The objective was to demonstrate the presence of airborne fungal spores, pollen grains, and vegetable cells in smears and establish their significance. Microscopic examination was of smears stained by the Papanicolaou technique. We found several types of airborne spores (Alternaria, Exserohilum, Aspergillus, Cladosporium, Epicoccum, Curvularia, and Ascosmycete), pollen grains (Lilium, bullrush, Pinus, Acacia, hazelnut, and oak), and several types of vegetable cells. The existence of these structures may be due to intrinsic or to extrinsic contamination of the sample. Anemophilous fungi spores and pollen grains have been shown to possess great allergenic capacity. Pollen grains and vegetable cells may be mistaken for certain microorganisms or malignant cells.

Different noncellular elements, such as round concentric calcified laminated structures, may be found in sputum smears. If these structures appear isolated on the background of the smear, the term usually used to describe them is "calcareous concretions" (CC). On the contrary, when the structures are part of epithelial cell groups or small tissue fragments, the term used to describe them is "Psammoma bodies" (PB). The aim of this work is to establish the relationship between these structures and pulmonary disease, especially lung carcinoma, by searching for the presence of CC and/or PB in sputum smears. Our study has taken as a basis 16.716 sputum smears from 696 patients obtained during a 7-year period (2003-2009). After reviewing them, it was found that from the total, 66 cases (0.39%) contained round calcified structures, 57 of them (0.34%) corresponding to CC, and the remaining 9 ones (0.05%) corresponding to PB. From these 57 CC cases, 56 corresponded to benign entities, and only one was found with lung carcinoma. On the other hand, from the 9 PB cases all of them (100%) were related to lung adenocarcinoma. We conclude that, even having a similar morphological structure, these aforementioned calcified structures we have observed in sputum smears have different and relevant clinical significance.

We describe several uncommon contaminants presumably derived from the tap water used in the staining procedure of cytological specimens. We would like to draw attention to the occasional presence of diatoms and fragments of rotifers in cytological specimens. Whilst most of these entities are harmless curiosities, they may cause concern as to their nature and significance.

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