MCP-461 Respiratory Tract Cells

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What is BAL widely used for?

investigation of infection and primary & metastatic cancer especially peripheral tumors

charcot Leyden crystals represent:

condensations of eosinophilic granules from eosinophils, represent a degenerative process

_______________ ___________ are condensations of glycoprotein from alveolar space usually preceded by pulmonary edema

corpora amylacea

_____________________ ____________ are associated with excess mucus and bronchial obstruction or asthma

curschmanns spirals

When is FNA used?

most often done to evaluate peripheral lesions and lesions that are inaccessible to bronchoscope

What is sputum?

mucus mixed with cells from lung and saliva serves to carry particulate matter to surface

What are markers for TB or granulomatous disease?

multinucleated giant cells

What is specimen adequacy of sputum?

must contain alveolar macrophages sample should be large enough for prep of 2-4 slides

Where do squamous cells in RT originate from and what specimen are they most likely seen in?

originate from oral cavity and most likely seen in sputum they should be sparse or absent in brochial specimens

What does presence of macrophages prove?

origins of deep portions of respiratory tract

When are charcot Leyden crystals found?

patients with asthma or allergies

What are sputum prep techniques?

pick and smear saccomanno technique liquid base cytology

What is predominant cell found in BAL specimen?

pulmonary macrophage

What must be seen in sputum specimen to verify lung origin?

pulmonary macrophages

name non epithelial cells

pulmonary macrophages or dust cells leukocytes smooth muscle cells fibroblasts

What does BAL recover?

recovers cells soluble proteins lipids and other chemical constituents from the epithelial surface of the lungs

Why may cells of bronchial wash be degenerate?

saline

What is the difference btwn calcospherites and psammoma bodies?

calcospherites are naked while psammoma bodies are surrounded by cells

What is predominant cell type in bronchial brushings?

ciliated respiratory columnar cells

What is the predominant cell in bronchial wash?

ciliated respiratory columnar cells

What are siderophages?

"heart failure cells" result of old hemorrhage

What are 8 normal constituents of lung FNA?

1. Pneumocytes 2. columnar cells 3. alveolar macrophages 4. inflammatory cells 5. connective tissue 6. adipose tissue 7. mesothelial cells 8. hepatocytes

What is used when the samples is beyond reach of bronchial scope ?

Bronchoalveolar lavage

What are 4 complications of FNA

Pneumothorax air embolism empyema hemoptysis

What are 4 types of FNA?

Transbronchial Transthoracic Endoscopic ultrasound FNA Endobronchial ultrasound FNA

When are reserve cells identified?

When they are in sheets or clusters

ferrunginous bodies are associated with:

associated with asbestos exposure they are elongated bamboo shaped structures

Where do pulmonary macrophages (type 3) originate from

bone marrow

smooth muscle cells associated with ____________ ___________ or _____________ ________________

bronchial ulceration or wegeners granulomatosis

What is the role of respiratory cytology?

diagnosis of primary and metastatic pulmonary tumors diagnosis of infection monitor disease assess interstitial lung disease

What is an important marker for adequacy of sputum specimen?

dust cells

what are Bronchial brushing recommended for?

endobronchial and central lesions but also helpful for peripheral lesions

What are two cells types of respiratory normal cells

epithelial and non epithelial

What is the specimen adequacy for Bronchial washing?

should contain large numbers of well preserved optimally stained ciliated bronchial epithelial cells

What is specimen adequacy for BAL?

should see abundant alveolar macrophages should be considered adequate is specific fungus, virus, neoplasm etc are ID'd

What do dust cells result from?

smoking, air pollution etc

What are respiratory cytology specimens?

sputum bronchial brushing/wash BAL FNA

What is predominant cell in sputum?

squamous cell of buccal origin

Name epithelial cell types

squamous cells respiratory cells -ciliated columnar -goblet cells -basal cells - alveolar pnemocytes -kulchitsky cells

What is considered unsatisfying for Lung FNA

too much blood, low cellularity, many benign bronchial mucosal cells and macrophages

This type of FNA is performed with a wang needle , the needle is passed thru bronchial wall into lesion

transbronchial

This type of FNA is transcutaneous, precutaneous and is performed using imaging techniques such as CT scan or ultrasound

transthoracic


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