Cytological examination of the stomach. Gastrograms

In a cytological study of the material obtained from the stomach using gastrobiopsy , the cellular elements of the gastric mucosa are clearly determined in the preparations: the integumentary-pit epithelium, the main and parietal cells of the glands.

The ratio in cytological preparations of cellular elements of the gastric mucosa, varying degrees of their differentiation, the appearance of signs of degeneration and atypia , as well as the appearance of leukocytes, reticular and histioid elements, make it possible to identify types of gastrocytograms . which are most characteristic of one or another disease of the stomach.

Gastrocytograms of patients with chronic gastritis are characterized by the presence of cells of the integumentary pit epithelium, which are located mainly in small layers and clusters. Cells have a high- and low- cylindrical shape, a basal or centrally located nucleus. broad, weakly basophilic cytoplasm. The cell nuclei are distinguished by some polymorphism; there are all transitions from immature, relatively large, light chromatin with a delicately reticulated pattern to mature, small, intensely stained nuclei.

The main and parietal cells of the glands are found in varying numbers, arranged separately, in small rounded groups or even rows, in which the correct alternation of the main and parietal cells is noted. In the main cells, coarse granules stained in blue-violet color are clearly visible, filling the entire cytoplasm. The parietal cells are distinguished by a wide light cytoplasm, stained in a pale pink color. The preparations contain lymphoid elements and polymorphonuclear neutrophilic leukocytes.

cytological examination of the stomach

In cytograms with polyps of the stomach, a large number of layers and large accumulations of the integumentary-pit epithelium, glandular-like structures are found. Compared with cytograms in gastritis, one can note the predominance of young, immature cells with enlarged nuclei and a delicate pattern of chromatin in them.

In case of gastric ulcer, segmentonuclear neutrophils predominate in gastrocytograms , in addition, lymphocytes, plasma cells, eosinophils, histioid tin cells , and accumulations of polymorphic epithelial cells are found in a significant amount. In the epithelium, signs of degeneration are usually noted in the form of vacuolization of the cytoplasm and nuclei, karyolysis , karyorrhexis and plasmolysis.

However, it should be noted that it is far from always possible to diagnose these diseases during a cytological examination of the material in non-tumor and tumor-like lesions of the stomach. The latter depends on the fact that the changes in the cells are of the same type and it is often possible to discuss only the degree of cell proliferation, attenuation , and reorganization of the epithelium according to the intestinal type.

Of the malignant neoplasms in the stomach, the most common adenocarcinoma is three types of adeocarcinoma with a high and low degree of differentiation, as well as adenocarcinoma with pronounced mucus formation . Less common are ring cell and undifferentiated cancers, as well as other non-epithelial tumors.

Cytograms of patients with gastric cancer are characterized by the presence of cells with morphological signs of malignancy. Cells are located in complexes, in the form of glandular-like or papillary structures, scattered. In complexes and structures, a disorderly heaping of nuclei is noted. Large cells. Nuclei occupy almost the entire cell, predominantly irregular in shape, hyperchromic with coarse, unevenly distributed chromatin, and hypertrophied multiple nucleoliamni .

It is not always possible to establish the histological form of the tumor; it is more often possible in cases of adenocarcinoma, where, as a rule, glandular-like structures are found. Colloidal cancer is characterized by the presence of a large number of mucous masses and cricoid tumor cells . In poorly differentiated cancer, cells are sharply anaplastic , with a large number of fission figures, usually scattered.

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