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302: Histopathology and Genetics > Cytopathology > Flashcards

Cytopathology Flashcards

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1
Q

Serous membrane

  • Structure
  • Function
  • Examples
A

Two layers of cells that are composed of mesothelial cells.

  • Secretes small about of serous fluid to lubricate cavity
  • Any effusion is pathological.

Inner layer= visceral
- Lines body cavity

Outer layer= Parietal
- Lines body wall

Examples

  • Thoracic (pleura)
  • Pericardium
  • Tunica vaginalis (penis)
  • Abdominal
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2
Q

Formation and reabsorption of serous fluid

A

Capillaries in serous membrane are under hydrostatic and oncotic pressure

Fluid is reabsorbed into lymphatics, capillaries and venules

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3
Q

Transudate

  • Formation
  • Appearance
  • Cells
  • Examples
A

Plasma ultrafiltrate
- High hydrostatic, low oncotic

Appearance

  • Clear, pale yellow
  • Low protein, <3g/dL
  • Does not clot

Cells= very few

  • Deranged mesothelial
  • Few lymphocytes, macrophages

Examples

  • Cardiac
  • Cirrhotic
  • Nephrotic
  • Hypoproteinaemia
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4
Q

Exudate

  • Formation
  • Appearance
  • Cells
A

Unfiltered plasma
- Due to changes in vascular permeability

Appearance: cloudy/ yellow/ bloody. High protein (>3g/dL), clots

Many cells

  • Inflammation
  • May be malignant
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5
Q

Indications of pale yellow and watery effusion

A

Transudate

  • CCF
  • Cirrhosis
  • Hypoproteinaemia
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6
Q

Indications of turbid+ yellow-white effusion

A
  • Infection
  • Malignancy
  • Pancreatitis
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7
Q

Indications of milky white / greenish effusion

A

Chylous effusion from thoracic duct obstruction (trauma, lymphoma)

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8
Q

Indications of Milky green with a silky sheen effusion

A

Pseudochylous effusion caused by cholesterol from

  • TB
  • rheumatoid disease
  • old effusion
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9
Q

Indications of a brown effusion

A
  • Haemorrhage (trauma pancreatitis malignancy)

- Melanin

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10
Q

Indications of a green effusion

A

Bile from biliary tract disease or ruptured bowel

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11
Q

Indications of a gelatinous effusion

A
  • Hyaluronic acid from mesothelioma

- Mucin in pseudomyxoma

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12
Q

Mesothelial cells

  • N:C ratio
  • Appearance
A

Make up serous membrane

N:C ratio is variable
- Can have multiple nuclei

Perinuclear cytoplasmic density
Peripheral lacy border

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13
Q

Macrophages

A

Usually present in effusion

  • Foamy pale cytoplasm
  • Bean shaped nucleus
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14
Q

Lymphocytes in effusions

A

Present, but few

If pathological
- Obstructed circulation from lymph nodes: TB, lyphoma

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15
Q

Neutrophils in effusions

A

May be present

Indications

  • Infection: often degenerate
  • Infarction
  • GI disease
  • Foreign body
  • Early TB
  • Tumour- usually benign.
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16
Q

Eosinophils in effusions

  • Location
  • Indications
A

Often idiopathic
- Mainly in pleura

Indications

  • Air in pleura (increases with aspiration)
  • Infection
  • Infarction
  • Drugs
  • Dialysis
  • Allergies, asthma
  • RARE- Hodgkins
17
Q

LE cells

A

Lupus erythematous cell

A neutrophil/ macrophage that has phagocytosed a nucleus of another cells

18
Q

Features of malignant cells in effusions

  • Nucelus
  • Cytoplasm
A

Groups: clumps, balls papillae, glands.

Single= dispersed

Cell nuclei

  • Large
  • Larger N:C ratio
  • Irregular membranes
  • Coarse, irregular chromatin

Cytoplasm

  • Vacuoles
  • Mucin/ melanin/ keratin
19
Q

Breast Cancer cell features

A

DIFFUSE cell pattern

Groups
- Small single cells of lobular carcinoma

Cytoplasm

  • Intracytoplasmic lumina, may dilate
  • Microvilli and mucin
  • Indian files
20
Q

Lung Cancer cell effusion features

A

Different patterns of differentiation

Groups- papillary

Cytoplasm

  • Dense
  • Can be highly vacuolated
21
Q

Stomach cancer cell effusion features

  • Cell pattern
  • Cell types
A

Pattern

  • Usuually dispersed, single
  • May form papillae/ acini

Signet ring (cell with large vacuole)/ columnar cells

22
Q

Colorectal cancer cell effusion features

  • Cell pattern
  • Cell types
  • Nucelus
A

Pattern
- Papillary + acinar

Cells
- Columnar

Nucleus
- Palisades with nuclear membrane

23
Q

Features of mesothelioma

  • Pleura
  • Uni or bilateral?
  • Fissures
A

Nodular pleural thickening, diffuse

Unilateral

Thickening of fissures

24
Q

Features of fixing sample with alcohol

A

See nucleus in more detail

Cells are transparent, can see keratinisation

Can see

  • Squamous differentiation
  • Hyperchromasia
  • necrosis

Stain: H+E

25
Q

Features of air drying cytology sample

A

See cytoplasm better

Can see
- Micin, granules
- Metachromasia
- Microbial agents
-
26
Q

Causes of reactive lypmhadenopathy

A

Non-specific lymphoid hyperplasia

HIV

Mononucelosis

RA, SLE (CT disease)

Syphilis

27
Q

Granulomatous lymphadenitis

- Causes

A

TB

Infective
- Cat scratch, leprosy, histoplasmosis, brucellosis

Foreign body

Lymphoma
Carcinoma
Sarcoid

28
Q

Fine needle aspiration

  • Specificity and sensitivity
  • Accuracy
A

Specificity + Sensitivity high

  • 94-100
  • 81-100

Accuracy= 80%

False negative
- non-representative sampling

False positive
- Rare

302: Histopathology and Genetics (3 decks)

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