Widespread posttracheostomy atypia simulating squamous cell carcinoma. A case report.
Squamous atypia appears as a benign posttracheostomy phenomenon occasionally mistaken for squamous carcinoma. Most often seen are clumps of atypical metaplastic cells with irregular nuclear rims and chromatin that can be either finely dispersed or coarsely clumped. The cytoplasm is thick, and the cytoplasmic membrane is sharply outlined. We describe a case of squamous atypia occurring in a patient 30 years after laryngectomy. The atypia was so extreme that segmental bronchoscopy was performed to search for occult carcinoma. No carcinoma was found, but numerous atypical cells were found in the segmental bronchi sampled by endobronchial brushings. This finding indicates that posttracheostomy atypia can involve respiratory mucosa distant from the tracheal (stump) mucosa. Sputum and bronchoscopic samples received from patients with tracheostomies should be screened with a clear understanding of the morphologically distinct atypia encountered.
Berman
J J
JJ
Cytology Section, Department of Veterans Affairs Medical Center, Baltimore, Maryland 21218.
Murray
R J
RJ
Lopez-Plaza
I M
IM
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002454:Cell Differentiation; D003937:Diagnosis, Differential; D006801:Humans; D007825:Laryngectomy; D008168:Lung / Q000473:pathology; D008297:Male; D013183:Sputum / Q000166:cytology*; D014132:Trachea / Q000473:pathology; D014139:Tracheostomy