exfoliative cytology Flashcards
What is exfoliative cytology?
It is a branch of medicine that deals with the study of cells exfoliated or scraped off from the lining epithelium and mucosa of different organs.
What does exfoliative cytology deal with?
It deals with cells that have been desquamated from epithelial surfaces.
What is cytopathology?
It is the study of abnormal cells, such as cancer cells.
What is cytotechnique?
It is the study of different methods of preparing cells for microscopic examination.
What are the purposes of diagnostic exfoliative cytology?
- Diagnosis of cancer
- Differentiation between malignant and benign tumors
- Differentiation of tumors from other diseases (e.g., infections, inflammations, or degenerations)
- Assessment of hormonal status (determining fertility conditions)
- Determination of the “true sex” of an individual
Why is the transformation zone (T-zone) important?
It is extremely important for the detection of dysplasias and carcinomas of the cervix.
What specimens require an adhesive?
Urinary sediment, bronchial lavage specimen, specimens utilizing proteolytic enzymes during processing.
What are examples of adhesives used in cytology?
Pooled human serum or plasma, celloidin ether alcohol, leuconostoc culture.
What equipment is used for vaginal aspiration?
Glass pipet and rubber bulb.
What is used for swab smears?
Ayre’s spatula.
What is used for endocervical or endometrial aspiration?
Laryngeal cannula attached to a 10 cc syringe.
What tool is used to collect samples from the endocervical canal?
Endocervical brush.
What type of smear is used for hysterectomy patients?
Vaginal scrape.
What is the purpose of a lateral vaginal scrape?
Hormonal evaluation.
What is the purpose of a four quadrant vaginal scrape?
Localization of vaginal adenosis.
What is the purpose of a vulvar scrape?
Detection of herpetic lesions or carcinoma.
When should smears be placed into the fixative?
Immediately after preparation.
What are some common fixatives used in cytology?
Equal parts of 95% ethyl alcohol and ether, 95% ethyl alcohol, isopropyl alcohol with ethyl alcohol, acetone with glycol, Carnoy’s fluid, Delaunoy’s fluid.
What is Harris Hematoxylin used for in Papanicolaou staining?
It is a nuclear stain or basophilic stain.
What is OG 6 (Orange – Green 6) used for?
It is a counterstain for the cytoplasm of mature superficial cells.
What is EA (eosin azure) used for?
It is a counterstain for the cytoplasm of immature cells (parabasal and intermediate cells).
What are the advantages of Pap’s stain?
- Transparent blue stain of the cytoplasm allows overlapped cells to be identified
- Excellent nuclear details
- Predictable color range valuable in cell identification and classification
- Useful for comparing cellular appearances in smears
What are the criteria for microscopic diagnosis of cancer?
Polarity of cells, hyperchromatism, atypical mitotic figures, reversal of the nucleocytoplasmic ratio.
What changes occur in the intercellular structural pattern of malignant cells?
Increase in size, irregular shape, irregular pattern, anisocytosis and anisokaryosis in clusters, excessive grouping and crowding, indistinct cell membrane.
What changes occur in the cytoplasm of malignant cells?
Acidophilia or marked orangeophilia, excessive cytoplasmic inclusions, abnormal vacuolation.
What changes occur in the nucleus of malignant cells?
Larger and irregular nucleus, more deeply pigmented, multinucleation, increased number and size of nucleoli, irregular size and distribution of chromatin materials, thickened nuclear membrane, necrotic or degenerative changes.
What specimen is used for sex determination in cytology?
Scrapings from the buccal and vaginal mucosa.
How is true sex determined in cytology?
Based on the presence of Barr bodies in the inner aspect of the nuclear membrane.
Is vaginal hormonal cytology safe to perform regularly?
Yes, it can be performed regularly without undue risk.
What are the characteristics of mature superficial cells in vaginal smears?
Dark pyknotic nuclei, true acidophilia under estrogen influence.
What are intermediate cells in vaginal smears?
Medium-sized polyhedral or elongated cells with basophilic cytoplasm showing vacuoles.
What are navicular cells?
Boat-shaped cells with a tendency to fold or curl on edges, associated with the latter half of the menstrual cycle, pregnancy, and menopause.
What are pregnancy cells?
Round, oval, or boat-shaped cells with translucent basophilic cytoplasm, double-walled boundary appearance.
What are parabasal cells?
Cells with strongly basophilic cytoplasm and a large vesicular nucleus, seen two weeks of age up to puberty, after childbirth, abortions, and after menopause.
What does Class I indicate in cytologic smear reporting?
Absence of atypical or abnormal cells.
What does Class II indicate in cytologic smear reporting?
Atypical cytologic picture but no evidence of malignancy.
What does Class III indicate in cytologic smear reporting?
Cytologic picture suggestive but not conclusive of malignancy.
What does Class IV indicate in cytologic smear reporting?
Cytologic picture strongly suggestive of malignancy.
What does Class V indicate in cytologic smear reporting?
Cytologic picture conclusive of malignancy.
What does acridine orange bind with and how does it appear under fluorescence microscopy?
Binds with nucleic acids; RNA appears brick to orange red, DNA appears green and yellow.
What does increased basophilia (RNA) signify?
Growth.
What does increased acidophilia (DNA) signify?
Malignancy.
What is phase-contrast microscopy used for?
Hormonal evaluation of gynecologic specimens and cancer detection.
What does interference microscopy determine?
The dry weight of individual cells or cellular constituents.
How does the dry weight of cancer cell nucleus and cytoplasm compare to that of normal cells?
It is less than that of normal cells.
