Cytology Sample Collection - Ex 6 Flashcards Preview

724 Clin Path > Cytology Sample Collection - Ex 6 > Flashcards

Flashcards in Cytology Sample Collection - Ex 6 Deck (24):
1

Sample Collection - Solid Mass

1. Aspiration 2. Fenestration 3. Impression smear

2

Sample Collection - Fluid-filled Mass

1. Aspiration - direct smear - concentration preparation

3

Sample Collection - Excised Tissue

1. Imprint - blot tissue thoroughly - roll 2. Swab

4

Sample Collection Guidelines

1. Sample multiple areas 2. Aspirate edges of large lesions 3. Do NOT heat fix!! 4. Do NOT expose to formalin!

5

Aspiration/Fenestration

- Sterile 22G needle - 6 or 12 cc syringes - Stains - Scope

6

FNA - steps

1. attach needle to syringe and position needle in the mass 2. rapidly pull back several times 3. release pressure and withdraw lesion 4. take needle off --> pull air into syringe 5. reattach needle to syringe and expel air through to push cells onto slide 6. use additional glass slides to smear sample 7. air dry and stain

7

FNF - steps *good for firm, nodular lesions

1. 18 to 20 G needle 2. repeatedly reposition the needle in the mass without withdrawing needle from skin 3. expel cells in the needle hub onto a slide using air-filled syringe 4. use additional slide to smear 5. air dry & stain

8

Impression Smear - steps

1. gently press clean glass slide onto the surface of the lesion 2. air dry and stain **good for ulcerated lesion

9

Fluid-filled lesions

1. perform FNA 2. place portion of fluid into sterile tube for bacti or fungal culture 3. place additional fluid in an EDTA or heparinized tube 4. make direct smear *if cellularity is low - centrifuge and remove the supernatant and smear the cell pellet

10

Imprint - steps

1. cut section 2. blot vigorously to minimize blood contamination 3. press onto the slide multiple times

11

Artifacts

1. US/lubricant gel - eosinophilic material obscures cells - AVOID at all costs 2. glove powder 3. pollen 4. anucleated squamous epithelial cells - skin surface contaminants - finger prints on slides

12

What can damage cells?

- heat fixation - formalin fixation - poor sample handling *cell lysis, samples too thick, or poor staining technique

13

Staining - Cytology

1. Romanowski-type stain - diff-quick - extra time in fix for thick samples - send through stains twice if needed 2. Gram stain - only useful to determine if bacteria are Gram-+/- - NOT a 'cytological' stain

14

Slide Examination

* Cellularity - high vs low * Cellular components - inflammation - hyperplasia - neoplasia * Background - blood - protein - broken cells

15

Cytologic Interpretation - Cysts

poorly cellular fluid-filled

16

Cytologic Interpretation - Hemorrhage

blood erythrophagia

17

Cytologic Interpretation - Inflammation

purulent pyogranulomatous lymphocytic eosinophilic

18

Cytologic Interpretation - Mixed

inflammatory & non-inflammatory cells

19

If a cytologic description does not make your clinical findings...

... question it! *small sample, may not represent lesion *consider re-aspiration or biopsy with histopathology

20

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Gel 

21

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More Gel 

22

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Glove Powder 

23

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Pine Pollen 

24

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Surface Epithelium