Treatmen of exfoliative samples in cytology

U eksfolijativnoj citologiji se na temelju mikroskopske analize stanica prepoznaju patološke promjene i dijagnosticiraju benigni, premaligni i maligni procesi. Uzorkovanje se temelji na sakupljanju spontano ili mehanički odljuštenih stanica iz različitih dijelova tijela. Cilj rada je prikazati metode prikupljanja i obrade uzoraka te izgled stanica. Bolesnika treba uputiti u postupak uzorkovanja, uzorkovanje izvesti pravilno pa uzorak pohraniti na +4°C ako se ne može odmah obraditi. Obrada se razlikuje prema vrsti uzorka. Cerebrospinalna tekućina je obično gotovo acelularna pa je potrebna filtracija i smanjena brzina centrifugiranja da se sačuva što veći broj stanica koje se potom oboje po Papanicolaou. Ginekološki razmazi se također boje po Papanicolaou. Bris cerviksa je ujedno screening metoda od velike vrijednosti za rano otkrivanje karcinoma vrata maternice i genitalnog karcinoma. Uzorci izljeva se prikupljaju aspiracijom i centrifugiraju te oboje ovisno o načinu fiksacije, po Papanicolaou (fiksacija alkoholom) ili po May-Grünwald-Giemsi (fiksacija sušenjem na zraku). Bojenje po Papanicolaou se koristi za uzorke kože dobivene struganjem skalpelom ili tehnikom FNA. Ostali uzorci se boje isključivo po May-Grünwald-Giemsi. Bris nazalne šupljine je važan u dijagnostici alergija. Dobivanje sputuma može se olakšati inhalacijom aerosolnih otopina. Bronhalni aspirati, ispirci i četkanja se provode uvođenjem bronhoskopa u donji respiratorni trakt. Bronhoalveolarna lavaža se koristi za detekciju raka pluća i infekcija u imunokompromitiranih osoba. U citološkim laboratorijima najčešće se obrađuju uzorci iz urogenitalnog trakta i serozni izljevi. Prednosti eksfolijativne citologije su jednostavnost, brzina, ekonomičnost i neinvazinost postupka te prikupljanje velike količine materijala, a nedostatak nedefiniran sustav morfoloških promjena.Exfoliative cytology is a diagnostic branch of medicine which based on microscopic examination recognises physiological states and diagnoses benign, premalignant and malignant processes. Its activity is based on collecting of spontaneously or mechanically exfoliated cells from different parts of body. The purpose of this paper is to present the methods of collection and processing of samples and the appearance of cells. Patients should be informed about the sampling procedure, sampling must be performed correctly and the sample stored at 4°C if it can not be processed immediately. Treatment varies according to the type of sample. Cerebrospinal fluid is usually nearly acellular so filtration on reduced spin speed is required in order to preserve as many cells as possible which are afterward stained by Papanicolaou technique. Gynaecological smears are also stained by Papanicolaou technique. Cervical smear is a screening method of great value for early detection of cervical and genital cancer. Effusion samples are collected by aspiration, then centrifuged and stained by Papanicolaou (if fixated with alcohol) or by May-Grünwald-Giemsa (if fixated with air drying) technique. Staining by Papanicolaou is used for skin specimens obtained by scraping with a scalpel or FNA technique. Other samples are stained exclusively by May-Grünwald-Giemsa technique. Nasal cavity smears are important in the diagnoses of allergies. Sputum sampling may be facilitated by aerosol solution inhalation. Bronchial aspirates, washings and brushing are performed by introducing the bronchoscope into the lower respiratory tract. Bronchoalveolar lavage is used for the detection of lung cancer and infections in immunocompromised patients. Urogenital tract and serous effusions samples are the most frequently processed samples in cytology laboratories. Benefits of exfoliative cytology methods are simplicity, short processing time, cost-effectiveness, noninvasive sampling procedures and possibility of collection large amounts of material. Disadvantage of exfoliative cytology is a vaguely defined system of changes in the morphological characteristics of cells