Saturday, August 29, 2009

Cytology (Non-gynecology)

Hi everybody, This week is my turn to blog again =) I will talk about the things I have done in cytology as many people have been posted about histology stuff. For the first week in cytology lab, I had learnt to process gynecology specimens using the Thinprep 2000 processor. For the next 2 weeks, as we are not allowed to process non-gynecology specimens, so I had observed my trainers on how they process non-gynecology specimens, such as sputum, BAL, fluid, CSF and FNA. However, my supervisor allowed us to process our own urine or sputum samples so that we can learn how non-gynecology specimens are being processed. For the last week, I had learnt how to screen by screening their teaching slides.

Subject title: Lab Technique

Topic: Urine Papanicolaou Stain

Principle: The principle of this staining is to see detect whether the patient has any abnormalities in the kidney, bladder or the urethra. Such abnormalities can be infection, malignancy, reactive or carcinoma. Normal people should be negative which consists of urothelial cells. However, squamous cells might be also present in the urine as they shed from the trigone. Squamous cells consist of superficial cells, intermediate cells, parabasal cells and basal cells.

Steps involved: Mid stream urine is collected to ensure that the specimen is free from unnecessary contaminant. After the urine is collected, it is poured into a test tube and centrifuged at 2000 rpm for 10 minutes. The supernatant is poured away, leaving the cell pellet whereby it is dissolved in a few drops of Shandon fixative. The mixed solution is then put aside for 5-10 minutes to ensure that the cells are fixed. It is then cytocentrifuged where the mixture is being transferred onto the slides. The slides are then placed in 95% alcohol to fix the section so as to prevent the cells from dropping while staining. They are left aside for 15-20 minutes before putting into the staining machine for staining. The slides are mounted using Depex. They are screened to see whether there are any abnormalities such as infection or malignant.

Results

Normal urothelial and cervical cells are present. Below is a picture of normal urine papanicolaou stain.



However, if patient has any abnormalities such as infections, the papanicolaou stains will be different. Below are pictures on various types of infections.

Bacterial infection



Fungal infection



Viral infection



Patient might also be having urothelial carcinoma. Below is the picture of this example.



Things to note
Scums need to be removed every morning to ensure the quality of the slides are maintained.
If the specimen is malignant, all the staining solution must be filtered or stained to prevent contamination.

If anyone has any questions, feel free to ask me =)

Lok Pui
0704138G

References:

http://www.bostwicklaboratories.com/HOME/getdoc/f3882049-3705-4478-81b4-11112e4eb64b/Urinary-Tract-Infection.aspx

www.cytologystuff.com
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4 comments:

  1. TG02 - Group 8September 2, 2009 at 8:43 AM

    hello hello,

    you mentioned there are 4 types of squamous cells, namely basal cells, parabasal cells, intermediate cells and superficial cells. How are they differentiate in terms of appearance when viewed under the microscope?

    Cheers,
    Ang Yu Hui Jacelyn
    0702632A

    ReplyDelete
  2. BordetellasSeptember 3, 2009 at 6:15 AM

    hey.

    you said that there are 3 various types of infections i.e bacterial, fungal and viral. Can i know, what you look for (anyting singnificant) under the microscope, so as to differentiate these types of infections, besides the colour?

    Sit shahimah
    0702717j

    ReplyDelete
  3. Sesame Chicken (:September 6, 2009 at 7:01 AM

    Hi jacelyn,

    The difference of the 4 types of squamous cells are quite significant. Firstly, its their size such as basal cells are normally 8-10µm, parabasal cells are 15-20µm, intermediate cells are 30-60µm and superficial cells are 40-60µm. Secondly, its the shape of the cells, whereby basal and parabasal cells are usually round while intermediate and superfcial cells are mostly polygonal. Thirdly, their cytoplasmic stain are also different, such as basal cells are stained deep blue, parabasal cells are stained blue, intermediate cells are stained pink or blue while superficial cells are stained orange. Lastly, their chromatin pattern of the nucleus are also different, whereby the chromatin pattern of the basal cells are coarse, parabasal cells are granular, intermediate cells are finely granular and superficial cells are pyknotic.

    From all these characteristics, the four types of squamous cells can be distinguished more easily.

    Hi Shahimah,

    Other than the colour, you can also look at the charcteristics of the different types of infections. For example, for bacterial infection, you can see the morphology of the bacterium, whether it is rod and strepto or circular and cluster. For fungal infection, you are able to see the hyphae and spores that are present. For virus infection, you will normally see an increase in granularity and the multinucleated cells.

    Hope these can clear your doubts =)

    Lok Pui

    ReplyDelete
  4. BordetellasOctober 6, 2009 at 12:26 AM

    hi lok pui,

    why is it that only when the specimen is maliganant, the staining solution has to be filtered?

    thanks!
    eriko 0700477c

    ReplyDelete

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