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Cytology
d;fj
104
Veterinary Medicine
Undergraduate 2
10/22/2013

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Term
What is Cytology?
Definition
Removing cells from a tissue and examining them under a microscope. A diagnostic aid.
Term
What is an alternative to cytology?
Definition
Histopathology
Term
Why do we do cytology?
Definition
For identification of masses, lesions, fluid in the body cavity, and pathology of internal organs
Term
What are some advantages to cytology?
Definition
-No special equipment needed
-Fast procedure
-Relatively non-invasive (anesthesia usually not needed)
-Often can ID cellular reaction (inflammation, neoplasia, hyperplasia)
-May be able to ID cause
Term
What are some disadvantages of cytology?
Definition
-Some training needed to ID cells
-May not be able to ID cells (if TOO abnormal)
-May need to supplement with histoathology
Term
What is the tissue sample required for histopathology called?
Definition
a Biopsy
Term
Is anesthesia required for histopathology?
Definition
Usually, because a piece is being surgically removed
Term
What do we store the sample in before sending it off to the pathologist?
Definition
10% buffered formalin
Term
What happens to the sample when it is sent off for pathology?
Definition
Sample is prepared to go into the microtome, which slices the tissue thin. The slices are put on slides to be examined with the microscope.
Term
What are some advantages of histopathology?
Definition
-Slides examined by trained pathologist
-Tissue architecture visualized
-Special stains can be used
-May give more precise diagnosis
Term
What are some disadvantages of histopathology?
Definition
-More involved procedure
-Expensive
-Pathologist does not see patient
-Takes time
Term
Why is it important to be thorough when reporting patient history and description of lesion to the pathologist?
Definition
Will increase the chances of getting accurate results
Term
What are 4 cytological techniques?
Definition
-Aspiration
-Impression smear
-Wash
-Scraping
Term
What is aspiration?
Definition
Inserting a needle into the lesion
Term
What is an impression smear?
Definition
When we touch a slide to the lesion or swab lesion and roll onto slide
Term
What is important to remember to do when making an impression smear?
Definition
If open lesion, blot blood first
Term
What is a "wash"?
Definition
When you flush the area with saline
Term
When would we do a scraping?
Definition
When the lesion is firm
Term
What size needle should we use for aspiration?
Definition
22 or 25 gauge
Term
Why should you stop aspirating if you see tissue in the hub of the needle?
Definition
Because you don't want the sample to be contaminated with whatever substance has entered the hub
Term
What are some important things to remember when handling samples?
Definition
-Always culture first if needed
-Make slide ASAP
-Use squash or smear
-Always make 2 slides and stain 1
Term
Why do we only stain one of the slides we make?
Definition
So that if the first slide is not stained properly, we can stain the second one differently
Term
When would we use gram stain?
Definition
For bacteria and yeasts
Term
What color does gram positive bacteria stain?
Definition
Blue
Term
What color does gram negative bacteria stain?
Definition
Pink
Term
When examining slide, why do we look at it on low power?
Definition
To assess staining and cellularity
Term
What are the 2 things you are looking for when examining a slide?
Definition
-Which cellular reaction is occurring
-The cause of the reaction
Term
What are 3 cellular reactions that can occur?
Definition
-Inflammation
-Hyperplasia
-Neoplasia
Term
What is the most common cellular reaction seen?
Definition
Inflammation
Term
What is inflammation?
Definition
The body's reaction to insult
Term
What are the 3 inflammatory reactions you can see?
Definition
-Acute
-Chronic active
-Chronic
Term
What are the cardinal signs of inflammation?
Definition
-Swelling and redness
-Warmth and pain
-Not using the body part
Term
What is the most common inflammatory reaction seen?
Definition
Acute
Term
What percentage of cells must be segs to be called an acute reaction?
Definition
70%
Term
What is pyknosis?
Definition
When the nuclei of cells become small, dark, and condensed
Term
What is karyhorrhexis?
Definition
Nuclear fragmentation, chromatin disintegrates into variably sized granules
Term
What is karyolysis?
Definition
Swelling of nuclear membranes
Term
What does karyolysis look like?
Definition
Ragged nucleus with reduced staining
Term
If eosiniphils are seen, what is that commmonly due to?
Definition
Allergy, parasites, or eosinophilic disease
Term
If there are greater than 10% eosinophils what do we call this?
