Cytology Flashcards
- Analyze exfoliated/abraded cells
- Major role in determining etiology of disease
CYTOLOGY
- CELLS SEPARATED FROM SUPERFICIAL OR DEEP
SEROSAL/MUCOSAL SURFACES - EARLY DETECTION OF MALIGNANCY
EXFOLIATIVE CYTOLOGY
Exfoliative Cytology
- IF SUGGESTIVE OF MALIGNANCY
BIOPSY
- CELLS TAKEN DIRECTLY FROM SURFACES OF
EXCISED/INCISED SPECIMENS
-TOUCH WITH A CLEAN GLASS SLIDE
IMPRINT/ABRADED CYTOLOGY
Vocab (imprint/ abraded cytology)
-to surgically remove a part of the body (via cutting off)
-to remove a body part from the body
Excised/ Excision
Vocab (imprint/ abraded cytology)
-to make a cut or opening in/on the body (usually with a scalpel)
-no extraction
Incised/ Incision
TECHNIQUES IN EXFOLIATIVE CYTOLOGY
- CELLS AND OTHER COMPONENTS ARE SPREAD
OUT THINLY IN A CLEAN GLASS SLIDE
-FOR GYNECOLOGIC MATERIALS (CERVICAL,
VAGINAL, VAGINAL POOL, AND ENDOMETRIAL
SMEARS)
SMEAR TECHNIQUE
TECHNIQUES IN EXFOLIATIVE CYTOLOGY
Perpendicular placement of glass slides
SMEAR TECHNIQUE: CRUSH TECHNIQUE
TECHNIQUES IN EXFOLIATIVE CYTOLOGY
Parallel placement of glass slides
SMEAR TECHNIQUE: PUSH-PULL TECHNIQUE
TECHNIQUES IN EXFOLIATIVE CYTOLOGY
-
PARAFFIN-EMBEDDED SPECIMEN DERIVED FROM
DIFFERENT FLUIDS/ASPIRATED MATERIALS
-MAINLY USED WITH SMEARS - ESTABLISH A MORE DEFINITIVE
CYTOPATHOLOGIC DIAGNOSIS
CELL BLOCK TECHNIQUE (“MICROBIOPSY”)
TECHNIQUES IN EXFOLIATIVE CYTOLOGY
- FREQ. USED IN SUSPECTED MALIGNANCIES
CELL BLOCK TECHNIQUE (“MICROBIOPSY”)
ADVANTAGES OF CELL BLOCK TECHNIQUE (“MICROBIOPSY”)
- Architectural evaluation
(histologic pattern of tumor) - Categorization of tumors that are otherwise not possible for smears 3. Special stains and immunohistochemistry
- Immunophenotyping, molecular studies (CISH, FISH, PCR)
- As archival material for future studies
CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values
SEROUS FLUID
20-30 mL
CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values
GASTRIC WASHING
5-10mL
CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values
URINE
3 SAMPLES, FIRST-MORNING-VOID, 50-100 mL
CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values
SPUTUM
SPONTANEOUS/NORMAL TECHNIQUE OR
INDUCED COLLECTION
CELL BLOCK TECHNIQUE (“MICROBIOPSY”)
STEPS
- Centrifuge fluid
- Decant supernatant
- Pour 1/2 of the sediments over 10% formalin for cell block until they harden
- Place hardened sediments for microtomy
- Process sediments for microtomy
- Stain using Papnicolau stain
- Mount sediments
- Label the slide
- COLLECT CELLS USING FILTER WITH SPECIFIC
PORE SIZE
MEMBRANE FILTER METHOD
MEMBRANE FILTER COMPONENTS
POLYCARBONATE + CELLULOSE ESTERS
- CYTODIAGNOSIS OF URINE, SPINAL FLUID,
BRONCHIAL WASHING, SUBS W/ ↓ CELLULAR CONTENT
MEMBRANE FILTER METHOD
- CELLS ARE ISOLATED VIA SERIES OF
CENTRIFUGATION STEPS -
CONCENTRATES CELLS INTO SMALL
SUSPENSION
CONCENTRATION TECHNIQUE
CYTOSPIN + SEDIMENTAION PREPARATIONS
CONCENTRATION TECHNIQUE
- ENABLES CELLS TO BE SPREAD IN A SINGLE LAYER
LIQUID-BASED CYTOLOGY
LIQUID-BASED CYTOLOGY
TWO COMMON METHODS
1. ThinPrep
2. SurePap
ADVANTAGES OF LIQUID-BASED CYTOLOGY
- Improved cell representation
- Improved specificity & sensitivity due to better fixation and well visualized nuclear details
- Abnormal cells are clearly seen & easily identified (not obscured by blood, mucus, & inflammatory cells which contribute to unsatisfactory smears)
- Remaining/ residual cell suspension can be used to make further cytological preparations or other tests (detection of HPV DNA and imunocytochemistry)
- USED TO OBTAIN SPECIMENTS THAT DO NOT SHED
CELLS SPONTANEOUSLY - USED FOR DIAGNOSING ANY PALPABLE LESIONS AND
DEEP-SEATED/NON-PALPABLE LESIONS
ASPIRATION CYTOLOGY
Aspiration Cytology Techniques
- MOSTLY ON PALPABLE SUPERFICIAL LESIONS
- HAS BOTH DIAGNOSTIC AND THERAPEUTIC
INDICATIONS
FINE-NEEDLE ASPIRATION BIOPSY (FNAB)
Aspiration Cytology Techniques
ACCURACY OF TEST MAY DEPEND ON SIZE OF
LESION (I.E. SMALLER = ↓ SENSITIVE)
FINE-NEEDLE ASPIRATION BIOPSY (FNAB)
- TEST FOR CERVICAL CANCER IN WOMEN
- HUMAN PAPILLOMAVIRUS (HPV)
PAPANICOLAOU SMEAR (PAP SMEAR)
Fill in the Blanks
”ALL __ ARE CAUSED BY __,
BUT NOT ALL __ CAUSE __.”
”ALL CERVICAL CANCER CASES ARE CAUSED BY HPV,
BUT NOT ALL HPV INFECTIONS CAUSE CERVICAL
CANCER.”
PAP Smear Specimen Requirements
AGES 21 TO 29
CERVICAL CYTOLOGY ALONE
EVERY 3 YEARS
PAP Smear Specimen Requirements
AGES 30 TO 65
CERVICAL CYTOLOGY ALONE
EVERY 3 YEARS W/ hrHPV TEST ALONE EVERY 5
YEARS OR BOTH TESTS EVERY 5 YEARS
PAP Smear Specimen Requirements
AGES < 21 & >65
NO TESTING
- IF SMEAR SHOWS EPITHELIAL CELL
ABNORMALITY: COLPOSCOPY & BIOPSY
PAP SMEAR DIAGNOSTIC TEST
PAP SMEAR TESTING PROCEDURE
- COLLECT CELLS FROM TRANSFORMATION ZONE
- PROCEED WITH EITHER LIQUID-BASED
CYTOLOGY OR CONVENTIONAL METHOD
