Histopathology 3- Cytopathology Flashcards
Name some examples of Gynaecological Cytopathology
NHS CSP smears
Diagnostic (symptomatic) smears and endometrial sampling
Name some examples of Non-Gynaecological Cytopathology
Cytopathology
Exfoliative (serous effusion, joint, respiratory, GI, CSF)
Aspiration (lymph node, salivary gland, skin and soft tissue masses, cysts, breast, thyroid…)
What is a serous membrane?
Connective tissue lined by mesothelial cells
When is a serous effusion pathological?
Always
Give some examples of serous membranes
Pericardium, Pleura, Abdominal Cavity, Tunica Vaginalis of testis
Describe how a serous effusion is formed
Serous membranes well supplied with capillaries - High fluid turnover (up to 10 litres/day)
Formation
- Hydrostatic pressure in capillaries
- Oncotic pressure (albumin)
- Vascular permeability
Resorption - Via lymphatics, capillaries and venules
Describe transudative effusions
Plasma ultrafiltrate
‘Mechanical’ –Increased Hydrostatic and decreased Oncotic
Clear, pale yellow, low protein (<3g/dL), doesn’t clot
Single bland degenerate mesothelial cells and a few macrophages and lymphocytes
Usually Benign
List some causes of transudates
Cardiac, Cirrhosis, Nephrotic, Hypoproteinemia
Describe exudative effusions
- Unfiltered plasma
- Changes in vascular permeability
- Cloudy, yellow or bloody, high protein (>3g/dL), clots
- Many cells with proteinaceous background
- Inflammation (infection, infarction, autoimmune)
- May be malignant
What are mesothelial cells?
Mesothelial cells form a monolayer (mesothelium) lining the serosal cavities (pleural, pericardial and peritoneal) and the organs contained within these cavities.
What cells are found in effusions?
Mesothelial Macrophages Lymphocytes Eosinophils Neutrophils Plasma Cells Strangers
Describe mesothelial cells in effusions
Mesodermal epithelium Microvilli Single and grouped Clusters, balls, papillae, cell-in-cell, indian files Vary in size Lacy edges Windows Molding Variable nuclear number, size, N:C ratio Perinuclear cytoplasmic density Peripheral lacy border
Describe macrophages in effusions
Usually present Can be difficult to separate from mesothelial cells (esp. degenerate) Usually single or in loose aggregates Foamy pale cytoplasm Eccentric bean shaped nucleus Lack molding, windows
Describe lymphocytes in effusions
Usually a few present
More frequent in longstanding effusions
May be a range of maturation
Lymphocytic effusions are associated with obstructed circulation through lymph nodes and associated with tuberculosis and lymphoma
-part of chronic inflammatory process
Describe neutrophils in effusions
Often find a few
If non-infectious may be well preserved
If infectious then often degenerate
If masses then usually benign
