Cytology Introduction

Question 1

what are some possible causes of a lesion/mass?

Answer 1

infiltration of inflammatory cells
abnormal proliferation of cells
expansion by fluid or other substance
combination of the above

Question 2

what are the advantages of cytology?

Answer 2

no special equipment
faster results
less invasive and less costly than tissue biopsy
individual cells can be examined more closely

Question 3

what are the advantages of histopathology?

Answer 3

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

Question 4

what is the goal of the cytology sample collection technique?

Answer 4

obtain thin layer of intact, representative cells to facilitate staining and cytologic examination

Question 5

what are the two fine needle aspirate techniques?

Answer 5

suction
non-suction

Question 6

what are tissue imprints typically collected from?

Answer 6

a tissue biopsy sample collected for histopathology

Question 7

what is done in tissue scraping?

Answer 7

tissue to be sampled is scraped with scalpel blade to dislodge cells, and resulting sample is spread on a slide

Question 8

what should a cytology request include?

Answer 8

signalement
history

Question 9

what is assessed in a sample?

Answer 9

sample quality
evaluation of cells and material present
interpretation
clinical approach

Question 10

what do many failures in cytologic diagnoses or nondiagnostic results result from?

Answer 10

insufficient sample quality

Question 11

why is thickness of a sample important in cytology?

Answer 11

if too thick can be difficult or impossible to interpret
cells in thick areas are usually understained

Question 12

where can sample contamination of cytology come from?

Answer 12

lesion or surrounding tissue
sampling procedures and slide handling

Question 13

what can non-representative samples result from?

Answer 13

missing the lesion during sampling
sampling wrong area of lesion

Question 14

how can you handle things to reduce handling issues?

Answer 14

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

Question 15

when submitting cytology slides, what should you do?

Answer 15

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

Question 16

in terms of interpretation, what are the basic assumptions?

Answer 16

sample is representative of aspirated lesion or tissue
sample has high enough quality for a meaningful interpretation

Question 17

________________ hemorrhage may be impossible to distinguish cytologically from blood contamination

Answer 17

acute/ongoing

Question 18

what is assessed in inflammatory lesions?

Answer 18

cell numbers
cell types and relative proportions
presence of infectious organisms

Question 19

what is the primary evidence of sepsis or infection?

Answer 19

presence of infectious organisms

Question 20

what do cystic or non-cellular lesions arise from?

Answer 20

accumulation of fluid or non-cellular material, rather than proliferation of cells or inflammatory infiltrates

Question 21

what do fluid-filled cystic lesions usually appear as?

Answer 21

proteinaceous fluid with low cell counts

Question 22

what do cholesterol crystals appear as?

Answer 22

clear, rectangular shapes, typically with a notch in the corner

Question 23

what are inflammatory lesions characterized by?

Answer 23

increased number of inflammatory cells in cytology sample

Question 24

what are neoplastic or hyperplastic lesions characterized by?

Answer 24

presence of population of epithelial, mesenchymal, or round cell in abnormal numbers and/or with abnormal morphology

Question 25

what is cytologically interpreted in neoplastic lesions?

Answer 25

basic cell type
benign or malignant
specific cell type

Question 26

what is the shape of epithelial cells often?

Answer 26

round
polygonal
cuboidal

Question 27

what does presence of acini/tubules and/or cytoplasmic vacuolation suggest with epithelial cells?

Answer 27

glandular origin

Question 28

do mesenchymal cells usually have good cytoplasmic borders?

Answer 28

no: indistinct, often with “trails” of cytoplasm

Question 29

how well do round cells usually exfoliate?

Answer 29

well: highly cellular aspirate

Question 30

what are some examples of anaplastic or poorly-differentiated cells?

Answer 30

anaplaxtic carcinomas or sarcomas
amelanotic melanoma
histiocytic tumors

Question 31

what do the criteria of malignancy look at?

Answer 31

nuclear and cytoplasmic morphologic features suggesting rapid cell growth/division

Question 32

what is anisocytosis?

Answer 32

variation in cell size

Question 33

what is anisokaryosis?

Answer 33

variation in nuclear size between cells or within same cell

Question 34

____________________ nuclear:cytoplasmic ratio is associated with malignancy

Answer 34

increased

Question 35

what should you look at with nuclei for malignancy?

Answer 35

binucleation or multinucleation

Question 36

what does nuclear molding indicate?

Answer 36

loss of contact inhibition

Question 37

what should you look at for malignancy with mitotic figures?

Answer 37

increased number
unusual arrangements

Question 38

what can inflammation cause?

Answer 38

criteria of malignancy in local non-neoplastic cell populations