Cytology

Question 1

the body fluid most commonly sampled for cytology is..

Answer 1

venous blood

Question 2

cells may be mechanically removed for cytology by what methods?

Answer 2

aspirates
scrapes
washing

Question 3

when analyzing a fluid, you measure total protein by…

Answer 3

refractometry

Question 4

why do pure transudates form?

Answer 4

due to hypoalbuminemia

Question 5

why do modified transudates form?

Answer 5

due to impaired blood or lymph

-obstructing tumor example

Question 6

why do exudates form?

Answer 6

due to increased capillary permeability –> excess cytokines

Question 7

compare and contrast transudate vs. exudate

Answer 7

transudate: clear appearance, total protein 3 g/dL, NCC >6000/uL, clot formation = YES

Question 8

If you suspect a chylous effusion, what test would you like to run?

Answer 8

triglyceride measurement

Question 9

If you suspect a ruptured bile duct/bile leakage, what test would you like to run?

Answer 9

bilirubin measurement

Question 10

if you suspect uroabdomen, what test would you like to run?

Answer 10

creatinine measurement

Question 11

When taking an aspirate on a cat, what do you want to avoid? Want to remain anterior to the _____.

Answer 11

avoid the heart and liver when aspirating

remain anterior to the liver!

Question 12

If you need fluid from the thoracic cavity, what do you ask your tech. to bring you and why?

Answer 12

a catheter (it’s better than a needle) to avoid pneumothorax

Question 13

Aspiration biopsies are performed using (what gauge needle and what mL syringe) and are useful for obtaining cells from…

Answer 13

Aspirates are performed using 21-25 gauge needles and a 12 mL syringe.
Useful for obtaining cells from masses, internal organs, and lymph nodes

Question 14

advantages of the capillary method when obtaining an aspirate include..

Answer 14

less hemodilution of a sample and increased cellularity

Question 15

What are the slide prep. techniques?

Answer 15

push films
“line” films
pull films
cytospin preps

Question 16

Push Films are similar to blood films, what are the advantages/disadvantages of push films?

Answer 16

big cells at the edge - advantage

cells broken at the edge - disadvantage

Question 17

How do you perform a pull film? Advantages/Disadvantages?

Answer 17

place a drop of fluid on slide, place another slide on top, allow drop to spread, pull slides gently apart

Adv.- cells nicely spread out
DisAdv. - no concentration of big cells

Question 18

What is the deal with the cytospin preps?

Answer 18

concentrates cells nicely especially for CSF

it is very expensive

Question 19

bacteria stain ____ with Wright’s stain and are easier to visualize than with Gram Stain; but when bacteria die Gram+ may appear as _____

Answer 19

bacteria stain BLUE w/ wright’s and are easier to visualize than w/ Gram; but when bacteria die Gram+ may appear as Gram -

Question 20

What is the only disadvantage of Diff Quik, Quick Dip stain?

Answer 20

may not stain mast cell granules

Question 21

scrapings are useful for obtaining cells from…what tools do you use?

Answer 21

firm surfaces
Ex:conjunctival scrapings & firm cutaneous lesions

Use scalpel blades or spatulas

Question 22

swabs are used to obtain cells from…

Answer 22

mucosal surfaces (vagina, rectum, nose)

Question 23

what are imprints?

Answer 23

made of superficial cutaneous lesions or from tissues removed at surgery or necropsy

may be diagnostic but only reflect surface inflammation and contamination

Question 24

Suppurative inflammation is AKA ________

What cells predominate?

Answer 24

Suppurative Inflamm. is AKA Neutrophilic

Neutrophils predominate

Question 25

Mixed Inflammation means you see what cells?

Answer 25

segs, lymphs, macs, maybe eos

Question 26

Mononuclear Inflammation has _________________ cells predominately.

Answer 26

mononuclear inflammation has macrophages and lymphocytes predominately

Question 27

Why are transitional epithelial cells on a cytology misleading?

Answer 27

they appear malignant bc they divide rapidly and exhibit malignant features BUT they are BENIGN

Question 28

In body cavity effusions, what cells are often confused as carcinoma cells?

