Podcast
Questions and Answers
What minimum volume is optimal for collecting a body fluid specimen for cytological analysis?
What minimum volume is optimal for collecting a body fluid specimen for cytological analysis?
Which method is considered most acceptable for collecting cervical smears?
Which method is considered most acceptable for collecting cervical smears?
Which type of specimen is typically collected for cytological examination from the gastrointestinal tract?
Which type of specimen is typically collected for cytological examination from the gastrointestinal tract?
What is the preferred type of urine sample for cytological investigation?
What is the preferred type of urine sample for cytological investigation?
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Which cytological fixative is commonly used for routine preparations?
Which cytological fixative is commonly used for routine preparations?
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What is a key characteristic of the bronchoalveolar lavage (BAL) technique?
What is a key characteristic of the bronchoalveolar lavage (BAL) technique?
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Which type of cytology specimen involves the collection through a fine-needle aspiration (FNA)?
Which type of cytology specimen involves the collection through a fine-needle aspiration (FNA)?
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Which condition is a specific advantage of using 10% neutral formal saline as a fixative?
Which condition is a specific advantage of using 10% neutral formal saline as a fixative?
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What characteristic must be ensured for cytology specimens upon collection?
What characteristic must be ensured for cytology specimens upon collection?
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What anatomical sites are specifically mentioned for collecting gastrointestinal tract specimens?
What anatomical sites are specifically mentioned for collecting gastrointestinal tract specimens?
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Which fixative is primarily used for urine specimens?
Which fixative is primarily used for urine specimens?
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What is the purpose of fixing smears in 95% alcohol immediately?
What is the purpose of fixing smears in 95% alcohol immediately?
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Which staining method is commonly used in cytological preparations?
Which staining method is commonly used in cytological preparations?
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Which technique is used for preparing samples from fine needle aspirates?
Which technique is used for preparing samples from fine needle aspirates?
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For which types of specimens is direct spread smear collection appropriate?
For which types of specimens is direct spread smear collection appropriate?
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What is required before proceeding to prepare cell blocks from cytological specimens?
What is required before proceeding to prepare cell blocks from cytological specimens?
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How should cell suspensions obtained from centrifugation be treated before spreading on slides?
How should cell suspensions obtained from centrifugation be treated before spreading on slides?
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Which Romanowsky-type stain is used for detecting malaria in blood films?
Which Romanowsky-type stain is used for detecting malaria in blood films?
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What role does methanol play in the preparation of cytological smears?
What role does methanol play in the preparation of cytological smears?
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Which of the following is NOT a characteristic of fine needle aspirates?
Which of the following is NOT a characteristic of fine needle aspirates?
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Study Notes
Cytopreparatory Techniques
- Cytopreparatory techniques are used in histology
- ThinPrep is a technique
- Proper specimen collection is important
Cytology Specimen Collection
- Specimen integrity maintained by proper preservative
- Sample identification is crucial
- Patient identification must be clearly labeled on the specimen container and the slide
Specimen Collections - General Information
- All cytology specimens must be accompanied by a completed cytology requisition
- The following information must be included:
- Patient's full name
- Physician's name
- Saudi ID number
- Date of specimen collection
- Patient's date of birth
- Source of specimen (anatomic site)
- Brief clinical history (CLIA requirement)
Types of Cytological Specimens
- Body Fluid (Pleural, Peritoneal, Pericardial, and Synovial):
- Collect 10-200 ml specimen in a leak-proof, screw-top wide-mouth container
- Optimum sample size is 100 ml or larger
