This document provides information about fine needle aspiration cytology (FNAC). It begins with an introduction to cytopathology and cytology. FNAC is described as the modern method of obtaining cells rather than tissue samples using fine needles. The document outlines the procedure for FNAC including needle and syringe selection, sample collection techniques, slide preparation methods, and staining. Important criteria for analyzing samples such as nuclear/cytoplasmic ratios, chromatin patterns, and cytoplasmic features are also mentioned.
This document provides an overview of the cytology of the esophagus and stomach. It describes the normal anatomy and cytology of both organs and then discusses some abnormal cytology findings. For the esophagus, it details normal squamous cell cytology and then abnormal findings in Barrett's esophagus and esophagitis. For the stomach, it outlines the normal gastric gland cytology and then discusses the cytology of acute and chronic gastritis.
This document summarizes various intestinal and tissue parasites that can infect humans through contaminated food or water. It describes the clinical presentations, locations of infection, and histopathological findings for parasites such as Giardia lamblia, Strongyloides stercoralis, hookworm, Trichuris trichura, Cryptosporidium, Enterobius vermicularis, Entamoeba histolytica, Anisakis, Trichinella spiralis, Dracunculus medinensis, Schistosoma species, Echinococcus granulosus, Taenia saginata, cysticercosis, and filarial worms. Definitive diagnosis of many parasitic infections requires identification of eggs,
This document provides an overview of cytotechniques, including:
- The history of cytology and key figures like Papanicolaou
- Different types of cytology samples like exfoliative, aspiration, and body fluids
- Steps for processing samples including collection, preparation, fixation, staining
- Details of liquid-based cytology techniques like ThinPrep
- Commonly used stains like Papanicolaou and May-Grunwald-Giemsa
- Applications of immunocytochemistry in tumor diagnosis and prognostic markers
In summary, it discusses the development of cytology as a diagnostic tool, the various techniques used to process cytology samples, and how staining and immunocy
Efficacy of liquid based cytology versus conventional smearsAnamika Dev
This study compares the efficacy of liquid-based cytology (LBC) to conventional smear methods for fine needle aspiration cytology samples. The study analyzed 110 cases of various lesions collected over 2 years. Results showed that LBC produced more clear backgrounds and better preserved and dispersed cells compared to conventional smears. LBC allowed for improved diagnosis of lesions like ductal carcinoma, lymph node metastases, and bone lesions. However, LBC required more processing and had some artifacts that could complicate interpretation. Overall, LBC improved sample quality and reduced inadequate sampling compared to conventional smears.
The document summarizes a seminar presentation on histopathology staining techniques. It discusses the routine H&E stain and provides details on the principle, reagents, and procedure. It also describes special stains used to identify substances like carbohydrates, amyloid, nucleic acids, and lipids. Specific stains covered include periodic acid Schiff, Congo red, Feulgen, methyl green pyronin, and Oil red O. The document aims to inform attendees about common and special staining methods in histopathology.
This document discusses various histopathological patterns seen in tissue samples. It defines terms like trabeculae, syncytium, alveolus, herringbone, storiform, fascicle, cribriform, tubule, papillae, Indian file, hobnail, rossette, microcystic, and follicle. Examples of diseases that exhibit each pattern are provided. The objectives are to help differentiate patterns in histopathology. Key patterns include trabecular, syncytial, alveolar, herringbone, storiform, fascicular, cribriform, tubular, papillary, micropapillary, Indian file, hobnail, and rossette
The document discusses Pap smear testing, including:
- The definition and purpose of the Pap smear test in screening for cervical cancer.
- Guidelines for patient preparation, specimen collection using an Ayres spatula and cytobrush, sample preparation including fixation and staining.
- Criteria for evaluating specimen adequacy, including what constitutes an adequate, satisfactory but limited, and unsatisfactory smear.
- What constitutes normal cervical cells and abnormalities that may be detected, following the Bethesda system for reporting cervical cytology.
diagnostic Cytology introduction , Body fluids cytologyAayra
This document discusses diagnostic cytopathology. It covers:
1. Cytopathology examines cells from body cavities, mucosal surfaces, and organs/masses obtained via needle aspiration to determine the cause of disease microscopically.
2. The history of cytopathology including the contributions of Papanicolaou and Koss.
3. The advantages of cytopathology include rapid diagnosis, low cost, ability to sample without tissue injury, and ability to repeatedly sample. Disadvantages include inability to always determine tumor type or distinguish pre-invasive from invasive changes.
4. Types of cytopathology include exfoliative from spontaneously shed cells, abrasive which dislodges
This document provides an overview of the cytology of the esophagus and stomach. It describes the normal anatomy and cytology of both organs and then discusses some abnormal cytology findings. For the esophagus, it details normal squamous cell cytology and then abnormal findings in Barrett's esophagus and esophagitis. For the stomach, it outlines the normal gastric gland cytology and then discusses the cytology of acute and chronic gastritis.
This document summarizes various intestinal and tissue parasites that can infect humans through contaminated food or water. It describes the clinical presentations, locations of infection, and histopathological findings for parasites such as Giardia lamblia, Strongyloides stercoralis, hookworm, Trichuris trichura, Cryptosporidium, Enterobius vermicularis, Entamoeba histolytica, Anisakis, Trichinella spiralis, Dracunculus medinensis, Schistosoma species, Echinococcus granulosus, Taenia saginata, cysticercosis, and filarial worms. Definitive diagnosis of many parasitic infections requires identification of eggs,
This document provides an overview of cytotechniques, including:
- The history of cytology and key figures like Papanicolaou
- Different types of cytology samples like exfoliative, aspiration, and body fluids
- Steps for processing samples including collection, preparation, fixation, staining
- Details of liquid-based cytology techniques like ThinPrep
- Commonly used stains like Papanicolaou and May-Grunwald-Giemsa
- Applications of immunocytochemistry in tumor diagnosis and prognostic markers
In summary, it discusses the development of cytology as a diagnostic tool, the various techniques used to process cytology samples, and how staining and immunocy
Efficacy of liquid based cytology versus conventional smearsAnamika Dev
This study compares the efficacy of liquid-based cytology (LBC) to conventional smear methods for fine needle aspiration cytology samples. The study analyzed 110 cases of various lesions collected over 2 years. Results showed that LBC produced more clear backgrounds and better preserved and dispersed cells compared to conventional smears. LBC allowed for improved diagnosis of lesions like ductal carcinoma, lymph node metastases, and bone lesions. However, LBC required more processing and had some artifacts that could complicate interpretation. Overall, LBC improved sample quality and reduced inadequate sampling compared to conventional smears.
The document summarizes a seminar presentation on histopathology staining techniques. It discusses the routine H&E stain and provides details on the principle, reagents, and procedure. It also describes special stains used to identify substances like carbohydrates, amyloid, nucleic acids, and lipids. Specific stains covered include periodic acid Schiff, Congo red, Feulgen, methyl green pyronin, and Oil red O. The document aims to inform attendees about common and special staining methods in histopathology.
This document discusses various histopathological patterns seen in tissue samples. It defines terms like trabeculae, syncytium, alveolus, herringbone, storiform, fascicle, cribriform, tubule, papillae, Indian file, hobnail, rossette, microcystic, and follicle. Examples of diseases that exhibit each pattern are provided. The objectives are to help differentiate patterns in histopathology. Key patterns include trabecular, syncytial, alveolar, herringbone, storiform, fascicular, cribriform, tubular, papillary, micropapillary, Indian file, hobnail, and rossette
The document discusses Pap smear testing, including:
- The definition and purpose of the Pap smear test in screening for cervical cancer.
- Guidelines for patient preparation, specimen collection using an Ayres spatula and cytobrush, sample preparation including fixation and staining.
- Criteria for evaluating specimen adequacy, including what constitutes an adequate, satisfactory but limited, and unsatisfactory smear.
- What constitutes normal cervical cells and abnormalities that may be detected, following the Bethesda system for reporting cervical cytology.
diagnostic Cytology introduction , Body fluids cytologyAayra
This document discusses diagnostic cytopathology. It covers:
1. Cytopathology examines cells from body cavities, mucosal surfaces, and organs/masses obtained via needle aspiration to determine the cause of disease microscopically.
2. The history of cytopathology including the contributions of Papanicolaou and Koss.
3. The advantages of cytopathology include rapid diagnosis, low cost, ability to sample without tissue injury, and ability to repeatedly sample. Disadvantages include inability to always determine tumor type or distinguish pre-invasive from invasive changes.
4. Types of cytopathology include exfoliative from spontaneously shed cells, abrasive which dislodges
The document discusses the development and benefits of the Milan System for Reporting Salivary Gland Cytopathology. It aims to standardize terminology for salivary gland FNA reports which previously lacked uniformity. The system categorizes specimens as non-diagnostic, non-neoplastic, atypia of undetermined significance, neoplastic (benign or uncertain malignant potential), suspicious for malignancy, or malignant. It is intended to improve communication between pathologists and clinicians, enhance patient care, and facilitate research by allowing standardized data collection across institutions. While validation is ongoing, the system provides a practical framework for uniform reporting of salivary gland cytology.
1. Cytology of body fluids involves examining fluids from various body cavities including cerebrospinal fluid, pleural fluid, peritoneal fluid, pericardial fluid, and synovial fluid. Specimen collection and laboratory analysis includes gross examination, cell counts, biochemical analysis, and microscopic examination.
2. Transudates and exudates are distinguished based on characteristics like protein content and cell differentials. Infection, inflammation, and malignancy can be identified by analyzing changes in fluid characteristics.
3. Cytology of body fluids provides diagnostic information for conditions affecting various organ systems. Proper collection and analysis of physical and chemical properties aids in differential diagnosis.
technique of preparing imprint smear# comparision with frozen sections# application and its role in thyroid ,paathyroid,breast,skin,head and neck and mucinous tumors# advantages and limitations
Exfoliative vaginal cytology help to determine the stage of estrus, is very simple method, cost-effective and comparatively accurate test for predicting the she dogs fit for breeding.
The PAS stain demonstrates carbohydrates and carbohydrate-rich compounds in tissues through oxidizing glycol groups with periodic acid and forming a magenta-colored complex with Schiff's reagent. It is useful for detecting conditions like glycogen storage disease and assessing thickness of the glomerular basement membrane. The PAS stain demonstrates substances like mucins, fungi cell walls, gangliosides, lipofuscin, Russell bodies and the basement membranes of various tissues.
This document provides guidance on grossing (examining) different types of breast specimens in pathology. It describes how to properly collect, orient, measure, sample and submit lumpectomy, mastectomy, microdochectomy and lymph node specimens. Key steps include fixation in formalin, inking, slicing, measuring margins, evaluating tumors and lymph nodes, and submitting representative sections for histology. The goal is to thoroughly examine specimens and obtain high quality samples for accurate diagnosis.
