Blythe K. Gorman, MD, The ASC Bulletin Editorial Board

The Papanicolaou Society of Cytopathology System for Reporting Respiratory Cytology: Definitions, Criteria, Explanatory Notes, and Recommendations for Ancillary Testing, in paperback, is available from Springer for purchase.   This book succinctly presents the Papanicolaou Society guidelines for reporting respiratory specimens, including exfoliative pulmonary specimens and fine needle aspiration specimens from the lung and mediastinum.  The book is slim, but well organized and comprehensive, thus making it an obvious choice for reference during any busy sign out day.

The book is divided into nine chapters.  The first is dedicated to providing an overview of the terminology to be presented in subsequent chapters and provides recommendations for reporting.  This chapter features tables that lay out each diagnostic category, along with high yield explanatory notes.  There are also tables providing reported risks of malignancy with each diagnostic category based on literature review.  As in the other Papanicolaou Society books, there are examples for formatting of reports.

The following seven chapters are dedicated to each of the categories set by the reporting system:  Non diagnostic, Negative for Malignancy, Atypical, Neoplastic (Benign), Neoplasm – Undetermined Malignant Potential, Suspicious for Malignancy, and Malignant.  Each chapter begins with a brief background discussion to provide an overview of the category presented in that chapter.   The background section also provides guidance regarding the best use of each category, with helpful examples.

This is followed by a discussion of salient points for each entity included in the category, as well as a bullet-point presentation of cytological criteria needed for diagnosis.  Each entity has a section on explanatory notes with a discussion of relevant differential diagnoses, including immunoperoxidase stains and ancillary studies, when appropriate.  Management is also briefly addressed.   The book features generously sized color photographs that aptly illustrate the entities discussed.  The images include Diff-Quik and Papanicolaou stained preparations, as well as H and E and immunoperoxidase – stained cell block and histologic preparations.

The last chapter focuses on recommendations for ancillary testing.  Although the majority of the recommendations focus on handling neoplastic specimens, there is a very nice chart comparing the cytomorphology of selected infectious agents.   The remainder of the recommendations provide guidance for handling pulmonary carcinomas to ensure samples are put to best use.  Judicious use of immunohistochemistry is advised, and recommendations are also made regarding testing for EGFR, ALK, PD-L1, and other markers.

The appendices, although brief, are quite useful.  There is a handy template that outlines each category in the system for quick reference as well as a table compiling useful histochemical stains, immunostains, and molecular tests. 

Overall, this book (and the classification system) is helpful for guiding cytologists in the creation of a clear, concise report in addition to providing guidance for best use of ancillary studies. 

The Papanicolaou Society of Cytopathology System for Reporting Respiratory Cytology

Editors:  Lester J. Layfield, Zubair Baloch
Publisher:  Springer International Publishing, 2019
Pages:IX, 151
113 illustrations in color
Softcover ISBN:  978-319-97234-3