{"id":2124,"date":"2017-08-01T12:44:50","date_gmt":"2017-08-01T12:44:50","guid":{"rendered":"http:\/\/cytologystuff1.wpengine.com\/non-gyn-atlas\/respiratory-cytology-reactive-inflammatory\/"},"modified":"2025-02-10T20:04:43","modified_gmt":"2025-02-10T20:04:43","slug":"respiratory-cytology-reactive-inflammatory","status":"publish","type":"page","link":"https:\/\/cytologystuff.com\/zh-hans\/non-gyn-atlas\/respiratory-cytology-reactive-inflammatory\/","title":{"rendered":"Respiratory Cytology – Reactive Inflammatory"},"content":{"rendered":"

[vc_row 0=””][vc_column 0=”” offset=”vc_hidden-lg vc_hidden-md”][vc_raw_html 0=””]JTNDY2VudGVyJTNFJTNDYSUyMGNsYXNzJTNEJTIyc2hpZnRuYXYtdG9nZ2xlJTIwc2hpZnRuYXYtdG9nZ2xlLWJ1dHRvbiUyMiUyMGRhdGEtc2hpZnRuYXYtdGFyZ2V0JTNEJTIyc2hpZnRuYXYtbWFpbiUyMiUzRSUzQ2klMjBjbGFzcyUzRCUyMmZhJTIwZmEtYmFycyUyMiUzRSUzQyUyRmklM0UlMjBUYWJsZSUyMG9mJTIwQ29udGVudHMlMjAlM0MlMkZhJTNFJTNDJTJGY2VudGVyJTNF[\/vc_raw_html][\/vc_column][\/vc_row][vc_row][vc_column][vc_custom_heading text=”Respiratory Cytology – Reactive Inflammatory” font_container=”tag:h1|text_align:center” use_theme_fonts=”yes”][\/vc_column][\/vc_row][vc_row][vc_column width=”2\/3″][vc_column_text]<\/p>\n

REACTIVE INFLAMMATORY<\/p>\n

<\/a><\/p>\n

\n

Reminder: You may click on any slide image
\nfor an enlarged view.<\/strong><\/p>\n


\n\"Image<\/a><\/p>\n
Figure 22<\/strong>
\nBronchial wash
\nMultinucleated epithelial cells with intranuclear inclusions are characteristic of Herpes simplex infection of the lung. 60x<\/div>\n<\/div>\n
Figure 22<\/strong>
\nBronchial wash
\nMultinucleated epithelial cells with intranuclear inclusions are characteristic of Herpes simplex infection of the lung.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 23<\/strong>
\nBronchial wash
\nCompare the size of this multinucleated cell infected by Herpes to the adjacent superficial squamous cells. 60x<\/div>\n<\/div>\n
Figure 23<\/strong>
\nBronchial wash
\nCompare the size of this multinucleated cell infected by Herpes to the adjacent superficial squamous cells.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 24<\/strong>
\nBronchial wash
\nHerpes simplex infection may cause single intranuclear inclusions as illustrated in these epithelial cells. 60x<\/div>\n<\/div>\n
Figure 24<\/strong>
\nBronchial wash
\nHerpes simplex infection may cause single intranuclear inclusions as illustrated in these epithelial cells.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 25<\/strong>
\nBronchial wash
\nThe inclusions of H. simplex can also cause a “glassy” appearance to the nucleus. 60x<\/div>\n<\/div>\n
Figure 25<\/strong>
\nBronchial wash
\nThe inclusions of H. simplex can also cause a “glassy” appearance to the nucleus.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 26<\/strong>
\nBronchial wash
\nVegetable cells in respiratory samples may mimic atypical epithelial cells or cancer. 60x<\/div>\n<\/div>\n
Figure 26<\/strong>
\nBronchial wash
\nVegetable cells in respiratory samples may mimic atypical epithelial cells or cancer.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 27<\/strong>
\nBronchial wash
\nClusters of actinomycetes commonly contaminate respiratory samples 60x<\/div>\n<\/div>\n
Figure 27<\/strong>
\nBronchial wash
\nClusters of actinomycetes commonly contaminate respiratory samples
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 28<\/strong>
\nBronchial wash
\nHyphae of Candida species may represent oral contamination of the sample or underlying fungal pneumonia. 40x<\/div>\n<\/div>\n
Figure 28<\/strong>
\nBronchial wash
\nHyphae of Candida species may represent oral contamination of the sample or underlying fungal pneumonia.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 29<\/strong>
\nBronchial wash
\nAtypical metaplastic cells can accompany fungal infections of the lung. This finding is particularly striking with aspergillus<\/em> infection. 60x<\/div>\n<\/div>\n
Figure 29<\/strong>
\nBronchial wash
\nAtypical metaplastic cells can accompany fungal infections of the lung. This finding is particularly striking with Aspergillus<\/em> infection. 60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 30<\/strong>
\nBronchial wash
\nBronchial washing showing zygomycetes in an inflammatory background. 10x<\/div>\n<\/div>\n
Figure 30<\/strong>
\nBronchial wash
\nBronchial washing showing zygomycetes in an inflammatory background.