This document summarizes key information about major and minor salivary glands including their location and cell types. It describes common benign and malignant epithelial tumors of the salivary glands such as pleomorphic adenoma, Warthin's tumor, oncocytoma, and mucoepidermoid carcinoma. For each tumor, the clinical features, microscopic appearance, differential diagnosis, and important histological characteristics are outlined. The document provides an overview of salivary gland anatomy, histology, and the spectrum of tumors that can arise in these glands.
Frozen section is a pathology procedure that allows rapid microscopic examination of a specimen during surgery. Sir Louis B. Wilson pioneered the technique in 1905 at the Mayo Clinic to enable urgent intraoperative diagnosis. The procedure involves snap freezing tissue, sectioning it with a cryostat microtome, and staining for quick analysis. While fast, frozen sections can have artifacts from ice crystals and knife marks. Pathologists must communicate closely with surgeons to ensure the appropriate use of frozen sections for urgent diagnostic needs during operations.
The document discusses effusion cytology. It begins by describing the anatomy of serous cavities and membranes that line them, producing serous fluid. Any excess fluid is an effusion, indicating a pathological process. Effusions can be classified as hydrostatic, infectious, inflammatory, or malignant. Samples are collected and prepared as smears for staining.
Normal components in effusions include mesothelial cells, histiocytes, lymphocytes, and other inflammatory cells. Reactive mesothelial cells can appear atypical but maintain a uniform appearance. Malignant effusions result from direct extension or metastasis of cancers. Identifying malignant cells involves comparing size, shape and number to determine the primary tumor type and origin. The most
This document discusses various staining and preparation techniques used in cytology. It describes the Papanicolaou staining method and factors that can affect staining quality. It also summarizes rapid staining procedures like Diff-Quik and an ultrafast Papanicolaou method. Additionally, it outlines methods to prevent contamination between samples and describes procedures for cell block preparation and imprint cytology smears.
Squash cytology of cns paediatric tumoursSumanth Deva
This document provides an overview of squash cytology techniques for diagnosing pediatric central nervous system tumors, describing the smear patterns and key cytological features of common tumor types like medulloblastoma, atypical teratoid/rhabdoid tumors, choroid plexus papilloma, and choroid plexus carcinoma. Squash cytology allows rapid examination of biopsy samples during neurosurgery to aid diagnosis and surgical decision making.
1. Reticulin stain demonstrates reticular fibers and basement membrane material by staining them black using a silver impregnation process.
2. It is useful for studying lesions affecting organs rich in reticulin fibers like the liver and bone marrow, and can help diagnose conditions like cirrhosis, fibrosis, and tumors.
3. The staining process involves oxidizing, sensitizing, and impregnating slides with silver salts before developing and counterstaining to visualize the black reticulin fibers.
Fluid cytology in serous cavity effusionstashagarwal
The intrathoracic and intraperitoneal organs are covered by a single layer of mesothelial cells, which is continuous with the lining of the thoracic and peritoneal cavities. The potential space between the two layers of epithelium contains a small amount of lubricating fluid.
Serous fluid lies between the membranes lining the body cavities(parietal) and those covering the organs within the cavities(visceral).
Production and reabsorption are normally at a constant rate. They are influenced by
Changes in osmotic and hydrostatic pressure in the blood.
Concentration of chemical constituents in the plasma
Permeability of blood vessels and membranes.
An accumulation of fluid, called an effusion, results from an imbalance of fluid production and reabsorption. This fluid accumulation in the pleural, pericardial, and peritoneal cavities is known as serous effusion.
This slide presentation summarizes the cytology findings of a liver biopsy from a 60-year-old male. Giemsa stained smears showed moderately cellular tumor cells arranged in clusters and fragments with ill-defined edges. The tumor cells had round to oval nuclei and granular cytoplasm. Background showed lymphocytes and hemorrhage. A diagnosis of metastatic tumor was made, with the top differential diagnoses being metastatic papillary urothelial carcinoma, neuroendocrine tumor, solid pseudo-papillary neoplasm of the pancreas, or epithelioid gastrointestinal stromal tumor. Additional slides showed examples of various liver lesions and metastases that can present on cytology to aid in diagnosis.
The frozen section procedure allows for rapid microscopic analysis of tissue specimens. Tissue is frozen to preserve its structure and cellular components. This allows thin sections of the tissue to be cut without chemical processing. Frozen sections are used for rapid diagnosis during surgery and research applications where chemical fixation could damage antigens or enzymes. The cryostat machine houses a microtome that can precisely cut thin frozen sections at controlled temperatures for examination.
Broncho-Alveolar Lavage Fluid Analysis provides information on the status of the respiratory tract beyond what can be seen bronchoscopically. It involves instilling saline into segments of the lung and analyzing the cell types in the returned fluid. A satisfactory sample contains at least 2x10^6 cells including over 10 macrophages per field. Differential cell counts can indicate conditions like pneumonia, cancer, sarcoidosis, and alveolar hemorrhage. Special stains can identify pathogens, lipids, proteins, and minerals for diagnostic purposes. Complications are generally minor but loss of lung function is a risk in severely compromised patients.
The document discusses the history, utility, and methods of preparing cell blocks from fine needle aspiration cytology samples. Cell blocks allow examination of histological structure and use of ancillary tests. Key methods include the fixed sedimentation method using a 1:1 ratio of 100% alcohol and 40% formalin, the plasma thrombin method using equal parts plasma and thrombin, and the bacterial agar method using 3% agar. Cell blocks provide increased diagnostic sensitivity and specificity compared to cytology alone through examination of tissue architecture and ability to perform special stains and molecular testing.
Salivary glands produce saliva and are composed of major and minor glands. The major glands are the parotid, submandibular, and sublingual glands. Salivary gland cytology can detect both benign and malignant lesions. Common benign findings include pleomorphic adenoma, Warthin's tumor, and basal cell adenoma cells. Malignant lesions include adenoid cystic carcinoma, mucoepidermoid carcinoma, and adenocarcinoma. Fine needle aspiration cytology allows diagnosis of salivary gland lesions with high sensitivity and specificity to guide treatment.
1. The PAS stain uses periodic acid and Schiff's reagent to demonstrate glycogen, basement membranes, and mucus substances in tissues like skin, liver, and muscle.
2. Periodic acid oxidizes carbohydrates, and the resultant aldehydes react with Schiff's reagent to produce a magenta color.
3. The procedure involves oxidizing tissue sections with periodic acid, treating with Schiff's reagent to develop a magenta color for carbohydrates, and counterstaining with hematoxylin.
This document summarizes the hormonal effects on vaginal cytology and the interpretation of vaginal smear samples. It describes how hormones influence the cells seen in smears throughout a woman's life. Estrogen causes maturation of superficial cells while progesterone increases intermediate cells. The maturation index is used to assess the ratio of cell types. Smears change over the menstrual cycle and with life events like pregnancy and menopause due to varying hormone levels. Precise collection and interpreting samples in the context of a patient's history is important for evaluation.
This document provides an overview of fine needle aspiration cytology (FNAC). It discusses the history, advantages, limitations, equipment, techniques, processing, complications, and applications of FNAC for diagnosing lesions in the salivary gland, oral cavity, and other areas. FNAC is a simple, economical technique that can provide a rapid diagnosis without the need for an open biopsy. It describes the evaluation of FNAC samples under the microscope for diagnosing various conditions.
The document discusses the development and benefits of the Milan System for Reporting Salivary Gland Cytopathology. It aims to standardize terminology for salivary gland FNA reports which previously lacked uniformity. The system categorizes specimens as non-diagnostic, non-neoplastic, atypia of undetermined significance, neoplastic (benign or uncertain malignant potential), suspicious for malignancy, or malignant. It is intended to improve communication between pathologists and clinicians, enhance patient care, and facilitate research by allowing standardized data collection across institutions. While validation is ongoing, the system provides a practical framework for uniform reporting of salivary gland cytology.
1. Cytology of body fluids involves examining fluids from various body cavities including cerebrospinal fluid, pleural fluid, peritoneal fluid, pericardial fluid, and synovial fluid. Specimen collection and laboratory analysis includes gross examination, cell counts, biochemical analysis, and microscopic examination.
2. Transudates and exudates are distinguished based on characteristics like protein content and cell differentials. Infection, inflammation, and malignancy can be identified by analyzing changes in fluid characteristics.
3. Cytology of body fluids provides diagnostic information for conditions affecting various organ systems. Proper collection and analysis of physical and chemical properties aids in differential diagnosis.
technique of preparing imprint smear# comparision with frozen sections# application and its role in thyroid ,paathyroid,breast,skin,head and neck and mucinous tumors# advantages and limitations
Exfoliative vaginal cytology help to determine the stage of estrus, is very simple method, cost-effective and comparatively accurate test for predicting the she dogs fit for breeding.
The PAS stain demonstrates carbohydrates and carbohydrate-rich compounds in tissues through oxidizing glycol groups with periodic acid and forming a magenta-colored complex with Schiff's reagent. It is useful for detecting conditions like glycogen storage disease and assessing thickness of the glomerular basement membrane. The PAS stain demonstrates substances like mucins, fungi cell walls, gangliosides, lipofuscin, Russell bodies and the basement membranes of various tissues.
This document provides guidance on grossing (examining) different types of breast specimens in pathology. It describes how to properly collect, orient, measure, sample and submit lumpectomy, mastectomy, microdochectomy and lymph node specimens. Key steps include fixation in formalin, inking, slicing, measuring margins, evaluating tumors and lymph nodes, and submitting representative sections for histology. The goal is to thoroughly examine specimens and obtain high quality samples for accurate diagnosis.
This document summarizes key information about major and minor salivary glands including their location and cell types. It describes common benign and malignant epithelial tumors of the salivary glands such as pleomorphic adenoma, Warthin's tumor, oncocytoma, and mucoepidermoid carcinoma. For each tumor, the clinical features, microscopic appearance, differential diagnosis, and important histological characteristics are outlined. The document provides an overview of salivary gland anatomy, histology, and the spectrum of tumors that can arise in these glands.
Frozen section is a pathology procedure that allows rapid microscopic examination of a specimen during surgery. Sir Louis B. Wilson pioneered the technique in 1905 at the Mayo Clinic to enable urgent intraoperative diagnosis. The procedure involves snap freezing tissue, sectioning it with a cryostat microtome, and staining for quick analysis. While fast, frozen sections can have artifacts from ice crystals and knife marks. Pathologists must communicate closely with surgeons to ensure the appropriate use of frozen sections for urgent diagnostic needs during operations.
