literature by demay in 1995, are commonly observed in pap tests and may rarely be associated with serious but.
The light microscopic examination revealed squamous cell carcinoma scc as acanthotic squamous epithelium with deep rete pegs, epithelial and keratin pearls, pleomorphism, stromal infiltration and hyperchromatic nuclei fig. In this study, we specifically defined hcg as dark crowded cell groups with more than 15 cells which can be identified at 10. The cytology of squamous cell carcinomas in domestic animals. While the classic features of dyskaryosis are of undoubted value, the contribution of size, shape and colour intensity of hccgs is less certain.
Indeed, although hyperchromatic groups of cells classified as hsils are illustrated. Tumor cells frequently mors commonly arising from the skin3 or in organs with stratified squamous epithelium, such as tongue, esophagus, pharynx, nasal septum,17 and uterine cer. We incorporated liquidbased cytology lbc in populationbased screening for cervical cancer. Mesenchymal cell clusters were markedly hypercellular and consisted of small and short spindleshaped cells with hyperchromatic nuclei.
Tennis racket cells in severe dyskaryosis in hyperchromatic. Division of gastroenterology, department of internal medicine, seoul paik hospital, inje university college of medicine, seoul, korea. Hyperchromatic crowded groups in cervical cytology. Hyperchromatic crowded groups hcg, a term first introduced into the cytology literature by demay in 1995, are commonly observed in pap tests. Lbc diagnosis of clear cell adenocarcinoma of vagina. Thinprep preparations, and whether these groups differ.
In this study, endocervical cells were by far the most common cause of benign hcg cell groups. Kidney shaped small nuclei were not seen so the possibility of endometrial cancer was also not considered morphologically. Evaluation and significance of hyperchromatic crowded groups hcg. They are commonly found in liquidbased cytology lbc samplesin almost 80% according to one study 2 and are easily detected at lowpower magnification. Review proex c as diagnostic marker for detection of. Hyperchromatic crowded groups, or three dimensional syncitiallike aggregates, which are crowded clusters of cells with hyperchromatic nuclei in cervicovaginal smears, can be very challenging in gynecologic cytopathology.
Vandenbussche md phd associate professor of pathology the johns hopkins university school of medicine. Detecting and interpreting glandular lesions in cervical cytology. Cytologic specimens are cellular with increased numbers of dense hyperchromatic groups the socalled hyperchromatic crowded groups or. Apr 01, 20 read tennis racket cells in severe dyskaryosis in hyperchromatic crowded cell groups of surepath tm cervical samples, cytopathology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Hyperchromatic crowded cell groups in gynaecological liquidbased. Hyperchromatic crowded cell groups in gynecological liquid. Strips of columnar cells with crowded, basally oriented nuclei and pale, foamy, or vacuolated cytoplasm. Hyperchromatic crowded groups pitfalls in pap smear. Report of a case, diagnostic cytopathology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. The hyperchromatic nuclei vary in size and show coarsely granular chromatin arrows. Hyperchromatic crowded groups, termed hcg by demay 1, are a frequent occurrence in pap tests. Dec 30, 2015 cytologic specimens are cellular with increased numbers of dense hyperchromatic groups the socalled hyperchromatic crowded groups or hcgs.
Image analysis of hyperchromatic crowded cell groups in. Pdf evaluation and significance of hyperchromatic crowded. Hyperchromatic cell definition of hyperchromatic cell by. Comparison of diagnostic cytomorphology of atypical. While the classic features of dyskaryosis are of undoubted value, the contribution of. Hyperchromatic crowded cell groups in gynaecological liquidbased cytology samples. From 2009 to 2014, 157,061 individuals underwent mass screening for cervical cancer in aomori prefecture. Borderline nuclear change, highgrade dyskaryosis not excluded. The term hyperchromatic crowded groups hcg was introduced into the cytology literature in demays 1995 first edition of the art and science of cytopathology. Squamous cell atypia two cases and atypical squamous metaplasia three cases in the lbps were initially interpreted as reactive cellular changes in the cor. Evaluation and significance of hyperchromatic crowded groups.
Hyperchromatic crowded groups are well known to be difficult to classify in conventional smears,15, 7 but little is known about these groups in thinprep specimens. Pdf hyperchromatic crowded groups hcg, a term first introduced into the. Hyperchromatic crowded cell groups are threedimensional. Evaluation and significance of hyperchromatic crowded groups hcg in liquidbased paps article pdf available in cytojournal 41. Comparison of diagnostic cytomorphology of atypical squamous. Hyperchromatic medical definition merriamwebster medical. Abnormally highly colored, excessively stained, or overpigmented. This squamous cell from the ectocervix is an immature cell that is round to oval and has dense cytoplasm. Hyperchromatic cell legal definition of hyperchromatic cell. High grade squamous intraepithelial lesion hsil, atypical. Benign glandular cells hcg are seen far more frequently than either abnormal glandular cell hcg or squamous cell hcg, normal or abnormal in routine pap tests. Basophilic cytoplasm, dense and mildly vacuolated vacuolization resembles glandular cells but cellular findings are squamous. Figure 9c10 ac hyperchromatic crowded cell groups hsil favour cin3 a hyperchromatic crowded group of cells, with hardly any associated cytoplasm.
Nov 01, 2000 a problem in the diagnosis of papanicolaou smearsthe interpretation of hyperchromatic crowded groups hcgsis identified and analyzed. The differential diagnosis of some of the benign and neoplastic entities, which present as hyperchromatic crowded. Nonkeratinizing squamous cell carcinoma most common carcinoma of cervix uteri medium to large cells, sheets or syncytial groups. Specify if endocervical, endometrial or glandular cells. Hyperchromatic crowded groups of cells without distinct cell borders. Hyperchromatic crowded group of glandular cells with well formed cytoplasmic borders and terminal bars. At the opposite end of the spectrum, a spindlecell tumor may feature small, spindled, and round hyperchromatic cells and multinucleated giant cells with radially arranged floretlike nucleithat is, the features of a pleomorphic lipoma. Hyperchromatic crowded cell groups hccg difficult to assess in both lbc and conventional. To assess whether hyperchromatic crowded groups of cells in challenging hsil cases are a problem in. In our study, hyperchromatic crowded cell groups, which were the most common feature leading to asc diagnosis in cp smears, were rarely found in the corresponding lbps. The cytology of squamous cell carcinomas in domestic. Hyperchromatic definition of hyperchromatic by medical.
Evaluation and significance of hyperchromatic crowded groups hcg in liquidbased paps. At the opposite end of the spectrum, a spindle cell tumor may feature small, spindled, and round hyperchromatic cells and multinucleated giant cells with radially arranged floretlike nucleithat is, the features of a pleomorphic lipoma. Hyperchromatic cell article about hyperchromatic cell by. This is because better observation made possible by liquidbased pap tests may allow easier recognition of endometrial of cells in socalled hyperchromatic crowded groups 48 and their. The tumor cells are hyperchromatic and pleomorphic with.
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