MCP-461 Respiratory Tract Cells
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