Cytology

Question 1

nuclear characteristics of malignancy

Answer 1

• enlargemtne of the nucleus
• N:C ratio
• incrase in number and size of nucleoli
• hyperchromasia
• irregular chromatin pattern
• multinucleation
• abnormal mitosis

Question 2

cytoplasmic chracteristics of malignancy

Answer 2

• variation in staining reaction
• variation in shpes and size, bizzare shaped such as fibre cell or tadpole.
• increased vacuolation in adenocarcinomas
• cannbalism and phagocytosis

Question 3

pathogenesis of cervical cancer

Answer 3

• very vunerable to carcinogens at the early active phase
• may have a cell line emerge with neoplastic potential
• cell genome interferences and possible mutations
• initial chromosomal changes may remain
  dormant in the genome for years, to be
  triggered by other additional risk factors
• initiators and promotors involved
• multi factorial factors
• CIN seen leading up to cervical cancer

Question 4

3 characteritsics of pre cancerous lesions

Answer 4

• they are confined to the epitehlium and basement membrane
• they have no access to the bloodstream or lymphatics
• show no risk of spread

Question 5

BSCC grading system

Answer 5

• borderline nuclear changes
• CIN I mild dyskaryosis
• CIN II moderate
• CIN III severe

Question 6

NCI (national cancer institute) Bethesda system

Answer 6

• atypical sqaumous cells of undetermined significance
  LSIL - low grade sqaumous intraepithelial lesion (HPV or CIN I)
  HSIL - high grade sqamous intrepitheliail lesion (CIN II or III)

Question 7

3 characteristics of CIN

Answer 7

• basement membrane is intact
• no invasive pattern
• tumour cells are separated from the stroma

Sevre dyskaryosis and carcinoma in situ are very similar as they both do not invade the basement membrane. Remeber that the main differing factor from cervical cancer is invasion of the basement membrane

Question 8

general patient management guidelines

Answer 8

for borderline nuclear changes, HPV changes and mild dsykaryosis (CINI) 6 month follow up by cervical cytology and HPV dna testing

for CIN II and III, colposcopy examination and cervical biopsy

Question 9

malignant group characteristics

Answer 9

• loss of polarity
• lack of cytoplasmic perimter
• cell clumping, pleomorphism, anisonucleosis
• cannibalism and inclusion of cells
• abnormal mitosis with incomplte ellualr separation

Question 10

presence of alcohol in PAp stain

Answer 10

• greater cytoplasmic transparency
• overlapping cells are etter resolved
• sharp cytoplasmic contrast
• increased nuclear detail
• alcohol fixation