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L.11 Cytology & Cytopathology Flashcards

1
Q

What is Cytology?

A

Cytology is the study of cells using light microscopy to examine their structure, appearance, and function.

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2
Q

What are the sample collection methods in Cytology?

A
  • Exfoliated cells: Naturally shed cells, e.g., from body fluids like urine, sputum.
  • Scraped cells: Cells obtained by physically scraping a surface, e.g., cervical smear.
  • Aspirated cells: Cells collected via fine needle aspiration (FNA) from organs or tissues.
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3
Q

What is the purpose of Cytology?

A

To prepare, investigate, and evaluate cell samples for any abnormalities, infections, or signs of disease.

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4
Q

What is Cytopathology?

A

Cytopathology is the microscopic examination of cells from the body specifically for the diagnosis of disease.

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5
Q

What is the field of study of Cytopathology?

A
  • A specialized branch of pathology focused on disease manifestations at the cellular level.
  • It aims to detect:
    • Malignant and pre-malignant changes
    • Inflammatory conditions
    • Infectious processes
    • Benign lesions
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6
Q

What are the main divisions of Cytopathology?

A
  • Cervical Cytology (Gynaecological Cytology): Screening for cervical cancer and precancerous changes (e.g., Pap smears).
  • Diagnostic Cytology (Non-Gynaecological Cytology): Includes body fluids (pleural, peritoneal, cerebrospinal), respiratory samples, urine, and fine needle aspirates (FNAs) from lumps or organs (thyroid, breast, lymph nodes, etc.).
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7
Q

What is the fundamental tool for cytology?

A

The microscope

The microscope enables visualization of cells and their abnormalities.

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8
Q

Who developed high-quality lenses and first observed single-celled organisms?

A

Antonie van Leeuwenhoek (1632–1723)

He referred to single-celled organisms as ‘animalcules’.

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9
Q

What term did Robert Hooke coin after observing cork tissue?

A

Cell

This marked the beginning of the cell concept in biology.

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10
Q

What did Theodor Schwann and Matthias Schleiden establish?

A

Cell Theory

The Cell Theory states that all living organisms are made up of cells.

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11
Q

Who conducted early work on respiratory tract cells under the microscope?

A

Doone (1845)

His contributions were significant in the early understanding of cytology.

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12
Q

Who pioneered the description of the microscopic appearance of cancer cells?

A

Johannes Müller

His work contributed to the understanding of cancer at the cellular level.

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13
Q

What major improvement in microscopy did August Köhler develop in 1893?

A

Köhler illumination

This technique is essential for achieving optimal image quality with even lighting and minimal distortion.

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14
Q

Who is known as the Father of Exfoliative Cytology?

A

George Papanicolaou (1883–1962)

His work revolutionized early detection of cervical cancer.

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15
Q

What was one of George Papanicolaou’s key contributions related to cervical cells?

A

Identified morphological changes in cervical cells associated with carcinoma

This finding was critical for cancer detection.

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16
Q

What staining technique did George Papanicolaou develop?

A

Papanicolaou stain (Pap stain)

This multicolored staining technique highlights nuclei, cytoplasm, different cell types, and abnormalities.

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17
Q

What impact did Papanicolaou’s work have on cervical cancer detection?

A

Led to the widespread use of the Pap smear

The Pap smear became a standard practice in healthcare, saving countless lives through early intervention.

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18
Q

What is Liquid-Based Cytology (LBC)?

A

A modern collection method for cervical cells, where the sample is collected and suspended in a liquid medium rather than directly smeared on a slide.

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19
Q

What is a key advantage of LBC related to sample transfer?

A

Nearly all collected cells are preserved, reducing sampling error.

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20
Q

How does LBC improve the preservation of cellular material?

A
  • Cells are less likely to dry out or be damaged.
  • Cleaner background (removal of blood, mucus, debris).
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21
Q

What is a benefit of LBC in terms of slide quality?

A

Enhanced visualization of cellular details.

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22
Q

What is one impact of LBC in cervical screening related to residual samples?

A

Leftover material after making slides can be used for further testing and research.

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23
Q

How has LBC improved the understanding of HPV?

