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Histopath LEC > EXFOLIATIVE CYTOLOGY Prt 2 > Flashcards

EXFOLIATIVE CYTOLOGY Prt 2 Flashcards

1
Q

GYNECOLOGIC SPECIMENS

A

Vaginal and
Cervical smears

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2
Q

• Screening test for precancerous condition
• Not an identification for cancer
• Recommended for females (35 yrs old and above)

A

VAGINAL AND CERVICAL SMEARS

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3
Q

If the female has a child = recommended to undergo______

A

Pap Smear

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4
Q

True or False

Vaginal and Cervical Smears are diagnostic

A

False

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5
Q

: junction of endocervical mucosa

A

Transformation Zone
• T-zone

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6
Q

Vaginal and Cervical Smears

Collection:

A

Aspiration of posterior fornix
Swabbing

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7
Q

Vaginal and Cervical Smear

• Instruments:

A

• 8-inch alass pipette and rubber bulb (for cancer cytology
• Sterile tongue depressor (for hormonal studies)
• Avre’s spatula
• Cervix brush

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8
Q

Precautions for Vaginal Smear Prep

Patient must avoid vaginal examination or douching_____ before collection

Spread smear thinly in a_____ motion

Glass pipette must be absolutely____

No ____ or ____must be used

A

24-48 hrs

rotary

dry

No lubricant or powder

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9
Q

CYTOLOGIC COLLECTION AND PREPARATION

A

Vaginal scrape
Vulvar scrape
Endocervical brush
Lateral vaginal scrape
Four quadrant vaginal scrape

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10
Q

CYTOLOGIC COLLECTION AND PREPARATION

• Samples of endocervical canal

A

Endocervical brush

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11
Q

CYTOLOGIC COLLECTION AND PREPARATION

• Patients with hysterectomy

A

Vaginal scrape

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12
Q

CYTOLOGIC COLLECTION AND PREPARATION

For hormonal evaluation

A

Lateral vaginal scrape

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13
Q

CYTOLOGIC COLLECTION AND PREPARATION

For localization of vaginal adenosis

A

Four quadrant vaginal scrape

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14
Q

CYTOLOGIC COLLECTION AND PREPARATION

For detection of herpetic lesions or carcinoma

A

Vulvar scrape

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15
Q

Pap staining

Developed by

A

Dr. George Papanicolau

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16
Q

Detects human uterine and cervical CA.

A

Pap staining method

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17
Q

• Cytologic evaluation of other secretions
• Transparent blue staining of cytoplasm
• Excellent nuclear detail is produced
• Color range is predictable

A

Pap staining method

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18
Q

• Valuable in comparing cellular appearances in smears

A

Pap staining

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19
Q

3 stains used in pap staining

A

Hematoxylin
OG6 (Orange Green)
Eosin Azure

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20
Q

Hematoxylin stains..

A

Nuclear structure

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21
Q

OG6 (orange green) stains..

A

Cytoplasm of mature cell

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22
Q

Eosin Azure stains..

A

Cytoplasm of immature cell

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23
Q

Eosin Azure
Components:

A

• Eosin
• PTA
• Light Green Stain (36, 50, 65)
• Lithium carbonate
• Bismarck brown

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24
Q

• It omitted the Bismarck’s brown dye from the EA solution
• Sharpness of color and brilliant staining reactions are improved

A

MODIFIED PAP’S METHOD

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25
Q

MODIFIED PAP’S METHOD
It omitted the _______from the EA solution
• Sharpness of color and brilliant staining reactions are improved

A

Bismarck’s brown dye

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26
Q

• Inexpensive
• Not commonly used nowadays
• Performed regularly even in pregnant women without undue risk

A

VAGINAL HORMONAL CYTOLOGY

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27
Q

VAGINAL HORMONAL CYTOLOGY

• No prior vaginal examination or douching in the last_____

A

24 hrs

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28
Q

Wooden Hormonal Cytology

_________ of vaginal well
• Less contamination and accessible

_______is recommended only in vaginal hormonal studies

A

• Upper lateral 3rd

• Wooden spatula

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29
Q

Wooden Hormonal Cytology

Assess smear and staining quality
Detect RBC and WBC
Detect type of exfoliated cells
Rough assessment of cell proportion

A

LPO

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30
Q

Wooden Hormonal Cytology

LPO

Assess____ and _____ quality
Detect___ and ____
Detect type of_______
Rough assessment of______

A

smear and staining

RBC and WBC

exfoliated cells

cell proportion

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31
Q

Quantitate the cells that were observed under LPO

32
Q

CELLS FOUND IN CERVICO-VAGINAL SMEARS

A

• Mature Superficial Cells
• Intermediate Cells
• Parabasal Cells
• Endometrial Cells
• Endocervical Glandular cells
• Doderlein Bacilli
• Ferning Phenomenon

33
Q

MATURE SUPERFICIAL CELLS

Shape:
Color:
Nuclei:
Abundant during:

A

• Polygonal
• Pale pink cytoplasm
• Dark pyknotic nuclei (< 6 u)
• Abundant during proliferating phase

34
Q

• True acidophilia (Due to estrogen)

A

Mature superficial cells

35
Q

Vaginal prolapse and drying
Drying of smears o Infection
Chemicals

A

Pseudoacidophilia

Mature superficial cells

36
Q

Mature Superficial cells are influenced by

37
Q

INTERMEDIATE CELLS

Size and shape:
Color:
Abundant during:

A

Medium sized polyhedral or elongated cells

Basophilic cytoplasm with vacuoles

Abundant during secretory phase

38
Q

Intermediate cells are influenced by

A

Progesterone

39
Q

Types of intermediate cells

A

Navicular cells
Pregnancy cells

40
Q

• Boat-shaped
• Folds/curls on edges
• Estrogen-progesterone effect
• Latter half of menstrual cycle, pregnancy, and menopause

