ASCP CT flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Bethesda adequacy threshold

An adequate conventional Pap smear generally contains about 5,000 well-visualized squamous cells; liquid-based preparations require a similar minimum cellularity for reliable interpretation.

Koilocyte features

Koilocytes show nuclear enlargement, irregular nuclear contours, hyperchromasia, and a perinuclear halo; these changes reflect human papillomavirus cytopathic effect and define LSIL.

ASC-US criteria

ASC-US shows squamous nuclear enlargement about 2.5 to 3 times the area of a normal intermediate nucleus, with mild atypia but no definite koilocytosis; HPV triage or repeat testing is used.

ASC-H meaning

ASC-H denotes atypical squamous cells in which HSIL cannot be excluded; cells show high nuclear-to-cytoplasmic ratio and irregular nuclei, and colposcopy is recommended.

AGC postmenopausal endometrial cells

Exfoliated endometrial cells in a postmenopausal woman without hormone therapy are abnormal; they require evaluation for endometrial hyperplasia or carcinoma even when cytologic atypia is mild.

SCC tumor diathesis

Squamous cell carcinoma often shows tumor diathesis-necrotic debris, blood, and proteinaceous material-along with marked nuclear pleomorphism, hyperchromasia, and keratinization.

Alveolar macrophages adequacy

In sputum or bronchoalveolar lavage, alveolar macrophages indicate that the lower respiratory tract was sampled; their presence supports specimen adequacy for cytologic evaluation.

Small cell carcinoma cytology

Small cell carcinoma shows small cells with scant cytoplasm, nuclear molding, salt-and-pepper chromatin, and crush artifact; necrosis and mitotic activity are common.

Reactive mesothelial cells

Reactive mesothelial cells have abundant two-tone cytoplasm and intercellular windows; they may form clusters but lack the three-dimensional atypia and prominent nucleoli of adenocarcinoma.

Urine HGUC criteria

Under the Paris System, high-grade urothelial carcinoma requires nuclear-to-cytoplasmic ratio greater than 0.5, hyperchromasia, and irregular nuclear membranes in urothelial cells.

Decoy cells

Decoy cells are polyomavirus-infected urothelial cells with enlarged, ground-glass nuclei and a high nuclear-to-cytoplasmic ratio; they can mimic high-grade urothelial carcinoma.

Hemosiderin-laden macrophages

Hemosiderin-laden macrophages in bronchoalveolar lavage or sputum indicate prior alveolar hemorrhage; they are identified by brown cytoplasmic pigment that stains with Prussian blue.

Thyroid Bethesda categories

The six thyroid FNA categories are nondiagnostic, benign, atypia of undetermined significance/follicular lesion of undetermined significance, follicular neoplasm, suspicious for malignancy, and malignant.

Papillary thyroid carcinoma nuclei

Papillary thyroid carcinoma shows nuclear grooves, intranuclear pseudoinclusions, powdery chromatin, and psammoma bodies; these features are key in FNA interpretation.

Follicular neoplasm limitation

Cytology cannot reliably distinguish follicular adenoma from follicular carcinoma; the diagnosis requires histologic demonstration of capsular or vascular invasion.

Medullary carcinoma features

Medullary thyroid carcinoma shows salt-and-pepper chromatin, plasmacytoid or spindle cells, and amyloid stroma; calcitonin immunostaining supports the diagnosis.

Pleomorphic adenoma FNA

Pleomorphic adenoma yields biphasic epithelial and myoepithelial cells in a fibrillary chondromyxoid stroma; the stroma is a helpful diagnostic component.

Warthin tumor FNA

Warthin tumor aspirates show oncocytic epithelial cells and abundant lymphocytes, often with cystic debris; it commonly arises in the parotid gland.

Pap stain sequence

The Papanicolaou stain uses hematoxylin for nuclei, then OG-6 and EA-50 for cytoplasmic differentiation, followed by alcohol dehydration and xylene clearing.

Air-drying artifact

Air-drying before fixation causes nuclear enlargement and pseudokeratinization, which can mimic dysplasia; immediate wet fixation in 95% ethanol prevents this artifact.

CLIA screening limit

CLIA limits a cytotechnologist to examining no more than 100 gynecologic slides in a 24-hour period; workload must be documented and monitored.

Cell block utility

A cell block concentrates cells into a formalin-fixed pellet, permitting H&E review, immunohistochemistry, and special stains on the same specimen.

Specimen rejection criteria

Specimens with absent or incorrect patient identification, no fixative when required, or leaked containers may be rejected; the event is documented and recollection is requested.

Negative rescreen requirement

CLIA requires re-screening of at least 10% of negative gynecologic cytology cases by a qualified supervisor or cytotechnologist as part of quality control.

HSIL lookback review

When HSIL or carcinoma is diagnosed, prior negative gynecologic slides from the previous five years are reviewed to identify missed abnormalities.

Sensitivity formula

Sensitivity equals true positives divided by true positives plus false negatives; it measures the proportion of diseased cases correctly identified.

Specificity formula

Specificity equals true negatives divided by true negatives plus false positives; it measures the proportion of non-diseased cases correctly identified.

Cytology-histology correlation

Cytology-histology correlation compares Pap or FNA diagnoses with subsequent tissue diagnoses; discordances are reviewed to identify sampling or interpretive errors.

Formaldehyde exposure limits

OSHA sets the formaldehyde permissible exposure limit at 0.75 ppm as an 8-hour time-weighted average, with a 2 ppm short-term exposure limit over 15 minutes.

Xylene exposure limit

The OSHA permissible exposure limit for xylene is 100 ppm as an 8-hour time-weighted average; use local exhaust ventilation and appropriate PPE.

Bloodborne pathogen precautions

All clinical cytology specimens are treated as potentially infectious; use gloves, gowns, eye protection, hand hygiene, and puncture-resistant sharps containers.

Formalin waste disposal

Formalin and xylene are hazardous chemical wastes; they must be segregated, labeled, and disposed of through a licensed waste vendor, never poured down a drain.