cytopathology

Question 1

Which branch of pathology interprets cellular characteristics?

Answer 1

Cytology

Question 2

What 2 types of samples would a cytological examination be performed on?

Answer 2

1. Body fluids (e.g: blood, urine and CSF)
2. Mass samples: materials that have been aspirated from the body.

Question 3

Cytology is not as specific as histology when it comes to interpreting a biopsy. What 2 characteristics would cytology be able to tell you about cells in a biopsy?

Answer 3

1. Whether the cells are atypical.
2. Type of carcinoma / lymphoma

Question 4

FNA is often indicated with well demarcated mass lesions. Which type of lesion would it not be helpful with and what would be done instead?

Answer 4

Diffuse lesions - an excisional biopsy would be better indicated.

Question 5

Describe the process of Fine Needle NON-Aspiration Cytology.

Answer 5

1. Needle (without syringe) is used to puncture the lesion.
2. Cells are drawn up by pressure / capillary action.

good due to less bleeding present

Question 6

What type of needle is used for FNA?

Answer 6

21-25G

Question 7

How many ml does the syringe hold in an FNA?

Answer 7

20 ml

Question 8

Describe how an FNA is undertaken.

Answer 8

1. Lesion fixed with 1 hand.
2. Needle inserted into the lesion.
3. 15-20ml suction applied.
4. Needle is moved backwards and forwards for up to 20-30 seconds.
5. Change direction of needle track.

Question 9

How can losing some of the sample be avoided following a FNA?

Answer 9

By drawing in some air after withdrawing the needle.

Question 10

Describe the process of depositing the sample onto a slide to be examined.

Answer 10

1. Remove the syringe from the needle and draw in air.
2. Replace the needle on the syringe and gently expel onto the slide.
3. Spread with a second slide.
4. Rapidly airdry or fix in alcohol and stain.

Question 11

List 6 advantages of the use of ultrasound in cytopathology.

Answer 11

1. Improves clinical evaluation.
2. Reveals impalpable abnormalities.
3. Targeting and aspiration in real time enhances sampling accuracy.
4. Allows the avoidance of blood vessels.
5. Loses sensitivity with depth and doesn’t penetrate bone.
6. Targets lesions down to 5mm.

Question 12

When might you get false positives when taking a FNA from the lymph nodes?

Answer 12

Post-radiotherapy or with epithelial inclusions.

Question 13

Name the most common primary salivary gland neoplasm found in practice.

Answer 13

Pleomorphic adenoma.

Question 14

What are 4 things that can be diagnosed from a lymph node FNA.

Answer 14

1. Reactive lymphadenopathy.
2. Specific Inflammation (e.g: TB)
3. Hodgkin’s or non-Hodgkin’s lymphoma.
4. Metastatic Carcinoma.