Methods cytology

Under the influence of various processes, occurring in malignant tumors (hemorrhage, izayazvlenie, necrobiosis, necrosis and others.), and thanks to the reactivity of the surrounding tissue occurs desquamation individual cell, recovery and rejection of the smallest particles of tissue tumor, which can enter the isolation of human. The study of these cellular elements ottorgshihsya neoplasms engaged Exfoliative cytology.

It is necessary to carefully select the suspicious material particles (Sputum, gastric, feces, etc..) and to investigate their. For this purpose, the method of stratified study of liquid and dense material, and microscopic examination.

For the detection of small tissue particles test material (pus, sputum, aspirated fluid, and others.) is placed a thin layer in a Petri dish. Put a cup on a black or white paper, narrow thin metal spatula and dissecting needle selected among blood, particles of mucus and pus, characterized by its consistency, shape and color, and placed on a glass slide. Dense particles are digested and stretch with a spatula and the needle, to obtain thin preparations.

For diagnostic purposes is now widely used puncture opuholey (punktsionnaya cytology). At the same time studied cells and tiny particles of tumor, often invisible macroscopically.

Method puncture needle is very simple and accessible, It leads to slight traumatization of the patient and no complications, which are sometimes observed in the biopsy. If necessary, you can repeat the puncture. Calibration is done by a clinician experienced by all the rules of aseptic. Dotted soft or fluctuating most of the tumor. You can puncture and solid tumors.

After the puncture with the syringe needle is immediately transferred to the laboratory, where the contents of the syringe and needle, the piston which can remain small, important for the study of particles, carefully collected and prepared for microscopic examination preparations. When a large quantity of material is collected in a Petri dish, with a small - on a glass slide and carefully study its form.

Grossly appearance of punctate tumors can vary considerably, that it does not reveal the characteristic features.

Punctate cancer in most cases, bloody, lean, often it contains tiny particles of tissue. If the tumor is not subjected to dystrophic and necrotic changes, texture dense particles and are struggling to stretch the glass.

The punctate of sarcoma particles of very small tumors, translucent (reminiscent of a fish meat), easy stretch on glass (crushed).

Punctate benign tumor monotonous, mostly sparse and consists of several, or a drop of bloody fluid with small or tiny grayish-whitish dense tissue particles.

Punctate various cysts liquid, It can sometimes be abundant - to 20-30 ml and more. With high content of cholesterol punctate it has a characteristic pearlescent. Number of leukocytes and erythrocytes can vary widely, hence the color and turbidity punctate. The contents of epidermoid cysts detected macroscopically whitish mass friability, sometimes in very large numbers.

Festering punctate yellowish-gray, punctate with blood - brownish or dark red, thick, less viscous consistency or liquid. Festering punctate must be carefully examined macroscopically for the detection of small tissue particles, filmy formations (chitin shell fragments hydatid bubbles) , greyish-yellowish grains (Druze actinomycetes) and etc.

Microscopic examination of cytological preparations is carried out in two stages. First studied drugs in the native state, and then stained. The native of cancer drugs detected a greater or lesser number of cells of varying degrees of atypia, different sizes, but most of the major, large, sometimes with multiple cores, often eccentrically located with numerous nucleoli. In these cells, often expressed fatty degeneration of the cytoplasm, vacuolization or actinic. The cells can lie freely or, which is more typical for cancer, in groups, in the form of bands or "pearls", tracks, grozdevidnyh formations.

Dimensions, shape and type of cells, and their location depends on the histological structure and nature of the tumor. The fine particles of cancer usually present connective tissue stroma, sometimes with the elastic fibers, capillaries and a certain number of atypical cells described in various combinations (glandular-like formation, elongated complexes, sosochki, track, "Pearls" and others.). There are also coming from small necrotic tumors, bacteria particles coated fabric, gematondina containing crystals and a minor amount of cellular elements. Particles of this kind most often found in cancer of the larynx, esophagus and stomach.

Sarcoma cells are more homogeneous, what cancer cells, They are located mostly in the form of diffuse aggregations, going in different directions. Cellular composition punctate, dimensions and shape of the cells are dependent on the histological structure sarcoma. Common to all types of sarcoma cells are abundant, Polymorphism of varying severity or uniformity (when pronounced malignancy), diffuse location, set of mitosis. On the basis of these detection elements, in most cases it is possible to determine the nature of neoplasms and histological structure. However, differences in the elements of high-grade cytologic preparation lymphosarcoma of lymphoid cells in the lymph node punctate easy. In a number of cases in the study punctate or other material can not indicate with precision, Sarcoma is a cancer or. At the same time issued cytologic conclusion of a malignant neoplasm, what, taking into account the speed of issuing the conclusion, It is also important for the diagnosis.

Microscopic examination of the contents of the cyst fluid in addition it is possible to detect the leukocytes and erythrocytes in varying amounts, foam cells, cell, lining the cyst cavity, and almost always cholesterol crystals or neutral fat droplets. Number fatty degenerated cells and cells lining varies widely. Sometimes punctate cysts in its festering, or destruction of the wall can be found macrophages histiocytes, fibroblasts, plasma cells, etc..

The contents of dermoid cysts can be detected microscopically in native preparations layers of squamous epithelium with a neutral fat and cholesterol crystals. Comprehensive study of native and stained preparations allows to more fully appreciate the nature of the pathological process.

In the study of native drugs festering masses commonly found elements of disintegration of adipose tissue - neutral fat, Needle fatty acids and cholesterol crystals; particles in dense tissue - accumulation of elastic and collagen fibers, lying among the detritus, or leukocytes. The punctate or other test material can be found the remains of purulent granulation tissue infiltrated with capillary plexus, foam cells, and Druze actinomycetes, caseous mass elements decay and tuberculoma, etc..

Macro- and microscopic study of native and stained preparations will conclude with the conclusion of the cytological picture, which can be positive, conjectural, negative (if the task of the clinician - to identify cell malignancy) no evidence, that according to the cytologic picture to judge the nature of the pathological process is not possible.

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