Histopathology and Cytopathology

Histopathology and Cytopathology

Cytopathology refers to the examination of cells from bodily fluids or tissues to establish a diagnosis. The expert in this field is a pathologist, who looks at the cells in the tissue sample under the microscope to determine the abnormalities in the cells. As Cytopathology deals with the examination of only cells, which are very tiny, a very small sample of tissue is needed for a cytology test. Cytology is used in many different areas of medicine, but cytology tests are usually used for the screening and diagnosis of cancer.

Cytology is of two main types— intervention cytology and exfoliative cytology. Cytology tests are used by healthcare providers for almost all areas of the body. Some common types of cytology tests include urinary cytology, gynaecological cytology, thyroid cytology, breast cytology, respiratory cytology, lymph node cytology, ear cytology, and eye cytology.

What is exfoliative cytology?

Exfoliative cytology is a cytology branch in which the cells examined by a pathologist are either shed naturally by the body or are manually brushed or scraped from the surface of the tissue. Following are the examples of exfoliative cytology that involves manual tissue scraping or brushing:

  • Gynaecological samples
    The most well-known type of exfoliative cytology is a pap smear, which involves scraping off the cells from the cervix with the help of a swab.
  • Gastrointestinal tract samples
    Your doctor can scrape off the cells from the gastrointestinal tract lining during an endoscopy procedure for cytology testing.
  • Skin or mucus samples
    Your doctor scrapes off the cells from the mucous membranes or the skin such as from the inside of the mouth or nose for cytology testing.

Following are examples of exfoliative cytology that involve collecting fluids or tissues that your body naturally sheds:

  • Respiratory samples
    Your doctor can collect fluid samples such as mucus and saliva for a cytology test.
  • Urinary samples
    Your doctor will collect a urine sample for a cytology test.
  • Discharge or secretion samples
    If you have normal body discharge from vagina or eye, your doctor may collect a sample of the discharge for a cytology test.

What is intervention cytology?

Intervention cytology is a branch of cytology where the doctor gets samples of cells to perform tests on. They pierce your skin to derive a sample of cells. Fine-needle aspiration (FNA) is the commonest type of intervention cytology. A thin needle is injected by a healthcare provider into the area from where the sample has to be taken. Then, a pathologist examines the cells under the microscope in the fluid.

Following are some areas of the body that the healthcare provider uses for performing a fine-needle aspiration:

  • Solid lumps (nodules or masses) under your skin.
  • Fluid-filled lumps (cysts) under your skin.
  • Your pericardial fluid, which is the fluid in the sac around your heart.
  • Your lymph nodes.
  • Your pleural fluid, which is in the space between your lung and the inside of your chest wall.

Pathologists and healthcare providers commonly use cytology to screen or detect cancers. A healthcare provider only employs diagnostic tests for a person if they have signs and symptoms suggesting a certain disease or infection. A cytology test is a diagnostic test that determines the presence of abnormal cells. If so, the disease is accurately classified by the test.

Screening tests are also used by a healthcare provider to determine if a person could have a certain disease such as cancer, even before experiencing symptoms. Pap smear is a popular type of cytology screening test.

Following are other uses of cytology tests:

  • To diagnose inflammatory conditions.
  • To diagnose infectious diseases.
  • To diagnose diseases involving certain body cavities, such as the space between two thin membranes surrounding the lungs.
  • To examine thyroid lesions.

Many types of healthcare providers could take the cell sample, depending on the type of cytology test. For example, a cervical sample may be taken by a gynaecologist for a pap smear cytology test. The sample is then sent by a healthcare provider to a laboratory for testing. A cytopathologist or a pathologist visualises the cells from the sample of the tissue under the microscope and establishes a diagnosis. Consult the best cytopathologists in Indore at our hospital.

Every cytology test is different, depending on the type of cells being tested and if the sample is fluid or tissue. Generally, a cytology test has the following four steps:

  • Collection of the sample cells.
  • Processing the sample cells.
  • Examination of the sample cells.
  • Sharing the results.

Collecting the sample cells

Your doctor collects the cell sample from your body so that it can be examined by a pathologist. Following are some of the ways a healthcare provider employs to collect cytology test samples:

  • Collecting fluid or discharge samples from your body, such as a urine sample.
  • Brushing or scraping tissue from the surface of a part of your body.
  • Using fine-needle aspiration to draw a fluid sample from an area in your body.

Processing the sample cells

Some cytology tests involve samples of tissue that are spread on glass microscope slides called smears. Then, they send the smears to a pathology laboratory. If body fluid is involved in a cytology test, the healthcare provider will most likely not be able to use smears as the sample is too diluted. They will forward the sample most likely to a pathology laboratory.

After a cytology sample reaches the pathology laboratory, a lab technician or a pathologist dips the smears in some dyes. The type of dye used depends on the kind of sample. The stains make visualisation of the cells under the microscope easier.

If the sample for cytology is a fluid, the lab technician or a pathologist may use a centrifuge machine to separate the cells they want to examine. A centrifuge machine separates some cells from the fluid by spinning the sample very quickly. Then, the pathologist puts the cells on smears and stains them.

Examining the sample cells

After a lab technician or a pathologist processes and stains the cytology samples, those are examined under a microscope and checked for the presence of abnormal cells. If abnormal cells are found, those are marked with a special pen on the slides. Then, a pathologist makes a diagnosis based on the cells and prepares a report.

Sharing the results

After a report is prepared, the pathologist forwards it to the healthcare provider, who then discusses the report with you and determines the next steps.

Majority of cytology tests are painless and simple, therefore, you don’t need to do anything special to prepare for those. Your doctor will explain the process of the cytology test that has to be performed on you and will let you know about any specific preparation steps you need to take.

