Cytological diagnostics

Cytological diagnostics - method-recognition under the microscope cells, independently otorgada from tissues or artificially separated with them. In modern clinic for the diagnosis of human diseases resort to cytological study of sputum smears from the vagina, exudation, bronchial wash water and stomach, prints izyaslavsky mucous membranes and skin, as well as punctate lymph nodes, spleen, liver, kidney tumors and tumor formation in the mammary, thyroid and salivary glands, bones and soft tissues, using common for Cytology (the science of the cell) methods.
The drugs are prepared in the form of thin strokes, like strokes blood, so that the cellular elements were placed them in a single layer. For colouring preparations is used hematological methods (Pappenheim, Lasmane)and hematoxylin-eosin .
Cytological diagnostics main attention is paid to the structural features of individual cells. Signs of malignancy cells are divided into General, indicates a malignant cells in General and private, i.e. those which caused histological pathology or affiliation tumor cells to a particular organ or tissue.
It is possible to allocate some complex changes characteristic of cells of malignant tumors: polymorphism size and shape of cells, uneven perception of colours, offset nuclear-cytoplasmic relations in favor of the engine, increasing the size and number of nucleoli; marked incorrect figures division (mitotic and mitoticescoe), protoplasmatic inclusions and vacuoles. Pay attention to the mutual arrangement of the cells, their connection with each other, etc.,
Identification of cytological features allows you to diagnose cancer and to establish its nature - epithelial (cancer) or connective tissue (sarcoma).
Great help, cytological diagnosis and also in identifying non-specific inflammation.

Cytological diagnostics - method-recognition under the microscope motile cells and cells, independently otorgada from tissues or artificially separated with them.
The method was initially used as part of clinical laboratory analysis mainly for diagnostics of diseases of blood, blood-forming organs and inflammatory processes. Recently, the field of application of cytological diagnostics has considerably increased its diagnostic efficiency. Cytological diagnosis is used in all medical specialties, decoding as pathological changes, and some physiological state (for example, during menstruation, pregnancy, childbirth, and others). Cytological diagnosis became necessary for the proper and timely recognition of many types of malignant and benign tumors, for detection of precancer and early stages of cancer of the cervix (the so-called carcinoma in situ) during mass prophylactic examinations; used to dynamically monitor the treatment of skin diseases, wounds, malignant neoplasms. Cytological diagnostics does not compete with histological method; it often precedes it. In doubtful cases after cytological study biopsy and histological examination required; all these methods complement each other.
Compliance with the rules of collection and processing of material for cytological study provides a correct diagnosis.
Objects of cytological study are normal and pathological body fluids, which can be the cell, otorgada with the surface of the fabric. This section of the study is called exfoliative Cytology (from lat. ехfoliatio - flaking, peeling). The study of cells, spiritualy from the depth of the pathological center with the help of a puncture with injection needle, called needle Cytology. This method requires a physician correct choice of place and adherence to health puncture; in the study punctate it is necessary to take into account the progress of the needle in the direction of a pathological focus. If the diagnostic puncture studied the cell and cell complexes and not pieces of tissue, as biopsy.

cytological diagnostics
Fig. 1. Squamous cell carcinoma (sputum); color hematoxylin - eosin. Fig. 2. Squamous cell orogovevshi cancer (detachable cervix); color hematoxylin - eosin. Fig. 3. Small cell lung cancer (sputum); color hematoxylin - eosin. Fig. 4. Glandular cancer (sputum); color hematoxylin-eosin. Fig. 5. Breast cancer (discharge from the nipple); color on Pappenheim. Fig. 6. Breast cancer (punctat); color on Pappenheim. Fig. 7. Thyroid cancer (punctat); color on Pappenheim. Fig. 8. Gipernefroidnyi cancer, metastases in lymph node (punctat); color on Pappenheim. Fig. 9. Round-cell sarcoma (punctat); color on Pappenheim. Fig. 10. Polimorfnaya sarcoma (punctat); color on Pappenheim. Fig. 11. Veretenoobraznaya sarcoma (punctat); color on Pappenheim. Fig. 12. Osteogenic sarcoma (punctat); color on Pappenheim. Fig. 13. Chondrosarcoma (punctat); color on Pappenheim. Fig. 14. Melanoblastoma; metastases in lymph node (punctat); color on Pappenheim. Fig. 15. Retikulosarkoma (punctat lymph node); color on Pappenheim.
cytological diagnosis
Fig. 1. Lymphosarcoma (punctat lymph node); color on Pappenheim. Fig. 2. Plasmacytoma (punctat bone tumors); color on Pappenheim. Fig. 3. Chlamydia (punctat lymph node); color on Pappenheim. Fig. 4. Osteoblastoclastoma (punctat bone tumors); color on Pappenheim. Fig. 5. Mixed tumors of the salivary gland (punctat); color on Pappenheim. Fig. 6. Neuroma (punctat tumors of the neck); color on Pappenheim. Fig. 7. Cell specialistami (cerebrospinal fluid); paint on Romanovsky. Fig. 8. Cells Protocol (fluid in the ventricles of the brain); paint on Romanovsky. Fig. 9. Cell astrocytomas (fluid in the ventricles of the brain); paint on Romanovsky. Fig. 10. Tuberculosis granuloma (punctat lymph node); color on Pappenheim. Fig. 11. Nonspecific inflammation (punctat lymph node); color on Pappenheim. Fig. 12. Xantana granuloma (punctat tumor in the lung); color hematoxylin - eosin. Fig. 13. Eosinophilic granuloma (punctat bone tumors); color on Pappenheim. Fig. 14. Cancer cells in flushing with stomach (phase-contrast microscopy). Fig. 15. Cancer cells with different shades of lighting scrape from the cervix (luminescent microscopy; fluorochrome - acridine orange).


