Clinical cytology

Abstract

Klinička citologija je dijagnostička medicinska struka koja pomoću analize citoloških uzoraka pod svjetlosnim mikroskopom prepoznaje fiziološka stanja te dijagnosticira razne benigne, premaligne i maligne patološke procese, a uključena je u dijagnostiku gotovo svih organa i organskih sustava. Kod nas je gotovo 40 godina postojala kao samostalna specijalizacija iz medicinske, a potom kliničke citologije. Od 2015. godine uveden je novi program specijalizacije koji objedinjava citologiju i patologiju, pod nazivom specijalizacija iz patologije i citologije. Citologija je od svojih početaka neraskidivo vezana s klinikom i najbolji rezultati dobivaju se u uskom kontaktu pacijenta, kliničara raznih specijalnosti i citologa. Kao minimalno invazivna i brza metoda, gotovo bez kontraindikacija i značajnih komplikacija, citologija je izuzetno atraktivna dijagnostička metoda, a citološki uzorci prikladni su i za dodatne analize (imunofenotipizacija, citogenetika, molekularna analiza). U članku je prikazana primjena citologije u dijagnostici pojedinih organskih sustava, kao i prednosti i ograničenja citološke dijagnostike i čimbenici o kojima ovisi kvaliteta citoloških nalaza. Posebnu pažnju treba posvetiti pravilnom uzimanju uzoraka i pripremi preparata, i neophodno je da svaku fazu dijagnostičkog postupka izvode primjereno educirani zdravstveni djelatnici. Citološka analiza neizostavna je dijagnostička pretraga za rano otkrivanje, dijagnostiku i praćenje prvenstveno upalnih, benignih neoplastičnih, premalignih i malignih promjena gotovo svih organa i organskih sustava.Clinical cytology is a diagnostic medical branch that by means of light microscopic analysis of cell and tissue specimens recognizes various physiological variations, benign and malignant diseases. Cytology is involved in diagnostics of virtually every organ and tissue. Cytology has been a separate specialization in Croatia for almost 40 years, at first as Medical cytology, later as Clinical cytology. In 2015 a new specialization was introduced, synthesizing cytology and pathology, and is called “specialization in pathology and cytology”. From the very beginning, cytology is closely connected to clinics, and the best results are achieved in team work of the cytologists and clinicians of different specialities, and in direct contact with the patient. As minimally invasive and rapid diagnostic method, with almost no contraindications and rare and minor potential complications, cytology is extremely attractive diagnostic method, especially considering that cytological specimens are convenient for ancillary diagnostic methods such as flow cytometric immunofenotypization, cytogenetic, molecular techniques. In this paper we discuss the role of cytology in the diagnostics of some organ systems, as well as its advantages and limitations, and factors that influence the end the result and quality of cytological findings. Particular attention should be paid to the quality of sampling, and specimen preparation techniques. It is of utmost importance that all phases of the procedure are performed by adequately educated medical staff. Cytological analysis is an indispensable diagnostic procedure for early detection, diagnosis and follow-up of various, especially inflammatory, benign, premalignant and malignant conditions in various organs and organ systems