A

Studies on the relationship between Human Papillomavirus (HPV) and cervical cancer (Cx Ca) became possible.

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24
Q

What development in testing was created due to LBC?

A

Created reliable molecular tests for detecting HPV DNA.

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25
What significant shift occurred in screening programs because of LBC?
Screening programmes transitioned from Pap cytology to primary HPV testing.
26
In what other area are LBC methods applied?
Diagnostic (non-gynaecological) cytology to process samples like urine, body fluids, and FNAs.
27
When was cytology first used for diagnostic purposes?
As early as the 1800s.
28
Who were the key contributors to the early development of diagnostic cytology?
* Martin and Ellis (1930s): Pioneered diagnostic cytology techniques, especially using fine-needle aspiration. * Leopold Koss: Authored the classic text Diagnostic Cytology and Its Histopathologic Bases.
29
What did Leopold Koss establish in the field of cytology?
Firmly established cytology’s importance alongside histopathology.
30
What is Fine Needle Aspiration (FNA)?
A technique where a thin needle is used to extract cells from tissues or masses for examination. ## Footnote FNA is commonly used in diagnosing various conditions, including cancers.
31
What happened to the popularity of FNA in the United States?
It lost popularity for some time but continued to develop in Europe, especially at the Karolinska Institute from the 1940s to 1970s. ## Footnote The resurgence in the U.S. has made FNA a standard diagnostic tool.
32
What is the modern status of Fine Needle Aspiration?
It is now widely accepted and heavily used as a diagnostic tool worldwide.
33
What is the primary purpose of Diagnostic Cytology?
Not for screening purposes like cervical cytology, but for direct diagnosis of disease based on specific cellular features.
34
List the cellular features evaluated in Diagnostic Cytology.
* Nuclear features: size, shape, chromatin pattern, nucleoli * Cytoplasmic features: staining, volume, inclusions * Architectural features: arrangement of cells (sheets, clusters, papillary structures) * Extra-cellular materials: colloid, amyloid, lymphoglandular bodies.
35
What is the Pap stain used for?
A multicolored stain designed to highlight nuclear and cytoplasmic detail, standard for cervical and many diagnostic samples.
36
What is May-Grünwald Giemsa (MGG) stain commonly used for?
Commonly used for FNAs and fluid cytology, excellent for showing background features and inflammatory cells.
37
What does Grocott’s silver stain identify?
It stains fungi, such as Pneumocystis.
38
What is the purpose of Congo red stain?
Identifies amyloid deposits, showing apple-green birefringence under polarized light.
39
What does D/PAS (Diastase periodic acid-Schiff) stain highlight?
It highlights glycogen, mucins, and fungi.
40
What is Immunohistochemistry (IHC) used for?
Used to detect specific antigens in cells, with protocols similar to histology but adapted for cytology samples.
41
How does diagnostic cytology compare to histology?
Diagnostic cytology mirrors many histological techniques but focuses on individual cells rather than complete tissue architecture.
42
What is Diagnostic Cytology?
Examination of exfoliated cells or aspirated material for the diagnosis of disease. ## Footnote This technique is crucial for identifying various diseases through cellular analysis.
43
What are the sources of exfoliated cells in Diagnostic Cytology?
* Urine (for urinary tract lesions, e.g., bladder cancer) * Sputum (for lung lesions) * Body cavity fluids (pleural, peritoneal, pericardial effusions) * Cyst fluid (e.g., breast, thyroid, pancreatic cysts) ## Footnote Each source provides different insights into potential diseases affecting those areas.
44
What advancements have increased access to deep-seated lesions in Diagnostic Cytology?
* Developments in sampling (e.g., FNA) * Imaging techniques (e.g., ultrasound, CT-guidance) ## Footnote These advancements enhance the accuracy and efficiency of obtaining samples from difficult-to-reach areas.
45
What is Endoscopy-Assisted Collection in Diagnostic Cytology?
* Bronchoscopy: collects specimens from the respiratory tract * Other examples: gastroscopy, cystoscopy ## Footnote Endoscopy allows for direct visualization and collection of samples from internal organs.
46
What is Fine Needle Aspiration (FNA)?
