Atlas of Prostatic Cytology: Techniques and Diagnosis

ISBN-13: 9783642701122 / Angielski / Miękka / 2011 / 228 str.

W. Leistenschneider; R. Nagel; R. Mills

Opis

Diagnostic and exfoliative cytology has today achieved a status that few could have envisaged 20 years ago. While exfoliative cytology has long been employed in gynecological diagnosis, new and rewarding spheres have now developed in which cytological diagnosis plays an important role. Exfoliative cytology, for example, is widely employed as an aid in the continuous assessment of urinary tract tumors, and aspiration cytology in the diagnosis of thyroid dis eases. This has given rise to a growing demand for pathologists experienced in cytological diagnosis. However, clinicians with an interest in morphology were often the first to adopt these simple and safe methods, being naturally attracted by the chance to avoid conducting biopsy, which, in the last analysis, is nothing less than a surgical operation. In this Atlas of Prostatic Cytology Leistenschneider and Nagel expertly demonstrate what can be achieved when clinicians skilled in morphology take an interest in cytological methods. Not only do they have direct contact with the patient, but they also profit from immediately being in a position to assess the results of their diagnostic procedures by examining the specimen obtained. From the technical point of view aspiration biopsy of the prostate is by no means a simple procedure and the difficulties involved would seem to have been underestimated in the initial phase of enthusiastic acclaim. Consequently it has been not unusual for clinicians and pathologists to be disappointed by the high rate of unsatisfactory samples obtained by this method."

Spis treści

1 The Technical Bases of Aspiration Biopsy.- 1.1 Preparation and Positioning of the Patient.- 1.2 Lubricants and Anesthesia.- 1.2.1 Lubricants.- 1.2.2 Local Anesthesia.- 1.3 Instrumentarium for Aspriation.- 1.4 Technique of Aspiration.- 1.5 Acquisition of Suitable Cellular Material.- 1.6 Macroscopic Evaluation of the Aspirate in Biopsy Smears.- 1.6.1 Satisfactory Aspirate.- 1.6.2 Unsatisfactory Aspirate.- 1.7 Smear Technique.- 1.8 Fixation.- 1.8.1 Spray.- 1.8.2 Alcohol-Ether Solution.- 1.8.3 Air Drying.- 1.9 Shipment of Smears.- 1.10. Complications.- 1.10.1 Complications of Punch Biopsy.- 1.10.2 Complications of Aspiration Biopsy.- 1.11 Prophylaxis Against Infection.- 1.12 Staining Procedures.- 1.12.1 Staining According to Papanicolaou.- 1.12.2 Staining According to May-Grünwald-Giemsa (MGG).- 1.12.3 Hematoxylin-Eosin Staining.- 2 Cytological Microscopy.- 2.1 Microscope.- 2.1.1 Stand with Object Stage.- 2.1.2 Tube.- 2.1.3 Objective Carrier.- 2.1.4 Optical System (Eyepieces and Objectives).- 2.1.5 Illuminators.- 2.2 Brightfield Microscopy.- 2.2.1 Aperture Diaphragm.- 2.2.2 Field Diaphragm.- 2.2.3 Condenser.- 2.3 Fluorescence Microscopy.- 2.3.1 Principle of Fluorescence Microscopy.- 2.4 Guidelines for Brightfield Microscopy.- 2.5 Procedure.- 3 Normal Findings.- 3.1 Individual Cells, Sheets of Cells and Background.- 3.2 Nuclei.- 3.2.1 Chromatin.- 3.2.2 Nucleoli.- 4 Atypia.- 4.1 Classification According to Papanicolaou.- 4.1.1 Papanicolaou I (Normal Findings).- 4.1.2 Atypia (Papanicolaou II–IV).- 4.2 Atypical Hyperplasia.- 5 Secondary Findings.- 5.1 Erythrocytes.- 5.2 Seminal Vesicle Epithelial Cells.- 5.3 Epithelial Cells of Rectal Mucosa.- 5.4 Urothelial Cells.- 5.5 Metaplastic Squamous Epithelial Cells.- 5.6 Sheets of Keratin.- 5.7 Histiocytic Giant Cells.- 5.7.1 Cytoplasm.- 5.7.2 Nucleus.- 5.8 Intracytoplasmic Granules.- 6 Artefacts.- 7 Primary Diagnosis of Carcinoma.- 7.1 Procedural Reliability.- 7.2 Cytological Criteria for Prostatic Carcinoma.- 7.2.1 Structure of Cell Groups.- 7.2.2 Alterations in the Nuclei.- 8 Grading of Prostatic Carcinoma.- 8.1 Histology.- 8.2 Cytology.- 8.3 Cytological Grading According to the Uropathological Study Group on ‘Prostatic Carcinoma’.- 9 Treatment Control by Means of Regression Grading.- 9.1 Cytological Signs of Regression.- 9.1.1 Signs of Marked Regression.- 9.1.2 Signs of Slight Regression.- 9.2 Cytological Regression Grading.- 9.2.1 Cytomorphological Criteria of Regression Grading.- 9.3 Reproducibility.- 9.4 Clinical Significance of Cytological Regression Grading.- 9.5 Validity of Cytological Regression Grading.- 9.6 Signs of Regression After Initiation of Treatment.- 9.7 Cytological Regression Grading and Findings at Palpation.- 10 Sarcomas.- 11 Secondary Tumors of the Prostate.- 11.1 Cytomorphological Criteria.- 11.1.1 Urothelial Carcinoma.- 11.1.2 Malignant Lymphoma.- 11.1.3 Seminoma.- 12 Prostatitis.- 12.1 Classification.- 12.2 Diagnostic Reliability.- 12.3 Clinical Significance and Complications.- 12.4 General Cytological Criteria of Prostatitis.- 12.4.1 Specific Forms.- 12.5 Summary.- 13 DNA Cytophotometry.- 13.1 Feulgen’s Reaction.- 13.2 Single-cell Scanning Cytophotometry.- 13.2.1 Fluorometry.- 13.2.2 Absorption Scanning Cytophotometry.- 13.2.3 Cytophotogram.- 13.2.4 Statistics.- 13.3 Flow-through Cytophotometry.- 13.4 New Developments in Automatic Cytodiagnosis.- 13.4.1 The A.S.M. System.- 13.4.2 The Leytas System.- 14 Results of Measurement of Nuclear DNA by Single-cell Scanning Cytophotometry in Prostatic Carcinoma.- 14.1 Well Differentiated Carcinoma (Grade I).- 14.2 Moderately Differentiated Carcinoma (Grade II).- 14.3 Undifferentiated Carcinoma (Grade III).- 14.4 Our own Results with Nuclear DNA Analysis by Single-cell Cytophotometry in Treated Prostatic Carcinoma.- 14.4.1 Nuclear DNA Distribution Patterns During Treatment.- 14.4.2 Results.- 14.5 The Importance of DNA Cytophotometry in the Treatment of Prostatic Carcinoma.- References.