CYTOLOGY SAMPLE COLLECTION

 

CYTOLOGY SAMPLE COLLECTION

PREPARED BY MR. ABHIJIT DAS


FINE NEEDLE ASPIRATION PROCEDURE:

Fine Needle Aspiration (FNA) is a minimally invasive diagnostic procedure used to collect cells from a lump or mass for examination.

Preparation:

o   The area is cleaned and sometimes local anesthesia is applied.

o   For deep-seated lesions, ultrasound or CT imaging is used to guide the needle.

Procedure:

o   A fine needle (22-25 gauge) attached to a syringe is inserted into the lesion.

o   The syringe creates suction while the needle is moved gently to aspirate cells.

o   The sample is spread onto slides for microscopic examination.

Post-Procedure:

o   The area is cleaned and bandaged.

o   The patient is monitored briefly for any complications, such as minor bleeding.

USG FNAC:

Ultrasound-guided FNAC is a technique used to obtain cells from deep-seated or non-palpable (something that can’t be touched) lesions with real-time imaging assistance.

1.    Preparation:

o   The patient is positioned for optimal access to the target area.

o   The skin is cleaned, and a sterile ultrasound probe is used to locate the lesion.

o   Local anesthesia may be applied if necessary.

2.    Procedure:

o   The ultrasound provides real-time imaging of the lesion.

o   A fine needle (22-25 gauge) is inserted through the skin, guided by the ultrasound to the exact location of the lesion.

o   Suction is applied with a syringe, and the needle is moved to aspirate cells.

o   The sample is collected and prepared on slides for microscopic analysis.

3.    Post-Procedure:

o   The site is cleaned and bandaged.

o   The patient is monitored for any complications, such as bleeding.

CT-GUIDED FNAC:

CT-guided FNAC is a procedure used to collect cells from deep-seated or non-palpable lesions, guided by a Computed Tomography (CT) scan for precise needle placement.

1.    Preparation:

o   The patient is positioned on the CT scanner table.

o   The skin is cleaned and sometimes local anesthesia is applied.

o   A preliminary CT scan is taken to locate the lesion.

2.    Procedure:

o   Using the CT images, the doctor determines the best path for the needle.

o   A fine needle (22-25 gauge) is inserted into the lesion under CT guidance.

o   Once the needle is in position, suction is applied using a syringe to aspirate cells.

o   The sample is collected for cytological examination.

3.    Post-Procedure:

o   The area is cleaned and bandaged.

o   The patient is monitored for complications, such as bleeding.

EUS-FNAC:

EUS-FNAC is a procedure that combines endoscopy and ultrasound to obtain tissue samples from deep-seated lesions, especially in the gastrointestinal tract and surrounding organs (e.g., pancreas, liver, lymph nodes).

1.    Preparation:

o   The patient is sedated, and an endoscope (a flexible tube with a camera) equipped with an ultrasound probe is passed through the mouth into the digestive tract.

o   The ultrasound provides real-time imaging to locate the lesion.

2.    Procedure:

o   Once the lesion is identified using ultrasound, a fine needle is passed through the endoscope to puncture the wall of the gastrointestinal tract and reach the lesion.

o   Suction is applied to aspirate cells or tissue from the lesion into the needle.

o   The sample is collected for microscopic examination.

3.    Post-Procedure:

o   The patient is monitored during recovery for any complications, such as bleeding or infection.

o   The collected sample is analyzed to diagnose conditions such as cancers, cysts, or other abnormalities in organs like the pancreas or lymph nodes.


  • NOTE
  • ·       A lump or mass refers to an abnormal growth or swelling in the body.
  • ·       Aspirate means to draw in or remove a substance using suction.
  • ·       Palpable refers to something that can be touched or felt.

RESPIRATORY SAMPLES

Here are key methods of respiratory sample collection for cytological examination:

1.    Sputum Cytology:

o   Patients cough deeply to produce sputum (mucus from the lower airways).

o   Collected in the morning.

o   Useful for detecting lung infections, malignancies, or inflammatory conditions.

2.    Bronchoalveolar Lavage (BAL):

o   Performed during bronchoscopy.

o   Saline is instilled into a lung segment and then aspirated, collecting cells from deep within the lungs.

o   Often used to diagnose infections and lung cancer.

3.    Bronchial Brushings:

o   A brush is inserted via bronchoscope to scrape cells from bronchial walls.

o   Helps diagnose conditions like lung cancer.

4.    Pleural Fluid Cytology (Thoracentesis):

o   In cases of pleural effusion, a needle is inserted into the pleural space to collect fluid.

(Effusion refers to the abnormal accumulation of fluid in body cavities)

o   Examining pleural fluid can help identify infections, cancer, or other conditions affecting the pleura.

FIXATION OF CYTOLOGY SAMPLES

Fixation in cytology preserves cells on slides to keep their structure intact for examination. Common methods include:

1.    Air-Drying: Cells are allowed to dry on the slide, often used for stains like Giemsa. Stains like Giemsa react well with air-dried cells, improving visibility of cell features like the nucleus and cytoplasm.

2.    Wet Fixation: Slides are immediately placed in an alcohol fixative (e.g., 95% ethanol) to keep cells stable.

3.    Spray Fixatives: The alcohol based solution is sprayed directly onto the slide after the sample is smeared. 

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