The doctor who performed your cytology test will forward the cells of the tissue sample to a laboratory where a pathologist or a cytologist will examine those under a microscope to check for characteristics of abnormalities. Then, the pathologist will send a report of the findings to the primary doctor, who will share the interpretation with you.

The chances of developing complications from cytology tests are very minimal. Even if those happen, they are mild. Like many other medical tests, a cytology test can provide false positive or false negative results. Apart from that, in some cases, tissue biopsies provide a more accurate result as compared to cytology tests.

There are many benefits associated with cytology tests as a very small amount of fluid sample or tissue is required for the test. A cytology test is less invasive than a tissue biopsy, causes less pain and discomfort, costs less, and is less likely to result in complications.

What type of results do you get from a cytology test?

The type of results derived from a cytology test depends on its type and the part of the body that is sampled. The report of a pathologist for a cytology test includes:

  • Presence or absence of abnormal cells.
  • If abnormal cells are found, what type of infection, disease or cancer is present in the sample.
  • If cancer is found, the grade of the cancer. While the type of cancer cell in the sample is identified, pathologists also determine how closely the cancer cells look like the normal cells or tissues. This is known as the grade of the cancer.
  • If there is a need for further testing like a biopsy.

The time taken to get the results of the cytology test depends on a number of factors including the type of tissue cells examined. Some cytology tests could take only 1-2 days to give the results, while others could take 1-2 weeks. Following are some factors that affect how long it takes to get the cytology tests:

  • Special stains or tests.
  • The need to look at more tissue or cells.
  • Processing time.
  • The need for a second opinion.

The main aim of both cytology tests and biopsies is to determine a diagnosis, however, there are some differences between the two. Cytopathology refers to examination of individual cells or a cluster of cells. So, a small amount of sample is required to be examined under the microscope for cytopathology tests, which makes these tests painless.

Larger pieces of tissues are involved in biopsies than those required for cytology tests. A pathologist examines different types of cells in the sample of tissue taken from a biopsy. Biopsy is also generally more invasive than cytology tests. It may require general or local anaesthesia.

Cytology tests are a common, painless way of screening for cancers and determining the diagnosis. While waiting for a diagnosis can be stressful, your healthcare team will be there at all times to support you. Don’t be afraid to ask questions from your healthcare provider about your test or its results.

Histopathology is a procedure that doctors use to visualise tissues under a microscope to identify potential changes. A histopathologist can visualise potentially malignant or atypical tissues and help other medical specialists make diagnosis or assess the effectiveness of treatment plans.

If your doctor refers you to a histopathologist, you might have questions about what it implies. Histopathology is commonly performed by doctors so that a histopathologist views the samples for the presence of malignant cells. Following are some key questions that a histopathologist report includes:

  • What types of cancerous cells do the tissues appear to be?
  • Are there cancerous cells present?
  • What is the percentage of cancerous cells present? This can help determine the treatment response.

It takes time to view and collect this information. For example, a biopsy of a known cancerous area and several lymph nodes may be taken by a surgeon to determine if the cancer has spread. A histopathologist looks at the sample of tissue and the lymph nodes, try to find out how many cancerous cells are there in each lymph node, and determines the location of those lymph nodes.

Special preparations may be required for histopathology results. This includes applying dyes or chemicals to the tissue sample, which can take several days. The healthcare professionals may also have to send the samples to a separate laboratory, which takes time to review and report on. Consult the best histopathologists in Indore at our hospital.

In some instances, a histopathologist can visualise and diagnose a sample almost soon after obtaining it. The biopsy viewed during or soon after a surgical procedure is known as the “frozen” section by doctors. If you undergo a biopsy, your doctor will let you know about how long it might take for you before you receive your results.

Having a positive histopathology report means that atypical tissues are present in the sample. This might point towards the diagnosis of cancer. Receiving a diagnosis of cancer can be devastating. The healthcare provider will discuss the report with you and help you interpret the findings. Sometimes, you may require further testing to determine the extent of cancerous cells.

While your healthcare provider may have all the answers right away, it is important to understand your diagnosis and make a decision about the next steps you need to take in the treatment process. While receiving a diagnosis of cancer is overwhelming, you don’t need to navigate it alone. If you have questions about your condition or the treatment plan, you can ask those from your doctor or your oncology team. Making a list of the questions you may have will help you answer the doctor your doctor asks you to reach a diagnosis.

The Department of Laboratory Medicine at Kokilaben Dhirubhai Ambani Hospital, Indore houses highly qualified and experienced medical professionals who are dedicated to quality service and patient care. All the reports are prepared by highly skilled doctors who ensure that they are accurate and error-free. All our laboratories follow international protocols and quality standards to avoid tampering with samples and provide precise results. Along with a diverse range of testing facilities the laboratories also ensure rapid delivery of results.

The blood samples collected are handled with utmost care and precision. They are sent to the concerned laboratories right away with the help of pneumatic chutes which deliver the samples right to the accessioning area of the laboratory. From there, they are transferred to the concerned work stations promptly. This ensures prompt processing of samples and eliminates any delay in reports. Timely reports ensure that the doctors can diagnose the disease early and start treatment early.

We strive to provide world-class services through state-of-the-art infrastructure and highly advanced equipment. Our team follows the highest level of professionalism during all procedures. Additionally, our staff engages in various training and competency evaluation programmes to be able to deliver precise and accurate results without compromising the quality. Our laboratories are computerised workplaces equipped with high-end software for Hospital Information systems (HIS) which stores patient information and reports. This is common across the hospital and helps all the doctors access patient data at the click of a mouse.