exfoliative cytology

Question 1

What is exfoliative cytology?

Answer 1

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.

Question 2

What does exfoliative cytology deal with?

Answer 2

It deals with cells that have been desquamated from epithelial surfaces.

Question 3

What is cytopathology?

Answer 3

It is the study of abnormal cells, such as cancer cells.

Question 4

What is cytotechnique?

Answer 4

It is the study of different methods of preparing cells for microscopic examination.

Question 5

What are the purposes of diagnostic exfoliative cytology?

Answer 5

• 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

Question 6

Why is the transformation zone (T-zone) important?

Answer 6

It is extremely important for the detection of dysplasias and carcinomas of the cervix.

Question 7

What specimens require an adhesive?

Answer 7

Urinary sediment, bronchial lavage specimen, specimens utilizing proteolytic enzymes during processing.

Question 8

What are examples of adhesives used in cytology?

Answer 8

Pooled human serum or plasma, celloidin ether alcohol, leuconostoc culture.

Question 9

What equipment is used for vaginal aspiration?

Answer 9

Glass pipet and rubber bulb.

Question 10

What is used for swab smears?

Answer 10

Ayre’s spatula.

Question 11

What is used for endocervical or endometrial aspiration?

Answer 11

Laryngeal cannula attached to a 10 cc syringe.

Question 12

What tool is used to collect samples from the endocervical canal?

Answer 12

Endocervical brush.

Question 13

What type of smear is used for hysterectomy patients?

Answer 13

Vaginal scrape.

Question 14

What is the purpose of a lateral vaginal scrape?

Answer 14

Hormonal evaluation.

Question 15

What is the purpose of a four quadrant vaginal scrape?

Answer 15

Localization of vaginal adenosis.

Question 16

What is the purpose of a vulvar scrape?

Answer 16

Detection of herpetic lesions or carcinoma.

Question 17

When should smears be placed into the fixative?

Answer 17

Immediately after preparation.

Question 18

What are some common fixatives used in cytology?

Answer 18

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.

Question 19

What is Harris Hematoxylin used for in Papanicolaou staining?

Answer 19

It is a nuclear stain or basophilic stain.

Question 20

What is OG 6 (Orange – Green 6) used for?

Answer 20

It is a counterstain for the cytoplasm of mature superficial cells.

Question 21

What is EA (eosin azure) used for?

Answer 21

It is a counterstain for the cytoplasm of immature cells (parabasal and intermediate cells).

Question 22

What are the advantages of Pap’s stain?

Answer 22

• 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

Question 23

What are the criteria for microscopic diagnosis of cancer?

Answer 23

Polarity of cells, hyperchromatism, atypical mitotic figures, reversal of the nucleocytoplasmic ratio.

Question 24

What changes occur in the intercellular structural pattern of malignant cells?

Answer 24

Increase in size, irregular shape, irregular pattern, anisocytosis and anisokaryosis in clusters, excessive grouping and crowding, indistinct cell membrane.

Question 25

What changes occur in the cytoplasm of malignant cells?

Answer 25

Acidophilia or marked orangeophilia, excessive cytoplasmic inclusions, abnormal vacuolation.

Question 26

What changes occur in the nucleus of malignant cells?

Answer 26

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.

Question 27

What specimen is used for sex determination in cytology?

Answer 27

Scrapings from the buccal and vaginal mucosa.

Question 28

How is true sex determined in cytology?

Answer 28

Based on the presence of Barr bodies in the inner aspect of the nuclear membrane.

Question 29

Is vaginal hormonal cytology safe to perform regularly?

Answer 29

Yes, it can be performed regularly without undue risk.

Question 30

What are the characteristics of mature superficial cells in vaginal smears?

Answer 30

Dark pyknotic nuclei, true acidophilia under estrogen influence.

Question 31

What are intermediate cells in vaginal smears?

Answer 31

Medium-sized polyhedral or elongated cells with basophilic cytoplasm showing vacuoles.

Question 32

What are navicular cells?

Answer 32

Boat-shaped cells with a tendency to fold or curl on edges, associated with the latter half of the menstrual cycle, pregnancy, and menopause.

Question 33

What are pregnancy cells?

Answer 33

Round, oval, or boat-shaped cells with translucent basophilic cytoplasm, double-walled boundary appearance.

Question 34

What are parabasal cells?

Answer 34

Cells with strongly basophilic cytoplasm and a large vesicular nucleus, seen two weeks of age up to puberty, after childbirth, abortions, and after menopause.

Question 35

What does Class I indicate in cytologic smear reporting?

Answer 35

Absence of atypical or abnormal cells.

Question 36

What does Class II indicate in cytologic smear reporting?

Answer 36

Atypical cytologic picture but no evidence of malignancy.

Question 37

What does Class III indicate in cytologic smear reporting?

Answer 37

Cytologic picture suggestive but not conclusive of malignancy.

Question 38

What does Class IV indicate in cytologic smear reporting?

Answer 38

Cytologic picture strongly suggestive of malignancy.

Question 39

What does Class V indicate in cytologic smear reporting?

Answer 39

Cytologic picture conclusive of malignancy.

Question 40

What does acridine orange bind with and how does it appear under fluorescence microscopy?

Answer 40

Binds with nucleic acids; RNA appears brick to orange red, DNA appears green and yellow.

Question 41

What does increased basophilia (RNA) signify?

Answer 41

Growth.

Question 42

What does increased acidophilia (DNA) signify?

Answer 42

Malignancy.

Question 43

What is phase-contrast microscopy used for?

Answer 43

Hormonal evaluation of gynecologic specimens and cancer detection.

Question 44

What does interference microscopy determine?

Answer 44

The dry weight of individual cells or cellular constituents.

Question 45

How does the dry weight of cancer cell nucleus and cytoplasm compare to that of normal cells?

Answer 45

It is less than that of normal cells.