Low power: DQ stain
Cellular smear with cohesive clusters of cells
High power: DQ stain
Cohesive clusters of cells with columnar morphology and hyperchromasia
Medium power: Pap stain
Crowded 3D clusters of cells with columnar morphology, hyperchromatic nuclei with irregular nuclear membranes, coarse chromatin and moderate amounts of cytoplasm
High power: Pap stain
Crowded 3D clusters of cells with columnar morphology, hyperchromatic nuclei with irregular nuclear membranes, coarse chromatin, mitosis and moderate amounts of cytoplasm
Features
• Cellular smears
• Cohesive 3D clusters or disorganized sheets
• High N:C ratio
• Columnar-looking cells
• Cytoplasm may have mucin
• Enlarged, round to elongated nuclei
• Irregular nuclear membranes
• Coarse chromatin
• Prominent to multiple nucleoli
• Dirty, necrotic
• May have mitosis
• Express cytokeratin, Cam5.2, CK8, CK20, CDX2, CEA, Villin +/- ; usually negative for CK7, TTF-1,PSA, PAP, mammaglobin
• May have mutations in KRAS, BRAF; MSI testing for HNPCC-associated cancers
Knight CS et al. Diagn Cytopathol. 2013 Dec;41(12):1031-7.