The document discusses effusion cytology. It begins by describing the anatomy of serous cavities and membranes that line them, producing serous fluid. Any excess fluid is an effusion, indicating a pathological process. Effusions can be classified as hydrostatic, infectious, inflammatory, or malignant. Samples are collected and prepared as smears for staining.
Normal components in effusions include mesothelial cells, histiocytes, lymphocytes, and other inflammatory cells. Reactive mesothelial cells can appear atypical but maintain a uniform appearance. Malignant effusions result from direct extension or metastasis of cancers. Identifying malignant cells involves comparing size, shape and number to determine the primary tumor type and origin. The most
This document discusses various staining and preparation techniques used in cytology. It describes the Papanicolaou staining method and factors that can affect staining quality. It also summarizes rapid staining procedures like Diff-Quik and an ultrafast Papanicolaou method. Additionally, it outlines methods to prevent contamination between samples and describes procedures for cell block preparation and imprint cytology smears.
Squash cytology of cns paediatric tumoursSumanth Deva
This document provides an overview of squash cytology techniques for diagnosing pediatric central nervous system tumors, describing the smear patterns and key cytological features of common tumor types like medulloblastoma, atypical teratoid/rhabdoid tumors, choroid plexus papilloma, and choroid plexus carcinoma. Squash cytology allows rapid examination of biopsy samples during neurosurgery to aid diagnosis and surgical decision making.
1. Reticulin stain demonstrates reticular fibers and basement membrane material by staining them black using a silver impregnation process.
2. It is useful for studying lesions affecting organs rich in reticulin fibers like the liver and bone marrow, and can help diagnose conditions like cirrhosis, fibrosis, and tumors.
3. The staining process involves oxidizing, sensitizing, and impregnating slides with silver salts before developing and counterstaining to visualize the black reticulin fibers.
Fluid cytology in serous cavity effusionstashagarwal
The intrathoracic and intraperitoneal organs are covered by a single layer of mesothelial cells, which is continuous with the lining of the thoracic and peritoneal cavities. The potential space between the two layers of epithelium contains a small amount of lubricating fluid.
Serous fluid lies between the membranes lining the body cavities(parietal) and those covering the organs within the cavities(visceral).
Production and reabsorption are normally at a constant rate. They are influenced by
Changes in osmotic and hydrostatic pressure in the blood.
Concentration of chemical constituents in the plasma
Permeability of blood vessels and membranes.
An accumulation of fluid, called an effusion, results from an imbalance of fluid production and reabsorption. This fluid accumulation in the pleural, pericardial, and peritoneal cavities is known as serous effusion.
This slide presentation summarizes the cytology findings of a liver biopsy from a 60-year-old male. Giemsa stained smears showed moderately cellular tumor cells arranged in clusters and fragments with ill-defined edges. The tumor cells had round to oval nuclei and granular cytoplasm. Background showed lymphocytes and hemorrhage. A diagnosis of metastatic tumor was made, with the top differential diagnoses being metastatic papillary urothelial carcinoma, neuroendocrine tumor, solid pseudo-papillary neoplasm of the pancreas, or epithelioid gastrointestinal stromal tumor. Additional slides showed examples of various liver lesions and metastases that can present on cytology to aid in diagnosis.
The frozen section procedure allows for rapid microscopic analysis of tissue specimens. Tissue is frozen to preserve its structure and cellular components. This allows thin sections of the tissue to be cut without chemical processing. Frozen sections are used for rapid diagnosis during surgery and research applications where chemical fixation could damage antigens or enzymes. The cryostat machine houses a microtome that can precisely cut thin frozen sections at controlled temperatures for examination.
Broncho-Alveolar Lavage Fluid Analysis provides information on the status of the respiratory tract beyond what can be seen bronchoscopically. It involves instilling saline into segments of the lung and analyzing the cell types in the returned fluid. A satisfactory sample contains at least 2x10^6 cells including over 10 macrophages per field. Differential cell counts can indicate conditions like pneumonia, cancer, sarcoidosis, and alveolar hemorrhage. Special stains can identify pathogens, lipids, proteins, and minerals for diagnostic purposes. Complications are generally minor but loss of lung function is a risk in severely compromised patients.
The document discusses the history, utility, and methods of preparing cell blocks from fine needle aspiration cytology samples. Cell blocks allow examination of histological structure and use of ancillary tests. Key methods include the fixed sedimentation method using a 1:1 ratio of 100% alcohol and 40% formalin, the plasma thrombin method using equal parts plasma and thrombin, and the bacterial agar method using 3% agar. Cell blocks provide increased diagnostic sensitivity and specificity compared to cytology alone through examination of tissue architecture and ability to perform special stains and molecular testing.
Salivary glands produce saliva and are composed of major and minor glands. The major glands are the parotid, submandibular, and sublingual glands. Salivary gland cytology can detect both benign and malignant lesions. Common benign findings include pleomorphic adenoma, Warthin's tumor, and basal cell adenoma cells. Malignant lesions include adenoid cystic carcinoma, mucoepidermoid carcinoma, and adenocarcinoma. Fine needle aspiration cytology allows diagnosis of salivary gland lesions with high sensitivity and specificity to guide treatment.
1. The PAS stain uses periodic acid and Schiff's reagent to demonstrate glycogen, basement membranes, and mucus substances in tissues like skin, liver, and muscle.
2. Periodic acid oxidizes carbohydrates, and the resultant aldehydes react with Schiff's reagent to produce a magenta color.
3. The procedure involves oxidizing tissue sections with periodic acid, treating with Schiff's reagent to develop a magenta color for carbohydrates, and counterstaining with hematoxylin.
This document summarizes the hormonal effects on vaginal cytology and the interpretation of vaginal smear samples. It describes how hormones influence the cells seen in smears throughout a woman's life. Estrogen causes maturation of superficial cells while progesterone increases intermediate cells. The maturation index is used to assess the ratio of cell types. Smears change over the menstrual cycle and with life events like pregnancy and menopause due to varying hormone levels. Precise collection and interpreting samples in the context of a patient's history is important for evaluation.
This document provides an overview of fine needle aspiration cytology (FNAC). It discusses the history, advantages, limitations, equipment, techniques, processing, complications, and applications of FNAC for diagnosing lesions in the salivary gland, oral cavity, and other areas. FNAC is a simple, economical technique that can provide a rapid diagnosis without the need for an open biopsy. It describes the evaluation of FNAC samples under the microscope for diagnosing various conditions.
FNAC is a minimally invasive procedure used to diagnose palpable masses. It was first described in 1930 and became popular in the 1950s. FNAC samples lesions in the breast, thyroid, soft tissues and other accessible areas like the testicles, prostate, bones and lungs. It requires clinical skills like anatomy knowledge and physical exam proficiency. FNAC has advantages of not requiring anesthesia, being low cost, allowing repeat sampling with few complications. The procedure involves aspiration of the mass and smearing cell samples on slides for microscopic examination.
Laser scanning cytometry and liquid based cytologyanaonline
Liquid based cytology (LBC) has been introduced to improve cervical screening. It uses a liquid preservative instead of smearing cells directly on a slide. This allows automated processing to disperse cells and transfer them evenly to a slide. LBC reduces sampling errors, improves cell preservation and slide quality compared to conventional smears. However, it requires specialized equipment and is more expensive. Laser scanning cytometry is a technique that can analyze individual cells from LBC samples. It provides quantitative measurements and complements flow cytometry by allowing analysis of adherent cells and solid tissues.
This method is used to visualise the localisation and quantity of a protein of interest. The target protein is bound to by a specific primary antibody, which in turn is detected by a secondary antibody conjugated to a fluorophore. A fluorescent or confocal microscope is used to visualise the protein.
Immunocytochemistry (ICC) differs from immunohistochemistry (IHC) in that the former is performed on samples of intact cells that have had most, if not all, of their surrounding extracellular matrix removed. In contrast, immunohistochemical samples are sections of biological tissue, where each cell is surrounded by tissue architecture and other cells normally found in the intact tissue. These differences cause the samples to be prepared differently. For ICC, the sample requires permeabilisation so that the antibodies can reach the intracellular targets. Depending on the thickness of the sample, IHC samples do not require this.
Do you have a technical question? Get in touch: info@stjohnslabs.com
- Thyroid tumors can be benign or malignant. Benign tumors are not cancerous and do not spread, while malignant tumors are cancerous and can invade nearby tissues and spread via the bloodstream or lymphatic system.
- The major types of thyroid cancer are papillary, follicular, medullary, and anaplastic carcinoma. Papillary and follicular cancers together account for 80-90% of cases and generally have a good prognosis. Medullary cancer arises from C-cells and can be hereditary. Anaplastic carcinoma is very aggressive.
- Risk factors for thyroid cancer include radiation exposure, family history, being female, older age, and iodine deficiency. Symptoms may
This document provides an overview of various gynaecological procedures including:
1. Thin prep liquid based cytology, colposcopy, speculums, and biopsy tools for examining the cervix and vagina.
2. Transvaginal ultrasound, sonohysterography, saline infusion sonography, and MRI for examining the uterus.
3. Hysteroscopy, the gold standard for assessing the endometrium, which allows both diagnostic and operative procedures such as removing fibroids and polyps.
4. Endometrial ablation techniques for removing the endometrium without hysterectomy, including various laser, electrosurgery, balloon, and microwave methods.
02 Presentations Ii Vs (14 4 Mb) (3 30 08)vshidham
Part II of Four part symposium: “Diagnostic Cytopathology of Serous Effusion” on April 19, 2007 at Neenah, WI, USA
(2008 Wisconsin Society of Cytology, 40th Anniversary)
Quest Diagnostics acquired SmithKline Beecham Clinical Laboratories in 1999, making it the clear leader in diagnostic testing in the US. Net income excluding special items was $41.2 million in 1999 compared to $26.9 million in 1998 due to the acquisition. However, after special items related to the acquisition, the company reported a net loss of $3.4 million. The company's strategy is focused on capitalizing on its position in diagnostic testing, becoming a leading provider of medical information by leveraging its large database of test results, and becoming recognized as the quality leader in healthcare services.
Cancer arises from genetic mutations and epigenetic changes that alter gene expression and cellular processes like growth, survival and senescence. These changes are heritable and allow cancer cells to outcompete normal cells, forming clonal tumors. Cancers are characterized by autonomous growth, lack of response to growth signals, evasion of cell death, limitless replication, angiogenesis, invasion/metastasis, altered metabolism and evading the immune system. Tumors are classified based on tissue of origin, behavior, morphology and differentiation into benign or malignant types like carcinomas, sarcomas and leukemias/lymphomas.
This document discusses laboratory design and its importance. It outlines the following:
1) Learners must identify key features of laboratory design, such as services, furniture, access, safety equipment and describe how they relate to a specialist laboratory.
2) Learners must design a specialist laboratory and justify the key features in their design.