Definition
an eosinophilic inflammatory reactionn
Term
What is another name for chronic-active inflammation?
Definition
Mixed inflammation
Term
What percentage of segs/macs should be present?
Definition
50-70% segs, 30-50% macs
Term
What percentage of macrophages have to be preset to be called a chronic inflammation?
Definition
at least 50%
Term
What is chronic inflammation usually seen with?
Definition
systemic fungi and foreign bodies
Term
What is granulomatous inflammation?
Definition
Type of chronic inflammation. There is a fibrous wall around the tissue
Term
What does granulomatous inflammation look like?
Definition
Firm small or large masses that are usually white.
Term
What are the 2 "special" macrophages?
Definition
-Epithelioid Cells
-Giant cells
Term
What do epithelioid cells look like?
Definition
They have abundant pale cytoplasm, and a vesicular nucleus (lacy chromatin)
Term
What do giant cells look like?
Definition
Large, multinucleated cells with abundant pale cytoplasm
Term
What are 2 types of tissue cells you may see in cytology?
Definition
-Epithelial
-Connective
Term
What two tissues do we not commonly see in cytology?
Definition
-Muscle tissue
-Nervous tissue
Term
What is the second Cellular reaction that can occur?
Definition
Hyperplasia
Term
What is hyperplasia?
Definition
An increase in the population of normal cells.
Term
What specific tissues can you see hyperplasia in?
Definition
-Lymph nodes
-Spleen
-Prostate
Term
What are some characteristics of hyperplastic cells?
Definition
-Mostly young cells
-Large nuclei
-Basophilic cytoplasm
-High N:C ratio
-Normal mitotic figures
Term
What is the only tissue that can have all three cellular reactions?
Definition
The prostate
Term
What is the third cellular reaction that can occur?
Definition
Neoplasia
Term
What two types of neoplasia are there?
Definition
Benign and malignant
Term
What are some characteristics of benign neoplasms?
Definition
-Can be circumscribed (have distinct edges)
-Grow slowly
-Not invasive(don't grow into surrounding tissue)
-Grow to a certain size, then stop.
-Glands may increase secretions
Term
What are some common benign tumors?
Definition
-Fibromas (Sarcoid in horses)
-Lipoma
-Adenomas
-Skin tumors
Term
What are some characteristics of malignant neoplasms?
Definition
-Grow fast
-Locally invasive/destructive (destroy surrounding tissue)
-Metastasize (spread to different sites)
-Anaplastic (don't resemble the cells theyre meant to be)
-Some may look benign
Term
What are the Cytologic signs that we see associated with neoplasia? (benign and malignant)
Definition
-Uniform population of pleomorphic cells
-Nuclear and cytologic criteria.. (the more cytologic criteria you seen, the more likely it is malignant
Term
Why is inflammation commonly associated with neoplasia?
Definition
Because the tissues are growing so quickly that the blood supply can't keep up. When the blood supply can't keep up you see inflammatory reactions. Also when tissues destroy other tissues
Term
What does pleomorphic mean?
Definition
Differences in the appearance of the same cell type
Term
What is the nuclear criteria of malignant neoplasia?
Definition
-multiple # and sized nucleoli
-multiple # and sized nucleus
-variable staining of chromatin
-irregular nuclear membrane
-variable N:C ratio between cells
-abnormal mitotic figures
Term
What is anisokaryosis?
Definition
Variation in nuclear size
Term
What is the cytoplasmic criteria for malignant neoplasms?
Definition
-Increased basophilia
-Increased vacuolation
-Varying amounts per cell
-Indistinct cytoplasmic edges
Term
What are the types of malignant tumors?
Definition
-Carcinomas
-Sarcomas
-Discrete cell neoplasms
Term
What is a sarcoma?
Definition
A malignant tumor of connective tissue
Term
What are some characteristics of sarcomas?
Definition
-Firm
-Often must be scraped
-There are few cells seen
-Cells are elongated and hard to tell from another
Term
What are some common sarcomas? (6)
Definition
-Osteosarcoma
-Fibrosarcoma
-Lymphsarcoma
-Chondrosarcoma
-Hemangiosarcoma
-Melanosarcoma
Term
What is a carcinoma?
