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Linde's Sets > Cytology > Flashcards

Cytology Flashcards

1
Q

What are the advantages of cytology? (4)

A

simple, quick sampling & examination
inexpensive
minimally invasive
Fast turn around time

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2
Q

When can cytology outperform routine histopathologic exam?

A

when cell detail is critical (round cell tumors)

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3
Q

What are the advantages of biopsy (histopath)? (4)

A

Provides info on tissue architecture
Grading
Invasion
Easier to perform immunohistochemical examination (unusual lesions)

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4
Q

What are some common mistakes made during sampling? (9)

A 
creating a vacuum w/ the syringe 
contaminating the sample w/ blood
only sampling the middle of the lesion
forceful spraying of the sample
too little or too much pressure 
Not blotting the fresh cut surface dry (imprint smears)
Open formalin jars close 
Refrigerating samples
Not adequately describing the lesion (providing too little info)
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5
Q

When is it appropriate to perform an actual aspiration?

A

If several attempts w/ the needle only have failed

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6
Q

Which type of cells can only be examined in cytology?

A

only INTACT cells

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7
Q

Why should you provide the DDX along with your cytology preps?

A

can comment whether or not the cytologic picture is consistent/inconsistent w/ each of the listed DDX

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8
Q

Systematic approach to Cytology Specimens

A
  1. Evaluate quality of smear
  2. Scan entire slide on low mag (4x)
  3. Assess cellular arrangement
  4. Decided if it’s inflammatory or neoplastic
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9
Q

What 3 things evaluate the quality of a prep?

A

Adequate amount of cells
Adequate spread (thin areas)
Adequate staining

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10
Q

What do you do once you have decided a prep is inflammatory?

A

Decided if septic or not

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11
Q

What are the 3 categories of neoplasia?

A

Round cell tumor
Epithelial tumor
Mesenchymal/spindle cell tumor

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12
Q

What are the 4 different cell-type classifications for inflammation?

A

Neutrophilic (suppurative, purulent)
Mixed
Mononuclear
Eosinophilic

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13
Q

What is seen in neutrophilic inflammation?

A

> 70% of inflammatory cells = neutrophils

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14
Q

What is seen in mixed inflammation?

A

50-70% neutrophils

remainder: macrophages &/or lymphoid cells

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15
Q

What is seen in mononuclear inflammation?

A

> 50% of cells are macrophages &/or lymphocytes

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16
Q

What are the 2 types of mononuclear inflammation?

A

Histiocytic/granulomatous

Lymphocytic

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17
Q

What does the presence of degenerate neutrophils suggest?

A

lesion was caused by bacterial infection

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18
Q

What are the common sites Histoplasma capsulatum infects?

A

lymph nodes
intestinal mucosa
bone marrow

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19
Q

What is the main inflammatory cell type seen in Histoplasma capsulatum infections?

A

macrophages

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20
Q

What are the common sites of infection for Blastomyces dermatiditis?

A

Draining skin lesions
lymph nodes
respiratory samples

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21
Q

What is the main inflammatory cell type seen in Blastomyces infections?

A

mostly neutrophils w/ some macrophages `

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22
Q

What is the common site of infection for Dermatophilus congolensis?

A

scaly, scabby, cutaneous lesions in cattle

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23
Q

What is the main inflammatory cells seen in the lesions of Dermatophilus?

A

few, mostly keratinzed squamous cells/debris

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24
Q

What is the common site of infection for Sporotrichum schenkii?

A

draining lesions of cats

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25
Q

What is the main inflammatory cells seen in the lesions of Sporotrichum?

A

neutrophils, possible degenerate

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26
Q

What are the common sites of infection for Leishmania?

A

lymph nodes

bone marrow

27
Q

What is the main inflammatory cells seen in lesions of Leishmania?

A

macrophages

28
Q

_____ glands will have relatively normal appearing cells.

A

Hyperplastic

29
Q

What are some examples of discrete or round cell neoplasms? (6)

A 
mast cell tumor
Canine cutaneous histiocytoma
Melanoma (benign/malignant)
TVT
Cutaneous lymphosarcoma
Cutaneous plasmacytoma
30
Q

What are some examples of BENIGN epithelial neoplasms? (6)

A 
Perianal gland adenoma
kertoacanthoma
Sebaceous gland adenoma
Basal cell tumor/carcinoma
Papilloma
Many mammary gland tumors
31
Q

What are some examples of MALIGNANT epithelial neoplasms? (3)

A

Squamous cell carcinoma
Adnexal gland carcinoma
mammary gland carcinoma

32
Q

What are some examples of BENIGN non-epithelial neoplasms?

A

Lipoma
Fibroma
Hemangiopericytoma

33
Q

What are some examples of MALIGNANT non-epithelial neoplams?

A 
Fibrosarcoma
Osteosarcoma 
Liposarcoma
Chondroscarcoma 
Rhabdomyosarcoma
34
Q

What 3 malignant non-epithelial neoplasms are invasive to the SQ?

A

Osteosarcoma
Chondrosarcoma
Rhabdomyosarcoma

35
Q

How is determination of malignancy usually based?