3) Good laboratory design is important for efficiency, effectiveness, safety and security. Learners must analyze why through examples from industrial visits.
This document outlines various laboratory methods for diagnosing neoplasia, including morphological, immunohistochemistry, molecular, and flow cytometry techniques. Morphological methods include cytological examinations like fine needle aspiration cytology, exfoliative cytology, and abrasive cytology. Immunohistochemistry and molecular techniques help identify tumor origin and prognostic markers. Flow cytometry allows rapid quantification of individual cell characteristics to classify tumors. Together, an integrated approach using multiple diagnostic methods provides the most accurate assessment of cancer.
The female genital tract consists of both external and internal structures. The external structures include the labia majora, labia minora, and clitoris, which are covered by keratinized stratified squamous epithelium. Internally, the tract includes the vagina, uterus, fallopian tubes, and ovaries. The vagina and endocervix are lined by non-keratinizing stratified squamous epithelium. The endometrium lining the uterus changes throughout the menstrual cycle in response to hormones. The fallopian tubes are lined by ciliated columnar epithelium and the ovaries contain primordial follicles and ova.
A 58-year old man who works in a dye factory and smokes cigarettes is experiencing hematuria for 3 months. Urine cytology would be performed to screen for bladder cancer given his risk factors of occupational exposure to carcinogens and smoking history. Proper collection of the second morning voided urine sample is important for accurate cytology results. The patient is most likely to have transitional cell carcinoma of the bladder due to his risk factors, and this type of bladder cancer has different grades based on how abnormal the cells appear.
This document summarizes urine cytology and various urinary markers for detecting bladder cancer. Urine cytology is the gold standard but has low sensitivity of 40-62%. Newer urinary markers like BTA, ImmunoCyt, NMP-22, and UroVysion have higher sensitivities than cytology of 50-86%, but lower specificities and can be affected by benign conditions. No single marker currently has a sensitivity of 90%, which patients indicate is needed to replace cystoscopy. Therefore, the best approach is a combination of cystoscopy and urinary markers for non-muscle-invasive bladder cancer surveillance.
Bronchial cytology and fine needle aspiration are important techniques for diagnosing lung lesions. Bronchial cytology examines the central airways using bronchoscopy while fine needle aspiration can sample peripheral lung lesions. Normal respiratory cells include ciliated bronchial cells and alveolar macrophages. Benign lesions may show goblet cell or basal cell hyperplasia. Non-neoplastic lung diseases like sarcoidosis and pulmonary alveolar proteinosis can also be diagnosed through their characteristic cytology findings. Cytology is useful for identifying infection causes as well as diagnosing and classifying lung tumors.
Medical Diagnostic Centre, Medical diagnosis Services, Pathology Laboratory, ...Ajjay Kumar Gupta
A diagnostic centre provides a wide scope for detection of ailments and affords facilities for a detailed medical check-up through diagnostic procedures. To accomplish this objective a modern diagnostic centre is well equipped with most modern instruments, which help in following the requisites measures for diagnostic purposes.
Quite a number of tests are carried out including pathological tests viz.: - Hematological test, sputum test, semen test, Urological test, stool test etc. Besides, other tests are also carried out such as: - Radiological Test (X-rays), Ultrasound Test, Electrocardiographic and Electro Encephalographic Tests, IVP Test, Gynecological Test, Endoscopic test, BP Test, Koch syndrome Test (For Tuberculosis), MMR Test, Pregnancy Test, cardiological test etc.
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The document provides an overview of the histology of the female genital system, including the ovaries, oviducts, uterus, vagina, placenta, cervix, external genitalia, and mammary glands. It describes the ovarian cycle of follicle growth, ovulation, and corpus luteum formation. It also summarizes the histological changes that occur in the endometrium throughout the menstrual cycle, including the proliferative, secretory, and menstrual phases. Key structures and functions of each organ are highlighted.
This document discusses veterinary parasitology. It defines parasitology and symbiosis. There are two types of parasite life cycles - direct and indirect. Parasites can be transmitted passively, actively, or inoculatively. Parasites can harm hosts by causing blood loss, hypersensitivity reactions, toxicity, and transmitting other diseases. The Linnaean classification system is used to categorize parasites into kingdoms, phyla, classes, orders, families, genera and species. Common parasites of dogs, cats and horses are listed by their scientific names and host species.
This document defines key terms related to chemical carcinogenesis and provides an overview of the topic. It begins by defining terms like tumor, neoplasia, benign vs malignant tumors. It describes classical concepts of carcinogenesis as well as modern molecular understanding. It also discusses various assays and methods used to study carcinogenesis and assess toxicological risk. The overall goal is to explain the mechanisms and measurement of how chemicals can cause cancer at a molecular level.
George Papanicolaou is considered the father of cytopathology. He developed the Pap test in the 1920s as a screening method for cervical cancer. The Pap test involves collecting cells from the cervix and examining them under a microscope. It allows for early detection of precancerous and cancerous cells. Though initially met with skepticism, the Pap smear became widely accepted in the 1940s and has significantly reduced cervical cancer mortality rates. The test involves collecting a cell sample, processing and staining the cells, then examining them under a microscope to look for abnormalities. It is a simple yet effective screening tool.
This document discusses various cytology techniques including exfoliative cytology, abrasive cytology, and fine needle aspiration cytology (FNAC). It focuses on the use of FNAC and ultrasound guidance for sampling deep seated lesions. FNAC is a useful tool for diagnosing lesions without significant trauma. Ultrasound guidance allows real-time visualization of the needle for precise and safe sampling of deep lesions. Complications are usually minor bleeding or infection when the technique is performed appropriately. Cytology provides valuable diagnostic information with minimal risk to patients.
The document discusses various diagnostic tests involving visualization of body structures and functions. It describes procedures like endoscopy, colonoscopy and sigmoidoscopy which allow direct visualization of the gastrointestinal tract. Indirect visualization is achieved through radiographic imaging using barium and fluoroscopy. Procedures for visualizing the urinary system like IV pyelogram, cystoscopy and renal ultrasonography are also outlined. The document also discusses various cardiac diagnostic tests including electrocardiography, echocardiogram, stress testing and angiography. Visualization of the lungs can be achieved through procedures like bronchoscopy.
EUS enables sampling of lesions near the esophagus, stomach, duodenum, and rectum. The document describes a case of EUS-guided FNA of a gastric mass in a woman with weight loss, revealing a GIST. It also details a case of a large pancreatic head mass in a man with pancreatitis, where EUS-FNA obtained a diagnosis of pancreatic cancer. A third case involves EUS evaluation of mediastinal lymph nodes in a man with lung cancer history, with FNA to assess for recurrence. The type and size of EUS needle does not impact diagnostic yield, but rapid on-site cytopathology and experience improve efficacy.
TISSUE COLLECTION AND FIXATION final.pptxmwalunuym
1. The document describes techniques for collecting, fixing, and processing tissue specimens. It discusses biopsy methods, fixation using formaldehyde and other chemicals, and cytopathology techniques like exfoliative cytology and fine needle aspiration.
2. Tissue collection aims to provide adequate material for diagnosis while minimizing trauma. Specimens are placed in fixatives like 10% buffered formaldehyde within minutes of collection.
3. Cytopathology techniques include exfoliative methods using exfoliated cells and abrasive sampling using brushes or lavage. Fine needle aspiration is used for superficial and deep organs under imaging guidance.
Cancer diagnosis, Methods of cancer diagnosismanojjeya
This document discusses various methods for diagnosing cancer, including biopsies, imaging tests, and blood tests. Biopsies involve taking a tissue sample, which can be done with fine needle aspiration, core needle biopsy, or vacuum-assisted biopsy. Imaging tests include endoscopy, X-rays, CT scans, MRIs, PET scans, ultrasound, and upper endoscopy. These tests provide visual images of the inside of the body. Blood tests analyze the blood for tumor markers that some cancers release into the bloodstream. Together, biopsies, imaging tests, and blood work are used to detect cancers and determine diagnosis and staging.
This document provides an overview of initial investigations and radiological investigations in urology. It discusses urinalysis, urine culture, cytology, biochemistry, ultrasound, and prostate-specific antigen as initial investigations. Ultrasound uses include evaluating the kidneys, bladder, prostate, and scrotum. Urodynamics tests lower urinary tract function. Radiological investigations include plain x-rays, retrograde urethrograms, intravenous urography, CT scans, MRI, PET scans, and nuclear medicine tests. The document provides details on the procedures and clinical applications of each test.
This document discusses various radiation methods used to diagnose thyroid diseases and conditions, including ultrasound, radionuclide imaging, CT, and MRI. It provides details on how each modality is used, what they image, and their indications. Specific attention is given to ultrasound-guided fine needle aspiration biopsy of thyroid nodules. Examples of thyroid conditions imaged by radionuclide scans are also shown, such as hyperthyroidism, multinodular goiter, and thyroid nodules. Emergency thoracic and abdominal conditions that can be imaged are also reviewed, including pneumothorax, pleural effusions, bowel obstructions, and perforated ulcers.
Histopathology refers to the microscopic examination of tissue samples to study disease manifestations. A biopsy or surgical sample is processed by fixing, embedding, sectioning, and staining tissue before a pathologist examines it under a microscope. Key tools used in histopathology include microtomes, cryostats, and paraffin embedding systems to prepare thin tissue sections for analysis. The field of histopathology has advanced medical understanding of diseases since the 19th century through microscopic study of cells and tissues.
This document discusses types of specimens collected for medical diagnosis and the nurse's role in specimen collection. It describes 9 common types of specimens including blood, urine, stool, respiratory, CSF and other fluids, wounds, genital, ear, and conjunctival specimens. For each type, it provides details on collection methods and uses. The nurse's responsibilities in proper specimen collection include patient preparation, identification, technique, documentation, transportation, and ensuring quality assurance.
biopsy in oral lesions bbbbbbbbbbbbbpptxAebeenababu
Biopsy is the removal of tissue samples from the body for microscopic examination. There are several types of biopsies including incisional, excisional, punch, fine needle aspiration, and brush biopsies. Proper labeling of biopsy specimens with patient information and details of the lesion is important. While biopsies are useful for diagnosis, limitations include sampling error or non-specific histological findings that require further investigation.
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A cervical biopsy is a minor surgical procedure to remove a small sample of cervical tissue for examination. There are three main types: punch biopsy removes a circular sample; cone biopsy removes a cone-shaped piece of tissue; endocervical curettage scrapes the inner cervix. Cervical biopsies are performed to investigate abnormal bleeding, precancerous cells found on pap smears, or symptoms of cervical cancer. The procedure involves using a speculum and forceps to take a tissue sample, which is then sent to a lab for analysis. Potential side effects include pain, bleeding and infection.
