EXFOLIATIVE 1 Flashcards
INTRODUCTION:
- study of abnormal cells
- study of the different methods of preparing the cells for microscopic examination
DIAGNOSTIC EXFOLIATIVE CYTOLOGY
3. For differentiation between _____ & _____
4. Assessment of _______
5. Determination of the _____ of an individual
- CYTOPATHOLOGY
- CYTOTECHNIQUE
- malignant & benign tumors
- hormonal status of an individual
- true sex
EQUIPMENT FOR COLLECTION
Gynecological specimens
- pang open up
- swab smear; for obtaining mucous specimen
- concave
- convex - endocervical/endometrial aspiration
- obtain pieces of tissues from vagina/cervix/placental tissues from endometrium
- vaginal aspiration
** - Transformation Zone (T-zone): extremely important for detection of ____ & ____ of cervix
- SPECULUM
- AYRE’s SPATULA
- CERVIX OPENING
- SCRAPE THE LINING - LARYNGEAL CANNULA
- CURETTE
- GLASS PIPETTE & RUBBER BULB
** - dysplasias & carcinomas
SPECIMEN COLLECTION FOR CONVENTIONAL PAP SMEAR
- Samples of endocervical canal
- Hysterectomy patients
- Hormonal evaluation
- Localization of vaginal adenosis
- Detection of herpetic lesions or
carcinoma
- Endocervical brush
- Vaginal scrape
- Lateral vaginal scrape
- Four quadrant vaginal scrape
- Vulvar scrape
ADHESION
-
-
Adhesives (3)
- this might introduce an infection
-
-
Specimens that require an adhesive (3)
- Bronchial lavage specimen
- Urinary sediment
- Specimen that utilize proteolytic enzymes
Adhesives (3)
- Pooled human serum/plasma
- Celloidin ether alcohol
- Leuconostoc culture
METHODS OF COLLECTING SPECIMEN FOR CYTOLOGY EXAMINATION
- spontaneously shed cells in body fluids
- ex - dislodged cells from body surfaces & mucosal linings
- ex - cells from palpable lump or mass (FNAB)
- EXFOLIATIVE
- urine - ABRASIVE
- cervical smear/pap smear - ASPIRATION
PREP OF CYTOLOGIC SMEAR
- tenacious, lesser volume samples
- standard method in concentrating cellular sediments
- __mL = examples (2) - moderate amount of fluid (50-100 mL)
- fluids collected from cavities - large amount of clear fluid (100-500mL) like urine
- sample for special staining like immunohistochemistry
- SMEARING
- CYTOCENTRIFUGATION
- <1mL = CSF, vitreous fluid - ORDINARY CENTRIFUGE
- EFFUSIONS - MILLIPORE FILTER TECHNIQUE VILTRAFILTRATION
- CELL BLOCK
More about CYTOLOGIC PREP
SMEARING
1. freshly cut organ is made contact w/ slide to allow direct transfer of cell
2. tissue fragments can be crushed into individual cells by putting small size of tissue in between
CELL BLOCKIJG
1. reagent you’ll melt and add to the tissue
CYTOCENTRIFUGATIOJ
1. cytospin assembly
2. absorb excessive liquid
SMEARING
1. TOUCH PREP
2. SQUASHED PREP
CELL BLOCKIJG
1. HISTOGEL
CYTOCENTRIFUGATIOJ
1. SLIDE CLIP < SLIDES < FILTER CARD < CYTOFUNNEL
2. Filter card
FIXATIVES
- the best and common
- substitute
- ## other example (2)-
- most convenient way
- distance
- angle
- Equal parts of 95% ethyl alcohol and ether
- 95% ethyl alcohol
3.
- CARNOY’s FLUID
- ACETONE W/ GLYCOL - SPRAY FIXATIVE
- angle 45 degrees
- 15-25cm
Papanicolaou staining
1. primary stain
2. Counterstain for cytoplasm of mature superficial cells
- made up of _____ in ____ & _____
3. Counterstain for cytoplasm of immature cells
- types
- made up of (3)
- stabilizes the staining
Papanicolaou staining
1. Harris Hematoxylin
2. OG 6 (Orange – Green 6)
- 0.5 – 1.0% solution of OG in 95% ethyl alcohol & PTA (phosphotungstic acid)
3. EA (eosin azure)
- EA 36 EA-50
- eosin y, light green SG, lithium carbonate
- Bismarck brown
CRITERIA for MICROSCOPIC Dx of CANCER
- abnormal position and arrangement of cells
- increase in staining affinity above the normal, affecting mainly nuclear structures
- abnormal stages
- increase in # of nuclei
- reversal of _____
- variation in size, shape, form, and appearance of cells
- POLARITY OF CELLS
- HYPERCHROMATISM
- ATYPICAL MITOTIC FIGURES
- MULTINUCLEAR
- NUCLEO - CYTOPLASMIC Ratio
- variation in size, shape, form, and appearance of cells
CELLS IN VAGINAL SMEARS
- dark pynotic nuclei
- characteristic of superficial vaginal cells under Estrogen
influence) - medium-sized polyhedral or elongated cells with basophilic cytoplasm showing
vacuole
- boat-shaped w/ tendency to fold or curl on edges
- greatest at the center due to glycogen
- Mature superficial cells
- Intermediate cells
- Navicular cells
- Pregnancy cells
CELLS IN VAGINAL SMEARS
- fried egg appearance
- seen ___ of age up to puberty, after childbirth, aborrions, and menopause - found during & 1-4
days after menstruation - found before puberty & after menopause w/ relatively large nuclei
- large groups of small sheets (honeycomb appearance)
- gram + rods; indicates cellular destruction
- Parabasal cells
- two weeks - Endometrial cells
- Basal cells
- Endocervical glandular cells
- Doderlain bacillus
_____: presence of a “palm leaf” pattern on drying of the vaginal or cervical secretions
- Aka
- due to formation of salt crystals under influence of _____
FERNING
- arborization
- Estrogen
Criteria for cytologic diagnosis of normal pregnancy
- Marked _____ effect
- At least 50% of _____ in clusters
- Some typical ____ cells present
- Less than 30% _____
- _____-filled “dirty” background
- progesterone
- intermediate cells
- pregnancy cells
- superficial cells
- Doderlein
Other methods:
- binds with nucleic acids
- rna color
- dna color
- signifies growth
- signifies malignancy - 2nd best choice after Pap’s staining
- for hormonal evaluation of ____ & for ___ detection - determines dry weight of individual cells or cellular
constituents
- Acridine Orange
- brick to orange red
- green & yellow
- Increased basophilia
- Increased acidophilia - Phase – Contrast Microscopy
- gynecologic specimen & for CA detection - Interference Microscopy (IM)
