2. Introduction
• Cytology is that branch of life science, which
deals with the study of cells in terms of structure,
function and chemistry.
• It can be referred to as cell biology or
sytopathology according to the specific use of
cytology.
• Cell biology is the study of normal cellular
anatomy, function and chemistry.
• Cytopathology is a branch of pathology that
studies and diagnoses diseases on the cellular
level.
3. • Cytopathology is usually used to aid in the diagnosis of
cancer. However, it also helps in the diagnosis of certain
infectious dieases and other inflammatory conditions.
• Cytopathology is also commonly used to investigate
thyroid lessions, diseases involving sterile body cavities
(pleural, peritoneal, and cerebrospinal), and a wide
range of other body sites.
• Cytopathology is generally used on samples of free
cells or tissue fragments, in contrast to histopathology,
which studies whole tissues.
• A common application of cytopathology is the “PAP
smear”, used as a screening tool, to detect precancerous
cervical lesion and pervent cervical cancer.
4. Cytological study can be performed on
• Discharges collected from the body ( sinus,
nipple, vagina etc.)
• Scrapping obtained from mucosal surfaces(e.g.
buccal mucosa) and
• Aspirates collected from palpable lumps (
abscesses, growths etc.)
• Smears are prepared and fixed immediately
and stained appropriately for microscopic
examination.
5. Differentiation between normal and
abnormal cells
• The preliminary knowledge of differentiation
between normal and abnormal cells may be help a
technician to evaluate the preparation of the
specimen for microscopic examination.
• If the preparation is not satisfactory, it can be
repeated.
• Following observation may be useful for the
differentitation between normal and abnormal cells
6. • Epithelial cells from the surface layer of mucus and
serous membranes and the epidermis of skin. The
presence of various types of nucleated or non-
nucleated epithelial cells in the specimen ( collected
for exfoliatve cytology) is considered as normal
• In some normal specimens, macrophages or
reticuloendoethelial cells may be present
• Increased diameter with dense chromatin and increased
ratio of nucleus / cytoplasm are important observations
for malignant cells
• Epithelial cells are often observaed in groups but the
adhesiveness decreases in malignant tumor cells. They
may be present as loosely attached groups or as single
cells.
7. Sampling techniques in cytology
• Exfoliation of cells by nonabrasive methods: This is
spontaneous shedding of cells derived from the
lining of an organ into the body cavity. For
example, vaginal smears, sputum, urine, and other
body fluids.
• Collections of cells removed by brushing or similar
abrasive techniques: The method allows direct
sampling of the targets such as surface of the
uterine cervix or bronchus. With flexible fibro-optic
instruments, the sampling of organs of the
respiratory and gastrointestinal tract is possible
8. • Washing or lavage: Normal saline or similar
solutions are installed in the target organ under
visual control. These solutions are aspirated and
collected in small container. Various examples of
washing are bronchoalveolar lavage, peritoneal
lavage etc.
• Fine needle aspiration cytology (FNAC): Any
palpable or non palpable lesion in the body can be
sampling using either palpitation or imaging
techniques. The technique can be adapted as an
outpatient procedure. FNAC is rapid and cost
effective methodology.
9.
10. Various types of specimena and
requirements for cytological studies
• For cytological studies following information is
required, which is related to specific specimens:
• Personal information of a patient: Name, Age, Sex,
contact details, physician’s name and contact details.
• PAP smear: Date of last menstrual period(LMP),
symptoms like white discharge, inter-menstrual
bleeding, post coital bleeding, postmenopausal
bleeding, etc. previous treatment like surgery,
radiotherapy, chemotherapy, hormonal treatment,
etc.
11.
12. Sputum/broncho-alveolar lavage/ brush
smears
• : History of fever, cough, expectoration,
hemoptysis, chest pain, tobacco, smoking,
radiological findings.
• Past history of diseases like tuberculosis,
pneumonia and certain respiratory tract allergies
like asthma, malignancy, chemotherapy, and related
laboratory test reports
13.
14. • Urine: History of hematuria, dysuria, frquency of
micturition, burning while micturition, etc.
Reports of intravenous pyelogram(IVP),
ultrasonography(USG) or computed tomography
(CT) scan findings. Cytoscopic findings and
previous histopathology reports. Surgery details,
any medication like chemotherapy, radiotherapy,
and laboratory test reports.
• Nipple discharge: Mammography findings
duration of discharge, details of discharge
(unilateral or bilateral discharge), presence of any
lump, details of hormonal treatment, recent
pregnancy or lactation and last menstural period.
15. • Fine needle aspiration/ brush smears: Duration of
the lump or growth, pain, fever, weight
loss,USG/CT/MRI findings, any medication,
laboratory test reports and previous surgery details.
• Body fluids/ effusions: Pain, fever, weightloss,
USG/CT/MRI finding, laboratory test reports,
pervious surgery details, any medication,
radiothreapy, chemotherapy,etc.
• Gastric lavage/ esophageal-gastric brush
smears/scrapings from oral- laryngeal lesions:
Details of clinical symptoms, previous surgery
details, medication details, radiothreapy and
chemothreapy details, and laboratory reports.