\n10x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 31<\/strong>
\nBronchial wash
\nEven with just Pap stain, zygomycetes have brown-pigmented hyphae. 20x<\/div>\n<\/div>\n
Figure 31<\/strong>
\nBronchial wash
\nEven with just Pap stain, zygomycetes have brown-pigmented hyphae. 20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 32<\/strong>
\nBronchial wash
\nHyphal forms of zygomycetes in a bronchial wash specimen. 40x<\/div>\n<\/div>\n
Figure 32<\/strong>
\nBronchial wash
\nHyphal forms of zygomycetes in a bronchial wash specimen.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 33<\/strong>
\nBronchial wash
\nThe ribbon-like nature of these wide hyphae is shown. 40x<\/div>\n<\/div>\n
Figure 33<\/strong>
\nBronchial wash
\nThe ribbon-like nature of these wide hyphae is shown.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 34<\/strong>
\nLung wash
\nAspergillus <\/em>spp. is characterized by septate hyphae with parallel walls. 20x<\/div>\n<\/div>\n
Figure 34<\/strong>
\nLung wash
\nAspergillus<\/em> spp. is characterized by septate hyphae with parallel walls.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 35<\/strong>
\nBronchial wash
\nThis cluster of aspergillus<\/em> illustrates the 45 degree branching that is typical of the organism. 40x<\/div>\n<\/div>\n
Figure 35<\/strong>
\nBronchial wash
\nThis cluster of Aspergillus<\/em> illustrates the 45 degree branching that is typical of the organism.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 36<\/strong>
\nBronchial wash
\nScreening magnification showing Aspergillus<\/em> spp. 10x<\/div>\n<\/div>\n
Figure 36<\/strong>
\nBronchial wash
\nScreening magnification showing Aspergillus<\/em> spp. 10x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 37<\/strong>
\nBronchial wash
\nHigher power magnification shows the parallel cell walls with septate hyphae. 40x<\/div>\n<\/div>\n
Figure 37<\/strong>
\nBronchial wash
\nHigher power magnification shows the parallel cell walls with septate hyphae.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 38<\/strong>
\nBronchial wash
\nYeast-like fungi may be seen admixed with oral squamous cells. These most likely represent contamination. 20x<\/div>\n<\/div>\n
Figure 38<\/strong>
\nBronchial wash
\nYeast-like fungi may be seen admixed with oral squamous cells. These most likely represent contamination.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 39<\/strong>
\nBronchial wash
\nNumerous small yeast are seen in this photomicrograph. 60x<\/div>\n<\/div>\n
Figure 39<\/strong>
\nBronchial wash
\nNumerous small yeast are seen in this photomicrograph.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 40<\/strong>
\nBronchial wash
\nClusters of reactive bronchial epithelial cells a commonly accompany aspergillus<\/em> infections. 60x<\/div>\n<\/div>\n
Figure 40<\/strong>
\nBronchial wash
\nClusters of reactive bronchial epithelial cells a commonly accompany Aspergillus<\/em> infections.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 41<\/strong>
\nBronchial wash
\nAtypical metaplastic cells may be seen with aspergillus<\/em> infection. 60x<\/div>\n<\/div>\n
Figure 41<\/strong>
\nBronchial wash
\nAtypical metaplastic cells may be seen with Aspergillus<\/em> infection.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 42<\/strong>
\nBronchial wash
\nA reactive multinucleated bronchial epithelial cell is present in a background of necrosis. 60x<\/div>\n<\/div>\n
Figure 42<\/strong>
\nBronchial wash
\nA reactive multinucleated bronchial epithelial cell is present in a background of necrosis.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 43<\/strong>
