HISTOPATHOLOGY Flashcards
(133 cards)
1
Q
Branch of general cytology which deals with the microscopic study of cells desquamated
(Study of cell shed) from epithelial surfaces
A
EXFOLIATIVE CYTOLOGY
2
Q
3 purpose of exfoliative cytology
A
Detect cancerous / malignant conditions
Detect asymptomatic cancer in women
or pre-cancerous cervical lesions
Determination of genetic sex
3
Q
2 types of specimen for cytology
A
Gynecological
NON-gynecological
4
Q
which is for fluid specimen?
A
NON-gynecological
5
Q
3 preparations for non-gynecological specimen
A
Smears (2slides)
Cell block
Cytospin (Centri @ 1000rpm for 1min)
6
Q
The best method to collect cells from body fluids
A
cell block
7
Q
5 specimens for NON-GYNECOLOGIC
A
RESPIRATORY TRACT SPECIMEN (BAL, SPUTUM, GASTRIC SECRETIONS)
BREAST SECRETION
PERITONEAL-PERICARDIAL-PLUERAL FLUIDS
URINARY TRACT SEDIMENT
BODY CAVITIY EFFUSION (CSF, ASCITIC FLUID)
8
Q
4 METHOD IN SMEAR
A
1.Streaking
2. Spreading
3. Pull Apart
4. Touch preparation
9
Q
recommended for thick fluid
A
Pull Apart
10
Q
Also called: Impression Smear
A
TOUCH PREPARATION
11
Q
This may be submitted to cytology to detect or rule out Pneumocystis Jirovecii particularly among AIDS patients
A
BRONCHOALVEOLAR LAVAGE (BAL)
12
Q
MOST COMMON RESPIRATORY TRACT SPECIMEN
A
SPUTUM
13
Q
Sputum must be collected from a _____ and collect at least ______
A
DEEP COUGH
3 CONSECUTIVE MORNINGS
14
Q
Sample must be evaluate if it’s a real sputum , we can do it microscopically. Cell that would indicate satisfactory collection: We look for ______
A
Alveolar macrophages
15
Q
TRUE OR FALSE
- We do fixation ASAP, because the cell will decompose immediately
A
TRUE
16
Q
FIXATIVE FOR SPUTUM
A
SACCOMANO FLUID
17
Q
FIXATIVE FOR BRONCHIAL BRUSHING
A
Spray fixative or 95% Ethanol
18
Q
GASTRIC SECRETIONS / ASPIRATES (Gastric Lavage)
-Required prior to collection: patient must do fasting at least ____
A
8 HOURS
19
Q
GASTRIC SECRETION Immediate transport to the lab is required no delay beyond ____
A
30 MINS
20
Q
This is submitted for testing to rule out possible breast cancer, but compared to mammography and ultrasound it has less chance to detect the breast cancer
A
BREAST SECRETION (Nipple discharges)
21
Q
TRUE OR FALSE
discharge during and post lactation may be abnormal
A
FALSE (NORMAL)
22
Q
TRUE OR FALSE
discharge from breast nipple is usually malignant & may be due to lesion like duct ectasia & papilloma
A
FALSE ( benign)
23
Q
SMEAR PREP FOR BREAST SECRETION
A
PULL APART
24
Q
FIXATIVE FOR BREAST SECRETION
A
spray fix or 95% IP
25
When collecting this sample usually clotted
PERITONEAL-PLEURAL-PERICARDIAL FLUIDS (Body cavity fluid)
26
To prevent jelly clots: we add ____ per _____
300 units of HEPARIN
100ml of aspirates
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URINARY TRACT SPECIMENS Sample is submitted to detect what?
UROTHELIAL MALIGNANCY
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3 URINE SPECIMEN
Voided urine, catheterized urine,
washing from bladder or renal pelvis
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____ urine must be DISCARDED due to
overnight degeneration of cells. ____ is preferred
FIRST VOIDED URINE
SECOND COLLECTION
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IF THERE IS A DELAY IN URINE EXAMINATION WE DO ______
REFRIGERATION
31
TRUE OR FALSE
preservatives should not be added in urine specimens.
