INTRO TO CYTOLOGY

cytology

microscopic study of cells exfoliated or removed from tissues, as opposed to histology, which studies tissues

safer (less complications), simpler (often no anesthesia needed), quicker, and more cost-effective

What are the advantages of cytologic examination over tissue biopsy?

Ability to differentiate normal vs abnormal cells and inflammatory vs non-inflammatory cells

What are the key characteristics needed in cytologic examination?

Diagnosis, cancer screening, disease monitoring, and prognosis determination in neoplasms

What are the main uses of cytology?

exfoliative cytology

It involves the study of cells shed naturally from body surfaces or collected by gentle scraping or brushing.

Pap smear

Gynecologic cytology

Sputum, bronchial brushing

Respiratory cytology

Urine, bladder washings

Urine cytology

Pleural, CSF

Body fluid cytology

Endoscopy samples

GI tract cytology

Discharge cytology

Nipple Discharge cytology

Scrape cytology

Skin cytology

aspiration cytology

Use of fine needle aspiration (FNA) to extract cells from deep tissues or organs that do not exfoliate spontaneously

Proper training, use of clean slides, preparation of multiple smears, and choice of appropriate staining.

What are general requirements for cytologic specimen collection?

harder to collect and limited to superficial lesions

What is the main disadvantage of scrape cytology?

aspiration cytology

Uses a syringe to apply negative pressure.

non-aspiration cytology

No suction; uses rapid to-and-fro motion, suitable for vascular tissues.

squash preparation method

A second slide is placed over the aspirated material and gently separated to spread cells without pressure.

needle spread method

Aspirate is spread using the needle tip into a starfish-like projection.

sample is thick or fluid

When is the blood smear method used?

30-40

blood smear method angle

Process within 1–2 hours due to their low protein content and fragility—even if refrigerated.

What are the preservation guidelines for CSF and urine?

50% alcohol and 2% Carbovax.

What is Saccomanno’s fixative composed of?

Fixatives containing acetone or ether.

What substances should NOT be used for liquid specimens if smearing is delayed?

95% ethyl alcohol

What is the ideal fixative for smears?

Preserves nuclear details, does not overly shrink/swell cells, kills microbes, and enhances staining.

What are the advantages of 95% ethanol as a fixative?

Fixation with 90–96% ethanol
Nuclear staining with hematoxylin
Cytoplasmic staining with OG-6 and EA-50
Dehydration with ethanol
Clearing with xylene

What are the steps in Papanicolaou (Pap) stain?

Diff-Quik stain

Rapid assessment of sample adequacy and visualization of cytoplasm and microorganisms.

10x/15x

objective for general screening

40x

objective for cellular details

Battle-ment method (vertical)
Longitudinal strip method (horizontal)

What are the systematic methods to scan a slide?

Adequacy of specimen
Diagnosis (specific or broad)
Descriptive findings
Comments (for clarification or clinical correlation)
Recommendations

What are the essential components of cytologic reporting?

Special stains for microorganisms
Immunohistochemistry
Flow cytometry
Cytogenetics
Molecular pathology
Electron microscopy

What ancillary studies can be performed on cytologic material?