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Clinics! > Cytology (FNA) > Flashcards

Cytology (FNA) Flashcards

1
Q

Describe the cytologic features of epithelial cells.

A

Cohesive clusters of sheets.
*Distinct borders
round/oval/polygonal cells
can be acinar/glandular

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2
Q

Which epithelial neoplasms require histopath to determine malignancy?

A

Mammary

Hepatocellular (Circumanal gland adenoma v. carcinoma)

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3
Q

Most common epithelial tumor in dog?

A

Adnexal (includes epithelioma, trichoblastoma, sebaceous adenoma)

(But technically MCT is most common?)

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4
Q

most common route for metastatic spread of epithelial tumors?

A

lymphatics

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5
Q

two types of perianal neoplasms? How do they differ cytologically and in malignancy?

A
  1. Circumanal gland (or hepatoid) - looks epithelial

2. Anal sac apocrine gland (AGASACA) - looks neuroendocrine

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6
Q

common paraneoplastic syndrome associated with AGASACA?

A

Hypercalcemia of malignancy

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7
Q

cytologic features of neuroendocrine tumors?

A

high N:C
uniform nuclei
cells appear lysed/indistinct borders (unless handled very carefully)

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8
Q

How to determine biological behavior of a neuroendocrine neoplasm?

A

Histopath

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9
Q

Tumors with vacuolization

A

Epithelial: sebaceous
Neuroendocrine: insulinoma, adrenal

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10
Q

Defining features of thyroid neoplasms?

A
  1. neuroendocrine

2. Colloid(pink) and tyrosine granules(purple granules)

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11
Q

species with functional thyroid tumors?

A

cats

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12
Q

breeds with nonchromaffin chemoreceptor tumors?

A

heartbase(aortic body tumors)

Brachycephalic (boxer, boston terrier)

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13
Q

often incidental neuroendocrine tumor?

A

Pheochromocytoma

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14
Q

Tumor often seen with other concurrent neoplasms?

A

Pheochromocytoma

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15
Q

What are follicular cysts composed of?

When does it becomes inflamed?

A
  • keratinized cells, amorphous material, cholesterol crystals.
  • when ruptures (leads to self trauma/pyoderma)
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16
Q

Pigment seen with hemorrhage

A

hemosiderin, hematoidin

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17
Q

What are degenerative changes? (What part of the cell and where to they occur?) What are the implications of degenerative changes?Can they be artifact?

A

Nuclear changes that occur in the tissues
(toxic changes affect the cytoplasm and occur in the marrow)
- karyolysis can happen if in tube too long (ARTIFACT)
- karyorrhexis and pyknosis can happen with normal cell death or bacterial

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18
Q

8 criteria for malignancy

A 
anisokaryosis
pleomorphism
high/variable N:C(not for round)
mitotic figures
prominent nuclei
coarse chromatic
nuclear molding
multinucleation
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19
Q

Why use cautian when interpretting mixed cell populations?

A

neutrophils make cells look atypical;

reactive hyperplasia mimics malignancy

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20
Q

Cytology in reactive lymphoid hyperplasia

A

small cells predominate

increased intermediate/large cells but not over 20%. Plasma cells, neuts, eos, phages due to Ag stimulation.

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21
Q

cytology in lymphadenitis

A 
increased neuts/eos/phages. 
Neutrophillic if >5% neuts
Eosinophilic if over >3% 
Or Pyogran
look for bacteria, fungi, protozoa
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22
Q

cytology in lymphoma of peripheral lymph node

A

suspicious when >30% are blasts. 50-90% usually on clinical presentation

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23
Q

metastatic neoplasia to LN

A

cells not normally seen, usually with malignant characteristics. Easy to miss early disease

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24
Q

Signalment and important clinical findings of Feline Hodgkins-like lymphoma

A
  • Adults with enlarged nodes in neck, then works it way to the nodes in the chest and so on.
  • (mixed enlargement on cytology, with mirrored nuclei)
  • good prognosis when nodes removed
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25
Q

Signalment of Distinctive perif lymphoid hyperplasia (DPLH) of cats

A

young cats <2yrs
with peripheral lymphadenomegaly

(mimics multicentric lymphoma)

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26
Q

Signalment of cats with small cell lymphoma

A 
Old cats (often geriatric)
FeLV negative
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27
Q

Multiple Nodes with Reactive lymphoid hyperplasia implies what?

A

non-specific

Ag stimulation with many etiologies

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28
Q

Lymphoglandular body

A

basophilic cytoplasmic fragments

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29
Q

tests to determine lymphoma phenotype

A

Flow is best
also IHC/ICC

(PARR determine if lymphoma or reactive [clonality] )

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30
Q

Which conditions are associated with false positive PARR

A

chronic Ag stimulation (like ehrlichia)

false negatives are more common

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31
Q

Test to diagnose feline hodgkin’s like lymphoma

A

IHC

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32
Q

3 types of feline alimentary lymphoma

A

small cell
large granular (Cytotoxic T cell)
large B cell

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33
Q

Which alimentary lymphoma may present as a mass (of colon/stomach)

A

Large B cell

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34
Q

lymphocytic IBD is hard to differentiate from what on GI cytology and histology?

