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23 Cards in this Set
- Front
- Back
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What are the 3 categories of diagnoses in cytopath?
1. 2. 3. |
What are the 3 categories of diagnoses?
1. Negative for epithelial lesion or malignancy 2. epithelial cell abnormality 3. Other |
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What is the size of a normal intermediate cell nucleus?
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7-8 um
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Actinomyces assc. with what?
1. 2. |
1. acute inflammation
2. IUD use |
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features of reactive changes assc. with radiation?
1. 2. 3. 4. |
1. large cells with low N/C
2. Smudgy chromatin 3. polychromasia 4. cytoplasmic vacuoles |
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Features of ASC-US
1. 2. 3. What is the clinical f/u? |
1. No nucleoli
2. increased N/C ratio 2-3x IM cell 3. minimal chromatin clumping/nuclear irregularities F/u- of > 20 years, HPV, repeat cytology, colposcopy |
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Features of ASC-H
1. 2. 3. |
1. high N/C ratio
2. crowded sheets, loss of polarity 3. too few cells to call HSIL |
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features of LSIL
1. 2. 3. |
LSIL
1. slightly increased N/C 2. >3x normal IM cell 3. coarse chromatin 4. F/O HPV |
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features of HSIL
1. 2. 3. 4. |
1. single cells.sheets, syncitial
2. marked increased N/C ratio 3. small cells relative to LSIL 4. hyperchromasia with corase chromatin with irregular nuclear membranes |
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What is HSIL with features suspicious for invasion?
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very pleomorphic HSIL with cytoplasmic keratinization or suspicious background (diathesis, necrosis), but no malignant squames seen
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SCC features on pap?
1. 2. 3. 4. |
1. prominent nucleoli
2. tadpole cells, orangophilic cytoplasm 3. marked pleomorphism 4. tumor diathesis (dirty background) |
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Atypical glandular cells, favor endocervical features
1. 2. 3. 4. What is the distinction to AIS (adenocarcinoma in situ)? |
1. sheets/strips of cells with nuclear overlap and crowding
2. palisading 3. nuclear elongation 4. feathering of edge of clusters, no diathesis AIS has spindling out and hyperchromasia of the nuclei, mitoses. Often form rosettes |
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Metastatic lesions seen on paps
1. 2. 3. 4. |
1. breast
2. colon 3. gastric 4. melanoma |
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What is a cockleburr?
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crystaline array surrounded by histiocytes, assc with pregnancy, IUD, OCP
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What is the corn-flaking artifact?
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air trapping under the coverslip- brown pigment on cells
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What is Curshmann's spiral?
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strings of red inspissated mucus
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Pap shows mature lymphoid follicles with tingible body macrophages
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follicular cervicitis
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What is a Navicular cell?
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boat-shaped cell seen in high progesterone states- eccentric nucleus, yellow glycogen... typically seen in pregnancy
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HPV pathogenesis
1. What does the E6 gene do? 2. What does E7 do? 3. what are the 4 MC high-risk types? |
1. inactivate p53 (increase degradation)
2. inactivate Rb (upregulates Cyclins) 3. 16,18,31, 45 |
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Lab regulations....
1. % of mandatory negative cases that must be rescreened? 2. what about histology/permanents? 3. what is the 2/5/10 rule? 4. what is the 5 year mandatory review? |
1. 10%
2. All positive cases on histology must be reviewed in cytology for correlation, determine cause of any discrepancies 3. accesion logs and req forms must be kept for 2 years, all glass slides 5 years, all reports for 10 years. 4. all cases that show HSIL or cancer must have their previous slides reviewed. May have to correct reports. |
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1. What is the max number of slides a primary reviewer can screen/day?
2. what about non-GYN cases? |
1. 100
2. if thinprep, 200 (each count as 1/2 of a slide) |
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Reasons for inadequate cytopathology specimens
1. 2. 3. |
1. endocervical cell presence (need 10)
2. low squamous cellularity 3. >75% of squamous cells are obscurred by blood or inflammation |
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Epithelial cell abnormality categories (for squames) in cytopath
1. 2. 3. 4. 5. |
Epithelial cell abnormality categories
1. ASC-US 2. ASC-H 3. LSIL 4. HSIL 5. SCC |
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How many cells are needed for adequacy on a Pap?
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10,000 for conventional prep, 5000 for liquid based preps (thin prep)
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