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Thin prep morphology (Cervical cytology)

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Information about Thin prep morphology (Cervical cytology)
Health & Medicine

Published on January 7, 2014

Author: pathologybasics

Source: slideshare.net

Description

Ppt presentation on thin prep morphology..downloaded from cytologystuff.com
Good pictures with explanations..
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ThinPrep Morphology ® Hologic Proprietary © 2012

ThinPrep Morphology ® Normal Cytology Hologic Proprietary © 2012

Cytotechnologist & Pathologist Training • Microscopic Sessions • Evaluation Modules • Competency Assessment Modules Hologic Proprietary © 2012

ThinPrep Process ® Hologic Proprietary © 2012 Copyright © 2012 Hologic, All rights reserved.

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ThinPrep Characteristics ® • • • • • Liquid Based Fixation Cell Size Smear Pattern Specimen Background Similarities > Differences Hologic Proprietary © 2012

ThinPrep Characteristics ® Liquid Based Fixation • Enhanced Cytoplasmic Detail • Enhanced Nuclear Detail • Variability in Nuclear Staining Hologic Proprietary © 2012

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ThinPrep Characteristics ® Cell Size • “Proportionately” Smaller • Single Cells More Prominent • Cells Round-Up in Solution Hologic Proprietary © 2012

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ThinPrep Characteristics ® Smear Pattern • Mechanical Artifact Eliminated • Cellular Material Not Pulled Out in Mucus • Tissue Architecture Maintained Hologic Proprietary © 2012

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ThinPrep Characteristics ® Specimen Background • • • • Cleaner Background Cellular Debris More Clumped “Clues” in the Background “RATTY” Background: Infectious agent, Cytolysis, Blood, Disease Hologic Proprietary © 2012

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ThinPrep Characteristics ® Screening Technique • Systematic • Slow • Slight Overlap Hologic Proprietary © 2012

ThinPrep Characteristics ® Guidelines for Estimating Cellularity¹ FN20 eyepiece/10x obj. THIN PREP DIAM MM Area (mm²) # Fields @ FN20 10X # Cells/Field for 5K Total 20 314.2 100 50.0 FN20 eyepiece/40x obj. # Fields @ # Cells/Field FN20 for 5K Total 40X 1600 3.1 FN22 eyepiece/10x obj. # Fields @ FN22 10X # Cells/Field for 5K Total 82.6 60.5 FN22 eyepiece/40x obj. # Fields @ # Cells/Field FN22 for 5K Total 40X 1322 3.8 FN = Field Number Hologic Proprietary © 2012

10x FN 22 10x FN 22 Hologic Proprietary © 2012 Copyright © 2012 Hologic, All rights reserved.

Copyright © 2012 Hologic, All rights reserved. 10x FN 10 x 20 Hologic Proprietary © 2012 FN 22

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Endocervical Cells Honeycomb / Palisading Arrangements Maintained Round-Up in Solution More Tightly Packed Groups Smaller Cell Groups/Single Cells Nuclei “Busier” Hologic Proprietary © 2012

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Squamous Metaplasia Sheets/Cobblestone Arrangements Dense, Homogeneous Cytoplasm Cells Often Single Cells Appear Smaller & Rounder Hologic Proprietary © 2012

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Endometrial Cells Tight 3D Cell Clusters Loose Cell Clusters with Vacuolated Cytoplasm Single Cells More Prominent Nuclei “Busier” Menstrual Blood Lysed Hologic Proprietary © 2012

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Atrophy • Well Preserved Sheets of Parabasal Cells • Endocervical Cells May Be Distinguished • Bare Nuclei “Reduced” • “Atrophic Vaginitis” Pattern More Clumped Hologic Proprietary © 2012

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Trichomonas vaginalis Frequently Smaller Internal Structure Readily Identifiable Classic “Trich” Pattern Maintained Hologic Proprietary © 2012

