Cytopathology
CYTOPATHOLOGY
I. Introduction
Cytopathology
* Refers to diagnostic techniques used to examine cells from various body sites to determine the cause or nature of disease
History
1. first era (19th century) 2. second era (development and expansion) * George Papanicolaou (father of cytopathology) 3. third era (consolidation) * Dr. Leopold Koss ( diagnostic cytology) 4. fourth era * Bethesda system for reporting cervical/vaginal cytology diagnoses II. Advantages 1. Samples can be collected easily, prepared, stained, and interpreted quickly 2. Inexpensive 3. Little or no risk to the patient 4. Identify disease process * Neoplasia vs inflammation 5. Direct therapy 6. Prognostication 7. Determine next diagnostic procedures III. Disadvantages 1. Not always possible to: a. Localize neoplastic lesion b. Distinguish pre-invasive from invasive cancer c. Distinguish reactive from dysplastic and neoplastic changes d. Determine tumor type IV. Advantages of Histopathology 1. Microscopic examination usually much less demanding 2. Evaluate architecture 3. Cut additional section for special stains
Always use histopathology: * to examine margins of resection * to examine stromal invasion and depth of invasion * gross and microscopic discrepancies
Cytopathology should not be compared to histopathology; used together will provide rapid and most accurate diagnosis V. Cytopathology Methods A. Exfoliative cytology * spontaneously shed cells in body fluids 1. urine 2. CSF 3. sputum (70% as fixative) 4. effusion from body cavities (pleura, pericardium, peritoneum) B. Abrasive cytology * dislodge cells from body surfaces 1. imprints 2. scrapings 3. endoscopic brushings of mucosal surfaces 4. washings of mucosal of serosal surfaces 5. swabs C. fine-needle aspiration cytology * superficial nodules and
I. Introduction
Cytopathology
* Refers to diagnostic techniques used to examine cells from various body sites to determine the cause or nature of disease
History
1. first era (19th century) 2. second era (development and expansion) * George Papanicolaou (father of cytopathology) 3. third era (consolidation) * Dr. Leopold Koss ( diagnostic cytology) 4. fourth era * Bethesda system for reporting cervical/vaginal cytology diagnoses II. Advantages 1. Samples can be collected easily, prepared, stained, and interpreted quickly 2. Inexpensive 3. Little or no risk to the patient 4. Identify disease process * Neoplasia vs inflammation 5. Direct therapy 6. Prognostication 7. Determine next diagnostic procedures III. Disadvantages 1. Not always possible to: a. Localize neoplastic lesion b. Distinguish pre-invasive from invasive cancer c. Distinguish reactive from dysplastic and neoplastic changes d. Determine tumor type IV. Advantages of Histopathology 1. Microscopic examination usually much less demanding 2. Evaluate architecture 3. Cut additional section for special stains
Always use histopathology: * to examine margins of resection * to examine stromal invasion and depth of invasion * gross and microscopic discrepancies
Cytopathology should not be compared to histopathology; used together will provide rapid and most accurate diagnosis V. Cytopathology Methods A. Exfoliative cytology * spontaneously shed cells in body fluids 1. urine 2. CSF 3. sputum (70% as fixative) 4. effusion from body cavities (pleura, pericardium, peritoneum) B. Abrasive cytology * dislodge cells from body surfaces 1. imprints 2. scrapings 3. endoscopic brushings of mucosal surfaces 4. washings of mucosal of serosal surfaces 5. swabs C. fine-needle aspiration cytology * superficial nodules and