Cytopathology Flashcards
Based on spontaneous shedding of cells derived from the
lining of an organ into a cavity
Exfoliative Cytology
It is the simplest of the three sampling techniques
Exfoliative Cytology
Examples of Exfoliative cytology
Vaginal smear, sputum, urine, effusion
The material is collected spontaneously or by a syringe or a
cotton swab.
Exfoliative Cytology
Cells are obtained directly from the surface of the target of
interest.
Abrasive Cytology
Samples are taken by:
scraping; from cervix (pap smear), vagina, oral cavity (Buccal
mucosal smear), and skin lesions
Abrasive Cytology
Samples are taken by:
brushing, washing, and lavage: bronchi, GIT, and urinary tract
Abrasive Cytology
Examples: cervical scraper, endoscopy, and gastric lavage.
Abrasive Cytology
Samples can be obtained from superficial or deep lesions
Abrasive Cytology
The purpose of this procedure is to dislodge cells, enrich
the sample with cells obtained directly from the surface of
the target of interest.
Abrasive Cytology
Samples are obtained from solid tissue: body organs,
tumors & other swell
Fine Needle Aspiration Cytology
(FNAC)
Example of FNAC
lymph node, breast and thyroid
A needle with a syringe is used.
FNAC
Virtually every organ in the body is accessible to this
method
FNAC
Fixatives for Pap smear & FNA
95% ethyl alcohol
Fixatives does not result in lysis of RBC & better reserved of nuclear details
Fixatives
Fixatives for lysis of RBC
Carnoy’s fixative
Stain Mainly used in Exfoliative cytopathology.
Papanicolaou stain
Stain that is Good & better demonstration of nuclear details.
Papanicolaou stain
Stains Mainly used in FNA
Hematoxylin & Eosin (H&E)
Stains Mainly in FNA
Leishman & Giemsa stains
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Air drying
Air–dried Giemsa staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Staining with Giemsa
Air–dried Giemsa staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Staining with Pap’s or H&E
Wet–fixed Pap’s staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Well demonstrated cytoplasmic details
Air–dried Giemsa staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Excellent demonstration of nuclear details
Wet–fixed Pap’s staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Exaggerated cells & nuclear size
Air–dried Giemsa staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Excellent demonstration of nuclear details
Wet–fixed Pap’s staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Poorly seen individual cells
Air–dried Giemsa staining
Air–dried Giemsa staining or Wet–fixed Pap’s staining:
Clearly seen individual cells
Wet–fixed Pap’s staining
Histopath or Cytopath:
Deals with the form and the structure of the tissue.
Histopath
Histopath or Cytopath:
Deals with the changes within the nucleus
and cytoplasm of cells.
Cytopath
Histopath or Cytopath:
Fine needles with small gauge are usually preferred so it is less invasive and traumatic.
Cytopath
Histopath or Cytopath:
Basic stain is H&E.
Histopath
Histopath or Cytopath:
Basic stain is Pap stain (However H&E could be used as well.)
Cytopath
Histopath or Cytopath:
Diagnosis obtained after days
Histopath
Histopath or Cytopath:
Rapid diagnosis that could be obtained within minutes.
Cytopath
Histopath or Cytopath:
Expensive means of diagnosis do not allow for repetition
Histopath
include cervicovaginal cytopathology, etc.
Gynecological Cytopathology
include cytopathology of all other organs.
Non-gynecological Cytopathology
include FNA of breast, FNA of thyroid, etc
Fine Needle Aspiration (FNA)
Two types of epithelia are present in female genital organs:
Columnar epithelium
Squamous epithelium
lining of uterus & endocervix.
Columnar epithelium
lining of ectocervix & vagina.
Squamous epithelium
usual process occurring in all women, as a result of hormonal effects. (Changes more in cytoplasm of cells more than nuclei)
Squamous Metaplasia
For reporting of cervico- vaginal cytology, _______ is currently used.
Bethesda system (1991)
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Cell arrangement: Exfoliated singly
Normal Squamous cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Cell arrangement: Cohesive sheets or groups
Metaplastic
Squamous cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Cell arrangement: Singly or discohesive sheets. Variable size & shape of cells.
Malignant
Squamous cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Abundant cytoplasm Well defined cell borders
Normal Squamous
cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Either pale to dense cytoplasm. Cytoplasmic processes. Poor defined cell borders
Metaplastic
Squamous cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Scant cytoplasm
Malignant
Squamous cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Centrally located nucleus.
Absent nucleoli.
Low N/C ratio.
Normal Squamous
cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Larger nuclei than normal. With or without nucleoli.
Metaplastic
Squamous cells
Normal, Metaplastic squamous cells, or Malignant squamous cells:
Variable size & shape.
High N/c ratio.
Prominent nucleoli.
Malignant
Squamous cells
Metastatic carcinomas to the serous surfaces are from
lung, breast, colon, stomach, & ovary
