Cytology Flashcards by Linde Saunders

What are the advantages of cytology? (4)

simple, quick sampling & examination
inexpensive
minimally invasive
Fast turn around time

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When can cytology outperform routine histopathologic exam?

when cell detail is critical (round cell tumors)

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What are the advantages of biopsy (histopath)? (4)

Provides info on tissue architecture
Grading
Invasion
Easier to perform immunohistochemical examination (unusual lesions)

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What are some common mistakes made during sampling? (9)

creating a vacuum w/ the syringe 
contaminating the sample w/ blood
only sampling the middle of the lesion
forceful spraying of the sample
too little or too much pressure 
Not blotting the fresh cut surface dry (imprint smears)
Open formalin jars close 
Refrigerating samples
Not adequately describing the lesion (providing too little info)

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When is it appropriate to perform an actual aspiration?

If several attempts w/ the needle only have failed

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Which type of cells can only be examined in cytology?

only INTACT cells

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Why should you provide the DDX along with your cytology preps?

can comment whether or not the cytologic picture is consistent/inconsistent w/ each of the listed DDX

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Systematic approach to Cytology Specimens

Evaluate quality of smear
Scan entire slide on low mag (4x)
Assess cellular arrangement
Decided if it’s inflammatory or neoplastic

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What 3 things evaluate the quality of a prep?

Adequate amount of cells
Adequate spread (thin areas)
Adequate staining

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What do you do once you have decided a prep is inflammatory?

Decided if septic or not

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What are the 3 categories of neoplasia?

Round cell tumor
Epithelial tumor
Mesenchymal/spindle cell tumor

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What are the 4 different cell-type classifications for inflammation?

Neutrophilic (suppurative, purulent)
Mixed
Mononuclear
Eosinophilic

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What is seen in neutrophilic inflammation?

> 70% of inflammatory cells = neutrophils

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What is seen in mixed inflammation?

50-70% neutrophils

remainder: macrophages &/or lymphoid cells

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What is seen in mononuclear inflammation?

> 50% of cells are macrophages &/or lymphocytes

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What are the 2 types of mononuclear inflammation?

Histiocytic/granulomatous

Lymphocytic

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What does the presence of degenerate neutrophils suggest?

lesion was caused by bacterial infection

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What are the common sites Histoplasma capsulatum infects?

lymph nodes
intestinal mucosa
bone marrow

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What is the main inflammatory cell type seen in Histoplasma capsulatum infections?

macrophages

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What are the common sites of infection for Blastomyces dermatiditis?

Draining skin lesions
lymph nodes
respiratory samples

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What is the main inflammatory cell type seen in Blastomyces infections?

mostly neutrophils w/ some macrophages `

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What is the common site of infection for Dermatophilus congolensis?

scaly, scabby, cutaneous lesions in cattle

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What is the main inflammatory cells seen in the lesions of Dermatophilus?

few, mostly keratinzed squamous cells/debris

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What is the common site of infection for Sporotrichum schenkii?

draining lesions of cats

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What is the main inflammatory cells seen in the lesions of Sporotrichum?

neutrophils, possible degenerate

What are the common sites of infection for Leishmania?

lymph nodes | bone marrow

What is the main inflammatory cells seen in lesions of Leishmania?

macrophages

_____ glands will have relatively normal appearing cells.

Hyperplastic

What are some examples of discrete or round cell neoplasms? (6)

``` mast cell tumor Canine cutaneous histiocytoma Melanoma (benign/malignant) TVT Cutaneous lymphosarcoma Cutaneous plasmacytoma ```

What are some examples of BENIGN epithelial neoplasms? (6)

``` Perianal gland adenoma kertoacanthoma Sebaceous gland adenoma Basal cell tumor/carcinoma Papilloma Many mammary gland tumors ```

What are some examples of MALIGNANT epithelial neoplasms? (3)

Squamous cell carcinoma Adnexal gland carcinoma mammary gland carcinoma

What are some examples of BENIGN non-epithelial neoplasms?

