Cytology Flashcards
1
Q
What is Exfoliative Cytology?
A
examination of cells in body fluids (CSF, peritoneal, pleural, and synovial fluids), on mucosal surfaces (vaginal, trachea), or in secretions (semen, prostatic fluid and milk)
2
Q
What is the primary purpose of Cytology?
A
to differentiate inflammation from neoplasia
3
Q
What are several ways Cytology samples are prepared?
A
- impression smears
- compression or modified compression preparations
- line smears
- starfish smears
- wedge smears
4
Q
What are some Common Pitfalls of Cytology?
A
- improper specimen collection
- staining techniques are variable and subject to great error than standard staining methods
- formalin fumes near specimen collection or processing areas cause cells to become partially fixed and therefore unuseable for cytological evaluation
5
Q
What is Histopathology?
A
- evaluates cellular architecture
- preparation involves several complex steps and specialized equipment
6
Q
What is Cytology?
A
- evaluations observe cells individually or in small groups
- cells in cytology preparation are randomly distributed with no evidence of in vitro relation to one another
7
Q
What are methods of Sample Collection?
A
- swabs
- scrapings
- imprints
- fine needle biopsy
- tissue biopsy
- centesis
- transtracheal/bronchial wash
8
Q
When are Swabs collected?
A
only when imprints, scrapings and aspirates cannot be made
9
Q
What is the procedure for collecting Vaginal Samples?
A
- restrain animal in standing position with tail elevated
- clean and rinse vulva, insert lubricated speculum or smooth plastic tube to a point just cranial to urethral orifice in vagina
- cells collected are exfoliated from vaginal wall (epithelial cells and neutrophils) and pass through the vagina from the uterus
10
Q
What may Ear Samples contain that interferes with evaluation?
A
excess amounts of wax
11
Q
What is done to Ear Samples to remove the wax?
A
pass slide through a flame or gentle heat from a warm hair dryer to dissolve wax
12
Q
What can Smears of Scrapings be prepared from?
A
tissues collected during necropsy, surgery or from external lesions on a living animal
13
Q
What are Scrapings useful for?
A
collection of cells from firm lesions
14
Q
What are Major Disadvantages of Scrapings?
A
- more difficult to collect
- collect only superficial cells
15
Q
What is the Scraping Procedure?
A
- prepare scraping by holding a scalpel blade perpendicular to cleaned and blotted surface of lesion and pull blade across lesion several times
- transfer material collected on blade to middle of glass slide and spread like peanut butter
16
Q
What are Imprints prepared from?
A
external lesions on the living animal or tissues removed during surgery or necropsy
17
Q
What is the Imprint Procedure?
A
- to prepare imprints from tissues collected during surgery or necropsy, remove blood and fluid from surface of lesion being imprinted by blotting with a clean absorbent material
- touch middle of a clean glass slide against blotted surface to be imprinted
- make multiple imprints on each slide
18
Q
What should be done if a delay occurs from time of sample collection until imprint is taken?
A
use a scalpel blade to expose a fresh surface before blotting and making impression
19
Q
What is the Tzanch Preparation?
A
- prepare atleast 4-6 clean glass slides
- imprint lesion before it’s cleaned and designate as slide 1
- clean lesion with saline moistened surgical sponge and re-imprint on slide 2
- debride lesion and re-imprint on slide 3
- if scab was present, imprint underside of scab and labe as slide 4
20
Q
Where are Fine Needle Biopsys collected from?
A
masses including lymph nodes, nodular lesions, and internal organs
21
Q
What is the Aspiration Procedure?
A
- use a 21-25g needle and a 3-20ml syringe
- the softer the aspirated tissue, smaller the needle and syringe
- hold mass to be aspirated firmly to aid penetration of skin and mass and control direction of needle
- introduce needle, with syringe attached, into center of the mass, apply strong negative pressure by withdrawing the plunger to approximately 3/4 the volume of syringe
- widely sample mass by redirecting needle to several areas
- maintain negative pressure during re-direction and movement of needle
- when material is observed, relieve negative pressure from syringe and withdraw needle from mass and skin
22
Q
How do you prepare an Aspiration Slide?
A
- remove needle from syringe and draw air into syringe
- replace needle onto syringe, expel some tissue in barrel and hub of needle onto middle of glass slide by rapidly depressing plunger
23
Q
What is the Non Aspirate Procedure
A
- hold mass to be sampled firmly to aid penetration of skin and mass and help direct the needle
- introduce 22g needle into mass
- can leave syringe with plunger removed attached to needle to facilitate handling
- move needle rapidly back and forth through mass 5-6 times along the same track
24
Q
How do you prepare a Non Aspirate Slide?
