EXFOLIATIVE CYTOLOGY

 

Branch of general Cytology which deals with the microscopic study of cells that have been desquamated from epithelial surfaces

 

= Exfoliated cell may be found in smears that have spontaneously been shed or physically removed from epithelial and mucous membranes and from body fluids.

 

 

= Spontaneous exfoliation is observed in normal cells due to constant growth and replacement with new cells- more readily observed in malignant tumor cells

 

Recommended for the following:

 

n      for assessing malignant or cancerous conditions

n      for detection of asymptomatic cancer in women (vaginal cytology)

n      for assessment of female hormonal activity in case of sterility and endocrine disorders

n      for determination of genetic sex

n      for determination of the presence of possible infection

 

Specimens for examination:

 

n      vaginal smears

n      endometrial and endocervical smears

n      Prostatic and breast secretions

n      Gastric or bronchial secretions

n      Pleural and peritoneal fluids

n      Sputum

n      Smears of urine sediment

n      Cerebrospinal fluid

 

Smears are usually made from fresh materials

 

Four principal methods:

n      Streaking

n      Spreading

n      Pull- apart

n      Touch Preparation

 

Proper labeling

 

n      Patient’s name

n      age

n      date

n      type of smear

 

 

Fixation:

 

15 minutes to one hour (to assure optimum dehydration and adhesion)

 

 

Common fixatives used:

 

a. Equal parts of 95% Ethyl alcohol and Ether ( best fixative)

b. 95% Ethyl Alcohol

c. Carnoy’s fluid

 

Precautions Observed during fixation:

           

a. Smears should be placed into the fixative immediately after preparations

b. Place each smear in fixative by a single uninterrupted motion to avoid rippling of smeared material

c. Avoid striking the bottom of the fixing container forcefully to prevent dislodging the material from the slide

d. Identify the slides before preparing smears

e. Attach a paper clip to the identified end of the slide before preparing the smear.  Paper clips prevent the slide from sticking together in the fixative

f. Have the individual fixative bottle open before preparing the smear

 

Storage = alcohol and refrigerated (not processed immediately)

             = Air-dried after fixation or Glycerin technique ( sent by mail)

 

a. 50% alcohol for pleural and peritoneal

b. 70% alcohol for sputum

c. 95% alcohol for urine, bronchial and 

   gastric aspirates