Specimen types

• sputum
• bronchial
  • bronchial aspiration
  • bronchial washing
  • bronchial lavage
• FNA
  • transbronchial
  • endobronchial
  • transesophageal
  • percutaneous

Negative for malignancy

• normal
  • upper respiratory tract
    • ciliated columnar cells
    • squamous cells
  • lower respiratory tract
    • trachea
      • same as bronchus
    • bronchus
      • ciliated columnar cells
      • goblet cells
      • reserve cells
      • neuroendocrine cells
    • terminal bronchioles
      • Clara cells
        • nonciliated
        • cuboidal/columnar
    • alveoli
      • type I pneumocyte
      • type II pneumocyte
      • alveolar macrophages
  • macrophages
• reactive
  • reactive squamous cells
  • reactive bronchial cells
  • bronchial reserve cell hyperplasia
  • repair
  • type II pneumocyte hyperplasia
• Infections
  • viral
    • HSV
    • CMV
    • measles
    • RSV
    • adenovirus
  • bacterial pneumonia
  • tuberculosis
  • fungal
    • candida
    • aspergillus
    • zygomycetes
    • cryptococcus
    • histoplasma
    • blastomycosis
    • coccidioidomycosis
    • sporotrichosis
    • PCP
  • parasites
    • strongyloides
    • dirofilariasis
    • echinococcus
• Medical lung
  • asthma
  • COPD
    • chronic bronchitis
    • emphysema
  • sarcoidosis
  • Wegener disease
  • amyloidosis
  • pulmonary alveolar proteinosis
  • interstitial pneumonia
• other
  • aspiration pneumonia
  • vegetable cells
  • pollen
  • actinomyces
  • atypical metaplastic cells
  • Upper respiratory tract contamination

Atypical cells present

Suspicious for malignancy

Neoplastic cells present

• carcinoid tumor
• atypical carcinoid tumor
• hamartoma
• inflammatory myofibroblastic tumor
• granular cell tumor
• thymoma

Positive for malignant cells

• Small cell carcinoma
• Non-small cell carcinoma
  • SCC
  • adenocarcinoma
  • large cell carcinoma
  • sarcomatoid carcinoma
  • rares
    • adenoid cystic carcinoma
    • PEComa
  • sarcoma
  • lymphoma
  • metastasis
• Mediastinal ddx
  • thymic carcinoma
  • lymphoma
  • GCTs
  • NUT midline carcinoma