Cytology Flashcards
What does cytology no provide information on compared to histopathology?
Tissue architecture
tumor grading, IHC
What can be sampled for cytology?
Most things that are reachable wih a needle/visible on ulrasound. Fluids can also be sampled.
How is a FNB performed?
Using a small guage needle incert this into the mass several times. Need to sample wall is a mass has a necrotic centre. Expel onto a slide using an air filled syringe.
What should one remember when removing an FNA needle?
Release negative pressure on the syringe
What are the goals of smear preparation?
Thin areas with cell spread.
Minimize cell damage
Minimize blood content
When is a ‘touch impression’/’imprint’ made?
Prior to contact with formalin.
What things are key to making a good imprint?
Use a freshly cut surface of tissue and DRY the sample first.
Outline the systematic approach to assessing a cytology sample.
- Is the preparation adequeate and => diagnostic?
- Is there inflammatory or neoplastic change
3.Inflammatory - septic/non septic
Neoplasic - type of cell
- Benign or malignant
What things are indicative of sample quality?
Enough cells Preserved cells Spreading Representative of lesion? Are normal cells expected?
How can inflammation and neoplasia be distinguished?
inflammatory cells or tissue cells?
If both then inflammation cold be primary –> dysplasia or neoplasia can be primary –> inflammation`
What things indicate septic inflammation?
Degenerate neutrophils
Bacteria must be INTRAcellular
What causes neurophil degeneration?
Toxins released by bacteria
What should one be careful of when looking for signs of sepsis?
Stains can produce arifacts that look like bacteria
What might cause increased macrophages?
Granulomaous inflammation (mycobacteria)
Fungal infections (also neutrophils)
FB reactions
What do round cells look like?
Individual cells hat are round to oval in shape and nuclei with well defined cell borders. Will often see a high cell yield.
What are the things that cause round cell tumours?
Lymphoma Histiocytoma Mast cell tumour TVT Melanoma
What do epithelial cells look like on cytology?
Clusters
Large cells
Cell-cell junctions
Good cell yield
What do mesenchymal cells look like cytologically?
Small-med size
Poor cell yield
What are the things that indicate malignancy and in what diseases do they occur?
pleomorphism
Monotony - in lymphoid tumours this is a sign of neoplasia
What are the cellular criteria of malignancy?
Anisocytosis Macrocytosis Anisokaryosis Multinucleation Macrokaryosis High nuclear to cytoplasmic ratio Increased/Abnormal mitotic figures Coarse chromatin Nuclear moulding Macronucleoli variation in nucleaolar size/shape
What are the common things to lok out for when storing/submitting samples?
Fumes from formalin
Refrigerating glass slides
