Intro to Cytology

Question 1

Cytology

Answer 1

Study of cells
* looks at a SINGLE cell
* cytopathology = study of diseased cells
* differentiate between inflammation and neoplasia (cancer)

Question 2

Histology

Answer 2

Study of tissue struction
* cells in relation to neighboring cells
* histopathology = study of diseased tissue

Question 3

Cytology Advantages

Answer 3

• Non-invasive
• Inexpensive
• Out-patient procedure
• Rapid results (1-2 days)

Question 4

Cytology Disadvantages

Answer 4

• Only used as a screening tool - not to be a diffinitive diagnostic
• Can produce false negatives

Question 5

Scraping Collection

Answer 5

• Collects many cells
• More difficult to collect
• Only collects superficial cells
• Infection and inflammation may mask neoplasia

Question 6

Imprint Collection

Answer 6

• Easy to collect
• Collects few cells and more contaminants
• Infection and inflammation may mask neoplasia

Question 7

Fine Needle Biopsy Collection

Answer 7

• Get fewer cells
• Avoides superficial contamination
• Aspirate vs Nonaspirate

Question 8

FNA Collection
DONT’s

Answer 8

• Avoid excess pressure on syringe and when transfering cells to slide
• Don’t ship slides in same box with formalin - can change cells
• Careful to not make slides too thick
• Needs to completely air dry before staining

Question 9

FNA Failures
(why might they not turn out)

Answer 9

• Poorly exfoliative tissue (don’t get good cells)
• Hemorrhage association
• Cells ruptured
• Pre-existing necrosis / inflammation
• Improper handling
• Localized and aspirated wrong area

Question 10

Answer 10

Compression Smear
* do not apply downward pressure - can lead to ruptured cells

Question 11

Answer 11

Modified Compression Smear
* less tendency to rupture cells

Question 12

Answer 12

Starfish Smear
* doesn’t damage fragile cells
* can have thick, unreadable areas

Question 13

Answer 13

Line Smear
* similar to blood, but lift straight up at the end
* best if sample has low cellularity
* line will be very cellular

Question 14

Romanowsky Stains

Answer 14

• Easy to use
• Readily available
• Inexpensive
• Stains cytoplasm and nuclear detail well enough
• Thicker smears = longer stain time
• Mast cells may or may not stain

Question 15

New Methylene Blue

Answer 15

• Stains cytoplasm weakly
• Excellent nuclear detail
• Good if hemorrage present (RBCs don’t stain)

Question 16

Cytology Microscopic Exam
Low Power

Answer 16

Start initial exam and look for
* adequate staining
* localized areas of increased cellularity
* large cells or clusters of cells
* parasites
* crystals

Question 17

Cytology Microscopic Exam
High Power

Answer 17

Second portion of exam for
* evaluation of individual cells
* cytoplasmic abnormalities
* malignancy signs

Question 18

Inflammation

Answer 18

Normal response to tissue damage and microorganisms
* see neutrophils and macrophages (sometimes lymphocytes and eosinophils)

Question 19

Inflammation Types

Answer 19

• Suppurative (purulent)
• Granulomatous
• Pyogranulomatous
• Eosinophilic

Question 20

Inflammation

Granulomatous or Pyogranulomatous

Answer 20

Consists of >15% macrophages of TNCC
* common for fungal and parasitic infections

Question 21

Inflammation

Suppurative (purulent)

Answer 21

Consists of >85% neutrophils of the TNCC

Question 22

Inflammation

Eosinophilic

Answer 22

Consists of increased neutrophils and >10% eosinophils of TNCC
* see with parasitic or neoplasitc disorders

Question 23

Inflammatory Changes

Answer 23

Degeneration of Leukocytes
* karyolysis
* karyorrhexis
* pyknosis

Presence of bacteria (septic)

Question 24

Identify Cell

Answer 24

Karyolysis
* Swollen nucleus with reduced staining
* Rapid cell death

Question 25

Identify Cell

Answer 25

Karyorrhexis * Fragmented nucleus * Breaks up into individual segments/blobs

Question 26

Identify Cell

Answer 26

Pyknosis * Small, condensed nucleus * Stains darkly * Slow cell death

Question 27

Neoplasia

Answer 27

Homogenous population of cells of the same origin * can have mixed populations (cancer with inflamation) * classify by cell type (origin) and their malignancy characteristics

Question 28

Hyperplasia

Answer 28

Non-neoplastic enlargement of tissue * step up from normal * overproduction of a cell type

Question 29

Dysplasia

Answer 29

* Step above hyperplasia * Cells starting to show signs of malignancy, but not enough to call it cancer

Question 30

Benign Neoplasia

Answer 30

* Cant differentiate between this and hyperplasia * No criteria of malignancy * Increased number of cells - uniform appearance

Question 31

Malignant Neoplasia

Answer 31

Have at least 3 signs of malignancy * anisokaryosis * pleomorphism * high / variable C:N ratio * increased mitotic activity * nucleoli * coarse chromatin pattern * nuclear molding * multinucleation

Question 32

Answer 32

Anisokaryosis * variable nuclear size

Question 33

Answer 33

Pleomorphism * also called anisocytosis * variable cell size and shape

Question 34

Answer 34

Increased Mitotic Activity * cells are rapidly dividing * not seen in normal tissue

Question 35

Answer 35

Coarse Chromatin Pattern * will appear ropy or cordlike * multiple variations of color within nucleus

Question 36

Answer 36

Nuclear Molding * deformation of nucleus by other nuclei within cell or from one in an adjacent cell

Question 37

Answer 37

Multinucleation * multiple nuclei within cell

Question 38

Criteria of Malignancy Exceptions

Answer 38

Rule does not apply if * inflammation if present * only a few cells display malignancy Histopathology required to verify

Question 39

Histopathology - Neoplasia

Answer 39

Assessment of whether there is local tissue infiltration (tissue is invading into other areas)

Question 40

Tissue Biopsy

Answer 40

Sampling of tissue for exam * wedge vs punch * technique depends on accessibility, tissue itself, and the location * want to have both normal and abnormal tissue

Question 41

Wedge Biopsy

Answer 41

* Obtain with a scalpel * Excisional: entire lession removed with a bit of normal area * Incisional: partial piece with a transition zone

Question 42

Punch Biopsy

Answer 42

* Come in various sizes * Easy and rapid use * Rotate in one direction to avoid shearing