cytology respiratory
what is the function of respiratory system?
clean and warm inspired air gas exchange immune protection voice production olfaction
what are the respiratory systems 2 main function
ventilation gas exchange
where are gasses exchanged?
alveoli
how many lobes does the L lung have, R lung?
Left 2 Right 3
The lungs are covered by a visceral....?
pleura
How are the two types of specimens taken?
Exfoliative - sputum, BB, BW, and BL's Aspirate - FNA, bronchoscope ultrasound
What epithelium lines the oral cavity, pharynx, and more common in sputum?
Stratified squamous epithelium
What epithelium makes up the bronchus?
pseudostratified ciliated columnar epithelium
What ratio is seen between Ciliated bronchioles:Goblet cells
5:1 ratio
what is the purpose of ciliated epithelium?
To clear debris from the airways with mucus to trap dust and other things
Cilia propels mucus away from
the alveoli
What is goblet cells most characteristic feature
abundant mucin
What does an increase amount of goblet cells indicate?
asthma allergies hyperplasia chronic bronchitis bronchiectasis smoker
If you see an abundant amount of goblet cells without ciliated cells....what does that suggest?
Mucinous adenocarcinoma
Clara cells become more numerous
distally
Clara cells produce surfactant to do what:
detoxes toxins by repair to clear airways
Kulchitsky cells can give rise to what carcinoma
SCC
What lines the alveoli?
type 1 and 2 pneumocytes
what do type 1 pneumocytes do?
gas exchange and covers the surface of the alveoli they are flat and rarely seen
what are type 2 pneumocytes
secrete surfactant
where do alveolar macrophages originate from?
bone marrow
Present type 3 macrophages in a sputum sample indicates
the deep lung has been sampled
Alveolar macrophages are seen more in smokers. True or False
True
Alveolar macrophages should be abundant in BAL. True or False
True
Siderophages
blood laden
what do siderphages indicate?
old bleeding which can occur in benign/malignant conditions
what do lipophages indicate?
pneumonia aspiration pneumonia fat embolism acute pancreatitis tissue destruction cancers
When are you likely to see Curschmann spirals?
Asthma chronic bronchitis cigarette smoking lung cancers
What is asbestos coated with?
iron salts glycoproteins
Is corpora amylacea calcified?
No, they are also bifringent
Sputum is more reliable in detecting which carcinoma type
SCC - squamous cell carcinoma
What will you see during BAL?
macrophages ciliated bronchioles pneumocytes goblet cells
What specimen collection is best for detecting adenocarcinomas?
BAL
BAL is useful in detecting which type of infection?
Opportunistic organisms/infections
What collection method is reserve cell hyperplasia most commonly observed?
Bronchial brushings
Cytologically describe reserve cell hyplerplasia
Cells are uniform and tightly cohesive in size hyperchromatic nuclei high nc ratios clean background
Reserve cell hyperplasia DD is small cell carcinoma. What are some differences between the two?
SCC - variable sizes, molding, crush artifact, salt and pepper chromatin RCH - uniform size, no molding, even chromatin
What is the most common cause of squamous metaplastic cells to be in the lung?
It is the columnar cells response to injury - commonly caused by smoking
What is the follow up for squamous metaplasia?
Sputum samples
Parakeratosis in the lung, from severe irritation
can mimic SCC can occur with squamous dysplasia or carcinoma
what is bronchial hyperplasia associated with
chronic disease of the lung
Bronchial hyperplasia cytologically
creola bodies papillary 3d compact group finely granular chromatin regular uniform nucleoli
When will you see charcot Leyden crystals
asthma allergies healing stage of Loffler's Syndrome