Low Power; DQ stain
Note the high cellularity and small cell size
Medium Power; DQ stain
High cellularity, monomorphous cell population
Plasmacytoid cells with lack of Golgi Hoff
Low Power; Pap stain
High cellularity, dyscohesive cells, focal loose cohesion
Small to medium cell size
High Power; DQ stain
Loosely cohesive groups, plasmacytoid cells,
Slight nuclear size variation, binucleation
High Power; Pap stain
Slight nuclear size variation, coarsely granular chromatin (Salt and Pepper)
Small nucleolus
Slight nuclear irregularity
High Power; Pap stain
Dyscohesive plasmacytoid cells with granular cytoplasm
Slight nuclear size variation and nuclear irregularity
High Power; Pap stain
Irregular nuclear contours, nuclear size variation, granular chromatin, rare inclusion
High Power; DQ stain
Pink to red granules in cytoplasm
Features
• Moderate to high cellularity
• Predominantly dyscohesive to loosely cohesive cells
• Monomorphous population
• Plasmacytoid cells
• Slightly increased N:C ratio
• No Golgi Hoff
• Pink/red cytoplasm with focal red granules
• Focal cytoplasmic condensation
• Eccentric nuclear location
• Slight variation in nuclear size
• Rare nuclei with ancient or endocrine atypia
• Slight nuclear irregularity
• Coarsely granular chromatin (Salt and pepper)
• Indistinct to single, small nucleolus • located closer to nuclear membrane
• Binucleation commonly seen
• Rare nuclear pseudoinclusions
• Variable mitoses (usually < 10/10 hpf)
• Recommend grading as Low or High • Three tiered grading recommended only on histology
• Variable necrosis
• Express Cam5.2, CD56, synaptophysin, chromogarnin, AE1/AE3 +/- ; usually CK7 and CK20 negative. Ki-67 for grading
Yoon et al. Endoscopy. 2013;45(3):189-94.