Figure 5.

(a) Positive for tumour cells—SurePath, staining Papanicolaou, lens 20×. Clinically, there is suspicion for a carcinoma. On low power, there is a highly irregular aspect of the slide. In the background there are deposits of amorphous material, sometimes with nuclear fragments. In addition to many mature cells with normal nuclei, there are immature, small epithelial cells, both singly and in small and large groups. Nuclear enlargement and prominent nucleoli can be seen in this magnification. Some bizarre orangeophilic cells represent atypical keratinization. Those cells may have opaque, nearly black nuclei with smudged chromatin. (b) Positive for tumour cells—detail, lens 40×. A loosely cohesive sheet of highly atypical, immature squamous cells. The N/C ratio is markedly increased. Nuclei are highly hyperchromatic and chromatin is coarse. Some cells show an irregular nuclear contour and/or small nucleoli. These findings constitute the cytological diagnosis of a moderately well differentiated, keratinizing squamous cell carcinoma (SCC). Almost all these cases show aneuploidy on DNA-karyometry.