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Difference between revisions of "Cytopathology"
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[[Image:Serous carcinoma 2c - cytology.gif | thumb| right| | [[Image:Serous carcinoma 2c - cytology.gif | thumb| right|An animation showing two [[micrograph]]s in different planes of focus of a cytopathology specimen with [[serous carcinoma]]. (WC)]] | ||
[[Image:Granulomatous inflammation - alt -- high mag.jpg|thumb|right|Granulomatous inflammation in the hilum of lung. [[Diff-Quik stain]].]] | |||
'''Cytopathology''', often called ''cytology'', is the study of pathologic changes in cells. | '''Cytopathology''', often called ''cytology'', is the study of pathologic changes in cells. | ||
Specimen types include exfoliated [[cervical cytology]] (Pap tests), [[urine cytology|urine]], [[mesothelial cytopathology|body cavity fluids]] (pleural, pericardial, and peritoneal), [[CNS cytopathology|cerebrospinal fluid]], and fine needle aspirations from any body site, among others (see ''[[Cytopathology#Detail_articles|detail articles section]]''). These are often collected by minimally invasive means. | |||
Cytologic preparation methods usually include viewing single cells or small clusters of cells on slides, in contrast to surgical biopsy specimens that usually include larger pieces of tissue, with tissue architecture. In some institutions, small tissue biopsies such as core needle biopsies may also be assigned to the cytology service. | |||
It is often divided into ''[[gynecologic cytology|gynecologic]]'' and ''non-gynecologic''. ''Gynecologic'' in this context usually refers to Pap test specimens, i.e. uterine cervix, vaginal vault; other gynecologic specimens are considered ''non-gynecologic''. | It is often divided into ''[[gynecologic cytology|gynecologic]]'' and ''non-gynecologic''. ''Gynecologic'' in this context usually refers to Pap test specimens, i.e. uterine cervix, vaginal vault; other gynecologic specimens are considered ''non-gynecologic''. | ||
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==Principles of FNA== | ==Principles of FNA== | ||
General: | General: | ||
*Fine needle aspiration of superficial lesions may be performed by pathologists or other clinicians | |||
*Fine needle aspiration of deep-seated lesions may be performed by interventional radiologists under imaging guidance | |||
*Endobronchial ultrasound may be used by pulmonologists and thoracic surgeons to access pulmonary lesions, while endoscopic ultrasound may be used by gastroenterologists to access GI tract or pancreatic lesions | |||
*Fine needle aspiration is an oxymoron.<ref>SB. 11 January 2010.</ref> | *Fine needle aspiration is an oxymoron.<ref>SB. 11 January 2010.</ref> | ||
**One does not really aspirate. | **One does not really aspirate. | ||
Principles:<ref>SB. 11 January 2010.</ref> | Principles:<ref>SB. 11 January 2010.</ref> | ||
*Use a small needle - 22 gauge. | *Use a small needle - 22-25 gauge. | ||
*Use minimal suction - aspiration per se is not the key; the sample is obtained by coring. | *Use minimal suction - aspiration per se is not the key; the sample is obtained by coring. | ||
*Use minimal back and forth angulation - it destroys blood vessels | *Use minimal back and forth angulation - it destroys blood vessels | ||
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Note 2 - see ''[[lymphoma]]'' article for detailed description of markers: | Note 2 - see ''[[lymphoma]]'' article for detailed description of markers: | ||
*The typical "full" panel is: | *The typical "full" panel is: | ||
**B-cell markers: CD10, CD19, CD20, [[CD23]], FMC7, Kappa, Lambda. | **B-cell markers: CD10, CD19, [[CD20]], [[CD23]], FMC7, Kappa, Lambda. | ||
**T-Cell markers: CD3, CD5, CD4, CD8, CD7, CD2. | **T-Cell markers: CD3, CD5, CD4, CD8, CD7, CD2. | ||
**NK-Cell markers: [[CD56]], CD16. | **NK-Cell markers: [[CD56]], CD16. | ||
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<gallery> | <gallery> | ||
Image:Granuloma_cytology.jpg | Granuloma - cytology. (WC) | Image:Granuloma_cytology.jpg | Granuloma - cytology. (WC) | ||
</gallery> | |||
<gallery> | |||
Image: Granulomatous inflammation -- intermed mag.jpg | GI - intermed. mag. (WC) | |||
Image: Granulomatous inflammation -- high mag.jpg | GI - high mag. (WC) | |||
Image: Granulomatous inflammation - alt -- high mag.jpg | GI - high mag. (WC) | |||
Image: Granulomatous inflammation -- very high mag.jpg | GI - very high mag. (WC) | |||
</gallery> | </gallery> | ||
*[http://moon.ouhsc.edu/kfung/jty1/CytoLearn/CytoQuiz/CQ-021-040/CI-Image-0803/FQ-051a.gif Granuloma (ouhsc.edu)].<ref name=ouhsc_31>URL: [http://moon.ouhsc.edu/kfung/jty1/CytoLearn/CytoQuiz/CQ-021-040/CQ-031-M.htm http://moon.ouhsc.edu/kfung/jty1/CytoLearn/CytoQuiz/CQ-021-040/CQ-031-M.htm]. Accessed on: 9 April 2012.</ref> | *[http://moon.ouhsc.edu/kfung/jty1/CytoLearn/CytoQuiz/CQ-021-040/CI-Image-0803/FQ-051a.gif Granuloma (ouhsc.edu)].<ref name=ouhsc_31>URL: [http://moon.ouhsc.edu/kfung/jty1/CytoLearn/CytoQuiz/CQ-021-040/CQ-031-M.htm http://moon.ouhsc.edu/kfung/jty1/CytoLearn/CytoQuiz/CQ-021-040/CQ-031-M.htm]. Accessed on: 9 April 2012.</ref> | ||