A
- remove needle from mass and attach a 10ml syringe prefilled with air
- expel material onto a clean glass slide by rapidly depressing plunger
- repeat procedure 2-3 times in different sites to have adequate slide numbers and areas of mass to evaluate
25
What is a Tissue Biopsy?
sampling of a piece of tissue for cytologic and/or histopathologic examination
26
What are the techniques of collecting a Tissue Biopsy?
- gentle abrasion with a blade
| - excision including punch biopsy and endoscopic guided biopsy
27
Should you scrub a lesion or disrupt any scales, crusts or surface debris?
no
28
What is the fixative of choice for Histopathologic Samples?
10% neutral phosphate buffered formalin
29
How do you ensure adequate fixation of a Tissue Biopsy?
place slabs of tissue no more than 1cm wide, in fluid tight jars containing formalin at approximately 10 times the specimen's volume
30
How do you prepare a Tissue Biopsy to be sent off to an outside lab?
- blot specimen gently on paper towel
- place on small piece of wooden tounge depressor, allow tissue to dry to "splint"
- immerse or float specimens with attached "splint" specimen side down in fixative
31
What are the advantages of Wedge Biopsy?
- large, variably sized specimen
| - can be easily oriented by pathology tech
32
How is a Wedge Biopsy performed?
use a sharp scalpel blade to excise entire lesion or take a wedge from an area of the lesion, through a transition zone to normal tissue
33
What are Keyes?
cutaneous biopsy punches (4,6, 8mm disposable skin biopsy punches)
34
How many sutures do Punch Biopsy require?
1 or 2
35
What is Centesis?
introduction of a needle into any body cavity or organ to remove fluid
36
What Centesis procedures require general anesthesia?
CSF
synovial fluid
aqueous and vitreous humor
37
What needle and syringe is needed for a Centesis Procedure?
21g, 60ml
38
What is the Centesis Procedure for a Thoracocentesis on a Small Animal?
perform with animal in standing position
| -needle is inserted in 7th or 8th intercostal space along cranial aspect of rib
39
What position is an animal in during an Abdominocentesis?
standing or lateral
40
Cytologic samples obtained from trachea, bronchi or bronchioles may assist with diagnosis of what?
pulmonary diseases of animals
41
What is the Percutaneous Technique?
involves insertion of needle into trachea through cricothyroid membrane and infuse saline and collect fluid when animal coughs
42
What is the Orotracheal Technique?
involves placing an ET in an anesthetized patient and collecting fluid through a jugular or urinary catheter
43
What is the Bronchoalveolar Lavage Technique?
orotracheal technique used to collect samples from the lower respiratory tract
bronchoscopy is preferred
44
What is the Nasal Flush Technique?
used for collecting cytologic samples from nasal cavity to investigate diseases affecting the upper airway
45
What are the types of Smear Preparations?
- compression technique
- combination technique
- starfish smear
46
How is the Compression Technique Prepared?
- made by expelling aspirate onto middle of one slide and gently placing a second slide over aspirate horizontal with and at right angles to first slide
- spreader slide is quickly and smoothly slid across prep slide, do not place pressure on spreader slide
47
What is the Combination Technique?
procedure produces a slide that contains a compression preparation on the back 1/3 of the aspirate, the middle 1/3 is untouched, and the front 1/3 of the aspirate is gently spread similar to a blood smear
48
How is the Starfish Smear performed?
- drag aspirate in several directions with point of syringe needle to produce a starfish shape
- least damaging to fragile cells but allows a thicker layer of tissue fluid to remain around cells
49
Samples for cytologic examination should be placed in what tube?
EDTA tubes
50
What influences the selection of a smear technique?
cellularity, viscosity and homogeneity of fluid
51
What is a Line Smear?
like a blood smear except slide is raised directly upward 3/4 of the way through smear, yielding a line containing a much higher concentration of cells than the rest of the smear
52
What is a Wedge Smear?
like a blood smear
53
What is the fixative of choice for Cytology samples?
methylene blue
54
How long should prepared Cytology slides remain in fixative?
