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ECNU - CCE Examination > Cytology For The Endocrinologost > Flashcards

Cytology For The Endocrinologost Flashcards

1
Q

Which stain is used in cytology slides?

A

Diff Quick

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2
Q

Which preservative is used in cytology slides?

A

Formalin of Cytolyt

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3
Q

How is a direct smear done?

A

Can be done like a peripheral blood smear or “book technique”

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4
Q

What is cytospin?

A

Centrifugation of needle washings onto a slide, to concentrate material.

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5
Q

What is a cell block?

A

Needle washing is spun down and clotted to embed and cut like tissue.

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6
Q

What are the two fixation techniques used in preparing slides?

A
  • Air drying

- Alcohol fixed

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7
Q

Which stains need the air drying method for fixation?

A
  • Diff-Quick

- Wright-Geimsa

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8
Q

What is the disadvantage of air drying method of fixation?

A

Cells tend to ‘spread out’ introducing some distortion.

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9
Q

What two types of alcohol fixation methods are they?

A
  • Dip

- Spray

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10
Q

Which stains are best with the alcohol method for fixation?

A
  • Pap

- Hematoxylin and Eosin

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11
Q

What is the advantage of alcohol fixation method?

A

Preserves the cytomorphologic detail.

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12
Q

What is Diff-Quick good for?

A

Good for nuclear size and shape.

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13
Q

What color is cytoplasm in Diff-Quick?

A

Pink

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14
Q

What color are nuclei in Diff-Quick?

A

Purple

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15
Q

What color is cytoplasm in Papanicolaou?

A

Pink-orange to green-grey

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16
Q

What color are nuclei in Papanicolaou?

A

Purple to blue

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17
Q

What is Papanicolaou good for?

A

Nuclear detail

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18
Q

What is Hematoxylin and Eosin stain good for?

A

Classic tissue stain for cell block material.

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19
Q

What color is cytoplasm on Hematoxylin and Eosin stain?

A

Pink

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20
Q

What color are nuclei on Hematoxylin and Eosin stain?

A

Purple

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21
Q

What are the three stains in the Diff-Quick?

A

First - 95% alcohol
Second - Orange G
Third - Hematoxylin

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22
Q

How long is the slide dipped into each of the three solutions in Diff-Quick?

A

30 seconds each.

23
Q

What four things are assessed with checking for adequacy?

A
  • Cellularity
  • Cell types
  • Colloid
  • Architecture
24
Q

Adequate:

____ groups of well-preserved cells with each group having at least _____ cells.

A

5 - 6 groups

10 to 15 cells

25
Q

Adequate:

Greater than ____ cell groups with at least ____ well-preserved cells per group.

A

8 cell groups

10 cells per group

26
Q

The Papanicolaou Society of Pathology defines an adequate thyroid FNA biopsy as:

_____ groups of well-preserved follicular cells (____ cells per group)

A

6 - 8 groups

10 or more cells

27
Q

The Papanicolaou Society of Pathology defines an adequate thyroid FNA biopsy as:

_____ groups of follicular cells on at least ____ slides from separate passes with a minimum of _____ clusters of follicular cells (____ cells/cluster)

A

6 groups
2 slides
10 clusters
20 cells/cluster

28
Q

What four things are needed for ROSE (rapid on-site evaluation)?

A
  • Patient sample on immediately prepared slides
  • Diff Quick stains
  • Microscope
  • Ability to recognize and count follicular cell and Hurthle cell clusters
29
Q

What is the billing code for the first pass?

A

88172

30
Q

What is the billing code for each subsequent pass after the second?

A

88177

31
Q

Billing for ROSE

Documentation must exist stating what was seen on each pass and if it was adequate or not.

True or false?

A

True

32
Q

Is a CLIA license needed for FNA biopsy with ROSE (rapid on-site evaluation)?

A

No

33
Q

What 6 categories exist in the Bethesda system for reporting thyroid cytopathology?