Ultrasonography uses high frequency sound waves to generate images of the eye and orbit. It can be used to evaluate the anterior and posterior segments when the media is opaque, detect tumors, orbital disorders, and intraocular foreign bodies. A-scan provides axial length measurements, while B-scan produces two-dimensional images to assess conditions like retinal detachments, tumors, infections, and more. Proper probe positioning and interpretation of real-time gray scale images allow ultrasonography to evaluate a wide range of ocular and orbital pathologies in a non-invasive manner.
ERS London 2016: Poster Discussion:Ultrasound Guided Pleural Brushing: a New ...Gamal Agmy
Ultrasound guided pleural brushing is a new technique for obtaining pleural specimens in patients with malignant pleural effusions. This study evaluated the diagnostic yield of ultrasound guided pleural brushing in 22 patients with suspected malignant pleural effusions. Pleural brushing alone yielded a positive diagnosis in 41% of patients and was the sole diagnostic technique in 14% of patients. When combined with pleural fluid cytology and biopsy forceps, ultrasound guided pleural brushing provided a positive diagnosis in 86% of patients. The study demonstrates that ultrasound guided pleural brushing is a simple, relatively safe procedure that provides additional diagnostic value in evaluating malignant pleural effusions.
Cytopathology is the study of exfoliated cells to detect normal and abnormal cell morphology. Cells can be collected naturally or artificially from various tissues and fluids. Cytopathology allows rapid, inexpensive diagnosis and monitoring of diseases without surgical trauma through techniques like Pap smears. While useful for screening, cytopathology has limitations like relying on individual cell analysis and sometimes requiring confirmation by histopathology. Pap smears played a pivotal role in decreasing cervical cancer rates, though they have limitations in sensitivity and require adequate follow up. The transformation zone of the cervix, where abnormal cells often arise, can change throughout a woman's life.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
1. Assignment on
Fine Needle
Aspiration Cytology
KARTHIKA SKARTHIKA S
M-5609M-5609
VPL – 606VPL – 606
Department of Veterinary Pathology
Indian Veterinary Research Institute
2. INTRODUCTION
Cytopathology refers to diagnostic techniques that are used toCytopathology refers to diagnostic techniques that are used to
examine from various body sites toexamine from various body sites to
determine the and of disease.determine the and of disease.
cells
causenature
(Sr. Kamenica 2002)
Cytology refers to the microscopic evaluation of cells, veryCytology refers to the microscopic evaluation of cells, very
useful in the clinical diagnosis of neoplasia.useful in the clinical diagnosis of neoplasia.
( Wellman ,1990)
3. Cont.. George Papanicolaou claimed to be the father of clinicalGeorge Papanicolaou claimed to be the father of clinical
cytology.cytology.
Cytology is a joint effort between the clinician andCytology is a joint effort between the clinician and
cytologist.cytologist.
General principles of cytology is identify inflammation vs.General principles of cytology is identify inflammation vs.
neoplasia of Skin, Lymph nodes, Bone marrow and otherneoplasia of Skin, Lymph nodes, Bone marrow and other
vital organs.vital organs.
Also examine Fluids, e.g. thoracic, abdomen, synovial fluidAlso examine Fluids, e.g. thoracic, abdomen, synovial fluid
Staging of estrous cycle in bitches (vaginal cytology)Staging of estrous cycle in bitches (vaginal cytology)
4. Indications For CytologicalIndications For Cytological
ExaminationExamination
Cutaneous or subcutaneous masses- peripheral lymphadenopathy (fine needleCutaneous or subcutaneous masses- peripheral lymphadenopathy (fine needle
aspiration or imprint cytology)aspiration or imprint cytology)
Intra-abdominal or intrathoracic masses (fine needle aspiration under ultrasoundIntra-abdominal or intrathoracic masses (fine needle aspiration under ultrasound
guidance)guidance)
Haematological diseases (bone marrow aspiration)Haematological diseases (bone marrow aspiration)
Examination of body cavity fluids (pleural, peritoneal and pericardial effusions)Examination of body cavity fluids (pleural, peritoneal and pericardial effusions)
Examination of urine sediment (e.g. stained preparation in addition to routine wetExamination of urine sediment (e.g. stained preparation in addition to routine wet
prep to check for neoplastic cells)prep to check for neoplastic cells)
Joint disease (joint tap to examine synovial fluid)Joint disease (joint tap to examine synovial fluid)
Neurological disease (cerebrospinal fluid analysis)Neurological disease (cerebrospinal fluid analysis)
Respiratory disease (tracheal wash, bronchoalveolar lavage, and lung aspirate)Respiratory disease (tracheal wash, bronchoalveolar lavage, and lung aspirate)
Prostatomegaly (prostatic wash or fine needle aspirate of the prostate under ultrasoundProstatomegaly (prostatic wash or fine needle aspirate of the prostate under ultrasound
guidance)guidance)
Oestrus detection (vaginal cytology to assess stage of the oestrus cycle)Oestrus detection (vaginal cytology to assess stage of the oestrus cycle)
Nasal disease (nasal flushings)Nasal disease (nasal flushings)
Conjunctival and/or ocular disease (conjunctival swab, third eyelid or cornealConjunctival and/or ocular disease (conjunctival swab, third eyelid or corneal
swab/scrape)swab/scrape)
5. BIOPSYBIOPSY
Removal of a sample of tissue or cells taken from any part of the
body.
IndicationsIndications
Determine tissue diagnosis where clinical diagnosis is in doubtDetermine tissue diagnosis where clinical diagnosis is in doubt
Determine whether benign or malignantDetermine whether benign or malignant
Ascertain the degree of differentiation (grade)Ascertain the degree of differentiation (grade)
Ascertain extent of spread of disease (stage)Ascertain extent of spread of disease (stage)
Determine the tissue of originDetermine the tissue of origin
Determine different therapeutic pathwaysDetermine different therapeutic pathways
Surgical resection margins provide critical informationSurgical resection margins provide critical information
7. Needle biopsy - Cells removed using a thin needle
Aspiration biopsy-Cells drawn out with a hollow needle that uses suction
Core needle biopsy -Sample of tissue is removed using a hollow core needle
that has a special cutting edge
Vacuum-assisted biopsy -A number of samples of tissue are taken using a
special rotating probe
Endoscopic biopsy -Area is viewed with an endoscope, tool is passed
through the tube to take the biopsy sample
Incisional biopsy - a portion of a mass is removed by cutting it out
Excisional biopsy - a mass is completely removed, such as a breast lump
Punch biopsy - a core of skin is removed with a special biopsy tool
Skin biopsy - a small piece of skin is cut off with a scalpel
Shave biopsy - top layers of skin are shaved off with a special blade
Bone marrow biopsy - a long needle is inserted into the bone marrow to
collect cells
Cancer liquid biopsy - Collection and evaluation of mitotic DNA
released into blood by cancerous cells
14. Cytopathology Methods
1.1. Exfoliative cytology – Vaginal cytology,Bronchio-alveolarExfoliative cytology – Vaginal cytology,Bronchio-alveolar
lavageslavages
2. Abrasive cytology - Scrapings2. Abrasive cytology - Scrapings
3. Fine needle aspiration cytology –3. Fine needle aspiration cytology – FNA, FNABFNA, FNAB
4. Fluid Cytology4. Fluid Cytology - Effusions from the body cavitiesEffusions from the body cavities
15. Fine needle aspiration cytology
Examination of cells aspirated or imprinted from body cavities,Examination of cells aspirated or imprinted from body cavities,
mammary gland secretions, nasal discharges, bronchialmammary gland secretions, nasal discharges, bronchial
washings, bone marrow, lymph nodes and Deep sited organs –washings, bone marrow, lymph nodes and Deep sited organs –
guidance of CT scan, US .guidance of CT scan, US .
The modern method of fine needle aspiration cytology wasThe modern method of fine needle aspiration cytology was
originally described by Martin and Ellis in 1930originally described by Martin and Ellis in 1930
It yields cells rather than a tissue sample, so that it is possible toIt yields cells rather than a tissue sample, so that it is possible to
assessassess only cellular featuresonly cellular features and not the architecturaland not the architectural
characteristics of the tumour tissue. Fine-needle aspiration hascharacteristics of the tumour tissue. Fine-needle aspiration has
many positive qualities. It is relatively painless and free ofmany positive qualities. It is relatively painless and free of
complications.complications.
(Vail et al,1996)(Vail et al,1996)
16. Fine Needle Aspiration (FNA)Fine Needle Aspiration (FNA)
The best overall method for sampling any mass or proliferativeThe best overall method for sampling any mass or proliferative
lesion, s/c glandular organs like lymph node, mammary glandlesion, s/c glandular organs like lymph node, mammary gland
or salivary glandor salivary gland
Fine needle procedure (21 to 25 gauge)Fine needle procedure (21 to 25 gauge)
Performed on the following tissue types:Performed on the following tissue types:
Neck lymph nodes, cystsNeck lymph nodes, cysts
Thyroid gland, salivary glandThyroid gland, salivary gland
Breast tissueBreast tissue
Any lump that can be feltAny lump that can be felt
70-80% success rate70-80% success rate
The four fundamental requirements on which the successThe four fundamental requirements on which the success
of FNAB depends areof FNAB depends are representativenessrepresentativeness,, adequacy of theadequacy of the
samplesample and highand high quality of preparationquality of preparation with relevant andwith relevant and
correct clinical / radiological informationcorrect clinical / radiological information
18. Selection Of Syringe And NeedleSelection Of Syringe And Needle
22 – 25 gauge needle22 – 25 gauge needle
3 – 20ml syringe3 – 20ml syringe
The softer the tissue – the smaller the needle and syringe used(lymphThe softer the tissue – the smaller the needle and syringe used(lymph
nodes – 3ml)nodes – 3ml)
The basic technique uses a 25-gauge needle and a 10-mL syringe
Larger needles – Tissue cores aspiratedLarger needles – Tissue cores aspirated
Poor yield of free cellsPoor yield of free cells
Greater blood contaminationGreater blood contamination
A larger bore needle and increased suction may be necessary for
mesenchymal tumours
A 12 ml syringe is a good choice if texture is unknown (Rick L.CowellA 12 ml syringe is a good choice if texture is unknown (Rick L.Cowell
et.al, Diagnostic cytology and hematology of the dog and cat)et.al, Diagnostic cytology and hematology of the dog and cat)
20. FNA ProcedureFNA Procedure
Preparation of the SitePreparation of the Site
The mass is stabilised with one handThe mass is stabilised with one hand
Needle with syringe attached introduced intoNeedle with syringe attached introduced into
mass Withdraw plunger to 3/4mass Withdraw plunger to 3/4thth
volumevolume
of syringe Needle is moved back andof syringe Needle is moved back and
forth repeatedly passing through 2/3forth repeatedly passing through 2/3rdrd
diameterdiameter
of massof mass
Avoid use of US gelAvoid use of US gel
Do not allow needle to exit the mass while
negative pressure is being applied
21. Negative pressure released Needle isNegative pressure released Needle is
removed from mass and skin Needle isremoved from mass and skin Needle is
removed from syringe Air drawn intoremoved from syringe Air drawn into
syringe Needle replaced onto the syringesyringe Needle replaced onto the syringe
and aspirate expelled onto the middle of aand aspirate expelled onto the middle of a
microscope slidemicroscope slide
24. Non – Aspiration ProcedureNon – Aspiration Procedure
No negative pressure is appliedNo negative pressure is applied
Barrel of syringe filled with air prior toBarrel of syringe filled with air prior to
introductionintroduction
Needle moved back and forth in a stabbingNeedle moved back and forth in a stabbing
motionmotion
Prevents desiccation and coagulation ofPrevents desiccation and coagulation of
samplesample
Yield samples of equal or better qualityYield samples of equal or better quality
25. Collection TipsCollection Tips
Make and submit multiple slidesMake and submit multiple slides
Stain and briefly examine for cellularity –Stain and briefly examine for cellularity –
averageaverage 100 cells100 cells
Use new needle and syringe for each massUse new needle and syringe for each mass
Needle passages should be quick adequateNeedle passages should be quick adequate
pressurepressure
Avoid blood dilution – prolonged aspirationAvoid blood dilution – prolonged aspiration
large needlelarge needle
A minimum of 4 -5 slides from several sites from any lesion
Any time material is visible in the hub of needle, STOP collection
26. Preparation Of SlidesPreparation Of Slides
Slide – over – slide smears ( Squash Preps )Slide – over – slide smears ( Squash Preps )
Blood Smear TechniqueBlood Smear Technique
Best method of preparing slide from FNB
28. Preparation TipPreparation Tip
Do not let the sample dry or clotDo not let the sample dry or clot
Do not spray the sample from long distanceDo not spray the sample from long distance
Avoid making too thick a smearAvoid making too thick a smear
Do not allow cytologic specimens to come in direct contact
with ice because cell lysis will occur (do not refrigerate
smears).