The object of research are (printing. table, Fig. 1-15): localization of pathological process in the larynx, trachea - material taken on a tampon with a special spoon; in the bronchi, lungs sputum, AspireRevo the contents of the bronchi or swabs last mark on the swab is taken through the bronchoscope from the site of lesion, punctat of a pathological focus (taken before or during surgery), exudate; in the gastrointestinal tract - material with a tampon at endoscopy (esophagus, available departments of the colon and rectum), the washing water from the stomach (taken gastric, duodenal probe, abrasive tip-cylinder), Tolstoy bowel (using enemas, irrigation and suction instruments); in the female genital organs - material surface scraping taken with a special spatula, with a swab aspirated or washed away from the vagina, cervix, uterus (a pipette with a balloon syringe brown, special tool), and ascitic fluid in ovarian cancer; in the urinary tract - newly urine away from the bladder; in the prostate gland - a secret after the massage; breast discharge from the nipple, an imprint of his eroded surface, punctat of like formation; in other bodies and tissues take punctat of a pathological focus at its accessibility to puncture held if necessary under x-ray control or after the evaluation of the data on x ray of the lungs, bones. With the localization process on the skin and mucous membranes, available for immediate and close contact, take the mark on the glass (after removal of necrotic masses by flushing) and washed away the liquid; when localization in the brain and spinal cord - spinal fluid. Mastered methods of detection of cancer cells in the blood stream and flush with postoperative wounds before suturing.
Mikroskopiruyut drugs made on slides, often in the form of smears or prints. The latter receive or directly touching the surface of the glass to pathological lesion, or after migration (printing) of material taken on the swab. The main method of cytological diagnostics - microscopy fixed and stained preparations; color allows you to determine the largest number of morphological changes of cells and nuclei. Identification of deviations in morphology engine is particularly important for early detection of malignancy. Use different methods of painting. Hematoxylin and eosin have an advantage in painting mucous objects (sputum, etc.,) by definition get the picture. Azur II - eosin yellow is the most convenient to study the material obtained by puncture (Romanovsky - the Institute; May - Grunwald - the Institute). Utility methods is a phase-contrast and fluorescence microscopy with the use of fluorochrome, which is used mainly for mass prophylactic examinations of women. Fluorescent method allows you to see the cells and distinguish them by the color of a luminescence, which arose under the influence of fluorochrome, phase-contrast - to consider the peculiarity of cells without having to commit and colouring (in native state) even with immersion system. Both methods do not require much time for preparation of the drug, however, and does not reduce the term of his research and do not always provide an opportunity to specify the diagnosis. Method of native products under the light microscope in Cytology plays an indicative role and is used in the General clinical laboratory analysis.
Developed zitohroma for the diagnosis of diseases such as tuberculosis, chlamydia, lymphoreticulosis, infectious mononucleosis, diseases of the blood and blood-forming organs. Zitohroma liver characterize some process: cirrhosis, hemochromatosis (pigment cirrhosis), epidemic hepatitis, primary liver cancer (hepatoma) and metastases. Possible cytological diagnosis of amyloidosis kidneys, spleen, and also diseases of the reticuloendothelial system: eosinophilic granuloma bones (Taratynova disease), xanthomatose, karasunogoh of reticuloendotheliosis (Gaucher disease). Known zitohroma water, exudation eczema, chronic disease of the maxillary sinus, etc., the Study of cytograms of various forms of inflammatory and regenerative processes allows them to differentiate from each other and from clinically similar diseases, and, most importantly, to differentiate from tumors (e.g. osteomyelitis from sarcoma). Defined cytological picture cancer (squamous cell carcinoma, small cell undifferentiated, glandular localization in any organ), proliferating papillary cystadenoma, papillary cystocarcinoma ovarian cancer, thyroid cancer, renal cell carcinoma, sarcoma of soft tissues and bones (retikulosarkoma, rhabdomyosarcoma, fibrosarcoma), angiosarcoma, osteogenic chondrosarcoma, microsurgery, and such neoplasms as osteoblastoclastoma (with malignancy and benign), Ewing sarcoma, neuroma, mixed swelling of the salivary glands, melanoblastoma, some types of intraocular tumors, brain tumors. Depending on localization and disease with the help of cytological diagnostics correct diagnosis is established in 85-95% of cases. Utility is cytological diagnosis of acquired for urgent detection of pathological process prints or punctatum during surgical interventions for neoplasms. Identifying early signs of cancer and degree of malignancy tissue often more available cytological method than histomorphologically.