TRUE
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For best result ____ URINE specimen must be collected
50mL
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BODY CAVITY EFFUSIONS Specimen MUST BE SUBMITTED _____. amount of CSF ATLEAST _____
FRESH
1mL
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in CELL BLOCK we will not embed the tissue but the _______
sediments
35
3 METHODS OF CELL BLOCK PREPARATION
DIRECT FILTRATION
PLASMA-THROMBIN
CARBOWAX
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Centrifugation fluid, add 1 ml of plasma and add thrombin. This will form gel like substance, place it in a filter paper and
add 10% formalin
(Used filter paper do reduce washing out of the cell)
Advantage – reduce washing out, but expensive
PLASMA-THROMBIN
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Centrifugation fluid, add 10% formalin to sediment.
Disadvantage – easily washed out
DIRECT FILTRATION
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Following centrifugation of fluid, add carbowax to sediment and place in a paraffin block
Advantage – no dehydration step but expensive
CARBOWAX
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ROUTINE METHOD OF CELL BLOCK PREPARATION
DIRECT FILTRATION
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TRUE OR FALSE
1st- Smears should be prepared from old material and must be prepared and FIX while dry.
2nd- We must prevent drying of specimens
1st- FALSE (spx. should be prep fresh, and prep while moist.
2nd- TRUE
41
TRUE OF FALSE
There is specimen that contains Increase Proteins, if specimen contains increase proteins NO need to use Adhesives
TRUE
42
4 specimens requiring adhesives
Urinary sediments
Bronchial lavage
Concentrated Sputum
Specimens with trypsin
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after smear we do fixation, In cytology fixation must be ___mins only
10-15mins
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4 ADHESIVES FOR CYTOLOGY
1.Pooled serum or plasma
2.Celloidin ether alcohol
3.Leuconostoc culture (leuconostoc is a bacteria: Gram positive cocci)
4.APES – 3 aminopropyltriethoxysilane
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Most common tissue adhesive
MAYER’S EGG ALBUMIN
46
We DO NOT used mayers egg albumin in cytology because this can be stained intensely by?
counter stain used in paps
47
THE BEST FIXATIVE FOR CYTOLOGY
95% Ethanol with Ether(but ether is hazardous because it is flammable)
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COMMONLY USED FIXATIVE FOR CYTOLOGY
95% Ethanol
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TISSUE FIXATIVE
10% buffered neutral formalin
50
CAN ALSO BE USED FIXATIVE FOR CYTOLOGY (2 ANSWERS)
1.SPRAY FIXATIVE
2.SACCOMANO PRESERVATIVE
51
May be used but slide must be kept at a distance of 1 foot (12 inches or 30. 5 cm) from the spray
SPRAY FIXATIVE
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This is a combination of 50% alcohol and 20% carbowax
SACCOMANO PRESERVATIVE
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4 OTHER EXAMPLE OF FIXATIVE IN CYTOLOGY
50% alcohol is for all types of effusion
50% Peritoneal and Pleural fluids
70% Sputum specimen
95% Urine, Gastric and bronchial aspirates
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Best FIXATIVE for bloody specimen
Carnoy’s fluid
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It is the Gold standard
staining for cytology
PAPANICOLAU STAIN
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3 dyes in pap's smear
HARRIS HEMATOXYLIN
OG6
EA 50
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This is the Nuclear Stain
HARRIS HEMATOXYLIN
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Counter stain. used to stain cytoplasm of superficial cells
0G6