Changes occur in the fluid samples with storage, such as
phagocytosis of erythrocytes (within a few hours) and bacteria
(within 30 min), so freshly made smears should ideally be
provided along with any fluid samples
29. Formalin-fixed cytology preparations must be
stained with either H&E or Papanicolaou stain.
Unstained cytology slides should never beUnstained cytology slides should never be
mailed with or stored near samples in formalinmailed with or stored near samples in formalin
30. Stains
Romanowsky type stainsRomanowsky type stains
(for air dried slides)(for air dried slides)
Wright’s stainWright’s stain
Giemsa stainGiemsa stain
Wright’s Giemsa stainWright’s Giemsa stain
Diff- Quik stainDiff- Quik stain
Cytoplasmatic features are wellCytoplasmatic features are well
preservedpreserved
Nuclear and nucleolar featuresNuclear and nucleolar features
are less preserved.are less preserved.
Diff- Quik stainDiff- Quik stain
31. Papanicolaou
stain
Nuclear and nucleolar featuresNuclear and nucleolar features
are better preservedare better preserved
Cytoplasmic changes andCytoplasmic changes and
micro-organismsmicro-organisms areare
not demonstrated.not demonstrated.
CumbersomeCumbersome
Hematoxylin stain + Orange stainHematoxylin stain + Orange stain
+ Polychromic stain =+ Polychromic stain =
Papanicolaou stain.Papanicolaou stain.
32. Only one colourOnly one colour
Not a permanent stainNot a permanent stain
Nucleoli well demonstratedNucleoli well demonstrated
Good for a bone marrow aspiratesGood for a bone marrow aspirates
New Methylene Blue
33. Observation of different criteria's :-Observation of different criteria's :-
Artifact during preservation & staining.Artifact during preservation & staining.
Nuclear/ cytoplasmic ratio:-Nuclear/ cytoplasmic ratio:- Normal / increased / decreased
Chromatin pattern and colorChromatin pattern and color Smooth / finely stippled /
hazy /coarse/ clumped / smudged
Nucleolar appearanceNucleolar appearance
*Nuclear size : Variable / uniform
*Nuclear or cytoplasmic : Yes / No
membrane distortion
Cytoplasmic featuresCytoplasmic features
Extracellular matrix visiability and colorExtracellular matrix visiability and color
35. NeutrophilsNeutrophils
Large numbers of neutrophils indicate acute
inflammation and often are accompanied by
smaller numbers of macrophages- infection or
foreign body reaction
Truly pathogenic bacteria should be within
the cytoplasm of the phagocytic cells
Neutrophils
36. variable morphology
If a macrophage exhibits vacuolation or phagocytosis, it is
often described as activated.
Can be multinucleated, especially with foreign body reactions
and in longstanding lesions.
Under certain circumstances, they may become epithelioid-
oval or round nuclei and small, often indistinct, nucleoli. Their
cytoplasm is expanded but uniformly stained and not
vacuolated
Common in bronchoalveolar lavage fluid, body cavity, joint
fluids
Macrophages
37. segmented nuclei
eosinophilic cytoplasmic granules
slightly larger than neutrophils
difficult to distinguish poorly stained eosinophils from neutrophils
Allergies, superficial cutaneous viral infection in cats, eosinophilic
granuloma in horses, canine eosinophilic folliculitis and furunculosis
Some cases of canine cutaneous mast cell tumors have a very high
proportion of eosinophils and very few mast cells
Rabbits, guinea pigs, birds and reptiles - heterophils with eosinophilic
granules
Eosinophils
38. small with very little cytoplasm and smudged chromatin with
no nucleoli
The almost-round nuclei are similar in size to those of red
cells.
Medium and large lymphocytes, which have a slightly more
open chromatin pattern and more cytoplasm, can also be seen
in inflammatory processes
If mostly medium to large cells are present, lymphoma is a
possibility
Normal and reactive lymphocytes in body fluids often appear
larger than the same cells from soft tissue.
Lymphocytes
39. Multinucleated Cells :These cells are large and have larger numbers of
nuclei with one to three small nucleoli and vacuolated cytoplasm.
These cells are usually seen in small numbers mixed with other
inflammatory cells as part of a granulomatous reaction
Common in many early focal inflammatory lesions in birds and reptiles
Fibroblasts :frequently seen in association with inflammation.
fibroblasts and fibrocytes are elongated cells with pointed tails of
cytoplasm. They have round or oval nuclei, indistinct nucleoli, and
moderate amounts of uniform, pale blue-staining cytoplasm. The
cytoplasmic boundaries are indistinct, giving a “wispy” appearance
Reactive fibroblasts cannot be definitively distinguished cytologically from
low-grade spindle cell tumors.
40. Ancillary TechniquesAncillary Techniques
FNAC samples for biomarker research isFNAC samples for biomarker research is
advancingadvancing
microbiological, immunohistochemical,
radiological, biochemical and special staining
techniques
electron microscopy, immunohistochemistry,electron microscopy, immunohistochemistry,
DNA ploidy, cytogenetics and FISHDNA ploidy, cytogenetics and FISH
42. Fluid Cytology
1.Centesis:-
Centesis is the process of perforation with an aspirator,Centesis is the process of perforation with an aspirator,
trocar, or needle for abdominal, thoracic, synovial ortrocar, or needle for abdominal, thoracic, synovial or
cerebrospinal fluid collection (EDTA tube).cerebrospinal fluid collection (EDTA tube).
2.Catheterization:-
transtracheal/ bronchial and prostatic washestranstracheal/ bronchial and prostatic washes
43. Peritoneal fluid cytological
examination
Indications
AscitesAscites
Inflammatory exudationInflammatory exudation
Rupture of urinary bladderRupture of urinary bladder
Colic and continuous weight loss in horsesColic and continuous weight loss in horses
(Thrall et al,1984)(Thrall et al,1984)
44. Cont….
Perform nucleated cell count :-Perform nucleated cell count :-
Normal peritoneal fluid has nucleated cells < 10000/microlit.Normal peritoneal fluid has nucleated cells < 10000/microlit.
Bacteria suspected : stain with Gram’s stain and describeBacteria suspected : stain with Gram’s stain and describe
its morphology ( cocci, bacilli)its morphology ( cocci, bacilli)
Congestive heart failure: TransudateCongestive heart failure: Transudate
Mono nuclear cell % increases.Mono nuclear cell % increases.
Macrophages
Neutrophil Cryptococcus org.
45. Pleural fluid examination
Indications
NeoplasiaNeoplasia
HemorrhageHemorrhage
TransudationTransudation
ChylothoraxChylothorax
Normally pleural fluid has nucleated cellsNormally pleural fluid has nucleated cells ≤≤ 10000/ micro lit.10000/ micro lit.
(Thrall et al,1984)(Thrall et al,1984)
46. BENIGN VS MALIGNANT
The presence of cells that are predominantly of the sameThe presence of cells that are predominantly of the same
population indicates normal tissue, hyperplasia, orpopulation indicates normal tissue, hyperplasia, or
neoplasianeoplasia
Benign neoplasia is characterized byBenign neoplasia is characterized by
uniform population of cells from normal tissue.uniform population of cells from normal tissue.
uniform cytoplasmic and nuclear size and shapeuniform cytoplasmic and nuclear size and shape
uniform nuclear-cytoplasmic ratio.uniform nuclear-cytoplasmic ratio.
Benign tumor cell generally organized intoBenign tumor cell generally organized into
Papillary structures,Papillary structures,
Clusters SheetClusters Sheet
Glandular formGlandular form
Honey combingHoney combing
Moulding patternMoulding pattern
48. CYTOLOGIC CRITERIA OF
NEOPLASTIC CELLS
Diagnostic criteria of neoplastic cells will be based on :Diagnostic criteria of neoplastic cells will be based on :
Cellular FeaturesCellular Features
Nuclear FeaturesNuclear Features
Cytoplasmic FeaturesCytoplasmic Features
49. Cellular Features of Malignant Cells
Hyper
chromasia
Anisocytosis Macrocytosis
Pleomorphism
High
N/C ratio
MALIGNANCY
CRITERIA
50. Anisocytosis Variation in cell size
Hypercellularity Increase cell exfoliation due to
decrease cell adherence
Pleomorphism Variable size and shape of the cell
Nuclear molding Deformation of nuclei by other
nuclei within same cell.
