临床检验基础脱落细胞学检查..pptVIP

临床检验基础 脱落细胞学检查 上海第二医科大学附属瑞金医院 袁勤 痰液脱落细胞学检查 肺脱落细胞学检查是早期诊断肺癌的重 要手段之一。肺癌的早期诊断可根据临 床症状、X线检查、痰液涂片检査和纤维 支气管等多方面配合进行 痰液标本采集:①痰液必须新鲜;②痰 液必须是肺部咳出。 痰液脱落细胞学检查 正常的痰涂片中可见来自口腔的鳞状上 皮细胞、纤毛柱状上皮细胞和肺泡吞噬 细胞(后两者为确定痰液来自肺及支气 管深部的标志)以及中性白细胞、淋巴 细胞、浆细胞、嗜酸性白细胞等。 痰液纤毛柱状上皮细胞 Ciliated columnar cells 纤毛柱状上皮细胞 Ciliated columnar cells Note the moderately coarse and hyperchromatic chromatin Also note the little tails where the cells were attached to the basement membrane and of course, the presence of terminal bars and cilia(oil) Goblet cells Goblet cell hyperplasia Normally, the ciliated cells far outnumber the secretory cells (by at least 5 to 1). However in asthma. for example, the goblet cells may actually outnumber the ciliated cells 痰液肺泡吞噬细胞 Alveolar macrophages in sputum Alveolar macrophages are key cells to look for in a sputum specimen. The presence of alveolar macrophages indicates that the deep lunghas been sampled dust cells 痰液肺泡吞噬细胞 Alveolar macrophages in sputum Giant Cell Histiocytes Giant cell histiocytes can be in a wide variety of pumonary disorders They can also be seen in apparently healthy people, and therefore do not necessarily indicate the presence of disease. 痰液良性病变脱落细胞 炎症病变脱落细胞:支气管炎、肺炎和肺结核 等急、慢性呼吸道炎症引起上皮细胞发生细胞 核轻度固缩退变或细胞轻度肿大 巴氏细胞( Papaniculaou cel1):因炎症刺激 造成,细胞体积较小,圆形或卵圆形,胞质深 红色,核小而圆形,致密深染,有轻度核异形, 可能是鳞状化生细胞。