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Counter stain. used to stain cytoplasm of both parabasal and intermediate cell
EA 50
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STAINING RESULT OF Cytoplasm of the superficial
GREEN
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STAINING RESULT OF OG6
ORANGE WITH HINT OF GREEN
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STAINING RESULT OF Cytoplasm of the parabasal intermediate
BROWN AND RED
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STAINING RESULT OF EA 50
olive green with a hint of brown and red
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STANING RESULT OF BACTERIA
DARK BLUE
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STAINING RESULT OF T.VAGINALIS
GREENINSH BLUE
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STANING RESULT OF VESICULAR NUCLEUS
BLUE
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STAINING RESUT OF PYKNOTIC NUCLEUS
DARK BLUE TO BLACK CYTOPLASM
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STAINING RESULT OF MYCELIA
VIOLET
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It is a screening test for cervical cancer
PAP'S SMEAR
70
THE ONE WHO PREPARE SMEAR
OBGYN
71
TWO METHODS OF PREPARING PAPS SMEAR
CONVENTIONAL PAP'S
LIQUID BASED PAP'S
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IN CONVENTIONAL PAP'S WHAT INSTRUMENT IS USED BY THE OB TO COLLECT THE SPECIMEN
AYRE'S SPATULA
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Directly spread on the slide then send to lab to be process. Crowded cell can be seen microscopically
CONVENTIONAL PAP'S
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use of spatula or brush/broom to collect specimen. Placed in a vial containing preservative. A thin layer of cells is placed on a slide
LIQUID BASED PAP'S
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4 COLLECTION SITES IN LIQUID BASED PAP'S
UPPER 3RD OF THE VAGINAL WALL
ENDOCERVIX
ECTOCERVIX
T-ZONE
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for evaluating of inflammatory conditions
Upper 3rd of the vaginal wall
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SITES FOR THE Detection of endocervical lesions or intrauterine lesions
ENDOCERVIX
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Endocervix is lined up with _______
SIMPLE COLUMNAR EPITHELIUM
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The most common site for cancer screening
ECTOCERVIX
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Ectocervix is lined up with ________
Stratified Squamous Non-Keratinized epithelium
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This Zone is the usual site for collection of Pap’s Smear
T-ZONE
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junction between the Endo and Ectocervix
T-ZONE
83
4 MAIN VAGINAL CELLS
SUPERFICIAL
INTERMEDIATE
PARABASAL
BASAL
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LARGEST AND MATURE 30-60U WITH PYKNOTIC NUCLEI
SUPERFICIAL
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MEDIUM SIZED 20-30 U
INTERMEDIATE
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ROUND AND OVAL 15-30 U
PARABASAL
87
SMALLEST 13-20 U
BASAL
88
-it is the steroid that influence desquamated (Shedding) of Superficial cells
ESTROGEN
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3 TYPES OF ESTROGEN
E1 (ESTRONE)
E2 (ESTADIOL)
E3 (ESTRIOL)
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The most predominant in Menopause
E1 ESTRONE
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the most predominant in Reproductive years
E2 ESTRADIOL
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the most plentiful but least potent
E3 ESTRIOL
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COLOR OF CYTOPLASM IN SUPERFICIAL CELLS
PINK
94
