Cytopathology
Cytopathology is a specialized medical field focused on the examination of individual cells to detect lesions or abnormalities that may indicate disease. Pathologists in this discipline are trained to identify pathological changes within cells caused by various factors, including aging and external agents like viruses, bacteria, or chemicals. The study involves analyzing cell samples from different body areas through techniques such as the Pap test, which can reveal significant information about potential malignancies.
Cytopathology plays a crucial role in cancer diagnosis and treatment, employing criteria like cell size variation, nuclear irregularities, and the presence of specific organelles to guide clinical decisions. The characteristics of cancerous cells, including their morphology and the degree of pleomorphism, inform prognosis and treatment options, which may include surgery, chemotherapy, or radiation. By understanding the cellular changes that occur due to disease processes, cytopathologists contribute valuable insights that aid in the effective management of various health conditions.
Subject Terms
Cytopathology
Anatomy or system affected: Cells, immune system
Definition: The medical field that deals with changes in cell structure or physiology as a result of injuries, genetic mutations, infectious agents, or toxic substances
Science and Profession
The profession of cytopathology deals with the search for lesions or abnormalities within individual cells or groups of cells. Generally speaking, a pathologist is a physician trained in pathology, the study of the nature of diseases. Observations of tissue or cell lesions are utilized in the diagnosis of disease or other agents associated with damage to cells.
Cell damage may result from endogenous phenomena, including the aging process, or from exogenous agents such as biological organisms (viruses or bacteria), chemical agents (bacterial toxins or other poisons), and physical agents (heat, cold, radiation, or electricity). For example, particular biological agents produce recognizable lesions that may be useful in the diagnosis of disease, such as the crystalline structures characteristic of certain viral infections.
The type of necrosis, or cell death, encountered is useful in diagnosing the problem. For example, certain types of enzymatic dissolution of cells, which result in areas of liquefaction, are the result of bacterial infection. Gangrenous necrosis often follows the restriction of the blood supply because of either infection or a blood clot.
Pathologic changes within the cell can also help pinpoint the time of death. Organelles degenerate at a rate dependent on their use of oxygen. For example, mitochondria, which utilize significant amounts of oxygen, are among the first organelles to degenerate.
Diagnostic and Treatment Techniques
The diagnosis and treatment of cancer are prime examples of the use of cytopathology, and cytology tests may be used on almost all areas of the body. The extent of pleomorphism in cell size and shape, irregularity of the nucleus, and presence (or absence) of organelles all provide the basis for the choice of treatment and help determine the ultimate prognosis. Specific organelles are stained with characteristic histochemicals, followed by microscopic observation. A preponderance of large, irregularly shaped cells provides for a poorer prognosis than if cells appear more normally differentiated. The nuclei in highly malignant tumors show a greater variation in size and chromatin pattern as compared with those of cells from benign growths. Such differences lead directly to decisions on the choice of treatment: surgical removal, chemotherapy, or radiation.
Bibliography
"About Cytopathology." American Society of Cytopathology, 2013.
“Cytology (Cytopathology): What It Is & Types.” Cleveland Clinic, 17 Aug 2021, my.clevelandclinic.org/health/diagnostics/21714-cytology. Accessed 23 July 2023.
Geisinger, Kim R., et al. Modern Cytopathology. Philadelphia: Churchill Livingstone/Elsevier, 2004.
Kumar, Vinay, et al., eds. Robbins Basic Pathology. 9th ed. Philadelphia: Saunders/Elsevier, 2012.
Lewin, Benjamin, et al., eds. Cells. 2d ed. Sudbury, Mass.: Jones and Bartlett, 2010.
MacDemay, Richard. The Art and Science of Cytopathology. 2d ed. Chicago: American Society for Clinical Pathology, 2011.
Majno, Guido, and Isabelle Joris. Cells, Tissues, and Disease: Principles of General Pathology. 2d ed. New York: Oxford University Press, 2004.
Silverberg, Steven G., ed. Silverberg’s Principles and Practice of Surgical Pathology and Cytopathology. 4th ed. New York: Churchill Livingstone/Elsevier, 2006.