Anisocytosis and Macrocytosis
Variation in cell size, with some cells 1.5x larger than normal
increased cell exfoliation due to decreased cell adherence
variable size and shape in cells of the same type
increased nuclear size. Cells with nuclei larger than 10u in diameter suggest malignancy
Increased nucleus:cytoplasm ratio
Normal nonlymphoid cells usually have a N:C of 1:3 to 1:8 depending on the tissue. Ratios > or = 1:2 suggest malignancy
Variation in nuclear size. This is especially important if the nuclei of multinucleated cells vary in size
multiple nucleation in a cell. This is especially important in the nuclei vary in size.
Increased mitotic figures
mitosis is rare in normal tissue
improper alignment of chromosomes
Coarse chromatin pattern
the chromatin pattern is coarser than normal. It may appear ropy or cord-like
Deformation of nuclei by other nuclei within the same cell or adjacent cells
Nucleoli are increased in size. Nucleoli > = 5 strongly suggest malignancy. For reference RBC are 6-7u
Nucleoli are fusiform or have other angular shapes, instead of their normal round to slightly oval shape
Variation in nucleolar shape or size (esp. important if the variation is within the same nucleus)
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