Polyhedral flat cells and cytoplasm may be acidophilic or basophilic
SUPERFICIAL
95
Polyhedral cells with basophilic cytoplasm with vacuoles
INTERMEDIATE
96
CELLS IN PAP'S THAT HAS THE SMALLEST NUCLEUS
INTERMEDIATE CELL
97
2 TYPES OF INTERMEDIATE CELL
NAVICULAR IC
PREGANANCY IC
98
boat shaped cells with a tendency to fold or curl on edges
Navicular Intermediate Cells
99
Found in the latter half of menstrual cycle, during pregnancy or menopause
Navicular Intermediate Cells
100
May be found as a result of abnormal androgen stimulation. May suggest progesterone-estrogen effect
Navicular Intermediate Cells
101
With strongly basophilic cytoplasm
PARABASAL CELL
102
Found from 2 weeks of age to puberty, after childbirth, abortion and after menopause
Parabasal
103
____ is most predominant cell after birthchild
Parabasal
104
This vaginal cell normally shed or desquamated
Superficial
Intermediate
Parabasal
105
NOT normally shed, they shed traumatically
basal
106
Round to slightly oval cells with large nucleus occupying half or more of the cell volume, with strongly basophilic cytoplasm
BASAL
107
Found only before pregnancy and following menopause
BASAL
108
This is normally seen but only few and if its many the patient has problem because ____ is not normally shed
BASAL
109
2 NORMAL CELLULAR COMPONENTS IN PAP'S
1. ENDOMETRIAL CELL
2. ENDOCERVICA GLANDULAR CELL
110
This can be Found during and 1-4 days after menstruation
ENDOMETRIAL CELL
111
This cell is Occurring in groups of 3 or more shed in response to ovarian hormone
ENDOMETRIAL CELL
112
If seen in post menopause women it may indicate possible endometrial carcinoma or endometrial hyperplasia
ENDOMETRIAL CELL
113
Occurring in large groups or sheets
ENDOCERVICA GLANDULAR CELL
114
Forms the characteristic HONEYCOMB APPEARANCE
ENDOCERVICA GLANDULAR CELL
115
5 ABNORMAL CELLULAR COMPONENT IN PAP'S
1. CANDIDA ABLICANS (OCCURING YEAST)
2. T. VAGINALIS
3. CLUE CELLS
4. KOILOCYTES
5. DODERLAIN BACILLUS
116
CANDIDA ABLICANS IS SEEN IN ? 4 ANSWERS
1.seen in diabetic patients
2.those taking oral contraceptives
3.patients under prolonged steroid therapy
4. among immunocompromised patients
117
pear shaped parasite. can also be detected in UA
T.VAGINALIS
118
Indicate of bacterial vaginosis
CLUE CELLS
119
abnormal squamous with atypical nucleus surrounded by non-staining halo. May be indicative of HPV infection
KOILOCYTES
120
It is actually normal finding, because this is a normal flora
DODERLAIN BACILLUS
121
TRUE OR FALSE
Increased number of doderlain bacillus is normal
FALSE (NOT NORMAL)
122
DODERLAINE BACILLUS USUALLY INCREASE IN 4 CONDITIONS, THESE ARE:
1. Last trimester of pregnancy
2. Infection
3. Estrogen deficiency
4. Diabetes
(LIED)
123
Involves evaluation of hormonal status based on the distribution of cells
CYTOHORMONAL MATURATION INDEX (CMI)
124
CMI= 0/90/10
New born (Predominant is Intermediate)
125
CMI= 0/80/20
Menopause (Predominant is Intermediate)
126
CMI= 0/70/30
POST OVULATION
127
Old method, obsolete manner of reporting PAP’s
CLASS SYSTEM
128
New system of reporting cervical and vaginal cytologic smears
BETHESDA SYSTEM
129
WHEN AND WHERE IS BETHESDA SYSTEM DEVELOPED?
ON DECEMBER 1988 AT NATIONAL CANCER INSTITUTE
130
REPORT FORMAT: (satisfactory, limited, unsatisfactory)
SPECIMEN ADEQUACY
131
REPORT FORMAT: Negative for Intraepithelial lesion or
malignant cell
Epithelial cell abnormality
Benign cellular changes
GENERAL CATEGORIZATION
132
REPORT FORMAT:
-Infection / Radiation effects
-Atypical squamous cells of unknown
significance
-Low Grade Squamousintraepithelial lesions
-High Grade squamous intraepithelial lesions
-Squamous cell carcinoma
-Glandular cell abnormality
-Atypical Glandular cells
-Adenocarcinoma
DESCRIPTIVE DIAGNOSIS
133
3 SPECIMEN USED IN HISTOLOGY
AUTOPSY
BIOPSY
CYTOLOGY
