Benign vs Malignant repost

Ok since I have lost this article I will go ahead and repost it.

I split the cytologic criteria in 2 major groups.

I. Low power features:

1. Necrosis ( careful with infections, foreign bodies, diabetes and RA)
2. Increased celularity
3. Unusual background substances ( mucin, colloid or keratin to name few)
4. 3 dimensional celular architecture. This feature is good for epithelial malignancies which express surface adhesion molecules EpCAM

II. High power features:

1. Increased celularity composed of s single cell clone
2. Increased N:C ratios
3. Nuclear membrane irregularities
4. Prominent, irregular "Cherri red" nucleoli. Especially if nucleoli are as big as a mature lymphocyte
5. Individual cell apoptosis
6. Abnormal mitoses as well as increased number of mitoses
7. Increased vascularity ( look for small capillaries)
8. Evidence of desmoplasia or invasion if large tissue fragments are present.
9. Necrosis ( demonstrated by nuclear dust)
10. 3D clusters as above
11. Nuclear margination ( nucleus is touching the cellular membrane)
12. Effaced cellular polarity. If not effaced then we call it "school of fish" which is feature of a reactive process.
13. Nuclear hyperchromasia ("pitch dark" nuclei like in squamous cell carcinoma or urotelial carcinomas)