EXFOLIATIVE CYTOLOGY Flashcards
Histology of exfoliated, abraded, or desquamated cells. study or histology of the cells that are being removed from the body.
Cytology
Study of cells directly taken from surfaces of excised specimens by touching them
Imprint/Abraded Cytology
Microscopic study of desquamated cells from epithelial surfaces. Study of cells that have been shed or physically removed.
Exfoliative Cytology
test to identify this asymptomatic cancer.
Papsmear
distance of spray fixative
12 inches or 1 foot away
optimal time of smear preparation
1 hour
Best (yet flammable) fixative
95% Ethanol-Ether
Routinely used fixative
95% Ethanol
If smears cannot be made immediately, place the
collected material in … and replaced by
50% alcohol; saccamono’s preservative
Saccamono’s preservative
50% Ethanol
2% Carbowax
storage for smear prep
add ROH and refrigerate
% for pleural/peritoneal
50%
% for sputum
70%
% for urine, bronchial, gastric
95% alcohol
air-dry for 10-15 minutes after 2
hours of fixation and place it in a container
Mailed Specimen
if there is a huge amount of specimen you must centrifuge it at what rpm and how many minutes
2000; 2 minutes
specimens needed in general processing
viscous specimen
mucoid specimen
bloody specimen
watery specimen
in viscous specimen you must immerse it in
ether alcohol
how to destroy rbc
adding 2-5 mL of concentrated
Acetic Acid per 100 mL of the
specimen.
For adequate adhesion of smeared material.
adhesion
not recommended because it will retain the OG (Orange Green) of Pap stain.
albumin
Specimens that require adhesives:
Urinary sediment
Bronchialveolar lavage
Specimens with proteolytic enzymes (saliva)
Concentrated sputum
Examples of good adhesives
Pooled serum/Plasma
Celloidin Ether Alcohol
Leuconostoc Culture
2 major areas of specimens
non-gynecologic specimens
gynecologic specimens
Demonstrate abnormal cells early in disease
Sputum
how many samples of sputum is needed and what time of the day and interval per sample
3; morning; 1 hour interval
Patients unable to produce sputum
induced sputum inhalation of aerosol solution for 20 minutes
Absence of … and … indicates that only saliva was collected.
histiocytes
alveolar macrophages
what technique should be used in bronchial brushing
pull-apart technique
Performed in patients with AIDS to rule out Pneumocystis jirovecci infection
Bronchoalveolar Lavage/Bronchial Washing
Pneumocystis jirovecci
causative agent of
pneumonia
old name of Pneumocystis jirovecci
Pneumocystis carinii
how should you collect broncial aspirate
aspiration
washing
in bronchial aspirate, you should centrifuge the specimen for how many minutes
20-30minutes
an indication of the doctor that is really a bronchial aspirate
presence of cilia
methods to be used in gastrointestinal specimens
through the mouth
levine method
collection mode of gastrointestinal specimens
irrigation
aspiration
how long do we need to wait before collecting gastrointesinal specimens
8 hours fasting before gastric washing
For the extraction of peritoneal, pleural, pericardial fluid
Paracentesis
Presence of malignant cells usually indicate
metastasis
in ppp smears, how many units of heparin do we need per 100mL of aspirate to avoid clots
300 units
test used to differentiate transudate and exudates in patients
revalta’s test
first sample of urine in men is not acceptable because?
the urine sits too long in the bladder that’s why we need to collect the 2nd sample in the morning
why females need to use a catheter when collecting the urine
the vagina is prone to
bacterial contamination
mL of urine needed for routine testing
50mL
mL of urine needed for drug testing
60mL
For hormonal imbalance testing
breast secretion
if there is blood present in breast secretion it means there is
benign intraductal papilloma
how many mL of sample needed in csf
1mL
manner of extraction in csf; to numb the area
lumbar puncture
how many urine specimens are needed in prostatic secretion
3
Screening test for precancerous condition; Recommended for females (35 yrs old and above)
vaginal and cervical smears
if the female has a child she is recommended to undergo …
Pap smear
junction of endocervical mucosa
Transformation Zone
collection of vaginal and cervical smears
aspiration of posterior fornix
swabbing
Samples of endocervical canal
Endocervical brush
Patients with hysterectomy
Vaginal scrape
For hormonal evaluation
Lateral vaginal scrape
For localization of vaginal
adenosis
Four Quadrant vaginal scrape
what is adenosis
benign type of malignancy
For detection of herpetic lesions or carcinoma
Vulvar scrape
Staining method of choice; Developed by Dr. George Papanicolau; Detects human uterine and cervical CA.
papanicolau staining method
stains used in papanicolau method
hematoxylin
OG6
eosin azure
the cell stained is nuclear structure
hematoxylin
the cell stained is the cytoplasm of matured cell
OG6
the cell stained is cytoplasm of immature cell
eosin azure
modified pap’s method
Bismarck’s brown dye from
the EA solution
Inexpensive
Not commonly used nowadays
Performed regularly even in pregnant women without undue risk
vaginal hormonal cytology
recommended only in vaginal
hormonal studies
wooden spatula
Abundant during proliferating phase
mature superficial cells
Abundant during secretory phase
intermediate cells
● Boat-shaped
● Folds/curls on edges
● Estrogen-progesterone effect
● Latter half of menstrual cycle, pregnancy, and
menopause
navicular cells
● Round, oval cells
● Translucent basophilic cytoplasm at the center of
cell due to central glycogen accumulation
● Eccentric nucleus
● Double walled boundary with deep blue stain at the
cytoplasmic periphery
pregnancy cells
● Smaller than intermediate cells
● Thick, round to oval
● Smaller strongly basophilic cytoplasmic area
● Larger vesicular nucleus than intermediate cells
● 2 weeks of age to puberty, after childbirth, abortions, and after menopause
parabasal cells
Found before puberty and after menopause
basal cells
Like parabasal cells; slightly cylindrical; During and 1-4 days after menstruation
endometrial cells
● Occur in large group or sheets
● Honeycomb appearance
● Finely vacuolated pale blue/gray cytoplasm
endocervical glandular cells
Most common normal vaginal flora
Lactobacillus acidophilus
pH of vagina
acidic
Numerous in: last trimester of pregnancy, infection, estrogen deficiency, DM
doderlein bacilli
Decreased number of doderlein bacilli leads to increase in population of invasive and with the presence of
Lepthothrix species; Trichomonas vaginalis.
“fern”/palm-leaf pattern of salt crystals; Basis for diagnosing early pregnancy
ferning phenomenon
Absence of atypical or abnormal cells
CLASS I
Atypical Cytologic Picture but no evidence of malignancy
CLASS II
Cytologic picture suggestive but not conclusive of malignancy
CLASS III
Cytologic picture strongly suggestive of malignancy
CLASS IV
Cytologic picture conclusive of malignancy
CLASS V
The second best choice after Pap’s
staining; Used for hormonal evaluation of gynecologic specimen and for cancer detection
phase contrast microscopy
Determines the dry weight or individual cells or cellular constituents
interference microscopy
if AOFT binds to DNA and it increases the result is
malignancy
if AOFT binds to RNA and it increases the result is
growth
