15 – Intro to Cytology Flashcards
1
Q
What is cytology?
A
- Microscopic assessment of cells from body tissues or fluids
2
Q
What are the advantages of cytology?
A
- rapid
- inexpensive
- minimally invasive
- can be done in-clinic
- assess fine cellular detail
- may give immediate diagnosis
- pre-surgical planning
3
Q
what are the disadvantages of cytology?
A
- May not fully represent lesion
- May not exfoliate
- No tissue architecture
4
Q
What can FNA be used for?
A
- Solid masses
- Swellings
- Organs (ultrasound guided)
- Bone marrow
5
Q
What can impression smears be used to evaluate?
A
- Biopsies
- Organ tissues (ectomies)
- Bone marrow
6
Q
What can scrapings and brushings be used to evaluate?
A
- Biopsies
- Firm tissue
- Corneal brush
- Oral/respiratory
- Vaginal swab
7
Q
What can fluids be used to evaluate?
A
- Effusions
- Joints
- Urine
- TTW/BAL
- CSF
- Prostatic wash
8
Q
What are your steps for FNA?
A
- Insert needle
- Redirect multiple times (with or w/o negative pressure)
- Withdraw (release negative pressure FIRST)
- Remove needle from syringe
- Draw back syringe
- Re-attach needle
- Expel onto slide
- Smear
9
Q
Non-aspiration: FNA
A
- Less blood/fluid contamination
10
Q
Aspiration: FNA
A
- Use of negative pressure while redirecting
- Firm tissue and less exfoliative lesions
11
Q
Sample collection: scraping
A
- Flat, dry cutaneous lesions
- Surface of firm biopsies
- Superficial only, contaminants
12
Q
What is Diff Quik?
A
- 1-2 mins, easy in clinic
- Confirm adequacy before submission
- Check 1-2 slides, submit others unstained
- May NOT stain mast cell granules
13
Q
Submission and handling
A
- Transport in a slide carrier (not just Styrofoam)
- *extremely susceptible to formalin fumes=blurry
14
Q
Approaching cytology: low power
A
- Adequate sample
- Cellularity (high, med, low)
- Where to look
15
Q
Approaching cytology: medium power
A
- Uniform vs. heterogenous
- Arrangement
- Extracellular material
16
Q
Approaching cytology: high power
A
- Cellular details (cytoplasm, nucleus)
- Granules, pigment, inclusions
- Organisms
17
Q
Sample adequacy
A
- Actually having cells on the slide
- Have intact cells
- Thin layer
- Minimal blood
18
Q
A
19
Q
Cell features
A
- Cytoplasm and nuclei
- Shape, colour, texture
- Borders can be indistinct=use nuclei to help distinguish cells
20
Q
Cell arrangements: cohesive clusters
A
- Look zippered together
- Tight edges to the cluster
- No space between cells
21
Q
Cell arrangements: aggregates
A
- Hard to tell from cohesive in the centre: look at edges
- Loose cells, look like could fall off
22
Q
Cell arrangements: individualized
A
- Cell border may be distinct or indistinct/wispy
23
Q
Cell types (3)
A
- Epithelial: cohesive clusters
- Mesenchymal: aggregates
- Round or discrete: individualized
24
Q
Degenerate vs. non-degenerative neutrophils
A
- NOT related to degenerative left shift
- Swollen nuclei
- Paler chromatin
- Segmentation less clear
- Ex. non-degenerate: crisp segments, dense chromatin: like a blood smear)
25
Macrophages
- Large cell
- Round/oval or kidney bean, eccentric nucleus
- Abundant cytoplasm
- Often vacuolated
- *phagocytic: pigment, RBC, WBC, organisms, foreign material
26
Bacteria
- Shapes: rods, cocci, filamentous (Nocardia & Actinomyces)
- Location
o Extracellular: may be contaminants
o Intracellular=septic inflammation
27
What are the different things used for criteria of malignancy?
- Pleomorphism: different shapes
- Anisocytosis: different sizes
- Anisokaryosis: different nuclei sizes
- High N:C ratio
- Bi/multinucleation
- Mitotic figures: atypical vs. typical
- Prominent/multiple nucleoli
- Angular or macronuclei
- Nuclear molding
28
Bacteria
29
30
Fungal Hyphae
31
Yeast
32
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