Cytology

Question 1

• Analyze exfoliated/abraded cells
• Major role in determining etiology of disease

Answer 1

CYTOLOGY

Question 2

• CELLS SEPARATED FROM SUPERFICIAL OR DEEP
  SEROSAL/MUCOSAL SURFACES
• EARLY DETECTION OF MALIGNANCY

Answer 2

EXFOLIATIVE CYTOLOGY

Question 3

Exfoliative Cytology

• IF SUGGESTIVE OF MALIGNANCY

Answer 3

BIOPSY

Question 4

• CELLS TAKEN DIRECTLY FROM SURFACES OF
  EXCISED/INCISED SPECIMENS
  -TOUCH WITH A CLEAN GLASS SLIDE

Answer 4

IMPRINT/ABRADED CYTOLOGY

Question 5

Vocab (imprint/ abraded cytology)

-to surgically remove a part of the body (via cutting off)
-to remove a body part from the body

Answer 5

Excised/ Excision

Question 6

Vocab (imprint/ abraded cytology)

-to make a cut or opening in/on the body (usually with a scalpel)
-no extraction

Answer 6

Incised/ Incision

Question 7

TECHNIQUES IN EXFOLIATIVE CYTOLOGY

• CELLS AND OTHER COMPONENTS ARE SPREAD
  OUT THINLY IN A CLEAN GLASS SLIDE
  -FOR GYNECOLOGIC MATERIALS (CERVICAL,
  VAGINAL, VAGINAL POOL, AND ENDOMETRIAL
  SMEARS)

Answer 7

SMEAR TECHNIQUE

Question 8

TECHNIQUES IN EXFOLIATIVE CYTOLOGY

Perpendicular placement of glass slides

Answer 8

SMEAR TECHNIQUE: CRUSH TECHNIQUE

Question 9

TECHNIQUES IN EXFOLIATIVE CYTOLOGY

Parallel placement of glass slides

Answer 9

SMEAR TECHNIQUE: PUSH-PULL TECHNIQUE

Question 10

TECHNIQUES IN EXFOLIATIVE CYTOLOGY

• PARAFFIN-EMBEDDED SPECIMEN DERIVED FROM
  DIFFERENT FLUIDS/ASPIRATED MATERIALS
  -MAINLY USED WITH SMEARS
• ESTABLISH A MORE DEFINITIVE
  CYTOPATHOLOGIC DIAGNOSIS

Answer 10

CELL BLOCK TECHNIQUE (“MICROBIOPSY”)

Question 11

TECHNIQUES IN EXFOLIATIVE CYTOLOGY

- FREQ. USED IN SUSPECTED MALIGNANCIES

Answer 11

CELL BLOCK TECHNIQUE (“MICROBIOPSY”)

Question 12

ADVANTAGES OF CELL BLOCK TECHNIQUE (“MICROBIOPSY”)

Answer 12

1. Architectural evaluation
   (histologic pattern of tumor)
2. Categorization of tumors that are otherwise not possible for smears 3. Special stains and immunohistochemistry
3. Immunophenotyping, molecular studies (CISH, FISH, PCR)
4. As archival material for future studies

Question 13

CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values

SEROUS FLUID

Answer 13

20-30 mL

Question 14

CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values

GASTRIC WASHING

Answer 14

5-10mL

Question 15

CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values

URINE

Answer 15

3 SAMPLES, FIRST-MORNING-VOID, 50-100 mL

Question 16

CELL BLOCK TECHNIQUE (“MICROBIOPSY”) Values

SPUTUM

Answer 16

SPONTANEOUS/NORMAL TECHNIQUE OR
INDUCED COLLECTION

Question 17

CELL BLOCK TECHNIQUE (“MICROBIOPSY”)
STEPS

Answer 17

1. Centrifuge fluid
2. Decant supernatant
3. Pour 1/2 of the sediments over 10% formalin for cell block until they harden
4. Place hardened sediments for microtomy
5. Process sediments for microtomy
6. Stain using Papnicolau stain
7. Mount sediments
8. Label the slide