Definition
A malignant tumor of epithelial tissue
Term
What are some characteristics of carcinomas?
Definition
-In epithelial tissue
-Very cellular
-May see glandular cells
Term
What are some common carcinomas? (6)
Definition
-Squamous cell carcinoma
-Mammary adenocarcinoma
-Prostatic carcinoma
-Adrenal adenocarcinoma
-Thyroid adenocarcinoma
-Transitional cell tumor
Term
What are discreet cell tumors?
Definition
Malignant tumors that affect one cell type
Term
What is a basal cell tumor?
Definition
A common skin tumor (most common in cats)that is usually benign and often on head, neck or shoulders. Will see cell clumps with high N:C ratio and blue cytoplasm
Term
What are plasmocytomas?
Definition
A usually benign tumor commonly seen in the oral cavity, ears, forelimb skin,, digits, or GIT in dogs
Term
When are plasmocytomas malignant?
Definition
In the bone marrow
Term
What are some characteristics of melanomas?
Definition
-Common on the skin and in the mouth
-Have brown to green-black granules
-Malignant if poorly differentiated
-Most in mouth malignant
-Rare in cats
Term
What percentage of skin melanomas are benign?
Definition
85%
Term
What are mast cell tumors?
Definition
The most common skin tumor in dogs
Term
Are all mast cell tumors potentially malignant in dogs?
Definition
yes
Term
When will you see an increased chance of malignancy in mast cell tumors in dogs?
Definition
If they are located in the perineum, groin, or around the muzzle
Term
What is a histiocytoma?
Definition
A benign cutaneous tumor
Term
What are characteristics of histiocytomas?
Definition
-Usually round nuclei with basophilic cytoplasm
-See most in dogs < 3 years old
-fast growing
-may spontaneously regress
Term
What are characteristics of Transmissible Venereal Tumors?
Definition
-Found on the lips and genitalia of dogs
-Transmissible
-Numerous round cells
-abundant blue cytoplasm
Term
Where is lymphoid tissue found?
Definition
All throughout the body, especially lymphnodes, tonsils, and the intestines
Term
What does lymphoid tissue do?
Definition
-Filters blood and lymph
-Makes lymphocytes and plasma cells
-One of the functions in humoral immunity
-Respond to many insults
Term
When will you see enlarged lymphnodes?
Definition
In primary or systemic disease
Term
Which reactions can you see when examining lymphnode cytology?
Definition
-Inflammation
-Hyperplasia
-First degree neoplasia (lymphoma)
-Second degree neoplasia
Term
What is second degree neoplasia?
Definition
Finding abnormal cells from other places in the body in the lymphnode aspirate. Demonstrating metastasis
Term
Which nodes can we palpate?
Definition
-Submandibular
-Axillary
-Prescapular
-Inguinal
-Popliteal
-Mesenteric
Term
How should you determine if lymphocytes in a node aspirate are Large or small?
Definition
Use RBC's or segs as a ruler. RBCs are normally smaller than Lymphs, and segs are normally larger
Term
What are the characteristics of cells in a normal node?
Definition
-90% small lymphs
-The rest are prolymphs, lymphoblasts, plasma cells, and macrophages
Term
What are characteristics of hyperplasia when looking at a slide?
Definition
->70% small lymphs
-Numerous plasma cells
-Increase in prolymphs and macrophages
Term
What does lymphadenitis look like on a slide?
Definition
-Predominantly segs
Term
If you have inflammation on your lymphnode aspirate what should you look for?
Definition
the etiology
Term
If there are many eosinophils what is this commonly due to?
Definition
Allergy or parasites
Term
If there is an increase in macrophages what is this normally due to?
Definition
Fungi or foreign bodies
Term
What is primary neoplasia also known as?
Definition
Lymphoma
Term
When should you Suspect lymphoma?
Definition
When many nodes are enlarged and there is no dermatitis
Term
What does lymphoma look like on a slide?
Definition
>50% medium/large lymphs and may also see lymphoglandular bodies
Term
What is the main give away of secondary neoplasia?
Definition
Seeing abnormal cells that don't belong in lymphoid tissue
Term
What does normal cytology of the spleen look like?
Definition
-Similar to normal lymphnode
-75% small lymphs
-Increased prolymphs, blasts, and plasma cells
-same reactions seen
-RBCs can obscure other cells
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