inflammation-induced tissue dysplasia. This markedly hinders their use indiagnosis of neoplasia. To reduce contamination and to obtain a morerepresentative sample, touch imprints are made on freshly excised surfaces. If the excised surface is very bloody or moist, it should be blotted with absorbentpaper. Touch the slide gently to the specimen, remove and quickly air dry.Dragging of the slide across the specimen will distort the cells. Tissue rich inconnective tissue imprints poorly.
Scraping has the advantage of collecting many cells from the tissue, andtherefore, is advantageous when the lesion is firm and yields few cells.Disadvantages are similar to those described for tissue imprints. The surface of the lesion is freshly excised and scraped with a scalpel blade until materialappears on the blade's surface. This material is then smeared thinly across aslide.
Swab smears are collected only when imprints, scrapings and aspirates cannotbe made; e.g., fistulous tracts, nasal and vaginal collections. The lesion or tissueis swabbed with a moist, sterile cotton swab. Sterile isotonic fluid, such as
, should be used to moisten the swab. This helps minimize cell damageduring sample collection and smear preparation. After sample collection, theswab is gently rolled, not rubbed, along the flat surface of a clean glassmicroscope slide.
4. Fine Needle Aspirations
Fine needle aspiration biopsies can be collected from masses such as lymphnodes, nodular lesions and internal organs. Aspiration of cutaneous massesavoids the superficial contamination common with imprints or scrapings, butcollects fewer cells than scrapings. The tissue to be aspirated is immobilized asclose to the skin surface as possible.
gauge needle attached to a 3-20ml syringe is used
(a 12-ml syringe is a good all-around size)
. The softer thetissue being aspirated, the smaller the needle and syringe used. When needleslarger than 21 gauge are used, tissue cores tend to be aspirated, resulting in apoor yield of free cells suitable for cytological preparation. Also, larger needlestend to increase the incidence of blood contamination.The needle with syringe attached is introduced into the center of the mass andstrong negative pressure is applied The cell population retrieved from a mass ishighly dependent upon the site aspirated. In order to obtain a representativesample, the needle is redirected and moved to several areas in the mass, takingprecautions to prevent the needle from leaving the mass. Negative pressure ismaintained during the redirection. However, when the mass is not large enough