Lipoma Fibroma Hemangiopericytoma

What are some examples of MALIGNANT non-epithelial neoplams?

``` Fibrosarcoma Osteosarcoma Liposarcoma Chondroscarcoma Rhabdomyosarcoma ```

What 3 malignant non-epithelial neoplasms are invasive to the SQ?

Osteosarcoma Chondrosarcoma Rhabdomyosarcoma

How is determination of malignancy usually based?

Based on the morphologic features of pleomorphism

What are the "Cytologic Criteria of Malignancy"? need to have >3

``` Anisokaryosis Variable N:C ratio due to large nuclei Poikilokaryosis Abnormally prominent or multiple nucleoli w/ variable sizes/shapes ABNORMAL mitotic figures Nuclear molding Increased cytoplasmic basophilia Abnormal cytoplasmic vacuolization &/or secretory granules ```

Cytologic characteristics of round cell (discrete) tumors? | 4

round cell w/ round nuclei Individual appearance of cells Well defined cell borders Good exfoliation

When is it difficult to distinguish a histiocytoma from an inflammatory lesions?

When the histiocytoma undergoes spontaneous regression

Characteristics of epithelial cells (glandular & non-glandular)?

shape: round, oval, polyhedral or columnar Arrangement: sheets, clusters or rafts Well-differentiated cells have abundant cytoplasm Can have cell-to-cell jxns Exfoliate well

Characteristics of spindle/mesenchymal cells (C.T.)?

Shape: elongated or spindle-form w/ cytoplasmic tails Arrangement: individually or unorganized clumps of cells Scant cytoplasm w/ indistinct cell borders Exfoliate poorly

What do you never do when interpreting lymph node aspirates? Why?

Interpret under-stained areas | will always look like lymphoma

What are the 5 categories for Lymph Nodes?

``` Normal Hyperplastic/reactive Lymphadenitis Lymphoma Metastatic neoplasia ```

Cell types found in a "Normal" Lymph node?

>90% small, mature lymphocytes low #'s of medium to large lymphocytes Occasional macrophage

Definition of a hyperplastic lymph node.

Enlarged lymph node w/ cell proportions similar to normal tissue

Cell types found in a "Hyperplastic" lymph node?

incr. # of MD to LG lymphocytes (still < 50%) | possible incr. in plasma cells & mitotic figures

"Lymphadenitis" is due to ________.

incr. % of inflammatory cells

Neutrophilic lymphadenitis

increase in neutrophils ( > 5%)

Eosinophilic lymphadenitis

increase in eosinophils ( > 3%)

Histiocytic lymphadenitis

increase in macrophages

Celly types found in a "Lymphoma" lymph node?

``` > 50% immature (MD to LG) lymphocytes (MONOTONY) Possible incr in mitotic figures low #'s of small, mature lymphocytes +/- plasma cells ```

Cell type found in a "Metastatic neoplasia" lymph node?

foreign cells

What are the advantages of liver cytology?

complements other DX tools may provide a specific DX cheap, non-invasive, safe

What are the limitations of Liver cytology.

best for diffuse lesions | Does NOT replace histopathology

What is the gold standard for examining liver cytology?

histopathology

What are the parts of the respiratory tract that can be evaluated by cytology?

Nasal cavity-nasal flush Airways- LRT by trans tracheal wash or BAL Lungs (paranchyma)-FNA Thoracic Cavity- Pleural flush

What do you need to do before you collect a histopathology/cytology sample of the nasal cavity?

Check clotting function and CBC

Are nasal swabs useful for cytology?

Sometimes, if lots of discharge is present, can ID fungal infections, but it is often nonspecific and only ID's inflammation.

What is the best way to collect cells from the nasal cavity?

Nasal Flush

What are normal findings in nasal cytology?

Low cellularity small amounts of mucus Low numbers of extra cellular bacteria (normal flora) Epithelial cells

What do normal epithelial cells of the nasal cavity look like?

Non-keratinized squamous with surface bacterial. Cilliated colomnar respiratory epithelium goblet cells

What are abnormal cytology findings from the nasal cavity?

Rhinitis (inflammation)- Neuts, Macs, lymphos, plasma cells with or w/o fugni or bacteria Increased mucus & goblet cells Changes to epithelial cells- hyperplasia, dysplasia, metaplasia

What are the 4 types of rhinitis and what cells do you find?

BacT- degenerate Neuts w/ IC bacT. (2ary to foriegn body) Fungal- Neuts and Macs maybe fungi, can be hard to dx Allergic- Eos, Neuts, Mast & Plasma cells (rare) Chronic-Lymphos, plasma cells, Macs and Neuts

What types of Neoplasia occur in the nasal cavity?

Adenocarcinoma, squamous cell carcinoma and lymphoma (cats)

Can neoplasia be Dx via nasal flush?

Yes but often require histopathology. Need to be able to differentiate btwn hyper/meta/dysplasia

Cytology Flashcards

(64 cards)