Cytology Introduction Flashcards
what are some possible causes of a lesion/mass?
infiltration of inflammatory cells
abnormal proliferation of cells
expansion by fluid or other substance
combination of the above
what are the advantages of cytology?
no special equipment
faster results
less invasive and less costly than tissue biopsy
individual cells can be examined more closely
what are the advantages of histopathology?
structural relationships/arrangements are maintained
allows evaluation of surgical margins
multiple recuts can be made from thee same sample
nondiagnostic samples are less common, because procedure does not rely on exfoliation of cells
what is the goal of the cytology sample collection technique?
obtain thin layer of intact, representative cells to facilitate staining and cytologic examination
what are the two fine needle aspirate techniques?
suction
non-suction
what are tissue imprints typically collected from?
a tissue biopsy sample collected for histopathology
what is done in tissue scraping?
tissue to be sampled is scraped with scalpel blade to dislodge cells, and resulting sample is spread on a slide
what should a cytology request include?
signalement
history
what is assessed in a sample?
sample quality
evaluation of cells and material present
interpretation
clinical approach
what do many failures in cytologic diagnoses or nondiagnostic results result from?
insufficient sample quality
why is thickness of a sample important in cytology?
if too thick can be difficult or impossible to interpret
cells in thick areas are usually understained
where can sample contamination of cytology come from?
lesion or surrounding tissue
sampling procedures and slide handling
what can non-representative samples result from?
missing the lesion during sampling
sampling wrong area of lesion
how can you handle things to reduce handling issues?
shipped in proper containers
do not ship cytology samples in the same box with formalin containers
if a fluid sample is shipped, also ship air-dried slides because cells with deteriorate in the fluid
when submitting cytology slides, what should you do?
put patient/site ID information on your slides
put sample on frosted side of slide if there
submit slides unstained
submit all slides collected
include history/description
in terms of interpretation, what are the basic assumptions?
sample is representative of aspirated lesion or tissue
sample has high enough quality for a meaningful interpretation
________________ hemorrhage may be impossible to distinguish cytologically from blood contamination
acute/ongoing
what is assessed in inflammatory lesions?
cell numbers
cell types and relative proportions
presence of infectious organisms
what is the primary evidence of sepsis or infection?
presence of infectious organisms
what do cystic or non-cellular lesions arise from?
accumulation of fluid or non-cellular material, rather than proliferation of cells or inflammatory infiltrates
what do fluid-filled cystic lesions usually appear as?
proteinaceous fluid with low cell counts
what do cholesterol crystals appear as?
clear, rectangular shapes, typically with a notch in the corner
what are inflammatory lesions characterized by?
increased number of inflammatory cells in cytology sample
what are neoplastic or hyperplastic lesions characterized by?
presence of population of epithelial, mesenchymal, or round cell in abnormal numbers and/or with abnormal morphology
what is cytologically interpreted in neoplastic lesions?
basic cell type
benign or malignant
specific cell type
what is the shape of epithelial cells often?
round
polygonal
cuboidal
what does presence of acini/tubules and/or cytoplasmic vacuolation suggest with epithelial cells?
glandular origin
do mesenchymal cells usually have good cytoplasmic borders?
no: indistinct, often with “trails” of cytoplasm
how well do round cells usually exfoliate?
well: highly cellular aspirate
what are some examples of anaplastic or poorly-differentiated cells?
anaplaxtic carcinomas or sarcomas
amelanotic melanoma
histiocytic tumors
what do the criteria of malignancy look at?
nuclear and cytoplasmic morphologic features suggesting rapid cell growth/division
what is anisocytosis?
variation in cell size
what is anisokaryosis?
variation in nuclear size between cells or within same cell
____________________ nuclear:cytoplasmic ratio is associated with malignancy
increased
what should you look at with nuclei for malignancy?
binucleation or multinucleation
what does nuclear molding indicate?
loss of contact inhibition
what should you look at for malignancy with mitotic figures?
increased number
unusual arrangements
what can inflammation cause?
criteria of malignancy in local non-neoplastic cell populations