\nBronchial wash
\nThe necrotic material associated with an aspergilloma may harbor reactive cells. 60x<\/div>\n<\/div>\n
Figure 43<\/strong>
\nBronchial wash
\nThe necrotic material associated with an aspergilloma may harbor reactive cells.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 44<\/strong>
\nBronchial wash
\nHigh magnification showing septate hyphae of Aspergillus<\/em>. 40x<\/div>\n<\/div>\n
Figure 44<\/strong>
\nBronchial wash
\nHigh magnification showing septate hyphae of Aspergillus<\/em>.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 45<\/strong>
\nBronchial wash
\nAsthma or chronic bronchitis may cause hyperplasia of bronchial epithelial cells. 20x<\/div>\n<\/div>\n
Figure 45<\/strong>
\nBronchial wash
\nAsthma or chronic bronchitis may cause hyperplasia of bronchial epithelial cells.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 46<\/strong>
\nBronchial wash
\nHyperplastic bronchial epithelial cells are enlarged, with nuclei that may be multiple times the diameter of normal. 60x<\/div>\n<\/div>\n
Figure 46<\/strong>
\nBronchial wash
\nHyperplastic bronchial epithelial cells are enlarged, with nuclei that may be multiple times the diameter of normal.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 47<\/strong>
\nBronchial wash
\nGoblet cells are seen in conjunction with chronic bronchitis and asthma. 60x<\/div>\n<\/div>\n
Figure 47<\/strong>
\nBronchial wash
\nGoblet cells are seen in conjunction with chronic bronchitis and asthma.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 48<\/strong>
\nBronchial wash
\nCurschmann’s spirals represent inspissated mucus that forms as a cast of a bronchiole. 20x<\/div>\n<\/div>\n
Figure 48<\/strong>
\nBronchial wash
\nCurschmann’s spirals represent inspissated mucus that forms as a cast of a bronchiole.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 49<\/strong>
\nBronchial wash
\nFiber material contaminating the lung may resemble a Curschmann’s spiral. 20x<\/div>\n<\/div>\n
Figure 49<\/strong>
\nBronchial wash
\nFiber material contaminating the lung may resemble a Curschmann’s spiral.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 50<\/strong>
\nBronchoalveolar lavage
\nBronchoalvelar lavage can be used to sample peripheral airways for infections. A cluster of Pneumocystis carinii<\/em> is shown in the lower left. 20x<\/div>\n<\/div>\n
Figure 50<\/strong>
\nBronchoalveolar lavage
\nBronchoalvelar lavage can be used to sample peripheral airways for infections. A cluster of Pneumocystis carinii<\/em> is shown in the lower left.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 51<\/strong>
\nBronchoalveolar lavage
\nHigher magnification of P. carinii<\/em> adjacent to respiratory debris. 60x<\/div>\n<\/div>\n
Figure 51<\/strong>
\nBronchoalveolar lavage
\nHigher magnification of P. carinii<\/em> adjacent to respiratory debris.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 52<\/strong>
\nBronchoalveolar lavage
\nThe cyst forms of P. carinii<\/em> form a foamy mass within the sample. 60x<\/div>\n<\/div>\n
Figure 52<\/strong>
\nBronchoalveolar lavage
\nThe cyst forms of P. carinii <\/em>form a foamy mass within the sample.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 53<\/strong>
\nBronchoalveolar lavage
\nAnother example of foamy clusters of P. carinii.<\/em> 60x<\/div>\n<\/div>\n
Figure 53<\/strong>
\nBronchoalveolar lavage
\nAnother example of foamy clusters of P. carinii. <\/em>60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 54<\/strong>
\nBronchoalveolar lavage
