Crushing Artifacts Resulting in Small Blue Cellular Clusters That Simulate Small Cell Carcinoma

The presence of “crushing” artifacts in histological sections is a very common finding and represents a potentially major pitfall for the surgical pathologist, particularly in small biopsy specimens. Microscopically, it appears as bluish clusters in which the cellular details are not recognizable. Here the authors report examples of this phenomenon that have been reported or that they have personally observed and emphasize some diagnostic clue to avoid its overinterpretation and the dire clinical consequences that this may entail.