General Cytology

  1. Define cytology.
    removing cells from a tissue and examining them microscopically.
  2. What is the alternative to histopathology?
  3. Is performing a cytology expensive?
  4. What is cytology used to identify?
    • masses
    • lesions
    • fluid in body cavity
    • pathology of internal organs
  5. What is a lesion?
    an abnormality in the tissue
  6. What are the advantages to doing a cytology?
    • no extra equipment needed
    • very quick procedure
    • relatively non-invasive (animal is usually awake)
    • often can ID cellular reaction
    • may be able to ID cause
  7. What are the disadvantages to doing a cytology?
    • some training is needed to ID cells present
    • may not be able to ID cells
    • may need to supplement with histopathology
  8. Why would we not be able to ID cells in a cytology and what does this mean?
    • cells could be unrecognizable
    • tells us something is wrong, but not what is wrong - usually means neoplasia of some sort
  9. Who is able to perform a cytology and read a cytology?
    • veterinarian
    • LVT
  10. What is required to do a histopathology?
    a tissue sample
  11. How do we do a histopathology?
    • anesthesia is often required
    • surgically remove the sample of tissue (sometimes its just a part of the tissue or the whole thing)
    • fixed it in 10% buffered formalin
    • send to pathologist
  12. How much 10% buffered formalin is needed for a histopathology?
    use 10x amount of formalin to size of the tissue sample
  13. How thick does the tissue sample need to be in order for the 10% buffered formalin to fix it?
    1 cm or less
  14. Once we send the histopathology sample off to the lab, what happens?
    • gets dehydrated
    • set in parifin (wax)
    • sliced
    • mounted on a slide
    • stained in HNE (blue and red stains)
    • analyzed by a pathologist
  15. What are the advantages to doing a histopathology?
    • slide examination is done by a trained pathologist (veterinarian with advanced training)
    • tissue architecture around cells are visualized
    • special stains can be used
    • may be given a more precise diagnosis (especially with neoplasia)
  16. What are the disadvantages to doing a histopathology?
    • more involved procedure
    • more expensive to the client
    • pathologist is unable to see the patient and can be fooled if it is a poor sample or the information is not thorough enough
    • results take time
  17. What are the different cytology techniques?
    • aspiration
    • impression smear
    • wash
    • scraping
  18. If we think there is a presence of bacteria should we culture it first before doing the cytology?
  19. What is another name for an aspiration?
    FNA (fine needle aspiration)
  20. What materials do we need to do an aspiration?
    • 22 - 25g needle
    • 3 - 12 cc syringe (don't always need to use)
    • slides
  21. How do we do an aspiration with a needle and syringe?
    • insert needle and syringe
    • aspirate
    • redirect needle and reaspirate
    • stop once you see tissue into the hub
    • remove needle and pull back the syringe to get air
    • put the needle back on the syringe and push the air out onto a slide
    • the sample from in the hub will come out onto the slide - flea sneeze
    • lay another slide at 90 degrees and pull apart
    • make at least 2 slides
  22. The sample we get from an a FNA is very small, what do we call it?
    flea sneeze
  23. What is the way to do an aspiration without using a syringe to aspirate?
    • just stick the needle directly into the lesion
    • redirect the needle several times
    • take the needle out and attach it to syringe that has air in it
    • push the air out onto a slide (flea sneeze)
    • lay another slide at 90 degrees and pull apart
    • make at least 2 slides
  24. If we are doing a centesis, should we stop aspirating when we get the sample in the hub of the needle?
    no keep pulling back on the syringe to collect the fluid into the syringe
  25. How do we do an impression smear?
    • avoid cleaning the lesion with anything first (can use alcohol if it is really dirty)
    • blot blood off the lesion first (don't wipe it off, just blot)
    • gently (avoid pressure) touch slide to the lesion
    • can touch in several different places for each slide
  26. What if we want to do an impression smear but the lesion is in a place we can't get to with a slide?
    • use a sterile swab
    • moisten with saline if site is dry
    • blot blood first
    • roll swab across lesion then across the slide
  27. How do we do a wash or a flush?
    • flush lesion with saline
    • aspirate back on syringe
    • may use a catheter to get to the sample and attach a syringe on the end
    • smear sample onto slide or centrifuge the sample down and then smear it onto the slide
  28. When would we use a scraping?
    used with firm lesions
  29. How do we do a scraping?
    • hold blade at 90 degrees to surface of the skin
    • scrape back and forth
    • spread debris on slide
    • lay another slide on top and pull apart
  30. Should we stain/fix both of the slides we make?  Why or why not?
    no, only stain 1 because if we see something on the slide that needs to send out to the lab, the lab does not want it stained