\nThe foamy masses of P. carinii<\/em> are literally casts of the alveoli. 60x<\/div>\n<\/div>\n
Figure 54<\/strong>
\nBronchoalveolar lavage
\nThe foamy masses of P. carinii<\/em> are literally casts of the alveoli.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 55<\/strong>
\nBronchoalveolar lavage
\nMethenamine silver stain illustrates the trophozoites of P. carinii<\/em>. 60x<\/div>\n<\/div>\n
Figure 55<\/strong>
\nBronchoalveolar lavage
\nMethenamine silver stain illustrates the trophozoites of P. carinii<\/em>.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 56<\/strong>
\nBronchoalveolar lavage
\nBronchoalveolar lavage showing metaplastic squamous cells. 40x<\/div>\n<\/div>\n
Figure 56<\/strong>
\nBronchoalveolar lavage
\nBronchoalveolar lavage showing metaplastic squamous cells.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 57<\/strong>
\nBronchoalveolar lavage
\nThis multinucleated giant histiocyte could be mistaken for a reactive cluster of bronchial epithelial cells. Nuclei retain benign morphology. 60x<\/div>\n<\/div>\n
Figure 57<\/strong>
\nBronchoalveolar lavage
\nThis multinucleated giant histiocyte could be mistaken for a reactive cluster of bronchial epithelial cells. Nuclei retain benign morphology.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 58<\/strong>
\nBronchoalveolar lavage
\nOral-derived bacteria may be found in the bronchoalveolar lavage sample. 40x<\/div>\n<\/div>\n
Figure 58<\/strong>
\nBronchoalveolar lavage
\nOral-derived bacteria may be found in the bronchoalveolar lavage sample.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 59<\/strong>
\nBronchoalveolar lavage
\nLow power magnification showing Blastomyces<\/em> among respiratory macrophages. 20x<\/div>\n<\/div>\n
Figure 59<\/strong>
\nBronchoalveolar lavage
\nLow power magnification showing Blastomyces<\/em> among respiratory macrophages.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 60<\/strong>
\nBronchoalveolar lavage
\nHigher magnification shows large, thick walled fungi. 40x<\/div>\n<\/div>\n
Figure 60<\/strong>
\nBronchoalveolar lavage
\nHigher magnification shows large, thick walled fungi.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 61<\/strong>
\nBronchoalveolar lavage
\nBroad-based budding and a thick refractile wall characterize Blastomycoses<\/em>. 60x<\/div>\n<\/div>\n
Figure 61<\/strong>
\nBronchoalveolar lavage
\nBroad-based budding and a thick refractile wall characterize Blastomycoses<\/em>.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 62<\/strong>
\nBronchoalveolar lavage
\nCompare the size of B. dermatitidis<\/em> with the nearby macrophages. 60x<\/div>\n<\/div>\n
Figure 62<\/strong>
\nBronchoalveolar lavage
\nCompare the size of B. dermatitidis<\/em> with the nearby macrophages.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 63<\/strong>
\nBronchoalveolar lavage
\nBronchoalveolar lavage collects macrophages, respiratory epithelia and other cells from the airways. BAL is commonly used to evaluate inflammatory and infectious disorders of the lung. 60x<\/div>\n<\/div>\n
Figure 63<\/strong>
\nBronchoalveolar lavage
\nBronchoalveolar lavage collects macrophages, respiratory epithelia and other cells from the airways. BAL is commonly used to evaluate inflammatory and infectious disorders of the lung.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 64<\/strong>
\nBronchoalveolar lavage
\nA benign cluster of epithelial cells is illustrated from this bronchoalveolar lavage sample. 40x<\/div>\n<\/div>\n
Figure 64<\/strong>
\nBronchoalveolar lavage
