Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2.2 Cellular Pathology > Diagnostic Cytology > Flashcards

Diagnostic Cytology Flashcards

1
Q

What is diagnostic cytology
(4)

A

The analysis of cytological specimens to aid the diagnosis of disease - not a screening test

Various body sites
Various specimen types
Various preparation techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is another application of diagnostic cytology other than in a hospital setting?

A

Cell analysis e.g.

Cell culture work
Morphological analysis of cells
Biochemical analysis
Molecular biology based analysis - genomics/proteomics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two diagnostic applications of cytology

A

Pathology e.g. morphological diagnosis

Differential diagnosis e.g. type/classification of pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some diagnostic applications of cytology in the lab

A

Benign vs malignant
Primary vs metastatic
Site of origin
Management strategies
Therapeutics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What body sites are samples for cytology from
(9)

A

Body cavities
Respiratory tract
Head and neck
Male/female genital tract
Urological
Neurological (CSF)
Soft tissue and bone
GIT
Organs and systems
- thyroid
- lymphoid
- breast
- liver
- kidney
- pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What specimen types would you expect in cytology

A

Fluids
Washings
Brushings
Fine Needle Aspirates (FNA)
Urine
CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What kinds of fluids would you see in cytology
(3)

A

Often drains
- e.g. liver tumours cause build up of cavity fluid (ascites) -> this can be drained and sent to cytology or it could be aspirates by a needle
- e.g. thyroid cyst fluid etc

Cells in suspension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give an example of a washing you would see in the lab
(4)

A

Abdominal washings -> someone under surgery e.g. hysterectomy

Surgeon will do a wash out of the body cavity afterwards

Will test to see if there are any malignant cells in the wash out

If so patient will have to go for chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give an example of a brushing you would see in the lab

A

Bile duct brushing
-> brush on end of endoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give an example of a fine needle aspirate

A

Needle is washed out -> cells from FNA put into a fluid and sent to a lab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is so important about CSF

A

You might only get a few drops to use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What miscellaneous specimens would you get in cytology
(4)

A

Imprints
Scrapings e.g. skin
Smears e.g. cervical
Faeces -> looking for fat globules in children failing to thrive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the principle behind FNA?
(3)

A

Cells are aspirated from a solid lesion using a fine needle under negative pressure (vacuum) and processed for microscopic examination

Can always go back and get more

Patients can often tolerate 2 or 3 FNA without anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the five most common FNAs

A

Lung (Transbronchial/Percutaneous/ EBUS)

Thyroid (Patient management)

Lymph node (Reactive/primary/metastatic)

Breast (symptomatic/Steriotactic)

Salivary gland (Patient management)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is an EBUS?
(3)

A

Endoscopic bronchial ultrasound

Mostly used for mediastinal lymph nodes

Use ultrasound and FNA to access lymph nodes instead of having to go for surgery to open the chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

FNA can be used on what internal organs

A

Liver
Pancreas
Kidney
Prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

FNA can be utilised along with what imaging

A

CT Scan
Ultrasound
EUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Write about the examination of thyroid tissue
(5)

A

FNA: patient management

High levels of follicular cells -> patient needs to go on for further investigation -> could be Benign vs malignant tumour

Therapeutic

Consideration:
- blood stained
- colloid (purple material, cracking when dry)

Hertle cells seen in hashimotos

Nuclear vaculation classic for papillary carcinoma of the thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What fluid types can you get in the lab

A

Body cavity fluids
- Pericardial
- Pleural
- Peritoneal

Ascitic fluid
- Abdomen

Cyst fluid
- Breast, Ovarian, thyroid, others

Joint fluid (synovial)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is mesothelioma?
(3)

A

Cancer that begins in the tissue mesothelium that lines the lungs, heart, stomach and other organs

3D balls of cells with inflammatory cells in the background

Often cells high in protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do signet cells indicate

A

Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give three examples of metastatic disease and how you would test for them

A

Melanoma (Melan A)
Ovarian cancer (Cytokeratin 7)
Ductal carcinoma of breast (Oestrogen receptor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What respiratory samples could you get
(5)

A

Sputum (not very often, this usually goes to micro)
Bronchial Wash/aspirate
Broncho-alveolar lavage
Bronchial brush
FNA
- transbronchial
- percutaneous
- Endoscopic bronchial ultrasound (EBUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two developments in bronchoscopy

A

EBUS
ROSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is an EBUS
(6)

A

Endoscopic bronchial ultrasound

Allows us to target lymph nodes

Ultrasound lets us see contrast

Allows for staging and diagnosis on the same sample

Might not even need to do a bronchoscopy -> can go straight to lymph nodes -> late stage

If no indication of lymph node involvement (early stage) then they will go for bronchoscopy only

However lung cancer is often only seen in late stage where the lymph nodes are affected

26
Q

What is ROSE?
(3)

A

Rapid on-site evaluation of fine needle aspirates (FNA)

Specimen management

Adequate samples for diagnosis and ancillary testing

Have we enough cells for downstream analysis and have the cells been preserves correctly -> are there sufficient abnormal cells

27
Q

What should you consider for biopsies

A

Small fragments
Assessment of invasion

28
Q

What should you consider for cytology samples
(4)

A

Mucus
Blood
Biological hazard
Representative specimen

29
Q

What should you consider for larger resections

A

Fixation
Perfusion of fixative

30
Q

What should you consider for biological hazards

A

Fresh or unfixed tissue

31
Q

How would you investigate lung cells
(6)

