Cytology

Individual cells are studied in cytology, and individual cells in disease are studied in cytopathology. A patient’s sampled fluid/tissue is smeared onto a slide and stained. The anatomical pathologist looks at the quantity of cells on the slide, what sorts of cells they are, how they are grouped together, and what the cell characteristics are under the microscope. This data is useful in establishing whether a disease is present and, if so, what the most likely diagnosis is.

Cytology is frequently used as a screening tool to detect disease and determine whether additional testing is required. The examination of a breast lump is an example of screening. A needle aspirate of the lump submitted for cytology, in combination with the clinician’s assessment and imaging tests, will reveal if the breast cells are suspicious for cancer or appear bland/ benign. If they appear to be questionable, a core biopsy with a bigger needle may be performed, allowing for a more certain diagnosis before choosing what type of surgery is required.
Sampling techniques in cytology:

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Exfoliative cytology:

This is the study of cells that are shed from the surface of the organism. The lining cells of the uterine cervix and the bladder are two examples. A cervical or Papanicolaou smear is a minimally invasive treatment that analyses cells from the cervix. A speculum is inserted into the vaginal canal to allow the practitioner to inspect the cervix directly. The cervix is then scraped gently to extract cervical cells, which are smeared directly onto glass slides at the bedside and sent to a laboratory for analysis. The material from the cervical scrape can also be examined directly for the wart virus, which is a major risk factor for cervical cancer.

Aspiration cytology:

Cells from within a mass or organ are analyzed in this procedure. Fine Needle Aspiration, a more intrusive sample approach, is used in this case. A needle is injected into the body part being checked, and imaging is sometimes used to guarantee that the suspect area is sampled. If the treatment involves a deep organ or tissue, it may be conducted after a local anesthetic injection to numb the skin, or even under light sedation. The cells are extracted, expressed on a slide, and produced in the same manner as a cervical smear. If fluid is aspirated, it should first be spun in a centrifuge so that the cell-containing sediment settles at the bottom of the test tube and the best material may be taken for evaluation.

Examining cytology material:

Exfoliative samples, such as cervical smears, urine, and sputum, are the most prevalent in cytology. To look for any problematic cells, these are routinely inspected by expert cytotechnicians or, in certain laboratories, computerized automated methods. Suspicious samples are sent to a pathologist for further microscopic analysis and diagnosis. A pathologist will usually examine the aspirated material directly.

Similar to histopathology sections, special stains are used to highlight the cells and background material on the slide.