  31. Which types of stains can we use?
    • romanowsky (diff quik)
    • new methylene blue (to look at nuclear morphology)
    • gram stain (for bacteria)
    • special stains
  32. Gram positive organisms stain _____ with gram stain.
  33. Gram negative organisms stain _____ with gram stain.
  34. What are other special stains that can be used?
    • pap stain
    • acid fast stain
  35. Where can we get special stains?
    almost all human hospitals have the special stains
  36. Once we have stained our cytology, how do we examine the slide?
    • look with low power to evaluate staining, cellularity
    • move to high power
    • only use oil if we can't see what we need on high power
  37. What are we looking for on the slide?
    • cellular reaction occuring
    • cause of the reaction
    • don't ignore bacteria, fungus, or parasites
  38. What types of cellular reactions could occur?
    • inflammation
    • hyperplasia
    • neoplasia
  39. What is an inflammatory reaction?
    body's reaction to some insult
  40. What are the 3 different types of inflammatory reactions?
    • acute
    • chronic active (or mixed inflammatory reaction)
    • chronic
  41. What are the 4 cardinal signs of inflammation when looking at an animal?
    • swelling
    • redness
    • warmth
    • pain
  42. Does inflammation equal infection?
  43. What is acute inflammation?
    >70% of inflammatory cells are segs
  44. Could cells other than segs be present in acute inflammation?
    yes, don't ignore them because neoplasia can be associated with inflammation
  45. What types of segs could we see with acute inflammation?
    • normal segs
    • hypersegs
    • degenerating segs
  46. When we are looking at a cytology, do we need to count the cells?
    no, just scan
  47. If we want to see bacteria what magnification do we need to be on?
  48. What are the different characteristics of degenerating segs?
    • pyknosis
    • karyorrhexis
    • karyolysis
    • cytoplasmic basophilia
    • vacuoles
  49. What is pyknosis?
    small, condensed, dark nucleus
  50. What is karyorrhexis?
    nucleus explodes and we see different pieces of the nucleus inside and outside the cell
  51. What is karyolysis?
    • swelling of nuclear membrane and cell gradually loses chromatin
    • nucleus is "melting away"
  52. Are there a lot of eosinophils in acute inflammation?
  53. If we see >10% of eosinophils in acute inflammation then what is it called and what is it due to?
    • eosinophilic inflammatory reaction
    • often due to allergy, parasites, eosinophilic disease
  54. What is chronic active inflammation?
    50 - 70% of cells are segs and the remainder are monocytes and macrophages
  55. What is another name for chronic active inflammation?
    mixed inflammatory reaction
  56. What is chronic inflammation?
    more than 50% of cells are monocytes and macrophages
  57. When will we see chronic inflammation?
    often seen with systemic fungal infections and foreign bodies
  58. What is granulomatous inflammation?
    a form of chronic inflammation
  59. What normally happens with granulomatous inflammation?
    • fibrous wall is built around the lesion (firm small or large white masses)
    • bodys response to the organism in the body
  60. What are special macrophages?
    • epithelioid cells
    • giant cell
  61. What can special macrophages be confused with?
  62. What does an epithelioid cell look like?
    • large cell with an abundance of pale cytoplasm
    • vesicular nucleus
  63. What does a giant cell look like?
    • large, multinucleated cell
    • an abundance of pale cytoplasm
  64. What is another way to look at a slide on oil and why is it better?
    • put oil on the slide and put a cover slip over it
    • examine on 400x
    • increases clarity and resolution
  65. To find organisms in a cytology where do we need to look?
    • in segs or between cells
    • check in macrophages too
  66. What color does mucus stain?
  67. Should we look at discharges under a microscope?
    • yes
    • make 2 smears
    • air dry and stain one
    • may need specific stains
  68. What are the specific stains we may need for examining discharges?
    • gram stain (for bacteria and yeast)
    • PAS (makes fungal organisms stand out)
    • acid fast stains (for acid fast organisms)
  69. What are the different types of tissue we can examine on a cytology?
    • epithelial
    • connective
    • muscle
    • nervous
  70. What are some types of epithelial tissues?
    • squamous (in body openings)
    • cuboidal (in glands)
    • columnar (in intestines and lungs)
    • glandular
    • transitional (in bladder and urinary tract)
  71. What are some types of connective tissue?
    • bone
    • cartilage
    • fibrous
    • blood
  72. What is hyperplasia?
    • tissue enlarged or thickened
    • increased population of normal cells
    • normal body process
  73. Which tissues would we see hyperplasia?
    • lymph nodes
    • spleen
    • prostate
  74. What does a cytology look like of hyperplasia?
    • mostly young cells
    • large nuclei with vesicular chromatin
    • basophilic cytoplasm
    • high N:C ratio
    • normal mitotic figures (chromosomes line up  like they normally do in mitosis)
  75. Image Upload 1
    What kind of inflammation is this?
    acute inflammation (>70% inflammatory cells are segs)
  76. Image Upload 2
    This urine sample was collected via cystocentesis. What is wrong?
