EXFOLIATIVE CYTOLOGY Prt 1 Flashcards by Kyra Catedral

Non-Gynecologic Specimens

Respiratory Specimens
Gastrointetinal Speicmens
Peritoneal, Pleural, and Pericardial Smears
Urine
Breast Secretions
CSF
Prostatic Secretion

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Cells found in Cervico-Vaginal Smears

A. Mature Superficial Cells
B. Intermediate Cells
C. Parabasal Cells
D. Basal Cells
E. Endometrial Cells
F. Endocervical Glandular Cells
G. Doderlein Bacilli
H. Ferning Phenomenon

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Histology of exfoliated, abraded, or desquamated cells

Cytology

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This is the study or histology of the cells that are being removed from the bodv. Cells that was scraped from the body.

Cytology

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• Study of cells directly taken from surfaces of excised specimens by touching them

Imprint/Abraded Cytology

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Microscopic study of desquamated cells from epithelial surfaces

Exfoliative Cytology

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Study of cells that have been shed or physically removed

Exfoliative Cytology

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EXFOLIATIVE CYTOLOGY PURPOSES

• Assessing cancerous conditions (staging)

• Detection of asymptomatic cancers

• Asessment of female hormonal activity (sterilitv & endocrine disorders) - maturity index

• Determination of genetic sex - Barr bodies (conglomeration of chromatin, XX chromosome)

• Detect presence of possible infection

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Material from fluids of the body may be examined either by:

Preparation of Smears

Preparation of Tissue Blocks (Cell Blocks)

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Here are the examples of different body fluids that we might receive that might be subjected for exfoliative cytology:

Various Regions

• Vaginal Smear
• Endometrial and Endocervical Smear
• Prostatic and breast secretion
• Gastric or bronchial secretions
• Pleural or peritoneal fluids
• Sputum
• Smears of urine sediment
• Cerebrospinal fluid

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SMEAR PREPARATION

• Make smears from fresh and moist material on clean slide; should not have_____

•________ is used to put identifiers on the smear (name, age, date, and type of smear);_______ may also be used.

• Immerse smears immediately in____ by a single uninterrupted motion (exfoliated cells decompose rapidly)

• Spray Fixatives:______

• Avoid_____ in the container to prevent the cells from being dislodged

• Optimal time:______ to allow dehydration, adhesion, and maximal penetration of the fixative

clumps

Diamond pen

frosted-end slides

fixative

12 inches or 1 foot away

vibrations

1 hour

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• Best (yet flammable) fixative
The best fixative but it is flammable.

95% Ethanol-Ether

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• Routinely used fixative

95% Ethanol

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If smears cannot be made immediately, place the collected material in_______ (for all types of effusions) - replaced by_____

50% alcohol

Saccamono’s preservative

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Saccamono’s preservative

50% Ethanol
2% Carbowax

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Storage of sample:

add ROH and refrigerate

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Storage of sample: Alcohol concentration

• 50% alcohol - pleural/peritoneal
• 70% alcohol - sputum
• 95% alcohol - urine, bronchial, gastric

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Fixation of Mailed Specimen:

air-dry for 10-15 minutes after 2 hours of fixation and place it in a container

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If specimen is more than a few drops:

• Centrifuge at 2,000 rpm for 2 minutes

• After centrifugation, decant the supernatant, and we will get a small portion of the sediment, then smear the sediment directly to glass slide, or cytocentrifuge directly on slide with albumin.

• Extra sediment can be used for cell block technique.

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Viscous Specimen

Cervical, Vaginal, Prostate Secretion

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Mucoid Specimens

Sputum
Bronchial
Stomach secretions

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Watery Specimens

Urine, Exudate, Aspirate

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General processing

Viscous Specimen
Cervical, Vaginal, Prostate Secretion

Immerse in ROH ASAP

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General processing

Mucoid Specimens

• Sputum, Bronchial and Stomach Secretions

Dry smear edges before fixing (to avoid runoff)

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General processing Blood Srecimens RBC can be destroyed by adding___________ of the specimen

2-5 mL of concentrated ***Acetic Acid*** per ***100 mL***

General processing Watery Specimens • Urine, Exudate, Aspirate Specimen is______ first and the sediment is smeared in an _______ glass slide. In the event that there is excess sediment, it may be subjected to biopsy.

centrifuged albumin-coated

• For adequate adhesion of smeared material.

ADHESION

• ADHESION not recommended because it will retain the OG (Orange Green) of Pap stain.