Question 18

• COLLECT CELLS USING FILTER WITH SPECIFIC
  PORE SIZE

Answer 18

MEMBRANE FILTER METHOD

Question 19

MEMBRANE FILTER COMPONENTS

Answer 19

POLYCARBONATE + CELLULOSE ESTERS

Question 20

• CYTODIAGNOSIS OF URINE, SPINAL FLUID,
  BRONCHIAL WASHING, SUBS W/ ↓ CELLULAR CONTENT

Answer 20

MEMBRANE FILTER METHOD

Question 21

• CELLS ARE ISOLATED VIA SERIES OF
  CENTRIFUGATION STEPS
• CONCENTRATES CELLS INTO SMALL
  SUSPENSION

Answer 21

CONCENTRATION TECHNIQUE

Question 22

CYTOSPIN + SEDIMENTAION PREPARATIONS

Answer 22

CONCENTRATION TECHNIQUE

Question 23

• ENABLES CELLS TO BE SPREAD IN A SINGLE LAYER

Answer 23

LIQUID-BASED CYTOLOGY

Question 24

LIQUID-BASED CYTOLOGY

TWO COMMON METHODS

Answer 24

1. ThinPrep
2. SurePap

Question 25

ADVANTAGES OF LIQUID-BASED CYTOLOGY

Answer 25

1. **Improved cell representation** 2. **Improved specificity & sensitivity** due to **better fixation** and **well visualized nuclear details** 3. **Abnormal cells are clearly seen & easily identified** (not obscured by blood, mucus, & inflammatory cells which contribute to unsatisfactory smears) 4. **Remaining/ residual cell suspension can be used to make further cytological preparations or other tests** (detection of HPV DNA and imunocytochemistry)

Question 26

- USED TO OBTAIN SPECIMENTS THAT **DO NOT SHED** CELLS SPONTANEOUSLY - USED FOR DIAGNOSING ANY **PALPABLE LESIONS** AND **DEEP-SEATED/NON-PALPABLE LESIONS**

Answer 26

**ASPIRATION CYTOLOGY**

Question 27

# Aspiration Cytology Techniques - MOSTLY ON PALPABLE SUPERFICIAL LESIONS - HAS **BOTH DIAGNOSTIC AND THERAPEUTIC** INDICATIONS

Answer 27

**FINE-NEEDLE ASPIRATION BIOPSY (FNAB)**

Question 28

# Aspiration Cytology Techniques ACCURACY OF TEST MAY DEPEND ON **SIZE OF LESION** (I.E. SMALLER = ↓ SENSITIVE)

Answer 28

**FINE-NEEDLE ASPIRATION BIOPSY (FNAB)**

Question 29

* TEST FOR **CERVICAL CANCER** IN WOMEN - **HUMAN PAPILLOMAVIRUS (HPV)**

Answer 29

**PAPANICOLAOU SMEAR (PAP SMEAR)**

Question 30

# Fill in the Blanks ”ALL __ ARE CAUSED BY __, BUT NOT ALL __ CAUSE __.”

Answer 30

**”ALL *CERVICAL CANCER CASES* ARE CAUSED BY *HPV*, BUT NOT ALL *HPV INFECTIONS* CAUSE *CERVICAL CANCER*.”**

Question 31

# PAP Smear Specimen Requirements AGES 21 TO 29

Answer 31

**CERVICAL CYTOLOGY ALONE EVERY 3 YEARS**

Question 32

# PAP Smear Specimen Requirements AGES 30 TO 65

Answer 32

**CERVICAL CYTOLOGY ALONE EVERY 3 YEARS W/ hrHPV TEST ALONE EVERY 5 YEARS OR BOTH TESTS EVERY 5 YEARS**

Question 33

# PAP Smear Specimen Requirements AGES < 21 & >65

Answer 33

**NO TESTING**

Question 34

- IF SMEAR SHOWS EPITHELIAL CELL ABNORMALITY: **COLPOSCOPY & BIOPSY**

Answer 34

**PAP SMEAR DIAGNOSTIC TEST**

Question 35

PAP SMEAR TESTING PROCEDURE

Answer 35

1. COLLECT CELLS FROM **TRANSFORMATION ZONE** 2. PROCEED WITH EITHER **LIQUID-BASED CYTOLOGY** OR **CONVENTIONAL METHOD**