Scribd
Upload
33 views

Lecture Introduction of Cytotpathology

Cytopathology is the study and diagnosis of diseases on the cellular level using samples of free cells or tissue fragments. The field began in the 1850s with contributions from Lionel Beale. Major advances in the 1920s-1940s from Dudgeon, Papanicolaou, Babes, and Trout established cytopathology as a tool for cancer diagnosis, particularly with the development and acceptance of the Pap smear. Cytopathology uses exfoliative cytology of spontaneously or manually collected cells as well as intervention cytology techniques like fine needle aspiration to diagnose cancers and other diseases.

Uploaded by

Jeevan Adhikari
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
33 views

Lecture Introduction of Cytotpathology

Cytopathology is the study and diagnosis of diseases on the cellular level using samples of free cells or tissue fragments. The field began in the 1850s with contributions from Lionel Beale. Major advances in the 1920s-1940s from Dudgeon, Papanicolaou, Babes, and Trout established cytopathology as a tool for cancer diagnosis, particularly with the development and acceptance of the Pap smear. Cytopathology uses exfoliative cytology of spontaneously or manually collected cells as well as intervention cytology techniques like fine needle aspiration to diagnose cancers and other diseases.

Uploaded by

Jeevan Adhikari
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 9

INTRODUCTION OF

CYTOPATHOLOGY
Early historical era, development, expansion and consolidation,
diagnostic utility and importance.
Early historical era
• Era of cytopathology began 170 years back.
• Lionel S. Beale of London made some of the earliest contributions to
Cytopathology in the 1850–1860s
• Beale advocated the routine microscopic examination of vaginal
discharges and urine.
• He reported the presence of cancer cells in the sputum in 1860.
• Historians consider Beale to be the “Father of Clinical Pathology” and
a founder of Cancer Cytopathology.
• After Beale, no real progress was made until the late 1920s when
there was a total rebirth of clinical cytology after a 60 year hiatus.
• The next important contribution to cytopathology was Leonard S.
Dudgeon’s wet film method first described in 1927.
• His method competed with the frozen section for intraoperative
diagnostic methodology.
• German pathologist Reinhold Dengler in 1929 developed a new
method: teasing tissue apart, mounting it on a slide in a drop of 1%
acetic acid, cover-slipping, and viewing under a microscope.
• In 1928, both George Papanicolaou and Romanian Aurel A. Babes¸
reported that cancer of the cervix could be diagnosed with vaginal
smears.
• The work of Dudgeon, Papanicolaou, and Babes¸ in the late 1920s
jump-started cytopathologic research after 60 years of little progress.
• In next 13 years time, George Papanicolaou and Herbert Trout in
1941 published paper on pap smear examination of cervical smears
after which it was a widely accepted diagnostic tool.
• This marked the early historic era and acceptance of cytopathology as
a major tool for diagnosing cancer.
Introduction
• Cytopathology:
 It is a branch of pathology that studies and diagnoses diseases on the
cellular level.
 Cytopathology is used on samples of free cells or tissue fragments, in
contrast to histopathology, which studies whole tissues.
 Cytopathology is commonly used to investigate diseases involving a
wide range of body sites, to diagnosis of cancer but also in the
diagnosis of some infectious diseases and other inflammatory
conditions.
• Cell collection:
• There are two methods of collecting cells for cytopathologic analysis:
1. Exfoliative cytology
2. Intervention cytology.
1. Exfoliative cytopathology:

 In this method, cells are collected after they have been either spontaneously shed by the
body ("spontaneous exfoliation"), or manually scraped/brushed off of a surface in the
body ("mechanical exfoliation").
 An example of spontaneous exfoliation is when cells of the pleural cavity or peritoneal
cavity are shed into the pleural or peritoneal fluid. This fluid can be collected via various
methods for examination.
 Examples of mechanical exfoliation include Pap smears, where cells are scraped from the
cervix with a cervical spatula, or bronchial brushings, where a bronchoscope is inserted
into the trachea and used to evaluate a visible lesion by brushing cells from its surface
and subjecting them to cytopathologic analysis.
 After sampling, two main techniques can be used; Conventional cytology and Liquid-
based cytology. With the latter, we place the sample in a liquid that is then processed
and allows for further investigation to be made.
2. Intervention cytopathology (FNAC):
• Fine-needle aspiration cytology (FNAC), involves use of a needle attached
to a syringe is to collect cells from lesions or masses in various body organs
by microcoring, often with the application of negative pressure (suction) to
increase yield.
• FNAC can be performed under palpation guidance (i.e., the clinician can
feel the lesion) on a mass in superficial regions like the neck, thyroid or
breast.
• FNAC may be assisted by ultrasound or CAT scan for sampling of deep-
seated lesions within the body that cannot be localized via palpation.
• FNAC is widely used in many countries, but success rate is dependent on
the skill of the practitioner.
• If performed by a pathologist alone, or as team with pathologist-
cytotechnologist, the success rate of proper diagnosis is higher than when
performed by a non-pathologist.
• This may be due to the pathologist's ability to immediately evaluate
specimens under a microscope and immediately repeat the procedure if
sampling was inadequate.
• Fine needles are 23 to 27 gauge.
• Because needles as small as 27 gauge can almost always yield diagnostic
material, FNAC is often the least injurious way to obtain diagnostic tissue
from a lesion

You might also like