CYTOLOGY

Cytology is the study of cells.

Cytopathology refers to diagnostic techniques that are used to examine cells from various
body sites to determine the cause or nature of disease.

Father of cytopathology is Dr. George Papanicolaou.

Advantages of Cytopathology over Histopathology

 Samples can be collected easily and quickly prepared, stained and interpreted.
 Inexpensive and little or no risk to the patient.
 Exfoliative cytology plays a prominent role in the mass screening and the early
detection of cancer.
 Cytological examinations identify disease process (neoplasia vs inflammation,
specific vs nonspecific).

Disadvantage

Some tumors do not exfoliate cells well and therefore may not provide adequate sample to
examine, it is not always possible to localise neoplastic lesion.

Different Branches of Cytopathology

1. Exfoliative cytology: - Spontaneously shed cells in body fluids.

2. Abrasive cytology:- Dislodges cells from body surfaces. Imprint Scraping,
Endoscopic brushing of mucosal surfaces or Washing (lavage) of mucosal or serosal
surfaces, Swab.
3. Fine needle aspiration evtology( FNAC)

Type of Specimens

Urine, CSF, Sputum, Effusions in body cavities like Pleura, Cervical smear, Buccal
scrapings Imprint Scraping, Endoscopic brushing of mucosal surfaces or Washing (Lavage)
of mucosal or serosal surfaces, Swabs, Needle aspirates.

Cervical smears and vaginal smears are collected using Ayer's spatuia.

Preparation of Smear
Fresh specimen is always recommended for cytological examination. Smears are prepared
from the specimen and are fix it immediately. Fluid specimens are centrifuged and the smear
is prepared from the deposit.

Fixation

Cytological specimens / smears are immediately fixed to avoid morphological changes of

cells. The classic cytological fixative is Ether- Ethyl alcohol mixture. 95% ethyl alcohol,
isopropyl alcohols, methanol are other fixatives used in cytology. Carnoy's fluid is used to fix
fluid specimens containing blood.

The optimum time for fixation is 15 - 30 minutes.

Staining Technique

Staining techniques employed mainly are

• Papanicolaou staining

The most commonly employed cytological staining technique is Papanicolaou staining (PAP
staining). Papanicolaou staining technique includes nuclear staining and cytoplasmic staining.
The nuclear stain used is Harris haematoxylin without acetic acid.

The cytoplasmic stains used as orange gelb (OG.) and Eosin azure (EA36 or EAso).

The stained smears are cleared in xylene and mounted in DPX. With PAP staining, the nuclei
stains blue, acidophilic cells red, basophilic cells blue-green and RBCs orange red colour.

• Shorr's staining for assessment of hormonal status and demonstration of barr body.

Applications of Diagnostic Cytology

 Diagnosis of cancer
 Assessment of hormonal status
 Diagnosis of infections
 Sex determination (Barr body)