Cytology

Question 1

Cytopathology

Answer 1

Study of diseased/ abnormal cells
Labs downsizin and being absorbed by Histopathology Labs

Question 2

Exfoliative Cytology

Answer 2

• Cells shed from a surface.
• Cells being shed into a space/fluid (sputum/urine) or directly scraped off (bronchoscopy/cervical smear).
• Often first line investigation : fairly easy to collect
  -Patient with unknown effusion aspirated (sucked up) with syringe
• Looked at down a microscope : spun down to concentrate cells together.

Question 3

Abrasive cytology

Answer 3

Cells removed by brushing/ similar abrasive techniques

Question 4

Fine Needle Aspiration Biopsy (FNAB)

Answer 4

Removal of cells from palpable/deeply seated lesions by means of needle with/without a syringe

Question 5

Fine Needle Aspiration Sample/Biopsy

Answer 5

Solid organs/ solid lesions
Testicles
Breast
-Liver
Kidney
Material can be aspirated into suspension and spun down
- then can be stained and viewed down a microscope?

Question 6

Difference between Histology and Cytology

Answer 6

Squamous Epithelium: - When tumours/cancer cells break through this layer it becomes more problematic (pre-cancerous before hand) as it can spread.
Histology shows you architecture.
cytology - nuclear cytoplasmic ratio is looked at in stratified squamous epthelium.

Question 7

Failure of maturation in dysplastic cells??

Answer 7

Cervical smear sample
Should mostly comprise superficial cells
- An increased proportion of immature cells indicates a possible pathology
- Dysplatic cells: cells showing abnormally increased growth or developmeny

Question 8

Why do we screen for disease

Answer 8

Cytology cant diagnose cancer but can only suggest it - can show if patients need more investigation, screening can clear patients with no signs of cancer.

Question 9

Cytology

Answer 9

Cytology:
- Detailed look at cells.
- Quick (minutes)
- Limited specificity
- Minimally invasive: Varies from urine in a pot to a needle sample
-Sample an invisible lesion : Bronchial washings, urine sample

Question 10

Histology:

Answer 10

• Tissue structure
  Relatively slow (minimum hours)
  Highly specific
  Moderately to severely invasive
• Varies from a small cut to whole organ removed
  Need to see something to sample it
• Sometimes representative samples are taken

Question 11

Diagnosis using Cytology - What do cytologists look for?

Answer 11

• Abnormal chromatin pattern
• Hyperchromasia
• Nucleo/cytoplasmic ratio
• Irregular nuclear outline
• Hyperchromatic
• Crowded Cell Groups (HCCG)

Question 12

Changes in the role of cervical cytology

Answer 12

Cervical cancer increasingly linked to HPV (HPV test replaces primary cervical screening)

Question 13

Respiratory Cytology: Asbestos

Answer 13

Asbestos fibres / ferruginous bodies
- More detail in lung lect
- Strong links to meothelioma

Question 14

Respiratory Cytology: Bronchoscopy

Answer 14

Been around for years
Can biopsy lesions
Can “wash” areas and suction the fluid to look for cells – “invisible lesions”

Question 15

Respiratory Cytology - EBUS-TBNA (Endobronchial Ultrasound-guided TransBronchial Needle Aspiration)

Answer 15

• New(ish)
• Mediastinal lymph node staging is one of the most important factors affecting patient outcome.
• Fine needle inserted into lymph nodes – guided by ultrasound
• Accurate staging is vital to determine the prognosis and the most suitable treatment plan.
• Slides can be made for H&E and / or ICC
• Cell blocks can be prepared
• Big growth area for molecular pathology and improcing patient outcomes
• Aneasthetic only needed once, going into theatre only once – preferred.

Question 16

Joint Cytology

Answer 16

• Swollen inflamed joint
• Aspirate fluid
• Crystals- cause painful pressure on joints and indicate gout or pseudogout (each form different crystals which are different colours)
• Enables correct treatment