CYTOPATHOLOGY Flashcards
1
Q
refers to diagnostic techniques that are used to examine cells from various body sites to determine the cause or nature of disease
A
cytopathology
2
Q
when does the first era of cytopathology started
A
19th century
3
Q
the second era in cytopathology is about the _____ and ____
A
development and expansion
4
Q
father of cytopathology
A
dr.george papanicolaou
5
Q
the third era in cytopathology is about
A
consolidation
6
Q
important ferson in the 3rd era of cytopathology
A
Dr. Leopold Koss - diagnostic cytology
7
Q
what is being contributed or invented in the 4th era of cytopathology
A
the bethesda system for reporting cervical/vaginal cytology diagnosis
8
Q
microscopic examination of cells from different body sites for diagnostic purposes
A
diagnostic cytology
9
Q
refers to the microscopic study of cells that have been desquamated from epithelial surfaces
A
exfoliative cytology
10
Q
Exfoliative cytology recommended ___
A
detection of malignant cells
detection of precancerous cervical lesions in women
assessment of female hormonal status
for detection of genetic sex
for detection of infectious agents
11
Q
2 categories/type of specimen for cytopathology
A
gynecologic specimen
non gynecologic specimen
12
Q
gynecologic specimen
A
cervicovaginal smear (pap smear)
13
Q
cervicovaginal smear (pap smear) is can be obtained from what sites/smears
A
vaginal
endometrial
endocervical
14
Q
non gynecologic specimens
A
prostatic and breast secretions
gastric or bronchial secretions
pleural and peritoneal fluids
sputum
smears of urine sediments
csf specimen
15
Q
methods of smear preparatiosn
A
streaking
spreading
pull apart
touch/impression/imprint/abraded smear
16
Q
characteristics of an ideal smear
A
should be evenly spread
uniformly thin and flat
17
Q
why should the smear is uniformly thin and flat
A
to enable rapid drying and fixation
to permit optimal penetration of stain
18
Q
what are the specimens that require adhesives agent
A
urinary sediment
bronchial lavage specimen
specimen that utilizes proteolytic enzymes
19
Q
adhesive agents used for cytologic method
A
pooled human serum or plasma
celloidin ether alcohol
leuconostoc culture
20
Q
fixative we use for all types of effusion if there is some delayed in smearing
A
50% alcohol
21
Q
saccomano preservative is made up of
A
50% alcohol and 2% carbowax
22
Q
common fixatives we use
A
ether alcohol
95% ethanol
23
Q
best fixative we can use for cytopathology
A
ether alcohol
24
Q
fixative for routine preparation
A
95% ethanol
25
this fixative selectively lyses rbc
carnoy's fluid
26
this fixative provides a protective waxy coating for postal despatch
polyethylene glycol in alcohol
27
cell concentration technique uses what preparation
cytospin and sedimentation preparations
28
the cells are isolated via a series of centrifugation steps to concentrate the cells into a small suspension
cytospin and sedimentation preparations
29
is a paraffin embedded specimen derived from different fluids and aspirated materials
cell block
30
used for establishing a more definitive cytopathologic diagnosis
cell block technique
31
example of a more definitive cytopathologic diagnosis
microbiopsy
32
serves as a bridge between cytology and histology
microbiopsy
33
uses of cell block
architectural evaluation
categorization of tumors that are not possible for smear
special stains and IHC
immunophenotyping, molecular studies
as archival material for future studies
34
stain for air dried slides
romanowsky type stains
35
romanowsky type stains example
wright's giemsa stain
may grunwald
giemsa stain
diff-quick
36
stain for immediate fixated slides
papanicolaou stains
37
it is a polychrome staining reaction that results in well stained nuclear chromatin, differential cytoplasmic counterstaining and cytoplasmic transparency
papanicolaou staining method
38
cytoplasmic stains example
OG 6 (monochrome stains)
EA 36 (polychrome stain )
39
formalin-fixed cytology preparations must be stained with wither
H&E or papanicolaou stain
40
a cytoplasmic stain for mature (superficial cells)
OG 6
41
stain for immature vaginal cells (parabasal, intermediate cells)
EA 36 or 50
42
stains for cytochemistry that is for glycogen
PAS - periodic acid schiff
43
stains for cytochemistry that is for hemosiderin
perl's stain
44
stains for cytochemistry that is for mucins
alcian blue
45
stains for cytochemistry that is for fungal organism
grocott methenamine silver
46
stains for cytochemistry that is for acid fast bacilli
Ziehl-Nielsen stain
47
these specimen are obtained to exclude the possibility of malignancy or infectious agents