A

Based on the morphologic features of pleomorphism

36
Q

What are the “Cytologic Criteria of Malignancy”?

need to have >3

A 
Anisokaryosis
Variable N:C ratio due to large nuclei
Poikilokaryosis
Abnormally prominent or multiple nucleoli w/ variable sizes/shapes
ABNORMAL mitotic figures
Nuclear molding
Increased cytoplasmic basophilia
Abnormal cytoplasmic vacuolization &/or secretory granules
37
Q

Cytologic characteristics of round cell (discrete) tumors?

4

A

round cell w/ round nuclei
Individual appearance of cells
Well defined cell borders
Good exfoliation

38
Q

When is it difficult to distinguish a histiocytoma from an inflammatory lesions?

A

When the histiocytoma undergoes spontaneous regression

39
Q

Characteristics of epithelial cells (glandular & non-glandular)?

A

shape: round, oval, polyhedral or columnar
Arrangement: sheets, clusters or rafts
Well-differentiated cells have abundant cytoplasm
Can have cell-to-cell jxns
Exfoliate well

40
Q

Characteristics of spindle/mesenchymal cells (C.T.)?

A

Shape: elongated or spindle-form w/ cytoplasmic tails
Arrangement: individually or unorganized clumps of cells
Scant cytoplasm w/ indistinct cell borders
Exfoliate poorly

41
Q

What do you never do when interpreting lymph node aspirates? Why?

A

Interpret under-stained areas

will always look like lymphoma

42
Q

What are the 5 categories for Lymph Nodes?

A 
Normal
Hyperplastic/reactive
Lymphadenitis
Lymphoma
Metastatic neoplasia
43
Q

Cell types found in a “Normal” Lymph node?

A

> 90% small, mature lymphocytes
low #’s of medium to large lymphocytes
Occasional macrophage

44
Q

Definition of a hyperplastic lymph node.

A

Enlarged lymph node w/ cell proportions similar to normal tissue

45
Q

Cell types found in a “Hyperplastic” lymph node?

A

incr. # of MD to LG lymphocytes (still < 50%)

possible incr. in plasma cells & mitotic figures

46
Q

“Lymphadenitis” is due to ________.

A

incr. % of inflammatory cells

47
Q

Neutrophilic lymphadenitis

A

increase in neutrophils ( > 5%)

48
Q

Eosinophilic lymphadenitis

A

increase in eosinophils ( > 3%)

49
Q

Histiocytic lymphadenitis

A

increase in macrophages

50
Q

Celly types found in a “Lymphoma” lymph node?

A 
> 50% immature (MD to LG) lymphocytes
 (MONOTONY) 
Possible incr in mitotic figures
low #'s of small, mature lymphocytes
\+/- plasma cells
51
Q

Cell type found in a “Metastatic neoplasia” lymph node?

A

foreign cells

52
Q

What are the advantages of liver cytology?

A

complements other DX tools
may provide a specific DX
cheap, non-invasive, safe

53
Q

What are the limitations of Liver cytology.

A

best for diffuse lesions

Does NOT replace histopathology

54
Q

What is the gold standard for examining liver cytology?

A

histopathology

55
Q

What are the parts of the respiratory tract that can be evaluated by cytology?

A

Nasal cavity-nasal flush
Airways- LRT by trans tracheal wash or BAL
Lungs (paranchyma)-FNA
Thoracic Cavity- Pleural flush

56
Q

What do you need to do before you collect a histopathology/cytology sample of the nasal cavity?

A

Check clotting function and CBC

57
Q

Are nasal swabs useful for cytology?

A

Sometimes, if lots of discharge is present, can ID fungal infections, but it is often nonspecific and only ID’s inflammation.

58
Q

What is the best way to collect cells from the nasal cavity?

A

Nasal Flush

59
Q

What are normal findings in nasal cytology?

A

Low cellularity
small amounts of mucus
Low numbers of extra cellular bacteria (normal flora)
Epithelial cells

60
Q

What do normal epithelial cells of the nasal cavity look like?

A

Non-keratinized squamous with surface bacterial.
Cilliated colomnar respiratory epithelium
goblet cells

61
Q

What are abnormal cytology findings from the nasal cavity?

A

Rhinitis (inflammation)- Neuts, Macs, lymphos, plasma cells with or w/o fugni or bacteria
Increased mucus & goblet cells
Changes to epithelial cells- hyperplasia, dysplasia, metaplasia

62
Q

What are the 4 types of rhinitis and what cells do you find?

A

BacT- degenerate Neuts w/ IC bacT. (2ary to foriegn body)
Fungal- Neuts and Macs maybe fungi, can be hard to dx
Allergic- Eos, Neuts, Mast & Plasma cells (rare)
Chronic-Lymphos, plasma cells, Macs and Neuts

63
Q

What types of Neoplasia occur in the nasal cavity?

A

Adenocarcinoma, squamous cell carcinoma and lymphoma (cats)

64
Q

Can neoplasia be Dx via nasal flush?

A

Yes but often require histopathology. Need to be able to differentiate btwn hyper/meta/dysplasia

Linde's Sets (16 decks)

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