Cytology Flashcards
When Evaluating Cytology Slides principally the Nucleus indicates what? And the Cytoplasm indicates what?
- Nuecleus - Indicates state of growth activity of a cell (euplasia, Proplasia, retroplasia, neoplasia)
- Cytoplasm - Indicates functional differentiation (lineage of cell)
What type of tumor is this?
Round Cell Tumour
Lymphoma
Note the Blue arrow pointing at a normal Lymphocyte
What should you look for within a cytology smear?
- Cell Populations
- List and define proportions of cell types (%diff. count) [Inflammatory of Monomorphic?]
- Sub-Cellular Morphology
- Nucleus and cytoplasm
- Background
- Protein, RBC’s, Foreign Organisms, Crystals, etc
What Features or Malignancy do you see here?
- High Nuclear/cytoplasmic ratio
- Anisokaryosis
- Nuclear molding (deformation by other nuclei)
When diagnosing Neoplasia from a cytology slide, what is used to :-
- Differente the type of tumour
- Diagnose the malignancy?
- Cytoplasmic appearance of cells is used to evaluate the degree of differentiation and the type of tumor
- Diagnosis of malignancy is based primarily on the nuclear criteria
What is Cytology?
The analysis of fresh cells collected from lumps, swellings, fluid and Urine.
When looking at cytology what do you look for to determine if it is inflammatory or not.
Presence of Neutrophils
By looking at these cytology pictures what can you tell me about them?
- They are both inflammatory reactions
- The second is acute inflammation as it consists of mainly neutrophils with maybe a monocyte and possibly an occasional lymphocyte but rarely a plasma cell
When looking at the background of a cytology slide what are we looking for?
- Cholesterol Crystals
- RBC’s
- Protein
WHat features or Malignancy do you see here?
- Marked variation in size, shape and number
- Irregular shapes with sharp angularity
- Enlarged Nucleoli
Describe how you would prepare a FNA slide?
Using the Squash Preparation technique
What 2 factors do we take into consideration when looking at cytology and trying to make a diagnosis?
- Tissue Type
- Type of Lesion Present
What are the Nuclear criteria of malignancy?
Must have at least four of these to be classed malignant
- Increased Nuclear-Cytoplasmic ratio
- Variation in nuclear size - anisokaryosis
- Increased mitotic figures
- Chromatin pattern - Clumping
- Multi-Nucleation
- Abnormal mitosis
- Nuclear Molding
What do the cells in the lymphnodes look like?
- Normal lymph nodes contain 75-90% small well differeentiated lymphocytes.
- THey contain a thin rim of cytoplasm and the nucleus is roundish to oval sometimes indented. It has dense clumps of dark chromatin and has no visible nucleoulus
Tissue/organ-specific cell types can be grouped into three basic forms based on their cytological characteristics. What are these 3 groups?
Why do we collect cell samples for Cytology?
- Detect and classify inflammation
- Determine the cause of an inflamatory response
- Detect the presence of Neoplasia
- Classify and define the neoplastic process
- Determine the cause of a body cavity effusion
- Aid in diagnosis of joint disease
- What is the preferred method for collecting cells from a mass for cytology?
- Why do we use this method?
- What are the two different techniques?
- What size needles do you use?
- Fine Needle Aspirate (FNA)
- Avoids superficial contamination, represents several areas of the mass
- Aspiration vs non-aspiration
- 21-23g needles only
What is hyperplasia?
Proliferation of normal cells
What features of Malignancy do you see here?
- Abnormal mitotic figures
- Binucleate cells with different sized daughter nuclei
How can you tell if the lymphnodes have inflammation within them?
Do a FNA and you will see Neutrophils and bacteria
What is
- Karyolysis
- Pyknosis
- Karyorrhexis
Round Cell Tumours have what indicators?
- Known as discrete cells (sit on their own and do not packet tightly)
- Cells appear as individuals
- Small to medium size
- Round Shape
- In cytology a diagnosis of malignancy of only possible when?
- What is required to make such a dianosis?
- When four or more nuclear criteria for malignancy are observed.
- Need adequate cell collection, Well preserved Cells, Minimal numbers of inflammatory cells, cannot make a diagnosis based on the appearance of a single cell.
What is the arrow pointing to?
Fungus
What is Anisocytosis?
Variation of Cell Size
What is Pleomorphism?
Variation in cell shape
What is the limitation of cytology?
- Not always definitive
- Inflammation is a complicating factor - Neoplasia vs dysplasia
What is the General approach to the evaluation of the cytology smear?
- Need a methodical approach
- Note the background of the smear
- Note the presence of red cells, crystals, debris
- Examine smear for the presence of nucleated cells
- Are cells normal or abnormal
- If abnormal - is the lesion inflammatory or non-inflammatory
- If have inflammation - is it septic or non-septic
- Non-inflammatory lesions may be either neoplastic or non-neoplastic
- If neoplastic attempt to identify tissue of origin
- Neoplasia may be malignat or benign
- Some neoplastic lesions may also have inflammation
Describe in a flow chart the general approach to a cytology smear
Where is a Mast cell tumor commonly found?
In the skin
What are the 5 round cell tumours?
- Lymphoma
- Histiocytoma
- Plasmacytoma
- Mast Cell Tumour
- Transitional Venereal Tumour
What is Anisokaryosis
Variation in nuclear size
- As inflammatory reactions progress what would you see more of?
- If these Cells are present how long at a minimum has the lump/mass been there for?
- You would see more macrophages and often these can be seen mopping up the inflammatory debris, including spend neutrophils and other cell detritus
- 4-5days minimum