2-5 minutes
55
What type of stains are used for Cytology?
romanowsky stains
new methylene blue
panpanicolaou stains
56
When are slides sent to an outside lab?
when in house evaluation of cytology doesn't provide sufficent, reliable info, or for histopathology
57
What should be sent to the outside lab?
submit 2-3 air dried, unstained slide and 2-3 dried, stained slides
EDTA and/or sterile serum tubes of samples if applicable
58
What should be performed during Initial Microscopic Evaluation?
- perform initial evaluation of cytology with low magnification to determine if staining is adequate and to detect any areas of increased cellularity
- large objects (cell clusters, parasites, crystals, and fungi) will also be apparent if present
- use initial eval. to characterize cellularity and composition of sample by recording types and relative numbers of cells present
59
What should be done during Microscopic Evaluation?
- high power examination should be performed to evaluate and compare individual cells and further characterize types of cells present
- use oil immersion to identify and differentiate evidence of inflammation vs. neoplasia
- cytology report should indicate cell types present, appearance and relative proportions
60
What is Inflammation?
normal physiologic response to tissue damage or invasion by microorganisms
61
What are Cytology samples from inflammatory sites characterized by?
presence of WBC's particularly neutrophils and macrophages
62
What might occasionally be seen in Inflammation samples?
eosinophils and lymphocytes
63
What do fluid samples of Inflammation look like?
turbid and white or pale yellow
64
What is Suppurative (purulent) Inflammation?
presence of large numbers of neutrophils (usually >85% of total nucleated cell count)
65
What is Granulomatous or Pyogranulomatous Inflammation?
more than 15% macrophages present
66
What is Eosinophilic Inflammation?
greater than 10% of eosinophils + increased neutrophils
67
What do Neoplasia specimens usually contain?
homogenous populations of a single cell type
68
What is Benign Neoplasia?
hyperplasia with no criteria of malignancy present in nucleus of cells
69
What is Malignant Neoplasia?
cells displaying at least 3 abnormal nuclear configurations
70
What are the Nuclear Criteria of Malignancy?
- anisokaryosis, macrokaryosis
- pleomorphism
- high or variable N/C ratio
- increased mitotic activity (mitotic figures)
- coarse chromatin pattern
- nuclear molding
- multinucleation
- nucleoli that vary in size, shape and number: anisonucleolosis, macronucleoli, angular nucleoli, multiple nucleoli
71
What are the primary types of tumors encountered in vet med?
- epithelial cell tumors
- mesenchymal cell tumors
- round cell tumors
72
What are Epithelial Cell Tumors?
aka carcinoma or adenocarcinoma
| samples tend to be highly cellular and often exfoliate in clumps
73
What are Mesenchymal Cell Tumors?
aka sarcoma
| usually less cellular, exfoliate singly or in wispy spindles
74
What are Round Cell Tumors?
include: histiocytoma, lymphoma, mast cell tumors, plasma cell tumors, melenoma
exfoliate well but not usually in clumps or clusters
75
Lymph Nodes may show evidence of:
inflammation (lymphadenitis), hyperplasia (benign neoplasia), mixed (both inflammator and neoplastic cells present), neoplasia (lymph node cells with abnormal nuclear features) and metastasis (neoplastic cells from other body tissues that spread to lymph nodes)
76
What is Primary Lymphoma characterized by?
predominance of lymphoblasts, mitotic figures are common
77
What are other neoplastic cells that may be present in lymph node aspirates?
mast cells, carcinoma cells, sarcoma cells, histiocytes
78
What do "normal" Ear cytology samples contain?
cornified squamous epithelial cells with negligible evidence of inflammation and a few microorganisms
79
What are common abnormal findings in Ear Cytologies?
bacteria and yeasts with or without inflammation
80
What are abnormalities found in Ear Cytologies?
inflammation caused by sepsis, fungi and yeasts and neoplasia
81
Anestrus
bitch has no vulvar swelling and doesn't attract males
82
What cells are seen in Anestrus?
- predominately intermediate and parabasal cells
- superficial cells are absent
- may contain neutrophils, but no RBC's
83
Proestrus
swollen vulva with reddish discharge
attracts males
not accepting males
84
What cells are seen in Proestrus?
- high number of RBC's
- intermediate and parabasal cells
- RBC's gradually decrease, presence of superficial cells are seen
85
Estrus
swollen vulva
pinkish to straw colored discharge
accept males
attractive to males
86
What cells are seen in Estrus?
all squamous cells
| rising levels of estrogen
87
Diestrus
no vulvar swelling or discharge
no longer attracts males
no longer accepts males
88
What cells are seen in Diestrus?
neutrophils increase
RBC's
intermediate and parabasal cells
