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Module 17 > Cytology: Inflammation & Cancer > Flashcards

Cytology: Inflammation & Cancer Flashcards

1
Q

what are the main differences between cytology and histopathology

A

cytology: relatively non invasive, rarely requires sedation or GA, minimal tissue disruption during sampling, rapidly performed, rapid results, cells only, cannot assess tumour grade, accurate assessment of tumour type may be impossible, cheap
histopathology: invasive, GA or sedation required, moderate tissue disruption during sampling, more time consuming, delay as sample is fixed/sectioned, larger more representative sample, tissue architechture interpreted, possible to assess tumour grade, immunohistochemical stains may allow accurate diagnosis, costly

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2
Q

what are the indications to perform cytology (8)

A
  1. skin and subcut masses
  2. lymphadenopathy
  3. intrathoracic and intra-abdominal masses
  4. body cavity effusions
  5. urine sediment
  6. traumatic catheterization (bladder neoplasia)
  7. prostatic washes, bronchoalveolar lavage
  8. bone marrow samples
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3
Q

what are the basics to collecting a good cytology sample (4)

A
  1. collection of good quality sample (non-aspiration, aspiration)
  2. prep of a good quality smear
  3. correct sample staining for in house analysis
  4. support of experienced and well trained clinical pathologist for external analysis
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4
Q

what are the benefits of non-aspiration sample (5)

A
  1. minimal cell disruption (tumour cells may be fragile)
  2. reduces hemodilution
  3. excellent for lymph node aspirates
  4. effective for many skin tumours (mast cell, lipoma)
  5. may not yield a cellular sample (mesenchymal cells)
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5
Q

how is an aspirate sample attained

A

use needle with syringe attached

suction can be continuous or intermittent

avoid needle exiting the tumour

often used if non-aspiration technique doesnt yield sample

can be ultrasound guided

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6
Q

what are the reasons for poor quality samples (5)

A
  1. poor technique
  2. intrinsic nature of the lesion being sampled (fibrous, vascular, cystic, necrotic)
  3. hemodilution
  4. dirty slides
  5. ultrasound gel contamination
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7
Q

what are potential complications of obtaining a sample (4)

A
  1. intro of infection
  2. hemorrhage
  3. pneumothorax
  4. tumour seeding
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8
Q

how do you prepare a cytology smear (7)

A
  1. fill syringe with air and attach, detach from needle first if aspiration method
  2. expel sample briskly onto slide
  3. prepare smear
  4. air dry quickly
  5. label carefully
  6. stain and examine in house
  7. send air dried, unstained smears to external lab
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9
Q

what are the stains used

A

modified romanowsky stain (diff quik rapid stain)

3 solutions

methancol (fixative)

solution I (eosinophilic dye)

solution II (basophilic dye)

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10
Q

what is the diagnostic approach to a cytology sample

A
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11
Q

what should you note on the first look

A

scan slide at low power (10x)

what is the cellularity?

how are the cells distributed?

are they inflammatory cells or tissue cells?

what is the background? (red cells)

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12
Q

what cells can indicate neutrophilic inflammation

A

neutrophilic inflammation (suppurative, acute)

degenerative change may be seen

bacteria may be seen (septic) ex. cat bite abscess, surgical site infection

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13
Q

what is shown here

A

neutrophilic inflammation

bacteria seen

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14
Q

what cells would be present in a pyogranulomatous inflammation and where would this be seen

A

macrophages and neutrophils

ex. foreign body reactions, fungal infections, chronic injury

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15
Q

what cells would be present in a granulomatous inflammation and where would this be seen

A

macrophages and lymphocytes

chronic inflammation, specific infections (mycobacteria)