    • too much bacteria for a cysto collection
    • indicates cystitis
  77. Image Upload 3
    What is wrong with this fecal sample?
  78. Image Upload 4
    What kind of inflammation is this?
    chronic active inflammation (50 - 70% inflammatory cells are segs and the rest are monocytes and macrophages)
  79. Image Upload 5
    What kind of inflammation is this?
    chronic inflammation (>50% inflammatory cells are monocytes and machrophages)
  80. Image Upload 6
    What is wrong with this fecal sample?
  81. Image Upload 7
    What is this?
  82. Image Upload 8
    What type of inflammation is this?
    eosinophilic inflammatory reaction
  83. Image Upload 9
    What is this?
    giant cell
  84. Image Upload 10
    What is this?
    giant cell
  85. Image Upload 11
    What is wrong with this fecal sample?
  86. Image Upload 12
    What kind of stain was used for this?
    gram stain
  87. Image Upload 13
    What is this?
  88. Image Upload 14
    What is this?
    hyphae from nasal discharge
  89. Image Upload 15
    What kind of smear technique is this?
    impression smear
  90. Image Upload 16
    What is this?
  91. Image Upload 17
    What kind of stain was used?
    new methylene blue
  92. Image Upload 18
    What kind of organism is this?
    nocardia (seen more in large animals)
  93. Image Upload 19
    What is this?  It is from the prostate.
    prostatic hyperplasia
  94. Image Upload 20
    What is wrong with this seg?
  95. Image Upload 21
    What is wrong with these cells?
  96. Image Upload 22
    What kind of cytology technique is this?
    aspiration (redirecting)
  97. Image Upload 23
    What kind of cytology collection technique is this?
  98. Image Upload 24
    What kind of organism is this?
    simonsiella (normal flora of the mouth)
  99. Image Upload 25
    What kind of sample collection is this?
  100. Image Upload 26
    What kind of inflammation is this?
    granulomatous inflammation (part of chronic inflammation)
  101. Image Upload 27
    What are these?
    epithelioid macrophages (large cell, abundance of pale cytoplasm, vesicular nucleus)
  102. Image Upload 28
    What is this?
  103. Image Upload 29
    What is this?
  104. Image Upload 30
    What is this?
    milk aspiration
  105. Image Upload 31
    What is this?
    mineral oil aspiration
  106. What are the 3 different types of cellular reaction?
    • inflammation
    • hyperplasia
    • neoplasia
  107. What are the two types of neoplasia?
    • benign
    • malignant
  108. We classify the neoplasia into benign or malignant based on what?
    biological behavior
  109. Describe benign neoplasms.
    • circumscribed
    • grow slow
    • not invasive
    • grow to a certain size then stop
  110. What is circumscribed?
    distinct nodule all the way around the mass
  111. If there is a benign neoplasm in a gland what might happen to the secretions of the gland?
    they might increase
  112. "-oma" = _____.
  113. What are some common benign tumors?
    • fibroma
    • lipoma
    • adenomas
    • skin tumors (melanoma, basal cell tumor)
  114. What do we call a fibroma in horses?
  115. What does a fibroma feel like?
  116. What is a lipoma?
    fatty tumor
  117. Where do we find adenomas?
    glands - mammary, adrenal, thyroid
  118. What is the difference between neoplasm and neoplasia?
    • neoplasm is a mass/tumor
    • neoplasia doesn't necessarily have to have a mass or tumor
  119. Do malignant neoplasms grow fast or slow?
    grow fast
  120. Are malignant neoplasms locally invasive/destructive?
    yes, they do not have a nice edge around them like benign neoplasms
  121. Do malignant neoplasms metastasize?
  122. What does metastasize mean?
    spread to distant places
  123. Where do malignant neoplasms usually metastasize to first?
    usually go to the lymph nodes first and then to the lungs
  124. Malignant neoplasms are anaplastic.  What does this mean?
    all the cells look like large immature cells and you can't tell them apart (undifferentiated)