Cell polarity Lost
Cont…
51. Nuclear Features of Malignant Cells
Aniso
nucleoliosis
Nuclear
molding
Abnormal
Mitotic
figures
Macronuclei
Anisokaryosis
MALIGNANCY
CRITERIA
55. Thyroid carcinomas -fairly uniform, well-differentiated cells,
in dogs tumors >3 cm are automatically considered malignant
Similarly apocrine gland carcinomas, basal cell tumors,
melanomas, and proliferative lesions of the liver cannot be
distinguished b/w benign and malignant
Lymphoma characterized by a uniform population of cells
that are larger than normal lymphoid cells. . If there is marked
variation and small lymphocytes are present, then that is more
typical of hyperplasia.
Hepatoid glands- have more than one cell type (reserve and
terminal cells) and can therefore show variation in
morphology, and benign tumors of hepatoid glands can have a
similar mixture.
Exceptions to the rules of interpretation
57. Cytoplasmic
Vacuolation
Basal Cell
Carcinoma
Epithelial
Tumour
Round to
caudate
cells
Round & oval
Nucleolus
Adenoma,adenocacinoma
Anaplastic carcinoma
Sebaceous gland adenoma
Keratinized
Epithelial cells
PapillomaSquamous cell
carcinoma
Small Cuboidal
Cells+ Oval Nucleus
No
Round cells +
Single distinct
nucleus
Seminoma
Hepatoid
cells
Perianal gland
adenoma
Caudate cells + pale
cytoplasm
Ceruminous gland
adenocarcinoma
+
(Krithiga et al,2005)
58. Epithelial Tumors
Aspirates of epithelial tumors tend to be of moderate to highAspirates of epithelial tumors tend to be of moderate to high
cellularity and contain large round to polygonal cells usuallycellularity and contain large round to polygonal cells usually
occurring in clusters or sheets.occurring in clusters or sheets.
The cells have large prominent nuclei. Acinar or ductalThe cells have large prominent nuclei. Acinar or ductal
arrangements may be noted with adenomas andarrangements may be noted with adenomas and
adenocarcinomas.adenocarcinomas.
Poorly differentiated epithelial neoplasms may producePoorly differentiated epithelial neoplasms may produce
more cells that occur individually as the cells lose theirmore cells that occur individually as the cells lose their
normal cellular attachmentsnormal cellular attachments
60. Papilloma
Papilloma is finger like projectionPapilloma is finger like projection
*Cytology revealed keratinized epithelial cell with*Cytology revealed keratinized epithelial cell with
small round to oval nucleus.small round to oval nucleus.
*Nucleus was distinct*Nucleus was distinct
*Chromatin finely dispersed*Chromatin finely dispersed
*Cytoplasm was vacuolated. H & E stain*Cytoplasm was vacuolated. H & E stain
61. They are the most commonly reported cutaneous tumorsThey are the most commonly reported cutaneous tumors
in dogin dog
Have a site predilection for the skin of head, neck &Have a site predilection for the skin of head, neck &
shouldersshoulders.
Basal cell tumors arise from multipotential germinalBasal cell tumors arise from multipotential germinal
epidermal cellsepidermal cells
The tumors may be pigmented, and often contain cysticThe tumors may be pigmented, and often contain cystic
spaces.spaces.
Basal cell tumors usually are benignBasal cell tumors usually are benign
Basal Cell Tumor
62. Cont.....
CYTOLOGYCYTOLOGY
*Clumps of tightly adherent cuboidal cells*Clumps of tightly adherent cuboidal cells
*Individual cell show cords or ribbons of small, uniform cell.*Individual cell show cords or ribbons of small, uniform cell.
*The cells have a high N:C ratio & mild anisokaryosis.*The cells have a high N:C ratio & mild anisokaryosis.
*Less cytoplasm*Less cytoplasm
63. The neoplastic squamous cells exhibit Tadpole cells.The neoplastic squamous cells exhibit Tadpole cells.
* Anisocytosis , anisokaryosis and waxy blue cytoplasm* Anisocytosis , anisokaryosis and waxy blue cytoplasm
* Asynchrony of nuclear and cytoplasmic maturation,* Asynchrony of nuclear and cytoplasmic maturation,
* Occasional binucleate forms* Occasional binucleate forms
( Lumsden,2002)( Lumsden,2002)
Squamous cell carcinoma
64. Cytologically,Cytologically,
*Clusters of highly basophilic cells,*Clusters of highly basophilic cells,
* small centrally located nuclei and abundant foamy* small centrally located nuclei and abundant foamy
cytoplasmcytoplasm
* higher N:C ratio.* higher N:C ratio.
* cytoplasmic secretory material displace the nucleus to the* cytoplasmic secretory material displace the nucleus to the
periphery of the cellperiphery of the cell (signet ring cell)(signet ring cell)
Sebaceous Gland Tumor
65. Urinary neoplasm is transitional cellUrinary neoplasm is transitional cell
carcinoma.carcinoma.
*The cells are pleomorphic with*The cells are pleomorphic with
abundant cytoplasmabundant cytoplasm
*Anisocytosis & anisokaryosis.*Anisocytosis & anisokaryosis.
*the cytoplasm may contain small to*the cytoplasm may contain small to
large pale vacuoles.large pale vacuoles.
( Frost et. al, 2001 )
Transitional cell carcinoma
68. FIBROMA
•Presence of spindle cells
•Nuclei oval and elongated with indistinct
nucleolus
•Cytoplasm- tapering
(McCarthy et.al, 2003)
69. Fine-needle aspirate from a mammaryFine-needle aspirate from a mammary
carcinoma in a dog.carcinoma in a dog.
Anisocytosis and anisokaryosisAnisocytosis and anisokaryosis
are present (Wright stain).are present (Wright stain).
Presence ofPresence of macro nucleolusmacro nucleolus
Mammary carcinoma
70. Hepatoid Gland Adenoma ,Perianal adenoma,
Circumanal gland adenoma
Large, cuboidal epithelial cells look likeLarge, cuboidal epithelial cells look like liver cellsliver cells..
Low N:C ratios, round nuclei, single distinct nucleolus,Low N:C ratios, round nuclei, single distinct nucleolus,
occassionaly binucleate.Mild anisocytosis andoccassionaly binucleate.Mild anisocytosis and
anisokaryosis presenceanisokaryosis presence
Slightly granular blue cytoplasm.Slightly granular blue cytoplasm.
71. Fine-needle aspirates of the testicular masses.Fine-needle aspirates of the testicular masses.
Highly cellular and vacuolated cells in sheets and palisades,Highly cellular and vacuolated cells in sheets and palisades,
Finely granular chromatin and prominent nucleoli,Finely granular chromatin and prominent nucleoli,
Central round area of amorphous, deeply eosinophilic, hyalineCentral round area of amorphous, deeply eosinophilic, hyaline
material surrounded by a peripheral, rosette-like arrangementmaterial surrounded by a peripheral, rosette-like arrangement
of single or multiple rows of Sertoli cells. These structures wereof single or multiple rows of Sertoli cells. These structures were
suggestive ofsuggestive of Call-Exner bodiesCall-Exner bodies
Sertoli Cell tumour
72. Round Cell Tumor
cells usually individual seen.
circular cells with round nuclei, distinct cytoplasmic borders
cells may be well differentiated.
Round
73. Yes Mast cell tumour
DISCRETE
ROUND
CELLS
Cytoplasmic
granules
No Cytoplasmic
vacuolations
Yes Transmissible
venereal tumour
No
Bean shaped and
indented nucleus
Multinucleated
giant cells
Yes Yes
Histiocytoma
a
b
dc
Histiocytic sarcoma
74. FNAC from the lesion on the lip of Dog.FNAC from the lesion on the lip of Dog.
large round cells and variable numbers oflarge round cells and variable numbers of meta-chromatic
intracytoplasmic granules (purple) typical of neoplastic mast(purple) typical of neoplastic mast
cells.cells.
A small percentage of mast cell tumors, however, are composed almost entirely
of inflammation, hemorrhage, and edema with only a small number of mast
cells. These can be difficult to identify even by histology.
Mast cell tumor - dog
75. Aspirate from an enlarged lymph node. TheAspirate from an enlarged lymph node. The
small blue droplets aresmall blue droplets are
““lymphoglandular bodies”lymphoglandular bodies” (arrows).(arrows).
• The nucleated lymphoblast , normal smallThe nucleated lymphoblast , normal small
Lymphocyte is indicated by red arrow.Lymphocyte is indicated by red arrow.
Neoplastic lymphocytes withNeoplastic lymphocytes with convoluted nucleiconvoluted nuclei
typical of some cutaneous lymphomas.typical of some cutaneous lymphomas.
(Wright’s Giemsa stain, ×1000).(Wright’s Giemsa stain, ×1000).
Lymphoma
76. Plasmacytoma are tumors of plasmaPlasmacytoma are tumors of plasma
cells that occur outside the bonecells that occur outside the bone
marrow cavity.marrow cavity.
Cytologically,Cytologically,
Eccentric nucleus,Eccentric nucleus,
Abundant blue cytoplasm,Abundant blue cytoplasm,
Golgi zone look like osteoblasts,Golgi zone look like osteoblasts,
mostly are benign in nature.mostly are benign in nature.
Plasmacytoma/ multiple myeloma
77. Fine needle aspirate from a mass on the penis of a dogFine needle aspirate from a mass on the penis of a dog
Individual round cells with fairly abundant blue cytoplasm andIndividual round cells with fairly abundant blue cytoplasm and
uniform round nucleus with discrete cytoplasmic vacuoles.uniform round nucleus with discrete cytoplasmic vacuoles.
Key to the diagnosis is: cytoplasmic vacuoles and Location-
genital area.
Transmissible venereal tumor
78. “histiocytoma" is a benign neoplasm of monocytic cells.histiocytoma" is a benign neoplasm of monocytic cells.
Tends to be ulceratedTends to be ulcerated
cutaneous histiocytomas are derived from a more specializedcutaneous histiocytomas are derived from a more specialized
population of cells called Langerhans cells.population of cells called Langerhans cells.
Histiocytes are mainly mature macrophages that reside inHistiocytes are mainly mature macrophages that reside in
connective tissue.connective tissue.
Cutaneous histiocytoma
79. In histiocytoma ,In histiocytoma ,
*Cells with a round to oval centrally located nucleus*Cells with a round to oval centrally located nucleus
*Moderately abundant blue cytoplasm that lacks vacuoles*Moderately abundant blue cytoplasm that lacks vacuoles
and granules.and granules.
*A binucleated cell and mitotic figure are present*A binucleated cell and mitotic figure are present
(Wright stain)(Wright stain)
80. Mesenchymal tumors
Mesenchyma is the meshwork of embryonal tissue that formsMesenchyma is the meshwork of embryonal tissue that forms
the body C.T. and vessels.the body C.T. and vessels.
