Pap stain; High power
Single orangeophilic cell with hyperchromatic nuclei and high nucleus to cytoplasmic ratio.
This single cell is diagnostic of keratinizing squamous cell carcinoma.
Note adjacent cluster of squamous cells forming a squamous eddy.
Pap stain; High power
Abnormal, tadpole like cell shape with condensed cytoplasm, irregular nucleus and cannabalism of a keratinized cell.
Note the presence of a small nucleolus.
Nucleoli are usually NOT seen in squamous cell carcinoma.
Pap stain; High power
Cellular pleomorphism characterized by range of bizarre cell shapes, including tadpoles.
Note orangeophilia and ink blot nucleus
Pap Stain; Medium Power
Numerous spindled and tadpole shaped cells with high N:C ratios and ink blot nuclei
Note the necrotic debris and acute inflammation in the background
Pap Stain: High Power
Note the orangeophilia, odd cell shape with tail and irregular nucleus with coarsely granular chromatin
Pap stain; High power
Necrotic keratin debris attached to dysplastic squamous cells
Pap Stain; High Power
Keratinized squamous cell with dense cytplasm and cell cannibalism
Compare the size of the nucleus of neoplastic cell to the adjacent neutrophil
Pap Stain; High Power
Squamous cells with high nucleus to cytoplasmic ratio, irregular nuclear contours and hyperchromatic nuclei
Note the cell in the middle shows thread like Herxheimer spiral
Features
• Liquid based
• Pleomorphism
• Dysplastic squamous cells
• Tadpole cells
• Spindled cells
• Dense cytoplasm
• Keratinization (orangeophilia)
• Occasional Herxheimer spirals
• High nucleus to cytoplasmic ratio is essential
• Irregular nuclear contours
• Hyperchromasia (ink blot nuclei)
• Coarsely granular chromatin
• Necrotic material at periphery of cell groups (clinging diathesis)
• Necrosis and inflammation