Test 2- Cytology of Solid Masses

Question 1

What are types of cytologic samples?

Answer 1

Fluids, needle aspirates, solid tissue imprints.

Question 2

What are advantages of cytology to clinician/practitioner?

Answer 2

Economical, rapid, profitable to practice

Question 3

What are advantages of cytology over histo

Answer 3

round cell tumors easier to dx (esp. mast cell), detecting of microorganisms, and no shrinkage

Question 4

What are disadvantages of cytology?

Answer 4

• Non diagnostic samples- stick a mass- nothing comes out.
• No tissue architecture so cant characterized local tissue invasion
and determine if margins are clean.
• Inability to see relationship w/ inflammation (can lead to a miss dx)
• Inability to distinguish hyperplasia form neoplasia in some tissues
• Inability to grade tumors
• Sample size
o side note: path definition:
o grading- Grading: Gives a semi-quantitative evaluation of
the degree of differentiation of the tumor. Cancers are classified from I to IV withincreasing anaplasia. Although histologic grading is useful, histologic appearance not always correlates with biologic behavior.
o staging- Staging: It is based on the size of the primary tumor, its extend of spread to regional lymph nodes, and the presence or absence of hematogenous metastases. • Staging from a clinical point of view has proved to be more useful than grading.

Question 5

What are basic rules you need to know for specimen evaluation?

Answer 5

1. Understand what normal looks like
   • 2. Examine the entire specimen on low mag (there may be very few
   cells on the slide, some areas may be inflammatory or some
   neoplastic)
   • 3. Only evaluate intact cells, avoid areas that are thick, under
   stained
   • 4. Recognize artifacts and contaminants (ex. Talc crystals from
   gloves, stain sediment, keratin (from poor handling of sample) ultrasound gel.

Question 6

what can occur if preparation is very thick?

Answer 6

The stain may not penetrate adequately and your sample is not
readable

Question 7

When performing a fine needle aspirate how long do you have to make the slide before clotting occurs?

Answer 7

30 seconds before tissue thromboplastic activates. So be quick or use EDTA

Question 8

what do you need to keep in mind when making a FNA?

Answer 8

prepare film quickly, too thick or broken cells are non diagnostic,
allow to air dry, keep away from formalin, stain w/ diff quik or
wright-giemsa stains

Question 9

What are reasons for non diagnostic samples?

Answer 9

• Only blood on the slide- needle too large, lesion is vascularized, or lesion is mesenchymal tissue (Connective tissue)
• All cells are broken- material clotted prior to making smear. Not gentle enough hen making smear
• Cells too thick to interpret- didn’t spread cells our adequately, made squirt preparation but did not spread slide
• Nothing on the slide- missed the lesion, lipoma (fat dissolved in alcohol dip) or lesion is connective tissue, inadequate staining due to formalin fumes, made preparation next to formalin, shipped the preparation in box w/ formalin, inadequate staining due to age of sample, should stain w/ in 4-5 days after making the smear.

Question 10

Why would you chose an imprint instead of aspirate?

Answer 10

Ulcerative lesions may not have representative cells on
imprint. Neutrophils and bacteria are almost always present.
Exception is for TVT. Avoid cutaneous imprints if you can

Question 11

Is inflammation present in a cytological sample?

Answer 11

If so, what kind of cells and are infectious agents present.
o Look for organisms other than bacteria as well- systemic fungal dz (histoplasmosis, cryptococociss, blastomycosis, coccidiomycosis) other fungal and also protozoal dz (leishmania or toxoplasma)

Question 12

Size difference of your mycosis

Answer 12

Coccicoides is the largest, blastomycoses (size of a neutrophil)and crypto are intermediate and about same size
(crypto has a capsule) and histoplasmosis is very small

Question 13

What does the capsule of Cryptococcus neoformans stain very well with?

Answer 13

New methylene blue stain

Question 14

How do you recognize malignancy (cytology of neoplasia)?

Answer 14

1. Variability- criteria of malignancy- malignant. Cells are not
   uniform in size.
   • 2. Cells where they don’t belong (epithelial in lymph node or
   abdominal fluid

Question 15

what do large cells with cell to cell relationship suggest?

Answer 15

Epithelial cells

Question 16

If you see connective tissue cells! those w/ tapered end. Going out in different directions w/out inflammation what may you assume?

