Cytology of Solid Tissues

Question 1

types of cytologic samples

Answer 1

fluids

needle aspirates

solid tissue imprints

Question 2

advantages of cytology to clinician/practitioner

Answer 2

economical

rapid

profitable to practice

Question 3

advantages over histopathology

Answer 3

Round cell tumors-easier to detect

Detection, Identification of microorganisms

No shrinkage artifact

Question 4

disadvantages

Answer 4

Non-diagnostic samples

No tissue architecture
- cant: characterize tissue invasion, see relationship with inflammation, distinguish hyperplasia from neoplasia in some tissues, grade tumors

Small sample size

Question 5

Basic rules to specimen evaluation

Answer 5

1) Understand what normal looks like for various collection sites
2) Examine the ENTIRE specimen at low magnification
3) Only evaluate intact cells, avoid areas that are thick, understained
4) Recognize artifacts & contaminants

Question 6

what is the start of a logical standard approach to cytology

Answer 6

inflammatory vs non-inflammatory

Question 7

FNA slide preparation

Answer 7

Prepare films quickly (can use EDTA)

Too thick or broken cells = non-diagnostic

Air dry

Keep away from formalin!
– Don’t ship slides in same box with biopsy

Stain
– Diff-quik, Wright-Giemsa

Question 8

non-diagnostic samples: only blood

Answer 8

Needle too large

Lesion is vascular

Lesion is mesenchymal tissue (connective tissue)

Question 9

non-diagnostic samples: all cells broken

Answer 9

Material clotted prior to making smear

Not gentle enough when making smear

Question 10

non-diagnostic samples: cells too thick to interpret

Answer 10

Didn’t spread cells out adequately

Made “squirt” preparation

Question 11

non-diagnostic samples: nothing on slide

Answer 11

Missed lesion

Lipoma (fat dissolved in alcohol dip)

Lesion is connective tissue

Inadequate staining due to formalin fumes

Made preparation next to formalin

Mailed samples in same box with tissues fixed in formalin

Inadequate staining due to age of sample - Should stain within 4 to 5 days of making smear.

Question 12

T/F ulcerated lesion may not have representative cells on imprint

Answer 12

true

bacteria and neutrophils almost always present

Question 13

why should you not refrigerate slides

Answer 13

condensation and cell lysis

Question 14

what will fingerprints on the slide result in

Answer 14

keratin artifacts

Question 15

cytology of inflammatory lesion

Answer 15

what kind of inflammatory cells present

is inflammation due to infectious agent

Question 16

organisms other than bacteria to look for

Answer 16

Systemic fungal diseases (Histoplasmosis, Cryptococcosis, Blastomycosis, Coccidiodomycosis)

Other fungal: Sporotrichosis, Aspergillus

Protozoal diseases (Leishmaniasis or Toxoplasmosis)

Question 17

T/F if have lots of lymphoblasts you have lymphoma

Answer 17

true

Question 18

how to recognize malignancy

Answer 18

1.Variability/pleomorphism (criteria of malignancy)

2. Cells where they don’t belong.
   Eg, epithelial cells in lymph nodes or abdomiinal fluid.

Question 19

T/F malignant neoplasms can have monotonous population of cells, usually have no significant inflammation, cellular piling

Answer 19

true

Question 20

Nuclear criteria of malignancy

Answer 20

Anisokaryosis (variation in size of nuclei)

Abnormally clumped chromatin

Abnormal nucleoli

Abnormal mitotic figures

Micronuclei (satellite nuclei)

Variable sized nuclei in same cell

Nuclear molding

Question 21

classification of neoplasms

Answer 21

Round (discrete) cell tumors

Tumors of epithelial origin

Tumors of connective tissue origin

Question 22

types of round cell tumors

Answer 22

Lymphoma (lymphosarcoma)

Plasma cell tumors

Histiocytomas

Transmissable venereal tumors

Malignant histiocytosis

Question 23

epithelial tumors

Answer 23

omas, adenomas, adenocarcinomas

Some have distinctive appearance, such as endocrine tumors, basal cell tumors, perianal gland tumors, etc.

Question 24

mesenchymal tumors

Answer 24

omas, sarcomas

Lipomas

hemangiopericytomas

hemangiosarcomas

osteosarcomas

chrondrosarcomas

Question 25

round cell tumors

Answer 25

cells usually individual (discrete) usually plenty of cells present circular cells with round nuclei, distinct cytoplasmic borders may be well differentiated (mast cell tumors)

Question 26

T/F cutaneous and subcutaneous plasma cells tumors are typically benign in behavior

Answer 26

true

Question 27

plasma cell tumors in bone marrow

Answer 27

multiple myeloma | very malignant, serum glob will be increased

Question 28

Transmissible venereal tumors

Answer 28

Round cells with discrete vacuoles in the cytoplasm TVT exfoliate readily, can imprint instead of aspirating **can be anywhere**

Question 29

histocytoma

Answer 29

typically young dogs (4-8 m;

Question 30

malignant histiocytic tumors

Answer 30

usually in large breed dogs can be either single tumors or systemic tumors like lymphoma If they are everywhere they are referred to malignant histocytosis Will have the round cells but will also have multi nucleated cells Can be derived from the monocytes line in the bone marrow- will be phagocytic

Question 31

Mast cell tumors-summary

Answer 31

granules; Diff Quik problem (5%?); eosinophils

Question 32

Histiocytoma- summary

Answer 32

often young dog (can be any age), benign appearing

Question 33

TVT summary

Answer 33

location (+/-), cytoplasmic vacuoles, prominent nucleoli

Question 34

lymphoma summary

Answer 34

small amt of cytoplasm, usually blast cells

Question 35

plasma cell summary

Answer 35

eccentric nuclei, Golgi, abundant cytoplasm

Question 36

Malignant histiocytosis, histiocytic sarcoma summary

Answer 36

abundant vacuolated cytoplasm, many multinucleated cells, look like macrophages with criteria of malignancy

Question 37

epithelial tumors

Answer 37

cells in sheets or clusters cells often large with abundant cytoplasm

Question 38

hepatoid tumors

Answer 38

resemble liver cells- lots of cytoplasm and single prominent nucleolus Common, tend to be benign and responsive to testosterone: usually neuter at time of removal

Question 39

T/F is a lesion is proliferating and eroding it is usually a tumor or fungal infection

Answer 39

true

Question 40

mesenchymal tumors

Answer 40

Elongated nuclei and cytoplasmic tails (spindle cells) Cells usually individual Active fibroblasts resemble malignant mesenchymal cells

Question 41

soft tissue sarcomas

Answer 41

Fibrosarcoma Hemangiopericytoma Neurofibrosarcoma Peripheral nerve sheath tumor Poorly differentiated sarcoma

Question 42

T/F soft tissue sarcoma grading schemes are based on histopathology

Answer 42

true

Question 43

examples of epithelial tumors

Answer 43

SCC, Thyroid tumor

Question 44

non neoplastic, non inflammatory agents

Answer 44

Hematomas, seromas Cysts Some infectious agents Eg, Cryptococcus, Malasezia

Question 45

what can you see with hematomas

Answer 45

macrophages have phagocytized RBCs and contain hemosiderin

Question 46

what are hematoid crystals

Answer 46

RBC breakdown product

Question 47

epidermal inclusion cysts

Answer 47

common in dogs looks like brown toothpaste make up of keratin