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Candida spp. • Classic Cell Clumping • Reactive Squamous Cells with Engulfed WBC’s • Distinguish Mucus Strands from Pseudohyphae Hologic Proprietary © 2012

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Actinomyces • Organized Clusters of Branching Filamentous Bacteria • Associated Blue Staining Bacteria Hologic Proprietary © 2012

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Herpes Simplex Virus Ground Glass Nuclei Multinucleation with Nuclear Molding Classic Eosinophilic Nuclear Inclusions Hologic Proprietary © 2012

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Reactive Changes: Inflammation • Slight Nuclear Enlargement • (2X Intermediate Cell Nucleus) • • • • • Perinuclear Halos Cytoplasmic Vacuolization & Bi-chromasia Clumped WBC’s Enhanced Cellular Detail Hologic Proprietary © 2012

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Reactive Changes: Repair • Sheets of Cells with Engulfed WBC’s • Sheets of Cells More Rounded • Greater Depth-of-Focus • Sheets of Cells Less “Pulled Out” Hologic Proprietary © 2012

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ThinPrep Morphology ® Epithelial Cell Abnormalities Hologic Proprietary © 2012

ThinPrep Characteristics ® • • • • • Liquid Based Fixation Cell Size Smear Pattern Specimen Background Similarities > Differences Hologic Proprietary © 2012

Epithelial Cell Abnormalities Squamous ASC-US • • • • Occur in Sheets or Singly Nuclei 2 ½ - 3X Intermediate Nucleus Uniform Chromatin Distribution Decrease in Preparation Artifact Hologic Proprietary © 2012

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Epithelial Cell Abnormalities Squamous LSIL • • • • Increased Nuclear Detail Irregular Nuclear Membrane Nuclei 3 - 4X Intermediate Nucleus Sharp, Irregular Cytoplasmic Cavitation (HPV Effect) Hologic Proprietary © 2012

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Epithelial Cell Abnormalities Squamous HSIL • Sheets & Syncytial Groupings Maintained • Cytoplasmic Borders More Distinct • Isolated, Immature Cell Forms; Function as “Clue” • Nuclear Membrane Irregularities Hologic Proprietary © 2012

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Epithelial Cell Abnormalities Squamous Squamous Cell Carcinoma • Tumor Diathesis Maintained • Distinctive Necrotic Background Pattern • Greater Depth-of-Focus to Cell Groups • Prominent Chromatin Clearing • Nucleoli More Prominent Hologic Proprietary © 2012

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Epithelial Cell Abnormalities Glandular Atypical – Endocervical cells (NOS) – Endometrial cells (NOS) – Glandular cells (NOS) Atypical – Endocervical cells, favor neoplastic – Glandular cells, favor neoplastic Endocervical adenocarcinoma in situ Hologic Proprietary © 2012

Epithelial Cell Abnormalities Glandular Endocervical adenocarcinoma in situ (AIS) • • • • • Abnormal Architectural Patterns Maintained Nuclear Crowding With Hyperchromasia Pseudostratification, “Feathering” Identified Rosettes & Strips Nucleoli Often Present Hologic Proprietary © 2012

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Epithelial Cell Abnormalities Glandular Adenocarcinoma • 3D Cell Clusters Maintained • Well Preserved Nuclear Features • Tumor Diathesis May Be Noted Hologic Proprietary © 2012

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Trademark Statement CytoLyt, Hologic, PreservCyt, ThinPrep, and UroCyte are registered trademarks of Hologic, Inc. and/or its subsidiaries in the United States. CytoLyt, Hologic, PreservCyt, ThinPrep, UroCyte and associated logos are trademarks of Hologic, Inc. and/or its subsidiaries in other countries. Hologic Proprietary © 2012

Bibliography [1] Solomon, Diane, and Ritu Nayar, eds. The Bethesda System for Reporting Cervical Cytology. 2nd edition, 2004. ADS-00690 Rev. 001 Hologic Proprietary © 2012

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