respiratory tract specimen
48
type of specimen for respiratory tract specimen
sputum, bronchoalveolar lavage, bronchial washing, bronchial brushing
49
cytologic collection and preparation of respiratory tract specimen
collect sputum at least 3 consecutive morning
collect every morning in a wide mounted jar containing saccamomano fluid
50
the collection is usually done to exclude the possibility of malignant tumors
gastrointestinal specimen
51
types of specimen for gastrointestinal specimen
gastric lavage
gall bladder
fine needle aspiration
52
cytologic collection and preparation of gastrointestinal specimen
8 hrs fasting before the gastric washing
53
the presence of malignant cells in serous effusions usually indicate
metastatic involvement
54
in peritoneal, pleural, and pericardial fluids
the jelly like clots forming after removal may prevented by adding ____ for every ____ aspirates
300 units of heparin for every 100 ml of aspirates
55
smears for breast secretion has _____ diagnostic yield for diagnosis of breast carcinoma
extremely low
56
spontaneous nipple discharge is usually a result of ____ in young patients
hormonal imbalance
57
Spontaneous nipple discharge is usually a result of hormonal imbalance in young patients, and when the secretion is bloody a __ should be considered clinically
benign intraductal papilloma
58
a sample of breast secretion must be smeared on a clean glass slide and immediately placed in fixative
t or f
truellau
59
urinary tract specimen is for the diagnosis of
malignancy in urothelial orgin
60
are prostatic carcinoma usually found in urinary specimens?
nope, rarely found
61
types of specimen for urinary tract specimen/smearing
voided urine
catheterized specimen
washing from bladder or renal pelvis
62
this type of specimen is important in diagnostic value in patients with a known history of cancer
body cavity effusions
63
___ is the first presentation of cancer of unknown origin
positive effusion of malignancy
64
types of specimen for body cavity effusions
pleural fluid
ascitic/abdominal fluid
peritoneal washing
pericard
cerebrospinal fluid
65
Cytologic Collection & Preparation of body cavity effusions
specimen is collected in a clean non sterile dry container
specimen place in a refrigerator if there is a delay
heparin does not interfere with cytologic preparation
1ml of csf is necessary for cytologic evaluation
66
is the study of cellular samples obtained from organs that do not shed cells spontaneously
fine needle aspiration
67
fine needle aspiration is obtained from organs that do not shed cells such as
breast
thyroid
lymph nodes
liver
lungs
skin
soft tissues
bones
68
useful in lesions that are easily palpable, like growth of skin, subcutaneous soft tissue tumors
thyroid, lymph nodes, salivary glands, and breast
fine needle aspiration
69
slide preparation of fine needle aspiration
recommend preparation of maximum 4 slides:
using 1-2 drops on each slide and using slide-pull technique (similar to the technique used for peripheral blood smears )
70
slide fixation for FNA
immediate fixation is important
95% alcohol
spray fixative
alcohol-acetone(papstain)
formalin
71
junction of endocervical and ectocervical mucosa
T-zone (transformation zone)
72
T zone is used for the detection of
dysplasias and carcinomas
73
type of specimen for T zone
squamous, columnar, and metaplastic cells
74
for Gynecologic specimen ___ is used for sample of endocervical canal
endocervical brush
75
for Gynecologic specimen ___ is used for patient with hysterectomy
vaginal scrape
76
for Gynecologic specimen ___ is used for hormonal evaluation
lateral vulvar scrape
77
for Gynecologic specimen ___ is used for localization of vaginal adenosis
four quadrant vulvar scrape
78
for Gynecologic specimen ___ is used for detetcion of herpectic lesions of carcinoma
vulvar scrape
79
this staining method will stain the cytoplasm a transparent blue
papanicolaou method
80
color range is predictable and of great value in identification and cell classification
papanicolaou method
81
staining method which is valuable in comparing cellular appearances in smears
papanicolaou method
82
characteristic of a mature superficial cell(cells found in cervico-vaginal smear)
polygonal squamous cells with 45-50um in diameter
83
pseudoacidophilia is observed due to
drying of smears especially before fixation
prolapse and drying of vaginal epithelium
infection
chemicals
84
true acidophilia of cervico-vaginal smear is when if it's under what influence
estrogen
85
