Clínic Barcelona. Hospital Universitari

Pathology

Cytology

In the Cytology Section, we perform cell morphology diagnosis based on the microscopic characteristics of the cells and extracellular components present in various biological samples.
Our activity is focused on:

  • Diagnosing and typing malignant tumors
  • Selecting high-risk patients that should be meticulously studied for a specific type of cancer
  • Specific diagnosis of benign lesions, such as benign tumors, hyperplasia, inflammatory processes, and viral or fungal infections.
  • In 2009, we carried out nearly 25 000 cytologies, more than half of which were for gynecological specimens.

Advantages and limitations of cytologic examination

As compared to biopsy, collecting cytologic samples is easier, less costly, and less invasive. Sample processing is also simpler and turnaround time is faster. Furthermore, cytologic samples encompass wider areas than biopsy samples. Cytology often enables detection of lesions that are not visible microscopically. This is the case of peritoneal lavage study, cervical-vaginal cytologies, and studies of pleural effusion or ascites. The limitations are related to the inability to directly evaluate the architecture of the lesions. Therefore, cytology is an initial screening and diagnostic technique associated with a good benefit-to-cost ratio for patient care.

Obtaining biological samples

Samples are obtained by fine-needle aspiration (FNA) puncture of lesions localized by palpation or under imaging guidance, by collection of fluids, and by exfoliative cytology; that is, collection of material that spontaneously detaches or is recovered from the surfaces of organs. This procedure is less invasive than those used to obtain biopsies.
FNA of palpable masses is performed by specialists in the Sample Extraction Center on appointment. Following puncture and aspiration, the cell preparations are microscopically assessed in situ to evaluate the quality of the sample and to properly manage the material obtained.

Techniques


In addition to conventional cytology studies and implementation of liquid-based cytology, we also use the biological analysis techniques inherent to highly specialized laboratories:

  • Immunohistochemical techniques are applied to cell blocs and cell preparations for daily clinical diagnosis.
  • Flow cytometry enables characterization of lymphocyte subpopulations and is appropriate for use in patients with suspected lymphoproliferative syndromes.
  • FISH and molecular biology techniques are used to identify specific genetic abnormalities that are important for patient diagnosis and treatment, achieved through the integrated, multidisciplinary functioning of the Department.
  • Determination of human papillomavirus (HPV) high-risk serotypes by hybrid capture, a molecular technique that directly identifies HPV nucleic acids. 
     

Teaching

The Section organizes weekly seminars in Hospital Clínic de Barcelona (30 teaching hours per year) on Wednesday or Friday from 8.30 a.m. to 9.30 a.m., which are accredited by the Catalan Council of Continuing Medical Education

Team

Llúcia Alós (Head of Section)

Llúcia Alós

Head of Section

Section of Cytology

Head of Department

Biomedical Diagnostic Center (CDB)

Villarroel, 170 · 08036 Barcelona
Tel: +34 93 227 54 64 · Fax: +34 93 227 98 75 · · www.hospitalclinic.org