Examination of sputum exfoliated cells in patients with primary lung cancer

Patients with primary lung cancer can undergo sputum exfoliative cell examination, and the results are as follows:

Squamous cell carcinoma

Squamous cell carcinoma refers to the squamous metaplastic epithelium of the bronchial mucosa that occurs in the large bronchi, that is, above the segmental bronchi. Examination of sputum exfoliated cells shows that the shape and size of cancer cells vary greatly, and can be round, polygonal, spindle-shaped, and bizarre cells, such as fibrous, tadpole-shaped, and snake-shaped cancer cells. They can appear alone or in groups of three or five in the smear. The cells are monolayer, with few three-dimensional structures or overlaps, which are different from adenocarcinoma cells; the nuclear shape of squamous cell carcinoma cells is variable and of different sizes; the cytoplasm is rich, the structure is dense and thick, the border is clear, and the cytoplasm of cancer cells without keratinization is blue, while that of keratinized cancer cells is orange-yellow. Sometimes the cancer cells are completely keratinized, the nucleus dissolves and disappears, and turns into anucleate shadow cells; a small cancer cell appears in the cytoplasm of a large cancer cell, squeezing the nucleus of the large cancer cell into a half-moon shape, which is offset, and a half-moon-shaped halo often appears between the two cancer cells. It may be a phagocytic phenomenon or it may be abnormal cell division.

Bronchial adenocarcinoma

Well-differentiated adenocarcinomas are mainly shed in groups, with large cell groups and overlapping cells in a three-dimensional structure. Poorly differentiated adenocarcinomas have more individual cancer cells, smaller and fewer cell groups, and loose structures; individual cancer cells are generally round or oval, with occasional columnar cells. The cytoplasm often has many small vacuoles, occasionally larger vacuoles, round or oval nuclei, and the nuclear membrane is often folded or serrated, obvious and offset. The chromatin is granular, and binucleated or multinucleated cells are common. There are one or more obvious nucleoli.