A

Benign vs Malignant

Primary -> squamous, adeno or small cell carcinoma
Secondary -> metastatic from where

Ancillary studies
- differential diagnosis
- Therapy related

32
Q

What are the two main types of lung cancer?
(2)

A

Small cell versus non-small cell carcinoma

NSC = squamous cell carcinoma vs adenocarcinoma

33
Q

How is typing a lung tumour important for therapeutics

A

Tyrosine kinase inhibitors (EGFR and ALK)

Immunotherapy such as PD-L1

34
Q

What are two names of EGFR inhibitors

A

Erlotnib
Gefitinib

35
Q

What is a name of an ALK inhibitor

A

Crizotinib

36
Q

Comment on the stats for lung cancer in Ireland

A

Over 2500 cases per year

Single most common cancer death

Approx 1800 deaths a year

Incidence in you women higher than EU average but decreasing in men

Reduction in squamous carcinoma but increase in adenocarcinoma

Only 55% live over 1 year after diagnosis

15% survive overall

Difficult to diagnose and treat

37
Q

What increases risk of lung cancer
(6)

A

Smoking (up to 90% of cases)

Environmental

Radon

Asbestos

Environmental carcinogens

Chronic lung disease

38
Q

How does smoking cause lung cancer
(5)

A

Cytochrome p450 activation

GST inactivation

DNA repair genes

Apoptosis bcl-bax pathway

p53, kras, Rb, E-cadherin-beta catenin complexes

39
Q

Comment on p53 and lung cancer

A

p53 protein and antibodies can be measured in blood as a prognostic inficator

40
Q

What is chromogranin used for?

A

detection of small cell carcinoma

41
Q

What percentage of lung cancer are small cell carcinomas

A

15%

42
Q

What percentage of lung cancer are non small cell lung cancer

A

65%

43
Q

What are the three types of NSCLC

A

Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma

44
Q

What percentage of NOS/other?

A

20%

45
Q

Write about the laboratory diagnosis is lung cancer
(6)

A

Need to use IHC/Molecular methods to sub-class lung tumour

Keratins -> CK5/6, CK7/CK20
p63
TTF-1
Napsin A
Chromogranin

46
Q

What therapeutics is there for lung cancer

A

EGFR
ALK

47
Q

What markers are used for NSCLC classification

A

p63
TTF-1
Napsin A

48
Q

What is considered a promising marker for squamous cell carcinoma?

A

PD-L1

49
Q

What are the treatment options for squamous cell carcinoma

A

Surgery
Chemotherapy
Radiotherapy

50
Q

What growth patterns are seen in adenocarcinoma

A

Glandular, papillary, mucins producing and lepidic growth patterns

51
Q

What are the oncogenic drivers of adenocarcinoma?
(5)

A

EGFR
KRAS
ALK
MET
BRAF

52
Q

What percentage of adenocarcinomas are caused by EGFR

A

10-40%

53
Q

Why would an EGFR mutation be considered a good thing in adenocarcinoma

A

These respond to tyrosine kinase inhibitors

54
Q

What happens to ALK in adenocarcinoma

A

ALK rearrangement in 5% of adenocarcinoma

Responds to Crizontinib

55
Q

What happens in most of the lung cancer treatments?

A

Between 6 months to 2 years, patients will develop resistance

Research into strategies/treamtents to overcome resistance

56
Q

Write about small cell lung cancer
(7)

A

High grade tumours
- present with early metastases
- fatal in 2-4 months if untreated
- less than 7% survive more than 5 years

Cisplatin and Etoposide used for treatment

Prophylactic cranial irradiation can be used if patient responds to chemotherapy at primary site

Rapid development of resistance -> relapse in 6-12 months with resistance

57
Q

What ancillary studies are there for Lung cancer
(4)

A

Histochemistry but limited applications

Tumour classification -> site of origin and primary or secondary, adeno, squamous, small cell, melanoma etc

Flow cytometry -> non-Hodgkins Lymphoma

Prognostic and therapy markers

58
Q

Write about immunocytochemistry

A

Important in diagnostic cytology and research

Fixation
- alcohol fixation, air dried or special fixation protocols

Cell blocks

Application:
- identify or confirm cell type
- identify cell constituents

Identify primary origin of metastatic tumours
- especially in fluids and FNAs

Prognostic and therapy markers

59
Q

Write about quality control
(6)

A

Documentation of any discrepancy

Remedial action

Quality of the slide preparation

Quality of the stains

Quality of coverslipping

Re-process sample
- Limitation if low cell yield

60
Q

What is UKNEQAS?
(5)

A

New EQA scheme for diagnostic cytology

Staining quality
- PAP and MGG

Interpretive scheme
- Digital format

61
Q

Write about screening
(5)

A

Primary screening of slides
- SHO/Registrars/Medical scientists

Mark cells of interest

Suggest diagnosis

Reporting session with Consultant

Developments in UK for BMS reporting (specialist diploma)

62
Q

Write about Reporting
(6)

A

Consultant reports the case
Additional tests may be requested at this stage -> often pre-requested at FNA procedure
Allocate SNOMED/SNOP codes
Computer generated report
Authorised and edited if necessary
Validated and released

2.2 Cellular Pathology (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions