Cytology: sampling and prep Flashcards

1
Q

What is cytology?

A
  • study of cells
  • called cytopathology in human medicine
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2
Q

What is wrong with this dog?

A
  • neoplasia of the skin
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3
Q

How would you take a sample from this dog?

A
  • use a fine needle
  • take the sample and put the cells on a glass slide and stain
  • also used for lesions within body cavities
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4
Q

What are the major differences between cytology and histopathology?

A

Cytology:

  • not highly invasive
  • no need for local anesthesia/ sedation
  • aspiration of individualised or grouped cells, loss of tissue architecture
  • less sampling processing
  • faster results
  • cheaper
  • not as accurate

Histopathology

  • more invasive
  • local anaesthesia/ sedation
  • aspiration of tissue, preservation of tissue architecture
  • prolonged sample processing
  • slower
  • more expensive
  • gold standard
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5
Q

What are the steps of cytological diagnosis?

A
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6
Q

Describe the techniques of sample collection

A
  • Fine needle aspiration (FNA)
    • cutaneous or subcutaneous masses
  • Impression smears
    • exudative skin lesions and prep of cytology smears from biopsy specimens
  • Tissue scrapings
    • indicated in flat skin lesions that cannot be easily aspirated/ on biopsy specimens that are poorly exfoliating
  • Swabs (ears, vaginal smears, fistulous tracts)
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7
Q

What are the 2 methods of FNA?

A
  1. Non-aspiration method: without applying suction with a syringe
    • useful in highly exfoliating, highly vascular lesions/ where cells are fragile
  2. Aspiration method
    • suction with a syringe attached to needle
    • needed in poorly exfoliating masses in order to increase the cell yield
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8
Q

Describe the steps of the aspiration method

A
  • mass stabilised by 1 hand
  • while the needle attached to the syringe is introduced to centre of mass
  • negative pressure applied using syringe to increase yield
  • needle re-directed several times while -ve pressure maintained
  • needle removed from syringe and air drawn into syringe
  • the needle is replaced onto syringe and some of the tissue in barrel and hub is expelled into one end of glass microscope slide
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9
Q

What can be a potential source of contamination in the aspiration method?

A
  • blood
  • becomes a haemodiluted sample
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10
Q

Describe the steps of the non-aspiration method

A
  • no negative pressure
  • barrel of the syringe is filled with air prior to the collection attempt to allow rapid expulsion of material onto glass slide
  • the needle is rapidly moved back and forth in a stabbing motion in an attempt to stay along the same tract
  • needle is withdrawn and the material is expelled onto a clean glass slide
  • used when dont want blood contamination
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11
Q

How can sampling errors occur? (3)

A
  • Geographical miss
  • apiration from necrotic centre
  • aspiration from adjacent area of inflam
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12
Q

How do you make a cytology smear from excised tissue?

A
  • tissue trimmed so that a fresh surface is created for making the smear
  • surface of tissue is blotted several times against an absorbent material to remove excess blood and tissue fluid
  • tissue is gently pressed several times against the surface of a clean glass slide
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13
Q

What are the 2 methods of cytology smear prep?

A
  • squash prep method
  • needle spread/ starfish method
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14
Q

Describe the squash prep method

A
  • a portion of aspirate is expelled onto a glass microscope slide, and another is placed over the sample to spread it
  • gently digital pressure can be applied to the top slide to increase spread
  • smoothly slide the slides apart
  • may result in excessive cell rupture
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15
Q

Describe the needle spread/ starfish method

A
  • a portion of the aspirate is expelled onto a glass microscope slide
  • the tip of needle is placed in the aspirate and moved peripherally, pulling a trail of the sample with it
  • this is repeated in several directions (get multiple projections)
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16
Q

What does this show?

A

a well made smear

17
Q

What could have caused this excessive cell disruption during smear?

A
  • excessive pressure causing bare nuclei
18
Q

This slide shows inadequate spreading - why has this occured?

A
  • monolayer not formed - overlapping
19
Q

What staining is usually used in cytology?

A
  • Romanowsky-type
20
Q

Why must smears be air dried well?

A
  • helps cell fixation
  • and adhesion to slide
21
Q

What are the 2 types of Romanowsky stains?

A
  • Aqueous based (e.g. Diff-Quick)
  • Methanol based (e.g. Wright, Giemsa)
22
Q

What do aqeous based stains fail to do?

A
  • stain the granules of mast cells, basophils and large granular lymphocytes
23
Q

Which picture shows methanol/ aqueous based?

A
  • first one = methanol (see the granules better)
24
Q

What does it mean if a tumour is not very granulated?

A
  • not well differentiated
  • more likely to be aggressive
25
Q

What fluids can be studied using cytology?

A
  • abdomial fluid
  • thoracic fluid
  • joint fluid
  • cerebrospinal fluid
  • respiratory fluid
  • prostatic fluid
  • urine
26
Q

What do each of these show?

A
  • clear - transudate from abdominal/ thoracic cavity
  • cloudy/purulent - contains higher number of wbcs (inflam) - exudate
  • bloody
  • milky - type of chylous (large amount of lipid)
    • more pink if contains blood
27
Q

What are the steps of sedimentation?

A
28
Q

What are the steps of cytocentrifugation?

A
29
Q

How should you label a smear?

A
  • use a pencil
  • write on frosted edge to avoid erasing during fixation and staining
30
Q

How do you send glass slides to the lab?

A
  • use rigid, air tight containers to avoid breaking slides
  • and avoid exposure to formalin fumes