Mesenchymal tumors exfoliate poorly because the cells areMesenchymal tumors exfoliate poorly because the cells are
embedded in extracellular matrix such as fibrous connectiveembedded in extracellular matrix such as fibrous connective
tissue, cartilage, or bone.tissue, cartilage, or bone.
Malignancy of mesenchymal origin are called sarcoma.Malignancy of mesenchymal origin are called sarcoma.
81. Cytologically,Cytologically,
cells are predominantlycells are predominantly fusiformfusiform
have elongated nuclei andhave elongated nuclei and
cytoplasmic tailscytoplasmic tails (spindle cells).(spindle cells).
so its either a mesenchymalso its either a mesenchymal
(spindle cell) tumor or granulation(spindle cell) tumor or granulation
tissuetissue
Cont…
Mesenchymal lesions should be submitted for HistopathologyMesenchymal lesions should be submitted for Histopathology
active fibroblasts are difficult to differentiate from neoplasticactive fibroblasts are difficult to differentiate from neoplastic
fibroblasts and may even have features that suggestfibroblasts and may even have features that suggest
malignancy.malignancy.
82. Lipomas are benign tumors but they can occasionallyLipomas are benign tumors but they can occasionally
infiltrate between muscle masses.infiltrate between muscle masses.
Fine-needle aspirate of a canine Lipoma, lipocytes have aFine-needle aspirate of a canine Lipoma, lipocytes have a
balloon-like appearanceballoon-like appearance with voluminous cytoplasm and awith voluminous cytoplasm and a
small peripherally displaced nucleussmall peripherally displaced nucleus
Lipoma
83. Cont….
Liposarcoma are rare malignant tumors of white adiposeLiposarcoma are rare malignant tumors of white adipose
cell lipoblastscell lipoblasts
Malignant lipocytes appear round to polyhedral withMalignant lipocytes appear round to polyhedral with
vacuolated basophilic cytoplasm,vacuolated basophilic cytoplasm,
A round nucleus (anisokaryosis), and occasional prominentA round nucleus (anisokaryosis), and occasional prominent
nucleoli and mitotic figure is present.nucleoli and mitotic figure is present.
84. Dermal melanomas are common in dogs and horses.Dermal melanomas are common in dogs and horses.
The tumor aspirate contains predominantly individualThe tumor aspirate contains predominantly individual
Melanocyte (round, oval, stellate or spindle shaped).Melanocyte (round, oval, stellate or spindle shaped).
Tumor cells with giant nuclei are often seen. MelaninTumor cells with giant nuclei are often seen. Melanin
pigment appears aspigment appears as brown-black to green-blackbrown-black to green-black
cytoplasmic granulescytoplasmic granules of irregular size and shape.of irregular size and shape.
Melanoma
85. hemangiosarcomas are tumors of blood vessel endothelium andhemangiosarcomas are tumors of blood vessel endothelium and
are contiguous with the blood vascular systemare contiguous with the blood vascular system
Neoplastic endothelial cells aspirated are large spindle toNeoplastic endothelial cells aspirated are large spindle to
polyhedral cells. The nucleus is round to oval and contains one orpolyhedral cells. The nucleus is round to oval and contains one or
more prominent nucleoli. The cytoplasm appears dark blue andmore prominent nucleoli. The cytoplasm appears dark blue and
usually contains many small, discrete, non staining vacuolesusually contains many small, discrete, non staining vacuoles
Hemangiosarcoma
86. Osteosarcoma (OSA) is a rapidly growing, destructive neoplasmOsteosarcoma (OSA) is a rapidly growing, destructive neoplasm
of boneof bone
Fine-needle aspirates of OSA contain mesenchymal cells thatFine-needle aspirates of OSA contain mesenchymal cells that
appear round, plump, or fusiformappear round, plump, or fusiform
Individual neoplastic cells may display anisocytosis,Individual neoplastic cells may display anisocytosis,
anisokaryosis, karyomegaly, eccentrically located nuclei, largeanisokaryosis, karyomegaly, eccentrically located nuclei, large
nucleoli, and basophilic vacuolated cytoplasm .nucleoli, and basophilic vacuolated cytoplasm .
Osteoclast
Osteoid matrix
Osteosarcoma
87. Chondrosarcoma are the second most common tumor ofChondrosarcoma are the second most common tumor of
bone and are difficult to differentiate from osteosarcomasbone and are difficult to differentiate from osteosarcomas
cytologicallycytologically
Individual neoplastic chondroblasts have cytologic featuresIndividual neoplastic chondroblasts have cytologic features
similar to those of osteosarcoma cells.similar to those of osteosarcoma cells.
Chondrosarcoma
88. Based on the type of cell in smear following conclusions canBased on the type of cell in smear following conclusions can
be drawn.be drawn.
Lymph node enlarged : Hyper plastic lymph nodeLymph node enlarged : Hyper plastic lymph node
Lymph node enlarged with : Reactive lymph nodeLymph node enlarged with : Reactive lymph node
increase in Lymphoblast, Mincrease in Lymphoblast, MØØ,,
with haemosiderin and debriswith haemosiderin and debris
Non lymphoid cells with : Metastatic NeoplasiaNon lymphoid cells with : Metastatic Neoplasia
malignant cellsmalignant cells
Majority of cells are : Lymphoid NeoplasiaMajority of cells are : Lymphoid Neoplasia
lymphoblastslymphoblasts
(Roshni(Roshni et alet al, 2007), 2007)
89.
90. Lymph Node Cytology
Aspirate from a hyperplastic lymph node. Numerous smallAspirate from a hyperplastic lymph node. Numerous small
lymphocytes (arrows) are present. A lymphoblast (double arrows)lymphocytes (arrows) are present. A lymphoblast (double arrows)
and prolymphocyte (arrowhead) are present also. Numerousand prolymphocyte (arrowhead) are present also. Numerous
lymphoglandular bodies are present in the background of thelymphoglandular bodies are present in the background of the
smear.smear.
91. Metastatic Neoplasia
Cytology smear showing clusters of keratinizing squamousCytology smear showing clusters of keratinizing squamous
carcinoma indicating metastasis in the lymph node.carcinoma indicating metastasis in the lymph node.
92. lymph node aspiration show majority of large lymphoblast, withlymph node aspiration show majority of large lymphoblast, with
one to several prominent nucleoli (Wright's-Giemsa stain)one to several prominent nucleoli (Wright's-Giemsa stain)
lymphoblastic lymphoma
96. Advantages of Cytology
Samples collected easily and quickly prepared stained andSamples collected easily and quickly prepared stained and
interpreted. less expensive and little or no risk to the patientinterpreted. less expensive and little or no risk to the patient
Cytologic examinations early identify disease process, neoplasiaCytologic examinations early identify disease process, neoplasia
vs. inflammation.vs. inflammation.
This may allow the treatment of the tumor when it is stillThis may allow the treatment of the tumor when it is still
very small, greatly increasing the chances of a cure.very small, greatly increasing the chances of a cure.
97. Limitations of Cytology
The most significant disadvantage of cytology is the absence ofThe most significant disadvantage of cytology is the absence of
tissue architecture.The arrangement of neoplastic cells withintissue architecture.The arrangement of neoplastic cells within
tissues is critical in determining the diagnosis of many types oftissues is critical in determining the diagnosis of many types of
tumors.tumors.
(M.L. Wellman,1990)(M.L. Wellman,1990)
It is not always possible to:It is not always possible to:
localize neoplastic lesion,distinguishe invasive cancer,localize neoplastic lesion,distinguishe invasive cancer,
distinguishe reactive dysplastic and neoplastic changes,distinguishe reactive dysplastic and neoplastic changes,
determine tumor type.determine tumor type.
(Sr. Kamenica 2002)(Sr. Kamenica 2002)
99. CONCLUSION
FNAC is a simple, rapid and in-expensive aid which
can be used in all clinics and hospitals
Impression smears can be made from incisional and
excisional biopsies for cytological examination
Haematoxylin and eosin staining gives familiar
tinctorial properties as that of histopathology
Romanowsky stains used on air-dried smears gives
good nuclear and nucleolar details
Expertise can be gained with experience by
following a systematic procedure
104. ReferencesReferences
Damadian et al.Damadian et al. “Method of Conducting a Needle Biopsy Procedure”.“Method of Conducting a Needle Biopsy Procedure”. United States PatentUnited States Patent
No. US 7,008,383 B1: March 7, 2006.No. US 7,008,383 B1: March 7, 2006.
““Fine Needle Aspiration”.Fine Needle Aspiration”. Medax Medical Devices: 2005. http://www.medaxmedical.comMedax Medical Devices: 2005. http://www.medaxmedical.com
““Fine Needle Aspiration”.Fine Needle Aspiration”. American Academy of Otolaryngology: 2006.American Academy of Otolaryngology: 2006.
http://www.entnet.orghttp://www.entnet.org
““Fine Needle Aspiration Biopsy (FNA)”.Fine Needle Aspiration Biopsy (FNA)”. Virtual Cancer Centre: 2006.Virtual Cancer Centre: 2006.
http://www.virtualcancercentre.comhttp://www.virtualcancercentre.com
Hopper MD, K. et al.Hopper MD, K. et al. “Fine-Needle Aspiration Biopsy for Cytopathologic Analysis: Utility of“Fine-Needle Aspiration Biopsy for Cytopathologic Analysis: Utility of
Syringe Handles, Automated Guns, and the Nonsuction Method”.Syringe Handles, Automated Guns, and the Nonsuction Method”. Radiology: December 1992,Radiology: December 1992,
(819-824).(819-824).
Kelcz MD, Frederick. Department of Radiology.Kelcz MD, Frederick. Department of Radiology.
Mladinich DVM, MS, C. et al.Mladinich DVM, MS, C. et al. “Evaluation and Comparison of Automated Biopsy Devices”.“Evaluation and Comparison of Automated Biopsy Devices”.
Radiology: September 1992, (845-847).Radiology: September 1992, (845-847).
Suen, K. “Fine-Needle Aspiration Biopsy of the Thyroid”. Canadian Medical AssociationSuen, K. “Fine-Needle Aspiration Biopsy of the Thyroid”. Canadian Medical Association
Journal: September 2002, (491-495).Journal: September 2002, (491-495).
105. Cytology is not a substitute
for histology
but……….
Thin needle aspiration biopsy is a procedure
whose time has come” and the pathologists not
already versed in the technique will come under
increasing and compelling pressure to provide it
Editor's Notes
Catheterization procedures are used for
cells usually individual: but sometimes are situated
closely together and look like they are in small aggregates as in
epithelial tumors, don’t get confused by this pattern
usually plenty of cells present
circular cells with round nuclei, distinct
cytoplasmic borders
cells may be well differentiated, e.g. mast cell
tumors
Chondrosarcomas are the second most common tumor of bone and are difficult to differentiate from osteosarcomas cytologically