A

NAVICULAR CELLS

41
Q

Navicular cells

Shape:
Folds:
Effect:
During:

A

• Boat-shaped
• Folds/curls on edges
• Estrogen-progesterone effect
• Latter half of menstrual cycle, pregnancy, and menopause

42
Q

• 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

A

PREGNANCY CELLS

43
Q

Pregnancy cells

Shape:
Color:
Nucleus:

A

• 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

44
Q

• Smaller than intermediate cells
• Thick, round to oval

A

PARABASAL CELLS

45
Q

• Smaller strongly basophilic cytoplasmic area
• Larger vesicular nucleus than intermediate cells

A

PARABASAL CELLS

46
Q

• 2 weeks of age to puberty, after childbirth, abortions, and after menopause

A

PARABASAL BODY

47
Q

PARABASAL CELLS

Shape:
Size/ color:
Nucleus:
Abundant during:

A

• 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

48
Q

T or F

We can identify the age of the patient through vaginal smear

49
Q

• Small, round to slightly oval cells
• Large nuclei (> half of cell volume)
• Nucleus almost occupies the entire cell
• Strongly basophilic cytoplasm
• Found before puberty and after menopause

A

BASAL CELLS

50
Q

BASAL CELLS

Size/ shape:
Nuclei:
Color:
Abundant during:

A

• Small, round to slightly oval cells
• Large nuclei (> half of cell volume)
• Nucleus almost occupies the entire cell
• Strongly basophilic cytoplasm
• Found before puberty and after menopause

51
Q

• Like parabasal cells; slightly cylindrical
• Less basophilic cytoplasm
• During and 1-4 days after menstruation

A

ENDOMETRIAL CELLS

52
Q

ENDOMETRIAL CELLS

Shape:
Color:
Abundant during:

A

• Like parabasal cells; slightly cylindrical
• Less basophilic cytoplasm
• During and 1-4 days after menstruation

53
Q

Occur in large group or sheets
Honeycomb appearance
Finely vacuolated pale blue/gray cytoplasm

A

ENDOCERVICAL GLANDULAR CELLS

54
Q

ENDOCERVICAL GLANDULAR CELLS

Shape/appearance:
Color:

A

Honeycomb appearance
Finely vacuolated pale blue/gray cytoplasm

55
Q

DODERLEIN BACILLI is from the family of

A

Lactobacillus acidophilus

56
Q

Most common normal vaginal flora

A

Doderlein Bacilli

57
Q

Color of doderlein bacilli

A

• Blue to lavender with Pap’s

58
Q

T or F

• Increased number of Doderlein bacilli indicates healthy vagina

59
Q

Doderlein bacilli

Numerous in:

A

last trimester of pregnancy, infection, estrogen deficiency, DM

60
Q

Doderlein bacilli

Decreased number leads to increase in population of invasive_______ species; comes with the presence of_______.

A

Lepthothrix

Trichomonas vaginalis

61
Q

if the vagina is not acidic, the number of________ will decrease because of the presence of Trichomonas vaginalis.

A

Lactobacillus acidophilus

62
Q

• Seen on dried cervical mucus
• Signifies persistent estrogen effect
• Basis for diagnosing early pregnancy

A

Ferning phenomenon

63
Q

“fern”/palm-leaf pattern of salt crystals

A

FERNING PHENOMENON

64
Q

CRITERIA FOR THE CYTOLOGIC DIAGNOSIS OF NORMAL PREGNANCY

A

• Marked progesterone effect
• At least 50% of intermediate cells in cluster
• At least some typical pregnancy cells are present
• Less than 30% mature superficial cells
• Doderlein-filled dirty background

65
Q

CRITERIA FOR THE CYTOLOGIC DIAGNOSIS OF NORMAL PREGNANCY

• Marked______ effect
• At least 50% of_____ cells in cluster
• At least some typical_____ cells are present
• Less than 30% _____cells
•______-filled dirty background

A

progesterone

intermediate

pregnancy

mature superficial

Doderlein

66
Q

REPORT FOR CYTOLOGIC SMEAR FOR DIAGNOSIS OF CANCER

o Absence of atypical or abnormal cells

67
Q

REPORT FOR CYTOLOGIC SMEAR FOR DIAGNOSIS OF CANCER

Atypical Cytologic Picture but no evidence of malignancy

A

• CLASS II

68
Q

REPORT FOR CYTOLOGIC SMEAR FOR DIAGNOSIS OF CANCER

• Cytologic picture suggestive but not conclusive of malignancy

A

• CLASS III

69
Q

REPORT FOR CYTOLOGIC SMEAR FOR DIAGNOSIS OF CANCER

• Cytologic picture strongly suggestive of malignancy

A

• CLASS IV

70
Q

REPORT FOR CYTOLOGIC SMEAR FOR DIAGNOSIS OF CANCER

• Cytologic picture conclusive of malignancy

A

• CLASS V

71
Q

OTHER MICROSCOPIC EXAMINATION TECHNIQUES OF CYTOLOGIC SMEARS

A

• Acridine Orange Fluorescent Technique

• Phase Contrast Microscopy

• Interference Microscopy

72
Q

Acridine Orange Fluorescent Technique

  • green/yellow
    • If increased: malignancy
  • brick-orange red
    • If increased: growth
A

Binds DNA

Binds RNA

73
Q

The second best choice after Pap’s staining

A

Phase Contrast Microscopy

74
Q

Used for hormonal evaluation of gynecologic specimen and for cancer detection

A

Phase Contrast Microscopy

75
Q

Determines the dry weight or individual cells or cellular constituents

Very expensive and complex

A

Interference Microscopy

Histopath LEC (37 decks)

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