Fast Facts: The Essentials of Cytopathology

P. Dalquen

Description

Cytology is a universally applicable technique that can be used by both general practitioners and specialists. It enables diagnosis of lesions on surfaces such as the skin, mucous membranes or cervix by smear, and the determination of findings from internal organs by fine needle aspiration. The method is technically both simple and inexpensive and can therefore be used in all parts of the world, regardless of their level of development. This book aims to summarize the essential basics of cytology. At the same time, it provides an overview of non-neoplastic and neoplastic lesions, covering both common and rare manifestations across various body sites. The related virtual Case Collection of more than 500 cases from almost all organs provides deeper insights into the morphological spectrum of lesions and into the cytological literature. It is free to access at courses.karger.com/bundles/essentials-of-cytopathology. Table of Contents: • Preparatory methods • Cervix uteri, vagina • Ovary • Breast • Male genital tract • Urinary tract • Respiratory tract • Effusions and tumors of the serous cavities • Lymphoreticular system • Thyroid • Salivary glands • Pancreas, liver and biliary system • Gastrointestinal tract • Central and peripheral nervous system • Soft tissue tumors

Sujets

• Médecine
• Médecine de laboratoire
• Laboratory Medicine
• Medical
• Laboratory

Informations

• Publié par: S. Karger AG
• Date de parution: 03 novembre 2022
• Nombre de lectures: 0
• EAN13: 9783318071474
• Langue: English
• Poids de l'ouvrage: 8 Mo

Extrait

Fast Facts: The Essentials of Cytopathology
First published 2023
Text 2023 Peter Dalquen
2023 in this edition S. Karger Publishers Ltd
S. Karger Publishers Ltd, Elizabeth House, Queen Street, Abingdon,
Oxford OX14 3LN, UK
Tel: [phone]
Book orders can be placed by telephone or email, or via the website.
Please telephone [phone] or email [e-mail]
To order via the website, please go to karger.com
Fast Facts is a trademark of S. Karger Publishers Ltd.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the express permission of the publisher.
The rights of Peter Dalquen to be identified as the authors of this work have been asserted in accordance with the Copyright, Designs Patents Act 1988 Sections 77 and 78.
The publisher and the authors have made every effort to ensure the accuracy of this book, but cannot accept responsibility for any errors or omissions.
For all drugs, please consult the product labeling approved in your country for prescribing information.
Registered names, trademarks, etc. used in this book, even when not marked as such, are not to be considered unprotected by law.
A CIP record for this title is available from the British Library.
ISBN 978-3-318-07143-6
Dalquen P. (Peter)
Fast Facts: The Essentials of Cytopathology/
Peter Dalquen
Typesetting by Amnet, Chennai, India.
Printed in the UK with Xpedient Print.
List of abbreviations
Foreword
Introduction
Preparatory methods
Cervix uteri, vagina
Ovary
Breast
Male genital tract
Urinary tract
Respiratory tract
Effusions and tumors of the serous cavities
Lymphoreticular system
Thyroid
Salivary glands
Pancreas, liver and biliary system
Gastrointestinal tract
Central and peripheral nervous system
Soft tissue tumors
Author biography
Index
List of abbreviations
CD: cluster of differentiation
CNB: core needle biopsy
FISH: fluorescence in-situ hybridization
FNA: fine needle aspiration/aspirate
H E: hematoxylin and eosin
HPF: high power field
ICC: immunocytochemistry
MGG: May-Gr nwald-Giemsa stain
NGS: next-generation sequencing
Pap: Papanicolaou s stain
PSC: Papanicolaou Society of Cytopathology
WHO: World Health Organization
ZN: Ziehl-Neelson stain
Foreword
The main purpose of cytopathology is to translate cellular morphology into a definite diagnosis that guides treatment decisions. Making sense of the broad spectrum of changes that we encounter under the microscope requires education and experience gained by continuous exposure during routine practice. This eventually sharpens our ability to recognize patterns and rapidly narrow down a multitude of features to one specific diagnosis. Despite rapid progress in ancillary methods and molecular testing, precise morphological diagnosis remains the cornerstone for subsequent analyses and clinical management.
It is a privilege and great pleasure to write a foreword to this outstanding text, which I hope will form a solid foundation in the varied cosmos of cytopathology. Fast Facts: The Essentials of Cytopathology provides an easy introduction to cytology for beginners as well as a convenient reference for use during daily practice. Importantly, it will also serve as a gateway to an innovative and interactive educational platform containing hundreds of cytology images covering all areas of cytology.
We owe this book to my good friend and former mentor Professor Peter Dalquen, a pioneer of cytology and a brilliant teacher. This educational project only came into life thanks to his energy, perseverance and relentless enthusiasm. The work is built on his vast cytological experience gained during a long professional life, and it has been supported by numerous colleagues providing their special expertise in specific fields. I hope that this book and the connected educational platform will gain a global reach to facilitate education, practice and progress in cytology across countries and continents.
Lukas Bubendorf MD
Professor and Head of Cytopathology
University of Basel, Switzerland
Introduction
Cytology is a universally applicable technique that can be used by both general practitioners and specialists. It enables diagnosis of lesions on surfaces such as the skin, mucous membranes or cervix by smear, and the determination of findings from internal organs by fine needle aspiration. The method is technically both simple and inexpensive and can therefore be used in all parts of the world, regardless of their level of development.