A
  • Non-diagnostic or Unsatisfactory
  • Benign
  • Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance
  • Follicular Neoplasm or Suspicious for a Follicular Neoplasm
  • Suspicion for Malignancy
  • Malignant
34
Q

If Bethesda system reports:

Non diagnostic or Unsatisfactory

Then what’s the usual management?

A

Repeat FNA with ultrasound

35
Q

If Bethesda system reports:

Benign

Then what’s the usual management?

A

Clinical follow-up

36
Q

If Bethesda system reports:

Atypical of undetermined significance or follicular lesion of Undetermined Significance…

Then what’s the usual management?

A

Repeat FNA

37
Q

If Bethesda system reports:

Follicular neoplasm or Suspicious for a follicular neoplasm…

Then what’s the usual management?

A

Surgical lobectomy

38
Q

If Bethesda system reports:

Suspicious for malignancy…

Then what’s the usual management?

A

Near-total thyroidectomy or surgical lobectomy

39
Q

If Bethesda system reports:

Malignant…

Then what’s the usual management?

A

Near-total thyroidectomy

40
Q

What should the glass slides be labeled with?

A

Pencil

41
Q

What four things can cause unsatisfactory / non-diagnostic classification of FNA sample?

A
  • Cyst fluid
  • Acellular
  • Blood only
  • Foreign material
42
Q

What four things can cause benign classification of FNA sample?

A
  • Hyperplastic nodule
  • Lymphocytic thyroiditis (Hashimoto’s or Graves’ disease)
  • Granulomatous thyroiditis (Reidels)
  • Acute thyroiditis
43
Q

What four types of cells / cellular material do you see in lymphocytic thyroiditis?

A
  • Follicular cells
  • Hurthle cells
  • Variable colloid
  • Lymphocytes
44
Q

What five things can cause ‘follicular neoplasm or suspicious for a follicular neoplasm’ classification of FNA sample?

A
  • Follicular adenoma
  • Follicular carcinoma
  • Hurthle cell adenoma
  • Hurthle cell carcinoma
  • Rare hyperplastic nodules
45
Q

What four things can cause ‘suspicious for malignancy’ classification of FNA sample?

A
  • Papillary carcinoma
  • Medullary carcinoma
  • Metastatic carcinoma
  • Lymphoma
46
Q

What should you check for medullary carcinoma?

A

Calcitonin

47
Q

What 7 things can cause ‘malignant’ classification of FNA sample?

A
  • Papillary thyroid carcinoma
  • Poorly differentiated carcinoma
  • Medullary thyroid carcinoma
  • Undifferentiated (Anaplastic) carcinoma
  • Squamous cell carcinoma
  • Metastatic carcinoma
  • Non-Hodgkin lymphoma
48
Q

What are four histological signs of papillary thyroid carcinoma?

A
  • Enlarged follicular cells
  • Nuclear pseudo-inclusions
  • Nuclear grooves
  • Psammoma bodies
49
Q

Where does medullary thyroid cancer originate from?

A

C-cells

50
Q

What are five histological signs of medullary thyroid carcinoma?

A
  • Salt and pepper neuroendocrine nuclei
  • Abundant granular cytoplasm
  • Multi-nucleation
  • More discohesive
  • Plasmacytoid, follicular or spindled
51
Q

What is the only way to diagnose follicular carcinoma?

A

On surgical pathology

52
Q

What two types of follicular carcinoma are they?

A
  • Follicular type

- Hurthle

53
Q

What are five histological signs of follicular thyroid carcinoma?

A
  • Back to back follicles
  • Over-lapping nuclei
  • Scant colloid
  • Invasion through capsule
  • Lymphovascular space involvement
54
Q

What two possible diagnoses show pleomorphic atypical cells?

A
  • Anaplastic thyroid carcinoma

- Metastatic carcinoma

ECNU - CCE Examination (13 decks)

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