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16
Q

what is an eosinophilic inflammation

A

allergic/hypersensitivity reactions

parasitism

eosinophilic granuloma

neoplasia: mast cell tumour, some lymphomas

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17
Q

what is an lymphoplasmacytic inflammation

A

allergic/immune reactions

chronic inflammation

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18
Q

what inflammation type is shown here

A

eosinophilic

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19
Q

what inflammation is shown here

A

granulomatous inflammation

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20
Q

what inflammation is shown here

A

pyogranulomatous inflammation

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21
Q

what types of cells can be present in neoplasia (3)

A
  1. round cells
  2. epithelial cells
  3. mesenchymal cells
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22
Q

what is the cellularity of round cells

A

high

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23
Q

what is the cellularity of the epithelial cells

A

high

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24
Q

what is the cellularity of samples of mesenchymal cells

A

low to high

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25
Q

what is the cell distribution of round cells

A

evenly distributed

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26
Q

what is the cell distribution of epithelial cells

A

clusters or rafts

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27
Q

what is the cell distribution of mesenchymal cells

A

discrete cells

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28
Q

what are the cell size/shape of round cells

A

round, distinct borders

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29
Q

what are the cell size/shape of epithelial cells

A

round to cuboidal

cell to cell borders

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30
Q

what are the cell size/shape of mesenchymal cells

A

spindle shaped

wispy cytoplasmic tails

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31
Q

what other features are commonly seen in round cells

A

distinctive morphology

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32
Q

what other features are commonly seen in epithelial cells

A

possible acini

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33
Q

what other features are commonly seen in mesenchymal cells

A

production of matrix

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34
Q

what are criterias of malignancy (7)

A
  1. pleomorphism
  2. increased nuclear:cytoplasmic (N:C) ratio
  3. immature (coarse) chromatin pattern
  4. prominent and/or multiple nucleoli
  5. multinucleation
  6. nuclear moulding
  7. increased and/or abnormal mitotic figures
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35
Q

what are pleomorphism changes seen in malignancy (4)

A
  1. cell shape
  2. cell size (anisocytosis)
  3. nuclear size (anisokaryosis)
  4. nucleolar size (anisonucleoliosis)
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36
Q

what origin is frequenlty seen in round cell tumours

A

hematopoietic orgin

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37
Q

what is the shape of the cytoplasm in round cell tumours

A

round shape with distinct cytoplasmic border and round to indented nucleus

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38
Q

what cell type is seen here

A

round cell tumour

39
Q

what are the round cell tumour types

A

LYMPH

L- lymphoma

Y- transmissible venereal tumour (TVT)

M- mast cell tumour

P- plasma cell tumour

H- histiocytic tumour

40
Q

what tumour type would this be

A

round cell tumour

lymphoma

41
Q

what cell tumour type is this

A

round cell tumour

lymphoma

42
Q

what cell tumour type is this

A

round cell tumour

lypmhoma

43
Q

what tumour type is this

A

round cell tumour

lymphoma

44
Q

what cell tumour type is seen here

A

round cell tumour

mast cell tumour

granulation

nucleus is difficult to see because there is purple staining granules within the cytoplasm

high #s of eosinophils because mast cell tumours release cytokines

45
Q

what cell tumour type is this

A

round cell tumour

mast cell tumour

46
Q

what tumour type is this

A

round cell tumour

mast cell tumour

47
Q

why do you need to be careful when staining mast cell tumours with diff quik

A

granules are not always picked up

48
Q

what tumour type is seen here

A

round cell

plasma cell tumour

very round nucleus that sits to one side of the cell, dark blue cytoplasm with clearing beside the nucleus

bi nucleation is seen more freq

49
Q

what tumour type is seen here

A

round cell tumour

plasma cell tumour

50
Q

what tumour type is seen here

A

round cell tumour

plasma cell tumour

51
Q

what tumour type is seen here

A

round cell tumour

histiocytoma

marcophage lineage, lots of cytoplasm that is pale in colour

common in young animals

52
Q

what tumour type is seen here

A

round cell tumour

histiocytoma

53
Q

what tumour type is seen here

A

round cell tumour

histiocytoma

54
Q

how do cells exfoliate in mesenchymal tumours

A

poorly

exfoliate as non-cohesive aggregates and/or individual discrete cells

55
Q

what are the shapes of mesenchymal cells

A

spindle to oval shaped with wispy cytoplasmic tails

56
Q

what cell tumour type is this

A

mesenchymal cells

57
Q

what can mesenchymal cells produce

A

matrix (pink)

