VAGINAL HORMONAL CYTOLOGY AND EXFOLIATIVE CYTOLOGY Flashcards
where in the vaginal wall is specimen bast taken for vaginal hormonal cytology
upper lateral third of the vaginal wall
t/f vaginal hormonal cytology may be performed regularly without undue risk
t
cells with dark pyknotic nuclei
mature superficial cells
(characteristic of superficial vaginal cells under estrogen influence)
true acidophilia
- polygonal squamous cell
- pale, pink - staining cytoplasm
mature superficial cells
medium-sized polyhedral or elongated cells with basophilic cytoplasm showing vacuoles
intermediate cells
boat - shaped with tendency to fold or curl on edges
navicular cells
combined estrogen-progesterone effect
navicular cells
Observed in latter half of the menstrual cycle or during pregnancy or menopause
navicular cells
- medium sized
- polyhedral or elongated
- basophilic cytoplasm
intermediate cells
fried egg appearance
parabasal cells
strongly basophilic cytoplasm and a large vesicular nucleus
parabasal cells
In what circumstances are parabasal cells observed
- 2 weeks of age to puberty
- After childbirth
- Abortions
- After menopause
slightly cylindrical w/ less basophilic cytoplasm; found during and 1-4 days after menstruation
endometrial cells
- round to oval
- small basophilic cytoplasm
parabasal cells
- large groups or small sheets
- pale blue/gray cytoplasm
- indistinct cell borders
- finely granular chromatin
endocervical cells
- Small round to slightly oval cells with relatively large nuclei
- Found before puberty and after menopause
basal cells
Presence of a “palm leaf” pattern (arborization) on drying of the vaginal or cervical secretions due to formation of salt crystals under the influence of estrogen (inhibited by progesterone)
ferning
CRITERIA FOR CYTOLOGIC DIAGNOSIS OF NORMAL PREGNANCY
- Marked progesterone effect (NO ferning)
- At least 50% of intermediate cells in clusters
- Some typical pregnancy cells present
- Less than 30% superficial cells
- Doderlein-filled “dirty” background
papanicolau stain
- Harris Hematoxylin
- OG 6 (Orange Green 6)
- EA – 36 or EA – 50
nuclear stain/basophilic stain
Harris hematoxylin
made up of 0.5
- 1.0% solution of OG in 95% EA and PTA
- Intensifier or differentiator
OG 6
Advantages of Pap’s stain
- Transparent blue stain of the cytoplasm; allows overlapped cells to be identified
- Excellent nuclear details
- Color range is predictable and of great value in identification and classification of cells
- Valuable in comparing cellular appearances in smears
binds with nucleic acids
Acridine Orange
color or RNA under fluorescence microscope
brick to orange red
color of DNA under fluorescence microscope
green and yellow
signifies growth
Increased basophilia (RNA)
signifies malignancy
Increased acidophilia (DNA)
2nd best choice after Pap’s staining
phase-contrast microscopy
Used for hormonal evaluation of gynecologic specimen and for CA detection
Phase - Contrast microscopy
Determines dry weight of individual cells or cellular constituents
Interference microscopy
CA cell nucleus and cytoplasmic dry weight is LESS than that of normal cells
Interference microscopy
Branch of medicine which deals with the study of cells that are exfoliated or scraped off from the lining epithelium and mucosa of different organs
exfoliative cytology
t/f Exfoliative cytology deals with cells that have been desquamated from epithelial surfaces
t
study of abnormal cells (e.g. CA cells)
cytopathology
study of the different methods of preparing the cells of microscopic examination
cytotechnique
sym. Malignancy; cells are markedly undifferentiated histologically
cancer
- For diagnosis of cancer
- For differentiation between malignant and benign tumors
- Differentiate tumors from other diseases (e.g. infections, inflammations or degenerations)
exfoliative cytology
- Assessment of hormonal status of an individual (determine fertility conditions among males and females)
- Determination of “true sex” of an individual
exfoliative cytology
variance of size, shape, form and appearance of the cells
pleomorphism
increase in staining affinity above the normal, affecting mainly the nuclear structures (in contrast to vesicular staining of cytoplasm)
hyperchromatism
increases in the no. of nuclei
multinucleation
abnormal stages
atypical mitotic figures
criteria for microscopic dx of cancer
- pleomorphism
- hyperchromatism
- multinucleation
- atypical mitotic figures
- reversal pf the nucleo-cytoplasmic ratio (N:C ratio)
condensation of the chromatin materials
pyknosis
breaking down of nuclear components
karyorrhexis
breaking down of nuclear structures
karyolysis
ability for reproductive function
fertility
Usually determined by assessment of the hormonal status of a female (Vaginal Hormonal Cytology)
fertility
fertility is Usually determined by assessment of ____
the hormonal status of a female (Vaginal Hormonal Cytology)
CHANGES IN THE CELL MEMBRANE
a. Variation in size, shape or form of the cell
b. Enlargement of the cells
c. Diminution in size of the cells
d. Indistinctness in the cellular boundary
changes in the cytoplasm
a. Excessive cytoplasmic inclusions (e.g. pigment granules)
b. Disintegration of the cytoplasmic organelles
c. Dissolution of cytoplasmic components
CHANGES IN THE NUCLEUS
a. Pyknosis – condensation of the chromatin materials
b. Karyorrhexis – breaking down of nuclear components
c. Karyolysis – breaking down of nuclear structures
T/F exfoliative cytolgy can detect infectious agents
t
specimen for sex determination
scrapings from the buccal and vaginal mucosa
True sex is determined based on the presence of ________
Barr bodies
inner aspect of nuclear membrane
barr bodies
Sample collection for exfoliative cytology from the lining epithelium and mucosa of the female reproductive tract includes which areas?
