Have you ever heard of a 'Pap smear'? Or have you ever heard of a small lump on your neck, and the doctor took a small sample of it with a fine needle and sent it for 'testing'? That's what we're going to talk about today, which is called cytology. Although it may seem like a small thing at first glance, this is a very valuable test that helps detect diseases in our body early. Let's talk about it simply.
What is Cytology in simple terms?
Simply put, cytology is the process of looking at the cells in our bodies under a microscope to diagnose diseases. It's like being a detective. A specialist, called a pathologist, looks at the cells in a very small sample of fluid or tissue taken from your body.
He mainly looks for any abnormal changes in these cells. These changes may be a sign of cancer . Or they may be a precancerous condition that has the potential to become cancer . Not only that, this test is also used to detect infections such as bacteria, parasites, fungi, or viruses.
Why would a doctor order a test like this?
There are several main reasons why your doctor may recommend a cytology test.
- As a screening and diagnostic test for cancer: This test can help detect some types of cancer before symptoms appear. It is also important to confirm whether a lump or abnormality is cancerous or not.
- To diagnose infectious diseases: This is used to find out which microorganism has caused an infection somewhere in the body.
- To identify inflammatory conditions: This test also helps to identify certain inflammatory conditions in the body, such as sarcoidosis.
What are the different methods for testing these cells?
These cytology tests can be divided into three main types, depending on how the doctor takes a sample of cells from you. Let's look at this in a simple way to understand it.
| Test type | How to obtain cells | Examples |
|---|---|---|
| Exfoliative Cytology | Examination of cells that are naturally shed or secreted by the body. These are found in body fluids. | - Urine cytology - Phlegm - Discharge from the eyes, vagina, or nipples - Cerebrospinal fluid in the brain and spinal cord - Fluid around the lungs, heart, or abdominal cavity |
| Abrasive Cytology | The cells are obtained by scraping or wiping them using a device. Sometimes, the cells are also washed using a liquid. | - Pap smear: This is the most common type of cervical smear. - During a bronchoscopy: To wash or brush cells from the airways or lungs. - During an endoscopy: Taking cells from areas such as the esophagus and stomach. - Scraping skin cells from blisters or wounds. |
| Intervention / Aspiration Cytology (FNA) | Using a very fine needle to puncture the skin and remove fluid containing cells from a lump or tumor. This is called Fine-Needle Aspiration (FNA) . | - Enlarged lymph nodes in the neck and armpits - Thyroid nodules - Breast lumps - Salivary masses |
How is a cell test done?
Okay, now let's see how this whole process works. There are several steps to this.
1. Taking the sample: First, your doctor will take a sample of cells from your body using the appropriate method (such as scraping, washing, or aspiration with a needle).
2. Sending to the lab: Next, this sample is either smeared on a glass slide or placed in a small bottle and sent to the lab.
3. Preparing the sample: In the lab, a cytopreparatory technologist prepares the sample for testing. Here, different dyes are applied to make the cells more visible. This is called 'staining'.
4. Microscopic examination: Now comes the most important part. A cytologist and a pathologist look at this prepared sample under a microscope. They examine the shape of the cells, their size, the way the cells are packed together, the nature of the nucleus, and many other things. They look for any unusual changes or the presence of infectious microorganisms.
5. Preparing the report: Finally, the pathologist creates a complete report including what he or she saw and the diagnosis. This report is what your doctor receives.
What happens before and after the test?
Most of the time, no special preparation is required for a cytology test. However, some tests (for example, if a sample is taken through an endoscopy) may require specific instructions. So it's best to ask your doctor if there's anything special you need to do before the test.
After the examination, when your doctor receives the pathologist's report, he or she will discuss the results with you and decide what to do next.
What are the advantages of a cell test? How is it different from a biopsy?
Cell tests have several major advantages, especially when compared to another testing method, a biopsy.
- A very small sample is sufficient for this.
- It is less painful than a biopsy.
- The invasiveness to the body is very low .
- The risk of complications is very low .
Difference between Cytology and Biopsy: Think of cytology as taking a piece of brick that has fallen off a brick wall and examining it. All we can see is what the brick looks like. A biopsy is taking a small piece of the wall and examining how the bricks and mortar all fit together. That is, in cytology, we look at individual cells or clusters of cells. In a biopsy, we examine the structure of an entire piece of tissue.
What is the meaning of the report received?
The results you receive will depend on the reason for the test and the part of the body from which the sample was taken. Typical results include:
| Nature of the result | Simple meaning |
|---|---|
| Normal / Negative | It means that no abnormalities or cancer cells were found in the cells examined. If an infection was found, it means that there was no infection. |
| Undetermined / Unsatisfactory | This means that there were not enough cells in the sample to reach a clear conclusion. The test may need to be repeated. |
| Abnormal / Positive | It means that the cells look different from normal cells. But this does not necessarily mean that you have cancer. It could be an infection or some other minor change. The report may include words like dysplasia, hyperplasia, or metaplasia. Your doctor will explain this. |
What happens next if the result is abnormal?
Don't panic if the result is abnormal. Your doctor will decide what to do next based on the nature of the abnormality. He or she may order other tests, such as a biopsy, or may recommend starting treatment. The most important thing is to talk to your doctor about it and follow his or her instructions.
Take-Home Message
- Cytology is a simple, safe, and painless test that examines the body's cells to diagnose diseases.
- This is a great help in early detection of cancer and various infections.
- The Pap smear, the most commonly performed test among women, is also a type of cytology test.
- If your test results are 'abnormal', it doesn't always mean you have cancer. So don't worry.
- If you have any questions or doubts about the test or the results, discuss them openly with your doctor.
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