Cells are aspirated from solid lesions using a fine needle. ## Footnote This method is often used to obtain samples for cytological examination.
47
How is FNA performed?
Performed with or without imaging guidance. ## Footnote Imaging guidance can improve accuracy in locating the lesion.
48
What types of material does FNA produce?
* Direct smears * Cell block preparations * Ancillary testing (e.g., IHC, molecular studies) ## Footnote These materials are essential for further analysis and diagnosis.
49
What are the uses of FNA in Diagnostic Cytology?
* Diagnosis of tumors (benign or malignant) * Assessment of metastatic disease * Evaluation of non-neoplastic lesions (infection, inflammation) ## Footnote FNA is versatile and can address a wide range of clinical questions.
50
What is Cytopathology?
The study of cellular changes in disease, used for first-line diagnosis. ## Footnote Cytopathology plays a critical role in identifying diseases at an early stage.
51
What conditions can be diagnosed through Cytopathology?
* Reactive changes (e.g., tissue response to injury or irritation) * Inflammation (e.g., infections, autoimmune diseases) * Infections (e.g., fungal, viral, bacterial) * Neoplasia (benign tumors, malignant tumors, metastatic cancers) ## Footnote This breadth of conditions highlights the importance of cytopathology in clinical practice.
52
What do ancillary techniques expand in cytology?
Diagnostic, prognostic, and therapeutic power ## Footnote Ancillary techniques enhance the capabilities of cytological analysis.
53
What is the purpose of Cell Block Preparation in cytology?
Converts cytology samples into paraffin-embedded blocks for histological staining and IHC ## Footnote This process allows for better visualization and analysis of cellular structures.
54
What does Immunocytochemistry (IHC) help characterize?
Cells by detecting specific antigens ## Footnote IHC is crucial for distinguishing between different tumor types.
55
What is Flow Cytometry primarily used for?
Rapid analysis of cell surface markers, mainly in hematologic malignancies ## Footnote This technique can provide quick results for cell classification.
56
What does Molecular Techniques in cytology include?
ISH for gene rearrangements, DNA and RNA analysis (e.g., PCR for gene mutations) ## Footnote These techniques identify genetic changes relevant to cancer diagnosis.
57
What is the first step in the Diagnostic Algorithm in Cytology?
Routine Staining (e.g., Pap, MGG) ## Footnote This is essential for initial cell evaluation.
58
What is assessed in the Initial Assessment of the Diagnostic Algorithm?
Is it benign or malignant? ## Footnote This is a critical determination in cytological evaluation.
59
When are ancillary techniques used in the Diagnostic Algorithm?
If needed, to assist in diagnosis ## Footnote Techniques like IHC and Flow Cytometry are utilized based on initial findings.
60
What can IHC help differentiate in tumors?
Primary vs secondary tumors and predict therapy response ## Footnote For example, PD-L1 testing in lung cancer is important for treatment decisions.
61
What are some uses of Flow Cytometry in cytology?
Mainly for lymphomas and leukemias ## Footnote It aids in the classification and treatment planning of hematological cancers.
62
What features can some tumors be graded by?
Cytological features ## Footnote Grading assists in understanding tumor aggressiveness.
63
What is the role of Consultant Cytopathologists?
Primarily responsible for reporting cytology ## Footnote They are trained to interpret cytological findings accurately.
64
What tasks do Biomedical Scientists (BMSs) perform related to cytology?
Prepare slides, perform Quality Control (QC), conduct pre-screening ## Footnote In the UK, BMSs can report in certain areas after specialized training.
65
What are two advantages of cytology?
* Minimally invasive sample collection * Faster turnaround time ## Footnote These factors make cytology a preferred method in many clinical settings.
66
What is a limitation of cytology?
Limited sample size ## Footnote This can affect the accuracy of the diagnosis.
67
Fill in the blank: Cytology is useful for _______ disease assessment.
[metastatic] ## Footnote This helps in managing patient treatment plans.
68
True or False: Cytology can always confirm invasion without histology.
False ## Footnote Histological examination is often necessary for definitive diagnosis.

Cell Pathology (30 decks)

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