- A cell block will be prepared if adequate specimen is obtained
Cervical Smears
- The most acceptable method for obtaining a satisfactory sample is using a spatula
- The optimum sample should reach the transformation zone and the squamocolumnar junction of the cervix
Pap Smears
- Gynecological specimen collection for Pap smears
- Use of different tools like brush and speculum
Respiratory Tract
- Sputum should be collected on 3 consecutive days
- Early morning expectorate preferred before food or toothpaste use to prevent contamination
- Sputum should come from a deep cough, not saliva, and collected in a sterile container
Bronchoalveolar Lavage (BAL)
- BAL involves introducing approximately 100 ml of sterile saline via bronchoscope
- BAL is used for:
- Investigating interstitial lung disease
- Detecting pneumocystis carinii pneumonia
- Identifying malignant disease
- Bronchial brushings can also be obtained using a small nylon brush via bronchoscope
Gastrointestinal (GI) Tract
- GI tract specimens obtained by indirect scrapes using endoscopic brushings and ultrasound-guided endoscopic FNA
- Specimens collected from:
- Oral
- Laryngeal lesions
- Esophagus
- Gastric brush samples
- Rectal and colon
Urinary Cytology
- A full voided specimen of urine is most appropriate for cytological investigation
- The urine sample should not be the first morning sample nor a 24-hour collection as cells deteriorate quickly
- Urine samples should be dispatched without delay to the laboratory for processing
- Brush samples may be received from bladder, ureteric lesions, and kidney aspirates
Fine-needle Aspiration (FNA)
- FNA is an important and rapidly expanding area of cytodiagnosis
- FNA is either of palpable or non-palpable lesions
- Common sites for palpable lesions include breast, thyroid, soft tissue, and lymph nodes
- Non-palpable lesions require identification by imaging (e.g., ultrasound, MRI) before FNA
Miscellaneous Specimen Types
- Skin scrapes may be taken in basal cell carcinoma cases
- Nipple secretions collected directly onto glass slides and fixed immediately
Cytological Fixatives
-
- Alcohol Fixation: Most laboratories use 95% ethyl alcohol for routine preparations requiring fixation. Industrial methylated spirit is a common substitute
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- Coating Fixatives: Widely used for cervical smears, covering the cervical smear in a waxy coating to protect it from damage. These are composed of polyethylene glycol in an alcohol base and applied using a dropper bottle or spray form.
Special Purpose of Fixatives
- 10% neutral formalin saline for serous clots and cell blocks
- Formal vapor for lipids. Saccomanno's fixative for sputum
- Eposti's fixative for urine (equal volume of fixative to urine)
- Glutaraldehyde for transmission electron microscopy
- Air-dried preparations for Romanowsky stains
- Methanol for fixing air-dried smears
Specimen Preparation
- Direct spread smears: for gynecological, cervix, vagina, and vulva specimens, collected using wooden or plastic spatulas. Specimens should be evenly and thinly spread and fixed immediately in 95% alcohol.
- Fine needle aspirates: detach syringe from aspirator, air draw. Material is distributed over two slides placed on top of each other. Slides slid in opposite directions. Smears fixed immediately in 95% alcohol
Cytocentrifugation
- Urine, serous effusions, and watery lavages require cell concentration
- Agitate specimens gently before transfer to glass slides
- After centrifugation, cells should be at the bottom of the centrifuge tube
- Remove the supernatant (liquid above cells)
- Using a pipette carefully transfer cells, place on slide, and rapidly spread
Cell Blocks
- Cell blocks are methods for preparing cytology material, processed as histology sections.
- They can be prepared from a variety of specimens like effusions for example, endometrial aspirations, and fine needle aspirates (FNAs)
- Liquefaction is necessary prior to proceeding
- The most common method is 2% agar in 100ml of distilled water.
Cytology Staining
- The universal stain is the Papanicolaou stain (Pap stain)
- Harris's hematoxylin used as a nuclear stain
- A combination of OG-6 (orange gelb) and EA 50 give subtle shades for cell cytoplasm (green, blue, and pink hues)
Romanowsky Stains
- Commonly used in blood and bone marrow films, to detect parasites such as malaria.
- These stains consist of methylene blue/azur B and eosin dissolved in acetone-free methanol
- Related stains include Jenner, Giemsa, May Grunwald Giemsa, and Leishman stains
Some Useful Special Stains
- PAS/diastase
- Mucicarmine
- Oil red O
- Sudan black
- Masson-Fontana
- Grocott's methenamine silver
- Immunocytochemistry
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Description
This quiz covers essential cytopreparatory techniques used in histology, focusing on proper specimen collection and specimen integrity. Participants will learn about different cytological specimens, the importance of patient identification, and the necessary information required for cytology requisitions.