58
Q

what is usually required to classify mesenchymal cells

A

histopathology

aspiration generally required

59
Q

what benign mesenchymal tumour types (5)

A
  1. fibroplasia
  2. inflammation: granulation tissue
  3. lipoma
  4. fibroma
60
Q

what tumour type is seen here

A

benign mesenchymal tumour

lipoma

61
Q

what tumour type is seen here

A

benign mesenchymal tumour

lipoma

62
Q

what are malignant mesenchymal tumour types

A

sarcomas (hemangiosarcoma, leiomyosarcoma, liposarcoma)

melanoma

soft tissue sarcoma

63
Q

what tumour type is this

A

malignant mesenchymal

sarcoma

64
Q

what tumour type is this

A

malignant mesenchymal

sarcoma

65
Q

what tumour type is seen here

A

malignant mesenchymal

sarcoma

66
Q

what tumour type is seen here

A

malignant mesenchymal

sarcoma

67
Q

where can epithelial cell tumours originate from

A

skin, resp tract, GI tract, urogenital tract, tumours of glands and organs

68
Q

how do epithelial tumours exfoliate

A

in cohesive clumps in rafts

69
Q

how are epithelial arranged

A

intracellular adhesions seen as tight line

70
Q

what are the shapes of epithelial cell tumours

A

polygonal, ovoid, round, angular, cuboid, columnar

71
Q

what tumour type is seen here

A

epithelial tumours

72
Q

what are benign epithelial tumours (4)

A
  1. follicular or epidermal inclusion cysts
  2. basal cell tumours
  3. sebaceous adenoma
  4. epithelioma
73
Q

what are malignant epithelial tumours

A

carcinomas

74
Q

what cell tumour type is this

A

epithelial tumour

75
Q

what tumour type is seen here

A

epithelial tumour

sebaceous adenoma

76
Q

what tumour type is seen here

A

epithelial tumour

77
Q

what arrangements can carcinomas be in

A

acinar, palisading, honeycomb, papillary etc

78
Q

what tumour type is seen here

A

epithelial cell

carcinomas

79
Q

what tumour type is seen here

A

malignant epithelial cell tumour

carcinoma

80
Q

what tumour type is this

A

malignant epithelial cell tumour

carcinoma

81
Q

what tumour type is this

A

malignant epithelial cell tumour

carcinoma

82
Q

what tumour type is seen

A

malignant epithelial cell tumour

carcinoma

83
Q

what tumour cell type is this

A

malignant epithelial cell tumour

carcinoma

84
Q

what tumour type is this

A

malignant epithelial cell tumour

carcinoma

85
Q

what tumour type is this

A

malignant epithelial cell tumour

carcinoma

86
Q

what is the cellularity of naked nuclei tumours

A

highly cellular

87
Q

how are naked nuclei tumours arranged

A

loosely adherent cell arrangement

occasional clusters

88
Q

what are the features of cell borders of naked nuclei tumours

A

indistinct cell borders

89
Q

what are the features of the nuclei in naked nuclei tumours

A

many free nuclei

nuclei round to indented

minimal anisokaryosis

90
Q

what are the origins of naked nuclei tumours

A

endocrine/neuroendocrine

anal sac adenocarcinoma

insulinoma

thyroid tumours

91
Q

what cell tumour type is this

A

naked nuclei tumour

92
Q

what cell tumour is this

A

naked nuclei tumour

93
Q

what tumour cell type is this

A

naked nuclei tumour

Module 17 (31 decks)

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