Answer 28

Mesothelial cells

Question 29

Successful cytology is only when cells are ________ thick and not _____.

Answer 29

successful cytology is only when cells are 1 layer thick and not broken

Question 30

When are you most likely to get a thick preparation?

Answer 30

lymph nodes, bone marrow, and mass aspirates are thick | squirt preps are thick

Question 31

In general, the more inflammatory cells that are present, the less likely it is that the lesion is _________. The exception to this is...?

Answer 31

The more inflammatory cells that are present, the less likely it is that the lesion is NEOPLASTIC. The exception = SCC which elicits an inflammatory response.

Question 32

In septic inflammatory lesions, neutrophils undergo rapid degeneration and eventual rupture through a process called karyolysis. If you see karyolysis, you should look hard for....

Answer 32

bacteria in the cytoplasm of the neutrophils | stain blue with Wright's stain

Question 33

Plasma cells are most commonly seen in ______________ and indicate antibody production as a result of _____________.

Answer 33

plasma cells are most commonly seen in chronic inflammatory lesions and indicate antibody production as a result of antigenic stimulation

Question 34

Eosinophils are present in cytologies when...

Answer 34

allergic responses occur | present in large numbers with mast cell tumors

Question 35

What are almost always the predominate cell type in aspirates of mast cell tumors?

Answer 35

mast cells

Question 36

In a pt. w/ enterocentesis or septic peritonitis, describe what leukogram you expect...

Answer 36

inflammatory leukogram and likely neutropenia w/ a left shift

Question 37

most bacteria are phagocytized by neutrophils. what is the exception?

Answer 37

mycobacteria - phagocytized by macrophages

Question 38

What is the criteria of malignancy?

Answer 38

variable nuclear size (anisokaryosis) large multiple nuclei abnormal mitoses nuclear molding

Question 39

what cell types do you encounter in neoplastic effusions?

Answer 39

lymphoblasts | carcinoma cells

Question 40

``` 3yo cat presents with abdominal effusion and dyspnea. T Pro 5.5 g/dL NCC 8900/uL 40% neutrophils 20% lymphocytes 40% lrg. mononuclear cells ``` What is your diagnosis?

Answer 40

FIP! Cats with high protein and relatively low cell concentrations = FIP!!!

Question 41

2yo cat with acute anorexia, weight loss and dyspnea. T Pro 3.6 g/dL NCC 15,700/uL Small Lymphocytes on Histo. What test do you want to run?

Answer 41

Test - cholesterol: triglyceride ratio

Question 42

If chylous effusion is prolonged, you expect to see....

Answer 42

inflammatory cells - neutrophils and macrophages

Question 43

2yo cat with acute anorexia, weight loss and dyspnea. T Pro 3.6 g/dL NCC 15,700/uL ``` Small Lymphocytes on Histo. cholesterol: triglyceride ratio = TP 5g/dL NCC 9000/uL fluid triglyceride concentration > than that of serum ``` Does the cholesterol: triglyceride ratio confirm the presence of chyle? If an animal is eating, where do you expect to find chyle? Diagnosis?

Answer 43

Chyle presence confirmed If an animal is eating, you expect to find chyle in the triglycerides. Diagnosis : chylous effusion

Question 44

Chylous effusion...what cells? What if it is secondary to lymphoma?

Answer 44

acute - small lymphocytes prolonged - inflammatory cells (neuts and macs) if chylous effusion is secondary to lymphoma, lymphoblasts are normally present

Question 45

``` 8yo German Shepherd with acute weakness, enlarged abdomen, pale MMs and dyspnea. CBC PCV - 18% TP - 5.8 g/dL Abdominal fluid analysis Red, cloudy TP - 6 g/dL NCC - 10000/uL PCV - 24% ``` Histo: Macrophages that have phagocytized erythrocytes and contain hemosiderin. You convince the owner that you need to perform exploratory surgery and take an imprint from a mass on the liver. The imprint shows spindle shaped sarcoma cells. Diagnosis?

Answer 45

Hemangiosarcoma of the spleen and liver that ruptured, resulting in hemoabdomen. Remove the spleen and liver lobe.