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Clinicals Pathology - Cytology

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dpearce's version from 2017-02-28 01:50

Section

Question Answer
What is key to determining if a sample is diagnostic or not?sample quality
What are the three conditions where cytology can be diagnostic?inflammation, mixed, neoplastic
What are the two types of inflammation?septic- caused by microorganisms, non-septic- caused by trauma, foreign bodies, etc.
What should you do if a sample is non-diagnostic?resample - if it was a poorly obtained sample; histopathology - if it is a condition that cytology can not provide a diagnosis for
What are the 3 types of neoplastic cells?epithelial, spindle, round
Which two types of neoplastic cells can be benign or malignant?epithelial, spindle
Spindle cell originate fromconnective or mesenchymal cells
After diagnosis with cytology what is the next step in neoplastic findings?biopsy, histopathology
Diagnostic cytology is:aspect of clinical pathology that deals with nucleated cell populations
What are the three locations that diagnostic cytology is used?cutaneous masses of unknown origin, internal organs, accumulated fluid
What is the goal of diagnostic cytology?confirm diagnosis (inflammation vs neoplasia or both, to help establish a differential diagnosis)
Does cytology replace histopathology?No; histopathology is the gold standard for diagnostics
What gauge needle should you use to collect FNA samples and why?22-25; this small gauge ensures that you are collecting cells and not a histopathological sample (punch biopsy)
What are idications for FNA?cutaneous masses of unknown origin, lymph nodes, masses on internal organs
What should be utilized when taking an FNA of internal organs?ultrasound; if the mass is an abscess and you puncture it multiple times it can lead to spread of infection
What is needed to ensure a good quality FNA smear?do not attache syringe to sample needle (can be done after several unsuccessful attempts; negative pressure --> cell lysis); redirect needle peripherally; FNA must be smeared (excessive pressure --> cell lysis; inadequate pressure --> thick smears)
When should a touch impression smear be obtained from an excisional biopsy? How do you prepare the lesion? Why?perform before tissue is dropped in formalin; cut lesion in half --> exposes intra-lesion cells and facilitates penetration of formalin
What must the cut surface of the lesion be free of? How many imprints should be done per slide?Cut surface must be free of juices or blood (dry by touching cut surface to paper towel); perform several imprints on the same slide
Where do fluids accumulate?pleural, peritoneal, or pericardial spaces
What are the specific fluids that can accumulate in these cavities? urine, bile, chyle, or blood
What other fluids might be used in diagnostic cytology?synovial fluid, cerebrospinal fluid, lavages or washes
Where might lavages or washes come from?tracheal, bronchoalveolar, bladder, or vaginal
What type of tube are fluids normally collected in?EDTA and sterilin/red top tubes (may be collected in other tubes depending on diagnostic needs Ex: glucose for staining)
What are some reasons that cause samples to be non-diagnostic?Placing a sample close to formalin (during prep or shipment), refrigeration of smears (causes cells to swell and lyse), contaminated samples (not fresh or recent), techniques (sampling or smearing), breakage or leakage during shipment, staining (under-stained, over-stained)
What are some advantages of of diagnostic cytology?quick, easy to perform using inexpensive equipment; poses minimum risk to patient, important screeing tool
Using diagnostic cytology as a screening tool can be helpful in?diagnostic plan, treatment plan
Cytology can establish an actual diagnosis of? round cell neoplasms
Limitations of Diagnostic Cytologyquality of material sampled, experience of cytologist, lack of tissue architecture (limited to broad diagnosis), unable to grade neoplasms, few diagnostic options for carcinomas and sarcomas, false positives and negatives
What does an ideal diagnostic sample include?representative sample collection, well spread smear, avoid cell lysis, avoid contamination, submit multiple unstained slides, proper medical history and clinical signs, adequate signalment
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