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Clin Path > Cytology > Flashcards

Cytology Flashcards

1
Q

Procedure for fine needle aspirate

A

1) Dont attach syringe
2) Insert needle, redirect more peripherally
3) Make smear - use enough but not too much presusure

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2
Q

Guage for FNA

A

22-25

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3
Q

Indications for FNA

A

1) Cutaneous mass of unknown origin
2) Enlarge LN
3) Masses on internal organs – use ultrasound

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4
Q

When do you make touch impression smear

A

Before dropping sample in formalin

1) Cut lesion in half
2) Ensure cut surface is free of fluid
3) Touch cut surface to slide (several per slide)

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5
Q

What do you collect fluid samples in

A
  • EDTA
  • Sterilin/red tops
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6
Q

Give six factors that make samples undiagnostic

A
  1. Placing near formalin
  2. Refridgerating smears
  3. Contaminated sample –> needs to be fresh
  4. Poor sampling and smearing techniques
  5. Breakage/leakage
  6. Staining (over, under)
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7
Q

Is this a diagnostic preparation? Describe it

A

No - there is nuclear streaking/debris

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8
Q

Is this a diagnostic preparation? Describe it

A

No - blood contamination

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9
Q

Is this a diagnostic preparation? Describe it

A

No - lack of spread

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10
Q

Is this a diagnostic preparation? Describe it

A

No - free or naked nuclei

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11
Q

Advantages of cytology (3)

A

1) Quick, easy (cheaper and faster than histopath)
2) Minimal risk to patient
3) Important screening tool – form diagnostic and treatment plans

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12
Q

Disadvantages of cytology (6)

A

1) Results depend on quality of sample
2) Diagnosis depends on skill of cytologist
3) Lack of tissue architecture – diagnosis limited to inflammation and neoplasia
4) Unable to grade neoplasm
5) Few diagnostic options for carinomas and sarcomas
6) False pos/False neg

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13
Q
A
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14
Q

What type of lesion is characterized by presence of inflammatory cells

A

Inflammatory lesions

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15
Q

Your sample has non-degenerate neutrophils, some lymphs and macs, but no bacteria. What kind of lesion is this? What are some expamples of its cause

A

Non-purulent (non-septic) inflammation

Causes:

  • Seroma
  • Foreign body
  • Necrosis
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16
Q

Describe degenerate neutrophils

A

Swollen nucleus, karylozyed (blobbed nucleus, rather than multi-segmented)

Cytoplasm stains more pink than purple

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17
Q

Your sample has mainly neutrophils which are noted to be degenerate. You also observe microorganisms. What type of sample is this? What follow up tests can you run

A

Neutrophilic septic inflammation

Caused by infectious microorganisms

Next step

  • Mixed or single bacterial population
  • Special stains (modified ZN, fontana, PAS)
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18
Q

Your sample is found to be neutrophilic septic inflammation, which you suspect is due to fungal infection. Which stains can you use to confirm? *

A

Fontana

Periodic acid schiff (PAS)

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19
Q

Your sample has mixed population of neutrophils and macrophages. What type of sample is this

A

Chronic-Active inflammation

(aka neutrophilic macrophagic inflammation)

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20
Q

Your sample is composed mainly of macrophages and multinucleated giant cells. What is going on?

A

Granulomatous inflammation

21
Q

Your sample has a mixed cel population with neutrophils and eosinophils. What is going on?

A

Eosinophilic inflammation

Due to hypersensitivity (allergic reactions)

22
Q

Neoplasms are characterized by changes in what

A
  • Changes in nucleus
  • Changes in cytoplasm
23
Q

What’s a benign round cell neoplasm called?

A

All round cell neoplasms are malignant

24
Q

What are epithelial cell neoplasms called

A

Benign = oma

Malignant = carcinoma

25
Q

What are spindle cell neoplasms called

A

Benign = oma

Malignant = sarcoma

26
Q

Main features of benign neoplasms (3)

A

1) Orderly cell proliferation - monomorphism
- Uniform size/shape of cells
- Uniform N:C ratios
- Uniform size, shape, number of nuclei
2) No inflammatory cells
3) No malignant cells

27
Q

Your lesion is a bloody, non-clotting fluid. You notice an absence of platelets. What is this?

A

Hematoma

28
Q

What cells are present in hematomas

A

First, RBCs

Then - erythrophages (= RBCs in macs)

Finally - hemosiderophages (= macs with hemosiderin (RBC products))

29
Q

The mass you sampled is hypocellular with few squames and few RBCs. What do you suspect?

A

Lipoma

30
Q

Which stains can you use for lipomas *

A

Sudan III

ORO

31
Q

You see clumps of benign tissue. This is indicative of….

A

Lipoma

32
Q

Your patient has a firm, painless mass in the submaxillary space. You remove a red-black, viscous fluid with clumps of mucin. What do you suspect?

A

Sialoceles

33
Q

Your sample has cell debris and squames. You also observe cholesterol crystals. What does this indicate?

A

Epithelioma/Epidermal cyst

34
Q

Name the benign neoplasms *

A

Hematoma

Lipoma

Siacoele

Epidermal cyst/Epithelioma

35
Q

Does this show a feature of malignancy?

A

Yes - anisocytosis (different sized cells)

36
Q

Does this show a feature of malignancy?

A

Yes - polymorphism

37
Q

Does this show a feature of malignancy?

A

Yes - cytoplasmic granules (red arrow) and cellular molding (green arrow)

Mast cell tumor!

38
Q

Does this show features of malignancy

A

Yes - cytoplasmic vacuoles, reduced N:C ratio, basophilic cytoplasm

39
Q

List cytoplasmic featuers of maligancy (6)

A
  1. Cellular molding - flattening out due to unregulated growth. Grow into each other
  2. Basophilia – blue cytoplasm
  3. Vacules - TVT
  4. Granules - MCT
  5. Various nucleus:cytoplasm ratio
  6. Pseudopod formation - lymphoma
40
Q

Cytoplasmic granulation is often seen in which malignant neoplasms

A

Mast cell tumors

Melanomas

41
Q

Cellular vacuolating is a sign of which tumor

A

TVT!

42
Q

Pseudopods are common in which tumor

A

Lymphomas

43
Q

Name nuclear features of malignancy (6)

A
  1. Poikilokaryosis: abnormal nucleus shape, nuclear fragmentation
  2. Anisokaryosis: different nucleus size
  3. Nuclear modling: nucleus molding into neighboring nucleus, concave appearance
  4. Binucleation/Multi-nucleation
  5. Prominent nucleolus
  6. Mitotic figures
44
Q

What’s this

A

Mitotic figure (nuclear feature of malignancy)

45
Q

Is this a malignant sample?

A
46
Q

Are these cells malignant

A

Yes - poikilokaryosis, anisokaryosis, nuclear molding

47
Q

Are these cells malignant

A

Yes - nuclear molding, multinucleation, chromatin clumping

48
Q

What are two consequences of using excessive pressure when making cytology slides

A
  1. Free/naked nuclei
  2. Nuclear streaking/debris

Clin Path (11 decks)

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