Figure 0.1 Non-small-cell lung carcinoma cell showing all the key features of malignancy: enlargement, multinucleation, varying size and shape of nuclei, coarse chromatin structure, atypical macro-nucleoli, and multiple protrusions of cytoplasmic receptors.
This book aims to summarize the essential basics of cytology. At the same time, it provides an overview of non-neoplastic and neoplastic lesions ( Figure 0.1 , opposite), covering both common and rare manifestations across various body sites. The related virtual Case Collection of more than 500 cases from almost all organs provides deeper insights into the morphological spectrum of lesions and into the cytological literature. It is free to access at courses.karger.com/bundles/essentials-of-cytopathology .
The main motivation for writing this book and compiling a globally accessible Case Collection has been the exchange of ideas over many years with colleagues from around the world, including Bangladesh, Afghanistan and other underserved countries.
Acknowledgments. First and foremost, I would like to thank Guido Sauter, Head and Chairman of the Institute for Pathology, UKE Hamburg, Germany, and also my colleagues there, Andrea Hinsch and Andreas Luebke, who, over many years, made it possible to compile the essential parts of the Case Collection. I thank my friend Michael J. Mihatsch, Basel, Switzerland, for the first critical review of the manuscript, and Lukas Bubendorf, Head of Cytopathology at the Institute of Medical Genetics and Pathology, University Hospital Basel, and his colleagues Daniel Baumhoer, Obinna Chijioke, J rgen Hench, Spasenija Savic Prince, Luigi Terracciano and Tatjana Vlajnic for their expert review of the individual chapters. Finally, I thank Stephen Batsford for proofreading the English text.
1 Preparatory methods
Cytology is based on two fundamental discoveries. The first is Virchow s statement:

The nucleus is that structure which orders the substances within the cell itself and serves as the inner center of attraction, as the actual center of the preserved activity.
The second is the staining method (Pap staining) developed by George N Papanicolaou from hematoxylin-eosin staining, with which it is possible to show structural changes of the cell nuclei extremely precisely. Since tumors are distinguished from normal cells by aberrations of nuclear chromatin, Pap staining is advantageous in diagnostic cytology. In contrast, other stains, especially variants of the Romanowsky stain such as May-Gr nwald-Giemsa (MGG), are more suitable for the diagnosis of hematologic diseases in which cytoplasmic criteria are crucial.
The most important methodological requirements for optimal Pap staining are described here.
Cell sampling methods
Tissue smears. Spatulas or brushes ( Figure 1.1a ) should be used for tissue smears instead of cotton swabs, to prevent artifacts arising from drying (see also pages 17 and 22 ). For the same reason, swab preparations made by the imprint method from fresh tissue are not recommended. Preparations that will stain particularly well are obtained by scraping cells with a scalpel from the cut surface of fresh tissue immediately after surgical resection. Such rapidly stained smears are an adjunct or alternative to frozen sections during surgery. The scraped cells are immediately smeared onto a slide with the scalpel blade and fixed.

Figure 1.1 Methods of cell sampling: (a) smear with spatula (top), brush (middle) and aspiration of endometrial cells with a balloon pipette (bottom); (b) example of syringe holder for fine needle aspiration; (c) body cavity fluid; (d) bronchial secretion, viscous with brownish streaks (left bowl) and watery saliva with fine whitish squamous cell aggregates from the oral mucosa (right bowl).
Fine needle aspiration . The fine needle aspiration (FNA) technique is illustrated in Figure 1.2 . The use of a syringe holder (see Figure 1.1b ) simplifies the puncture procedure. The advantage of FNA over core needle biopsy (CNB) is the ability to make a fan-shaped puncture, which allows access to large parts of the lesion.

Figure 1.2 FNA technique. (a) After disinfecting the skin with a cotton swab moistened with 50% ethanol, the needle is inserted into the tumor. (b) The plunger of the syringe is pulled back as far as it will go to create a negative pressure for aspiration. (c) The needle is then moved back and forth three or four times in different directions. To avoid bleeding from tissue injury, it is important to retract the needle under suction to below the skin surface before changing the needle direction. In the case of a small nodule (1 cm in diameter), the needle is carefully moved back and forth in one direction only.
At the end of the puncture, the plunger is released and the syringe is disconnected from the needle. Only then is the needle removed from the tissue and replaced on the syringe, and the aspirate is applied dropwise to slides as shown in Figure 1.3 . The needle contents should not be distributed on to more than three or four slides. The technique for removing cells from the needle hub is illustrated in Figure 1.4a .

Figure 1.3 Preparation of cytological smears. (a) When voiding the needle contents, the needle tip must be in contact with the glass