A preliminary diagnosis is often provided, but it should be emphasized that this is only a preliminary interpretation. Final diagnosis involves examination of the whole sample, including cell block and possible ancillary testing. The sample adequacy depends on the nature of the lesion sampled, and the experience of the aspirator – sometimes only two to three needle passes may be PD0332991 supplier adequate to appropriately aspirate the target lesion. The advantages

of rapid on-site evaluation are a decrease in procedure time, less inadequate/non diagnostic specimens and diminished repeat interventional Inhibitors,research,lifescience,medical procedures (11). The assessment should be as confident and accurate as the sample permits. Slide preparation and staining Prepare smears rapidly. This is optimal if smears are prepared by trained professionals. Half of the slides may be stained for immediate assessment, the remainder quickly placed in 95% ethyl alcohol for later Papanicolaou

staining. Needles should be rinsed in liquid medium for cell block preparation. This permits Inhibitors,research,lifescience,medical histologic assessment and special stains to be performed, if necessary. Extra smears may also be saved for possible immunochemistry. Pathologists should use the rapid stain with which they are most confident: (I) Romanowsky stain requires air dried smears – cell size and stromal components are better defined, however nuclear morphology is Inhibitors,research,lifescience,medical limited. (II) Rapid Papanicolaou stain – provides greater nuclear detail, ability to focus through thicker smears and overlapping cell groups. (III) Toluidine Blue stain – This is ultra fast, but requires subsequent destaining and restaining with

a permanent stain. (IV) Hematoxylin and eosin Inhibitors,research,lifescience,medical – Requires rapid fixation and is more time consuming. However many non cytopathology subspecialty trained pathologists are familiar and more comfortable using this staining Inhibitors,research,lifescience,medical method. Cells of the pancreas The pancreas consists predominantly of the exocrine pancreatic acinar and ductal cells, and a smaller endocrine component consisting of the islets of Langerhans and scattered neuroendocrine Kulchitsky cells in the ducts. Exocrine tissue Serous acinar cells These comprise 80% of the cellularity of the normal pancreas. They are pyramidal, polygonal shaped cells Suplatast tosilate in small cohesive raspberry-like groups. Single serous acinar cells may be seen with aggressive smearing, similar to islet cell tumors. There are indistinct cell borders between cells, but margins of a group of cells are well defined. There is abundant cytoplasm containing coarse zymogen granules. The nucleus is eccentric, may be binucleated, small, round, and uniform (about the size of a red blood cell). Bare nuclei are common. Nuclear membranes are smooth, and there is granular, evenly distributed chromatin, with a prominent nucleolus. Excretory ductal cells This is a minor component in aspirates of normal pancreas.