Answer 16

If they were mixed w/ inflammatory cells probably chronic inflammation (fibroplsia0 but w/ no inflame. cells! probably a tumor of Connective tissue origin

Question 17

What is a tumor of the mouth that is common to illicit a inflammatory response?

Answer 17

Squamous cell carcinoma

Question 18

What are nuclear characteristics of malignancy?

Answer 18

Anisokaryosis, abnormally clumped chromatin, abnormal nucleoli, abnormal mitotic figures, micronuclei (satellite nuclei) variable sized nuclei in same cell, nuclear molding

Question 19

What are you classification of tumors ?

Answer 19

1.Round (discrete) cell tumor- lymphoma, plasma cell tumor,
histocytic tumor (histioctoma, localized histiocytic sarcoma,
disseminated histocytic sarcoma- malignant histiocytosos),
transmissible venereal tumor, malignant histiocytosis
o PLEASE HELP ME LEARN THIS (PHMLT)
• 2. Tumor of epithelial origin
3. Tumor of CT origin
•.

Question 20

•. How do you classify neoplasms?

Answer 20

• Epithelial tumors- omas, adenomas, adenocarcinomas.
• Mesenchymal tumor- oma, sarcoma
• Lipoma; hemangiopericytoma; hemanigosarcoma; osteosarcoma;
chondrosarcoma;

Question 21

How do round cell tumors normally appear?

Answer 21

Cells normally are individual but sometimes they are
situated closely together and are in small aggregates like epithelial tumors. Usually there are plenty of cells present in tumors, circular cells w/ round nuclei, distinct cytoplasmic boarder, cells can be very well differentiated (ex. Mast cell tumors)

Question 22

TVT

Answer 22

often has vacuolated cytoplasm

Question 23

Plasma cell tumors

Answer 23

often have eccentric nuclei, binucleate cells

Question 24

What can occur when you stain a mast cell w/ diff quick?

Answer 24

Can not stain the granules. Can see eosoniphils often w/ mast cells

Question 25

What are some differences to distinguish the round cell tumors?

Answer 25

• MCT- diff quick problem, look for eosinophils, granules present
• Histoiocytoma- often young dogs (but can be any age) benign appearing
• TVT- location, cytoplasmic vacuoles, prominent nucleoli
• Lymphoma- small amount to cytoplasm present, usually
blast cells (LARGE NUCLEUS)
• Plasma cell- eccentric nucli, gogli,
• Malignant histiocytosis, histiocytic srcoma
vacuolated cytoplasm, many multinucleated cells, look like
macros /w criteria of malignancy

Question 26

How do epithelial tumors present?

Answer 26

Cells in sheets or clusters, usually many cells present. Distinct
cytoplasmic borders, cells often lare w/ abundant cytoplasm,
sometimes show signs of differentiation

Question 27

What do you know about thyroid tumors in the dog?

Answer 27

Almost always malignant

Question 28

You have hypercalcemia, what is a sequel of this in associated w/ the kidney?

Answer 28

can be due to hypercaclemia of malignancy w/ perianal acinar gland
PU/PD- calcium interferes w/ ADH receptorscarcinoma

Question 29

How do mesenchyme tumors present?

Answer 29

Elongated nuclei and cytoplasmic tails (spindle cells), may be few cells present, cells usually individual but sometimes in clusters w/ intercellular matrix. active fibroblasts resemble malignant mesenchymal cell

Question 30

What are examples of soft tissue sarcomas? What are the grading schemes associated w/ histopathology?

Answer 30

• Fibrosarcoma, hemangiopericytoma, neurofirossarcoma, peripheral nerve sheath tumor, poorly differentiated sarcoma
• Grading system:! low grad canine cutaneous sarcomas have a recurrence rate of 25% after surgery survival time is 118 weeks, 2 % metasttic rate.
o High grade sarcomas- recurrence rate of 62% after surgical excision, mean survival time of 49 weeks and metastatic rate of 15%

Question 31

What are examples of non neoplastic, non inflammatory sold tissues?

Answer 31

• Hematomas, seromas, cysts, some infectious agents (Cryptococcus, malasexzia)
o Macros that have phagocytized RBC that contain hemosiderin- is it a hematoma?
o Salivary mucocele- very viscous fluid, hematoidin crystals often in the cells.