Vagina, cervix, and endometrium
How are prostatic secretions collected for exfoliative cytology?
By massage through intrarectal route using the middle and index fingers.
How are bronchial secretions or sputum collected for exfoliative cytology?
Through a “deep cough” specimen or bronchoscopic aspiration.
How are gastric contents and duodenal fluid obtained for exfoliative cytology?
By intubation technique using a naso-gastric tube.
Describe the characteristics of gastric contents collected for exfoliative cytology.
Watery, acidic fluid with food debris.
Greenish-yellow, alkaline, and mucoid.
duodenal fluid
watery, acidic fluid with food debris
gastric contents
lumbar tap done on the intervertebral spaces between the 2nd and 3rd lumbar vertebra
CSF
what is used to collect CSF sample for exfoliative cytology
vim silverman needle
How is cerebrospinal fluid (CSF) obtained for exfoliative cytology?
By lumbar tap done on the intervertebral spaces between the 2nd and 3rd lumbar vertebra using a Vim Silverman needle.
How is pleural fluid obtained for exfoliative cytology?
By thoracocentesis.
How is pericardial fluid obtained for exfoliative cytology?
By pericardiocentesis.
How is peritoneal fluid obtained for exfoliative cytology?
By paracentesis abdominis.
Which sample is collected for exfoliative cytology using thoracocentesis?
Pleural fluid.
Which sample is collected for exfoliative cytology using pericardiocentesis?
Pericardial fluid.
Which sample is collected for exfoliative cytology using paracentesis abdominis?
peritoneal fluid
What type of sample is collected from bone marrow for exfoliative cytology?
Bone marrow sample.
What type of sample is collected for exfoliative cytology to analyze urinary sediments?
urinary sediments
obtained by thoracocentesis
pleural fluid
obtained by pericardiocentesis
pericardial fluid
obtained by paracentesis abdominis
peritoneal fluid
sample collection for exfoliative cytology
a. scrapings and aspirates
b. prostatic secretions
c. bronchial secretions or sputum
d. gastric contents and duodenal fluid
e. CSF
f. pleural fluid
- pericardial fluid
- peritoneal fluid
g. bone marrow
h. urinary sediments
PREPARATION OF CYTOLOGIC SMEARS
- Touch Preparation
- Spreading
- Streaking
- Pull-apart
- Teasing
Specimen that requires an adhesive:
- Urinary sediment
- Bronchial lavage specimen
- Specimen that utilizes proteolytic enzymes during processing
adhesives
- Pooled human serum or plasma
- Celloidin ether or alcohol
- Leuconostoc culture
T/F Smears should be placed into the fixative immediately after preparation
T
common fixatives
- Ethyl ether
- 95% ethyl alcohol
- Isopropyl alcohol with ethyl alcohol
- Acetone with glycol
- Carnoy’s fluid
- Delaunoy’s fluid
T/F Exfoliated cells decompose rapidly. Drying rapidly destroys cellular and nuclear details
T
Average size of mature superficial cells
45-50u
In what stage of menstruation will there be an increase in the level of progesterone
Luteal phase
Round, oval, or boat-shaped cells with translucent basophilic cytoplasm
Pregnancy cells
Double walled boundary appearance
Pregnancy cell
Intermediate cell that has a blue/purple cytoplasm
Pregnancy
- smaller than intermediate cells
- larger vesicular nucleus
Parabasal cells
- Indistinct cells borders
- finely granular chromatin
Endocervical cells
Ensures that the sample is representative of the cervical canal
Endocervical cells
Normal cervical cells
-superficial cells
- intermediate cells
- parabasal cells
- basal cells
Counterstain for Harris Hematoxylin
EA (eosin azure)-36 / EA-50