13: Intro to Cytology

Question 1

When should you try to aspirate from a lesion?

Answer 1

Very solid, internal lymph nodes

Question 2

Why masses should you not aspirate from?

Answer 2

Lymph nodes, spleen, liver, thyroids, +/- bone

Question 3

Why should you only use a needle for vascular masses and lymph nodes?

Answer 3

Reduce blood contamination

Question 4

Why should you use continuous suction for a spindle cell tumour?

Answer 4

May not get good cellularity

Question 5

Why should you use intermittent suction for internal masses?

Answer 5

Risk of laceration

Question 6

How many lymph nodes should you sample?

Answer 6

More than 2, not mandibular

Question 7

What should you check before aspirating liver/spleen?

Answer 7

Platelets/coagulation

Question 8

WHy shouldn’t you aspirate an adrenal mass?

Answer 8

Mass adrenaline release

Question 9

Why shouldn’t you aspirate carcinomas esp prostate, bladder?

Answer 9

Seeding

Question 10

Which type of neoplasia has especially delicate cells?

Answer 10

Lymphoma

Question 11

Why tumours are unlikely to exfoliate for an impression/swab smear?

Answer 11

Mesenchymal tumours/fibrous tissues

Question 12

How can you prepare a biopsy from the GI tract?

Answer 12

Squash

Question 13

What’s a problem with scraping?

Answer 13

Often just get debris or inflammation, but can get Demodex or Cryptococcus

Question 14

Which tubes should you use for fluid samples?

Answer 14

EDTA and plain

Question 15

What may you do with a fluid if it is less cellular?

Answer 15

Centrifuge or make a buffy coat preparation

Question 16

What’s the problem with Diff Quik?

Answer 16

Does not always stain mast cells

Question 17

Where do you see degenerate neutrophils?

Answer 17

Tissue not blood

Question 18

What causes degenerate neutrophils?

Answer 18

Bacterial toxins break down the nuclear membrane causing it to swell

Question 19

What should you look for if you see degenerate neutrophils?

Answer 19

Intracellular cocci

Question 20

What are the three types of non-inflammatory cells?

Answer 20

Round, epithelial, mesenchmal

Question 21

What do round cells look like?

Answer 21

Individual, distinct borders, efoliate readily, round to oval

Question 22

What are four examples of round cells?

Answer 22

Mast, plasma, lymphocyte, histiocytoma

Question 23

What do epithelial cells look like?

Answer 23

Clustered, distinct borders, variable exfoliation, round to polygonal, round nucleus

Question 24

What do mesenchymal (spindle) cells look like?

Answer 24

Individual or loosely clustered, wispy borders, poor exfoliation, oval to fusiform, oval to elongated nucleus

Question 25

Where can you see low numbers or spindle cells?

Answer 25

Fibrosis/fibroplasia

Question 26

What are the five criteria of malignancy?

Answer 26

Pleomorphism, increased N:C ratio, nucleolar changes, multinucleation, abnormal mitotic figures

Question 27

Which organ is multinucleation normal?

Answer 27

Liver

Question 28

How many of the criteria do you need for a malignant neoplasia?

Answer 28

3 or more

Question 29

Below three of the criteria, what could the tissue be?

Answer 29

Benign, hyperplastic, dysplastic

Question 30

Which changes does inflammation lead to?

Answer 30

Dysplasia

Question 31

What do damaged cells look like on histo?

Answer 31

No cytoplasm, pale chromatin, prominent nucleoli

Question 32

Which malignant tumours can look benign?

Answer 32

Anal sac adenocarcinoma, thyroid, adrenal

Question 33

When do you see pleomorphic lymph nodes?

Answer 33

Non-neoplastic reactive lymphoid hyperplasia (lymphoma is monomorphic)