medium polyhedral or elongated cells with basophilic vacuolated cytoplasm
intermediate cell
86
boat shaped intermediate cells with strong tendency to fold or curl on edges
navicular cells
87
suggest of the combined estrogen-progesterone effect
navicular cells
88
seen in latter half of menstrual cycle, durinhg pregnancy, and menopause
navicular cells
89
pregnancy cells are shaped ___
round, oval, or boat shaped cells
90
nucleus pushed aside or towards cell membrane
pregnancy cells
91
with double walled boundary appearance (deep blue stain of the cytoplasm at the periphery )
pregnancy cells
92
round to oval cells with small dense basophilic cytoplasm
parabasal cells
93
Similar to fried fresh eggs with sunny side up
Parabasal cells
94
Parabasal cells size
15-30 um in diameter, smaller than IC, have a larger vesicular nucleus
95
Found from two weeks of age to puberty
Parabasal cells
96
After childbirth, with abortions and after
menopause
Parabasal cells
97
* Small cells, slightly cylindrical with less basophilic
cytoplasm
Endometrial cells
98
* tightly packed groups of 3 or more
Endometrial cells
99
* found during and 1-10 days after menstruation
Endometrial cells
100
shed in response to ovarian hormone
Endometrial cells
101
occur in large groups or small sheets
Endocervical glandular cells
102
cytoplasm stained pale blue/gray, finely vacuolated
Endocervical glandular cells
103
* present a honeycomb apperance
Endocervical glandular cells
104
G(+), slender rod-shaped m.o.
Doderlein Bacillus (Lactobacillus acidophilus)
105
comprising the most commont
organism found in a normal
vaginal flora
Doderlein Bacillus (Lactobacillus acidophilus)
106
staining blue to lavender with
Pap’s stain
Doderlein Bacillus (Lactobacillus acidophilus)
107
numerous in the Corpus luteum
phase a during pregnancy
Doderlein Bacillus (Lactobacillus acidophilus)
108
candidiasis commonly seen in
diabetic patients,
pt’s taking oral contraceptives,
immunocompromised states,
leukemia and lymphoma
109
pear shaped bacteria found in woman's genital
Trichomonas vaginalis
110
Mucus on drying, exhibit a “fern” or palm-leaf
pattern (arborization)due to formation of salt
crystals in high NaCl concentration in cervical
mucus under the influence of estrogen.
Ferning
111
is the percentage of cells staining pink-orange to red with Pap’s smear
Acidophilic Index
112
not reliable index due to the possible pseudoacidophilia
Acidophilic Index
113
Quantitation Evaluation for Vaginal Cytology
acidophilic index
pyknotic index
maturation index
114
is the percentage of cells with shrunken, dark, small structureless nuclei
Pyknotic index
115
is the percentage of cells from the main layers of vaginal epithelium: superficial, intermediate and deep (parabasal and basal) cells
Maturation index
116
__is used as criterion for mature superficial cells
Pyknosis
117
classification of pap test results
class I means
negative for malignant cells
118
classification of pap test results
class II means
atypical cells present but negative for malignancy
119
classification of pap test results
class III means
suspicious for malignant cells
120
classification of pap test results
class IV means
strongly suggestive for malignant cells
121
classification of pap test results
class V means
conclusive for malignant cells
122
specimen adequacy categories
satisfactory
limited
unsatisfactory
123
pap smear specimens are considered satisfactory for interpretation if there are:
* Adequate numbers of well-visualized squamous cells
present
* Adequate numbers of well-visualized endocervical cells or
squamous metaplastic cells (from the transformation zone)
* Less than 50% of the cells obscured by blood or
inflammation
* Properly labeled specimens
124
pap smear specimens are considered unsatisfactory for interpretation if there are:
* Inadequate numbers of well-visualized squamous cells
present
* Inadequate numbers of well-visualized endocervical cells or
squamous metaplastic cells (from the transformation zone)
* More than 75% of the cells obscured by blood or
inflammation
* Improperly labels specimens
* Usually, these specimens are recommended for repeat
sampling
125
pap smear specimens are considered rejected for interpretation if there are:
* Specimen is submitted without a requisition
* Specimen is not labeled with the patient’s name
* The patient’s name (or other identifying information) on the
specimen and requisition do not correspond
* The specimen is labeled appropriately but the requisition is
not labeled
* The specimen slide is irreparably broken
* Specimen is submitted from an unauthorized source
126