\nA benign cluster of epithelial cells is illustrated from this bronchoalveolar lavage sample.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 65<\/strong>
\nBronchoalveolar lavage
\nBenign cells of terminal bronchiolar origin are shown. Note the vacuolated cytoplasm. 40x<\/div>\n<\/div>\n
Figure 65<\/strong>
\nBronchoalveolar lavage
\nBenign cells of terminal bronchiolar origin are shown. Note the vacuolated cytoplasm.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 66<\/strong>
\nBronchoalveolar lavage
\nReactive\/atypical cells of terminal bronchiolar\/alveolar origin. Note the single, central nucleolus. 60x<\/div>\n<\/div>\n
Figure 66<\/strong>
\nBronchoalveolar lavage
\nReactive\/atypical cells of terminal bronchiolar\/alveolar origin. Note the single, central nucleolus.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 67<\/strong>
\nBronchoalveolar lavage
\nReactive\/atypical terminal bronchiolar cells from a bronchoalveolar lavage. 60X<\/div>\n<\/div>\n
Figure 67<\/strong>
\nBronchoalveolar lavage
\nReactive\/atypical terminal bronchiolar cells from a bronchoalveolar lavage.
\n60X<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 68<\/strong>
\nSputum
\nThis sputum sample contains respiratory macrophages, a criterion of adequacy. 40x<\/div>\n<\/div>\n
Figure 68<\/strong>
\nSputum
\nThis sputum sample contains respiratory macrophages, a criterion of adequacy.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 69<\/strong>
\nSputum
\nA Curschmann’s spiral, a cast of a small bronchiole, in a sputum sample, as may be seen in asthma. 20x<\/div>\n<\/div>\n
Figure 69<\/strong>
\nSputum
\nA Curschmann’s spiral, a cast of a small bronchiole, in a sputum sample, as may be seen in asthma.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 70<\/strong>
\nSputum
\nAnother example of a Curschmann’s spiral. 20x<\/div>\n<\/div>\n
Figure 70<\/strong>
\nSputum
\nAnother example of a Curschmann’s spiral.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 71<\/strong>
\nSputum
\nCandida<\/em> spp. , from the mouth, commonly contaminate sputum samples. 40x<\/div>\n<\/div>\n
Figure 71<\/strong>
\nSputum
\nCandida<\/em> spp. , from the mouth, commonly contaminate sputum samples.
\n40x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 72<\/strong>
\nActinomycetes<\/em>
\nActinomycetes<\/em> may be present in sputum. Note the filamentous bacteria. 60x<\/div>\n<\/div>\n
Figure 72<\/strong>
\nActinomycetes<\/em>
\nActinomycetes<\/em> may be present in sputum. Note the filamentous bacteria.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 73<\/strong>
\nBronchial wash
\nLow power magnification of cytomegalovirus infected cells in a bronchial wash sample. 20x<\/div>\n<\/div>\n
Figure 73<\/strong>
\nBronchial wash
\nLow power magnification of cytomegalovirus infected cells in a bronchial wash sample.
\n20x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 74<\/strong>
\nBronchial wash
\nHigher magnification shows a bi-nucleated macrophage with intranuclear inclusions of cytomegalovirus. 60x<\/div>\n<\/div>\n
Figure 74<\/strong>
\nBronchial wash
\nHigher magnification shows a bi-nucleated macrophage with intranuclear inclusions of cytomegalovirus.
\n60x<\/div>\n
<\/div>\n

\n\"Image<\/a><\/p>\n
Figure 75<\/strong>
\nBronchial wash
\nA single macrophage with both intranuclear and intracytoplasmic inclusions of CMV. 60x<\/div>\n<\/div>\n
Figure 75<\/strong>
\nBronchial wash
\nA single macrophage with both intranuclear and intracytoplasmic inclusions of CMV.
\n60x<\/div>\n<\/div>\n
<\/div>\n

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