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CYTOLOGICAL EXAMINATIONS

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CYTOLOGICAL EXAMINATIONS

The Cytology Department of our laboratory, possessing state-of-the-art technical equipment, is able to perform the entire range of Cytology exams available.

GYNECOLOGY

CERVICAL SMEARS (PAP TEST)

The examination that was introduced internationally with the term “PAP test” was invented by Georgios Papanikolaou (1883-1962) and was instrumental in the prevention of cervical cancer. It is a simple, painless test in which cells are taken from the vagina and the woman's cervix, they are spread on glass slides, stained and subjected to diagnostic evaluation.

By implementing the PAP test, cervical cells are detected which exhibit distortions and which in turn will eventually turn into cancer. As such it constitutes a recognized, proactive test for cervical cancer which every woman should take annually until the age of 65.

In order to achieve the most curate diagnosis a combination of techniques are used: Liquid -based Cytology and PCR- Reverse Dot blot Hybridization, a molecular technique, for investigating the genome of the human papillomavirus (HPV TEST DNA). There are two types of HPV DNA test performed:

  1. HPV screening test
  2. HPV typing test
Their difference lies in the fact that while the second test (HPV typing) detects 41 high-risk types of the virus, the first one is able to detect every high risk type of the virus that belong to a single group.

Additionally, a number of additional cytology exams are performed by our laboratory on:

SPUTUM-BRONCHSCOPIC MATERIAL:

The Sputum sample, usually collected in the morning, comes from deep expectoration or bronchoscopy and is instrumental in identifying primary and metastatic neoplasms.

BREAST PAPPILARY SECRETION – BREAST PAP TEST:

The papillary secretions of the breast, hemorrhagic ones in particular, should be submitted to cytological examination as this relatively simple (from a technical perspective) test allows the identification of neoplasias in the pores of the breasts.

FINE NEEDLE ASPIRATION BIOPSIES (FNAB):

The technique of Fine Needle Aspiration Biopsy (FNAB) is recommended and implemented in the diagnostic cytological assessment of cystic or solid tumors presented in the:

  • Thyroid gland
  • Salivary glands
  • Breast
  • Lymph nodes
  • Lungs
  • Liver
  • Pancreas
  • Kidney
  • Ovaries
  • Prostate
Fine Needle Aspiration Biopsy (FNAB, FNA, the NAB) or Fine Needle Aspiration Cytology (FNAC) is a diagnostic procedure used to examine subcutaneous (just under the skin surface) tumors or masses.

During this procedure, a thin needle is inserted in the mass with the aim of collecting a sample of cells which, after being stained, are examined under the microscope. The fine needle biopsies are classified as surgical procedures of relatively small disturbance. As such, the test is being currently widely used to diagnose cancer.

ADVANTAGES and LIMITATIONS of the FNAB test:

A Fine Needle Biopsy is much safer and far less traumatic than a biopsy performed through open surgery and the associated severe complications are rare and dependent on the area under examination. However there does exist some risk, since the sample collected through this procedure is very small (merely a few cells), which means that the problematic cells might not be included in it which can lead to a result that is falsely negative. Moreover, there exists the additional risk that the collected cells might not allow for a definitive diagnosis to be issued.

STRATEGIC MANAGEMENT OF CYTOLOGY MATERIAL – FNAB:

The CELL BLOCK technique:


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“Microdiagnostiki” differentiates itself from the competition by choosing to use the CELL BLOCK technique for every FNAB specimen collected. This means that the FNAB cytological specimen is treated in such a way that by the end of the preparatory steps it is enclosed in a paraffin cube, as is usually the case for histological material collected after a biopsy. This in turn has the following benefits:

1) The entirety of the collected material is collected, without wasting the morsels of tissue that oftentimes remain in the suction needle and with any other technique goes to waste.

2) A subsequent amount of material is secured in case follow-up testing is needed in order to glean a more accurate and clear diagnosis (immunohistochemistry)

3) Sufficient material is secured for further -molecular- testing so that if a tumor is found its genetic profile can be examined. This allows the patient to have access to a personalized treatment without having to undergo a second biopsy to have another sample collected.

By using this technique, “Microdiagnostiki” provides the collaborating doctor with maximal implementation of the sample, thus benefiting his or her patient by minimizing the necessity for a second sample collection. As such, through the use of immunohistochemistry/immunocytochemistry techniques a diagnosis is provided and, if so desired, the corresponding biomarkers are also identified.

The collection of the sample is performed without any delay by the Endocrinologists or the Radiologist, by simple palpation of the tumor, by ultrasound or tomographic (CT-MRI) guidance or endoscopically.

INTERNAL CAVITY BODILY FLUIDS

The fluids of internal bodily cavities include:
  • Preural fluid
  • Pericardial fluid
  • Ascitic fluid
  • Cerebrospinal fluid
  • Arhricular fluid
The liquid cytology sample is collected by using the FNAB technique and is subsequently submitted to the necessary preparation and diagnostic evaluation. This allows for the identification of inflamations or of protopathic and more commonly of metastatic malignant neoplasms.

URINE – BLADDER WASHOUTS

The cytological examination of 3 morning samples of urine as well as the washouts of the bladder which are collected during cystoscopy is the standard procedure to diagnose and monitor (follow-up) any neoplasias / tumors in the bladder.