  125. What do we analzye for the cytology of neoplasia?
    nuclear and cytologic criteria
  126. What is pleomorphism?
    variability in cell size and shape
  127. The more present the nuclear and cytologic criteria, the more _____.
  128. What is the nuclear criteria for determining malignancy?
    • multiple number and sized nucleoli
    • multiple number and sized nuclei
    • variable staining of chromatin
    • irregular nuclear membrane
    • variable N:C ratio from cell to cell
    • abnormal mitotic figures
  129. What is anisokaryosis?
    difference in size of nucleus from cell to cell
  130. What is the cytoplasmic criteria for determining malignancy?
    • increased basophilia (bluer cytoplasm)
    • increased vacuolation
    • varying amounts of cytoplasm per cell
    • indistinct cytoplasmic edges (hard to tell where once cell stops and the next one starts)
  131. What are the different types of malignant tumors?
    • carinoma
    • sarcoma
    • discrete cell neoplasms
  132. Where are carcinomas?
    • epithelial tissue
    • glands (adenocarinoma)
  133. Where are sarcomas?
    connective tissue
  134. What are discrete cell neoplasms?
    not just limited to one tissue type
  135. Describe sarcomas.
    • firm
    • few cells seen
    • cells elongated - hard to tell one from the other
  136. Because sarcomas are firm, how do we make the cytology?
  137. What are some common sarcomas?
    • osteosarcoma
    • fibrosarcoma
    • lymphosarcoma
    • chondrosarcoma
    • hemangiosarcoma
    • melanosarcoma
  138. Are carcinomas very cellular?
  139. What are some common carcinomas?
    • squamous cell carcinoma
    • mammary adenocarinoma
    • prostatic carcinoma
    • adrenal adenocarinoma
    • thyroid adenocarinoma
    • transitional cell tumor
  140. What are some different discrete cell tumors?
    • melanoma
    • mast cell tumor
    • lymphoma
    • histiocytoma
    • transmissible venereal tumor
  141. What is the most common skin tumor in cats?
    basal cell tumor
  142. Are basal cell tumors usually benign or malignant?
  143. Where do we usually see basal cell tumors?
    • head
    • neck
    • shoulders
  144. What do basal cell tumor cells look like?
    • cells clump
    • high N:C ratio
    • blue cytoplasm
    • may see melanin and vacuoles
  145. What are plasmacytomas?
    plasma cell tumors
  146. Which species do plasmacytomas usually affect?
  147. Where on dogs are plasmacytomas commonly seen?
    • oral cavity
    • ears
    • forelimb skin
    • digits
    • GIT
  148. Are plasmacytomas usually benign or malignant?
  149. When are plasmacytomas malignant?
    when they are in the marrow
  150. What are melanomas?
    neoplasia of melanocytes
  151. Where are melanomas common?
    • skin
    • mouth
    • iris of eyes
  152. _____% of melanomas on skin are _____.
    • 85
    • benign
  153. Most melanomas in the mouth and eyes are _____.
  154. What do melanoma cells look like?
    brown to green-black granules that may obsure the nucleus
  155. Are melanomas common in cats?
  156. What is the most common skin tumor in dogs?
    mast cell tumors
  157. What is the second most common skin tumor in cats?
    mast cell tumor
  158. Are all mast cell tumors potentially malignant in dogs?
    yes and we should treat all of them this way
  159. Mast cell tumors have an increased chance of being malignant if they are seen around what parts of the body?
    • perineum
    • groin
    • muzzle
  160. What are histiocytomas?
    benign cutaneous tumor
  161. What do histiocytomas look like?
    usually round nuclei with moderate basophilic cytoplasm
  162. What are histiocytomas often confused with?
  163. What age dogs do we usually see histiocytomas in?
    < 3 years old
  164. Are histiocytomas fast or slow growing?
    fast growing
  165. Can histiocytomas get better on their own?
  166. Where are transmissible venereal tumors?
    on the genitalia or on the lips
  167. How do dogs get transmissible venereal tumors?
    from other dogs
  168. What do transmissible venereal tumors look like?
    • numerous round cells
    • abundant blue cytoplasm
  169. Image Upload 32
    What type of nuclear criteria is this representing?
    abnormal mitotic figures
  170. Image Upload 33
    What is this?
    basal cell tumor
  171. Image Upload 34
    What is this?
    basal cell tumor on a cat
  172. Image Upload 35
    What type of neoplasia is this?
  173. Image Upload 36
    What type of sarcoma is this?
    chrondrosarcoma (in the cartildge)
  174. Image Upload 37
    What type of nuclear criteria is this representing?
    variable staining of chromatin
  175. Image Upload 38
    What type of cytoplasmic criteria is this representing?
    cytoplasmic vacuoles
  176. Image Upload 39
    What type of cell is this?
    a glandular cell
  177. Image Upload 40
    What type of sarcoma is this?
    • hemangiosarcoma - tumors in blood vessles in the spleen and liver
    • this is of the spleen
  178. Image Upload 41
    What type of sarcoma is this?
  179. Image Upload 42
    What is this?
Card Set
General Cytology
Lab Tech ll