4 - Other non-neoplastic lesions

Summary

Miscellaneous benign findings in respiratory cytology include asbestos bodies, Curschmann’s spirals, Charcot-Leyden crystals, calcium oxalate crystals, contaminants, and potential pitfalls such as Creola bodies (Fig. 4.1).

Clinical findings

Asbestos is classified into Amphiboles and Chrysotile, which represents 90% of the commercially used asbestos. Exposure to asbestos increases the risk for mesothelioma as well as lung cancer. Upon inhalation, asbestos fibers are phagocytized by alveolar macrophages and coated with a proteinaceous iron coat, resulting in asbestos bodies. Asbestos bodies are found in the sputum of about a third of occupationally exposed individuals and their presence correlates with the duration and extent of industrial exposure to asbestos. Asbestos bodies are more commonly seen in bronchioalveolar lavage (BAL) and as incidental findings in ~ 4% of lung fine needle aspiration (FNA) cases. A recent study has shown that asbestos bodies were found in cytospins in a third of individuals exposed to asbestos. The presence of asbestos bodies correlated with a higher prevalence of parenchymal abnormalities, respiratory symptoms, and reduced pulmonary function.