Cytology in practice

Question 1

advantages of cytology

Answer 1

quick, easy cheap
non-invasive
can be good diagnositic tool

Question 2

limitations of cytology

Answer 2

relies on sample quality

exp of examiner

Question 3

histopath

Answer 3

more expensive
slower - 48h
tumour grading
immunhistochemistry more avaiable

Question 4

what/where to sample - aspiration or imprints

Answer 4

superficial masses
lymph node
organs, deep masses

Question 5

what/where to sample - fluid

Answer 5

body cavities
joints
resp tract
cerebrospinal fluid

Question 6

fine needle biopsy

Answer 6

solid + fluid filled masses
visual/ultrasound guidance
similar to FNA but no -ve pressure
insert into mass several times - more representative
necrotic centre - sample wall + centre

Question 7

fine needle aspiration (FNA)

Answer 7

only if needle biopsy unrewarding
needle in centre of mass, apply -ve pressure
repeat 2-3x for representative sample
release plunger before removing needle

Question 8

touch impression (imprints)

Answer 8

good for excised tissue/superficial lesions

made before excised tissue in put in 10% buffered formalin + submitted for histopathology

Question 9

imprints

Answer 9

use fresh cut surface of tissue
blot till dry
imprint directly onto slide
4-5 imprints per slide

Question 10

collection of fluid

Answer 10

clot prevention - EDTA
bacteriology - sterile pot
slide prep - fresh

Question 11

inflammation vs neoplasia

Answer 11

sample mostly infl cells (WBC) or tissue cells (neoplastic)

if both, exp needed - one could be primary cause and the other secondary

Question 12

septic inflammation

Answer 12

bacteria/organisms
degenerate neutrophils
bacteria intracellular within neutrophils to be significant
if extracellular - contaminants

Question 13

non-septic inflammation

Answer 13

no bacteria/organisms
neutrophils non-degeneratie
no identifiable bacteria

Question 14

degenerative change in neutrophils

Answer 14

nuclear change
nucleus swells, loses lobulation + paler
secondary to release of bacterial toxins

Question 15

incr numbers of macrophages - causes

Answer 15

granulomatous infl - mycobacterium sp
if neutrophils also - pyogranulomatous infl - fungal
either can be seen with foreign bodies

Question 16

round cells

Answer 16

round/oval cell
round nuclei
well defined borders
good cell yield
advantage over histopathology

Question 17

round cell tumours

Answer 17

lymphoma
plasmacytoma
histiocytoma
hast cell tumour
transmissable venereal tumour (TVT)
(melanoma)

Question 18

epithelial cells

Answer 18

in sheets/rafts/cluster
cell-to-cell junctions
nuclei round + in centre
abudant cytoplasm
good cell yield
sebaceous, mammary, liver

Question 19

mesenchymal cells

Answer 19

individual or clumps
spindle - fusiform - stellate
indistinct cell border
long nucleus
matrix production

Question 20

cellular criteria of malignancy

Answer 20

anisocytosis - variation in cell size
macrocytosis - large cells
cell crowding

Question 21

nuclear criteria of malignancy

Answer 21

anisokaryosis - varying nuclear size
multinucleation - off numbers of nuclei
macrokaryosis - giant nuclei
high
incr + abnormal mitotic figures
nuclear-cytoplasmic ratio
coarse chromatin
nuclear moulding - deformation of nuclei by other nuclei

Question 22

mesenchymal tumour - what to beware of

Answer 22

granulation tissue has malignant features
well differentiated sarcoma can look benign
take biopsy

Question 23

mammary tumours

Answer 23

need to biopsy to differentiate between abscess, MCT or lipoma

Question 24

malignant tumours with uniform cells

Answer 24

thyroid carcinoma

Question 25

not seeing bacteria doesnt rule out ___

Answer 25

sepsis