Albumin

Specimens that require adhesives:

Urinary sediment BAL (Bronchial Alveolar Lavage) Specimens with proteolytic enzymes (saliva) Concentrated sputum

Characteristics of adhesives:

• Permeable to both fixative and stain

Examples of good adhesives:

• Pooled serum/Plasma • Celloidin Ether Alcohol • Leuconostoc Culture

SPECIMENS • Generally divided into two major areas. We have

non-gynecologic specimens gynecologic specimens

NON-GYNECOLOGIC SPECIMENS 1. RESPIRATORY SPECIMENS

• Sputum • Bronchial brushings • Bronchoalveolar Lavage/Bronchial Washing • Bronchial Aspirate

Demonstrate abnormal cells early in disease

Sputum

Collection of sputum

Fresh, unfixed, atleast 3 consecutive early morning sputum.

3 consecutive collection of early morning sputum must have what time interval?

1 hour

Collection of sputum Patients unable to produce sputum: INDUCED SPUTUM by inhalation of____ for _____

aerosol solution for 20 minutes

Why is aerosol used to induce sputum

Because it can trigger asthma. There will be sputum formation.

Collection of sputum: CONTAINER

Wide mouthed bottle with ***Saccomano's Fluid***

Sputum After collection: • Pour specimen in petri dish, examine for_______ particles • Remove particles, place on slide,_____ with another slide. Evenly distribute. • Fix for a minimum of_____.

solid or blood flecked crush 1 hour

Collection of sputum Absence of_____ and _____ indicates that only saliva was collected.

histiocytes and alveolar macrophages

Collection of Bronchial Brushing • Directly smear on two slides using_____ technique • Fix immediately to avoid production of_____ artifacts

pull-apart air drying

• Bronchoalveolar Lavage/Bronchial Washing Performed in patients with_____ to rule out________ infection Also the causative agent of_____

AIDS Pneumocystis jirovecci pneumonia

Performed in patients with AIDS to rule out Pneumocystis jirovecci infection Also the causative agent of pneumonia

• Bronchoalveolar Lavage/Bronchial Washing

• Bronchial Aspirate Collection:

• aspiration (with glass suction apparatus) or • washing (with saline)

Show evidences of malignancy in advanced stage of the disease

Bronchial aspirate

Bronchial Aspirate - Centrifuge specimen for______, medium speed - Smear must contain… - If specimen is scanty, prepare smear in OR to prevent drying

20-30 mins epithelial cells (ciliated bronchial cells) + RBC and WBC

Among the four respiratory specimen What is the only one collected by the patient?

Sputum

2. GASTROINTESTINAL SPECIMENS • 2 methods

• Through the mouth • Levine method - through nasogastric

Gastrointestinal specimen Collection:

Irrigation Aspiration

Gastrointestinal specimen Difficult due to_____ and presence of____

inaccessibility gastric fluid

Gastrointestinal specimen • Examine ASAP • Sample must be processed as soon as possible •_______ before gastric washing Even_____ is prohibited

8 hours fasting water

3. PERITONEAL, PLEURAL AND PERICARDIAL SMEARS For the extraction of peritoneal, pleural, pericardial fluid

Paracentesis

Collection of PERITONEAL, PLEURAL AND PERICARDIAL SMEARS

Same as bronchial specimens

• Increased fluid indicates vatholoaic process • Presence of malignant cells usually indicate metastasis

PERITONEAL, PLEURAL AND PERICARDIAL SMEARS

Since peritoneal, pleural, and pericardial samples are prone to clotting, ADD

300 units of heparin per 100 mL of aspirate to avoid clots

4. URINE • Collection: • Male -

second-voided urine

• Male - second-voided urine ______is not recommended for cytologic evaluation because the cells may degenerate after spending extended period in acid environment in the bladder

First morning

URINE Collection Female -

catheterized

Because the vagina is prone to bacterial contamination In order to have a sterile sample, it should be…

catheterized

Urine collection • Atleast_____ is needed

50 mL

URINE For more reliable evaluation, urine may be collected and examined twice

Early morning and later in the day

T OR F URINE • Use of preservative is not recommended

True

• For diagnosis of urothelial malignancy and not for prostatic carcinomas

Urine

BREAST SECRETION • Collection:

Spontaneous nipple discharge

Breast secretion Materials

Cotton swab or touch prep ( Touch the nipple directly during discharge using the slide or cotton swab)

For hormonal imbalance testing • Not an indication or phase of cancer

Breast secretion

• Benign breast lesion or endocrine problems • Extremely low diagnostic yield for breast carcinoma diagnosis

Breast secretion

Breast secretion • If bloody =

benign intraductal papilloma

6. CEREBROSPINAL FLUID _______performed to obtain cerebrospinal fluid or CSF Fluid is_____ Minimum of____ is necessary

Lumbar puncture colorless 1 mL

7. PROSTATIC SECRETION 3 specimens required:

• Voided urine before massage • Smear of prostatic secretion by massage • Urine after massage

Prostatic secretion • Cytologic examination of_____ specimen after unproductive massage is recommended

3rd

EXFOLIATIVE CYTOLOGY Prt 1 Flashcards

(72 cards)