A

small cell alimentary lymphoma

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35
Q

Which is worse t or b cell

A

T cell lymphoma

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36
Q

which substage of lymphoma has a better prognosis?

A

A, its subclinical

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37
Q

which phenotype of lymphoma is associated with hyper Ca more commonly

A

T cell

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38
Q

What is PARR used for?

A

Determining if neoplastic or not. monoclonal v. polyclonal.

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39
Q

What is Flow used for?

A

phenotype. B v. T cell

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40
Q

Differentials for benign and neoplastic lymphoid proliferation:

  1. LGL in circulation
  2. Lymphocyte rich fluid with mediastinal mass
  3. lymphoblasts predominate splenic aspirate
  4. expanded small lymphocytes in GI
A
  1. ehrlichia v. Leukemia
  2. chyloud effusion v. small lymphoma or thymoma
  3. aspirating germinal center of lymphoid follicle vs. lymphoma
  4. IBD v. small lymphoma
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41
Q

Is the thymus able to be aspirated in adult animals

A

no

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42
Q

mast cells are present in ____ numbers in the thymus

A

moderate

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43
Q

paraneoplastic syndromes associated with thymic neoplasia

A

hyper Ca
megaesophagus
myasthenia gravis

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44
Q

Which biopsy is more representative of hepatic architecture?

A

wedge biopsy (needed to diagnose hepatitis/cirrosis, fibrosis, portovascular anomaly)

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45
Q

Blind FNA can yield diagnostic samples for which diseases?

A

diffuse diseases:

  • hepatic lipidosis
  • vacuolar hepatopathy
  • lymphoma
  • neutrophilic hepatitis
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46
Q

why use ultrasound guided FNA of focal hepatic lesions?

A

distinguish inflammatory, hyperplastic, and neoplastic (may not be possible with FNA alone)
- good screening tool before getting a biopsy

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47
Q

What is the significance of nuclear crystals in hepatic cytology?

A

Nothing (they can in the kidney too though)

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48
Q

When can hepatocellular binucleation be observed?

A

normally, and with hyperplasia

49
Q

2 types of hepatocellular vacuolar degeneration and why do each occur?

A

distinct (fat / hepatic lipidosis)

indistinct = rarifaction (glycogen or water accumulation)

50
Q

What type of vacuolar degeneration is more common in cats? in dogs?

A

cats - distinct

dogs - indistinct

51
Q

What liver pigments are most commonly observed?

A

bile (from cholestasis)
lipofuschin (wear and tear)
hemosiderin (hemorrhage, iron breakdown)
Cu (certain breeds)

52
Q

What are bile casts? When do they occur?

A

Cholestasis. when bile backs up

53
Q

Can you differentiate hepatitis and cholangitis on cytology?

A

no need histology

both have a normal sized liver and low number of lymphocytes

54
Q

what type of inflammation in the liver is cytology sensitive to?

A

neutrophillic and macrophage inflammation

55
Q

nodular hyperplasia v. hepatocellular regeneration

A

nodular hyperplasia is normal in older dogs, no clinical signs, cytology has vacuolar degeneration, bile, lipofuscin, and EMH.

vs. Regeneration is chronic, also vacuolar degeneration, bile and bile CASTS, clumped FIBROBLASTS
- cant always tell difference on cytology

56
Q

metastatic rates of hepatocellular carcinoma

A
  1. diffuse 100% (more aggressive)
  2. nodular 90% (more aggressive)
  3. Massive 5-35%
57
Q

most common hepatic neoplasia?

A

metastatic lymphoma

58
Q

most common primary hepatic tumor in DOGS and its site predilection

A

hepatocellular carcinoma - massive form

59
Q

Most common primary hepatic tumor in cats

A

bile duct carcinoma

60
Q

Which tube do you use for cytology and culture of cavitary effusions?

A

cytology - EDTA

Culture - Red Top

61
Q

most common clinical sign of severe effusion

A

dyspnea

62
Q

If there is delay is processing a fluid sample (transport >30 minutes) What should you do?

A

make a (direct smear) slide at time of collection, and keep the fluid refrigerated

63
Q

What is the predominate cell type in normal cavity fluid of dogs and cats?

A

mononuclear cells (macrophages)

64
Q

What is the predominate cell type in normal cavity fluid of horses?

A

mature neutrophils

65
Q

How to classify types of cavity effusions?

A
  1. Transudate - (Low, Low) TP <2.5, <1,500 cells
  2. Modified Transudate - (Intermediate) TP ABOVE 2.5, 1,000-7,000 cells
  3. Nonseptic exudate - (High, High) TP >3, >5,000 cells (NEUTROPHILS)
  4. Septic exudate - “” “” with intracellular bacteria
  5. Chylous - variable TP, cells, LYMPHOCYTES
  6. Hemorrhagic - Erythrophagia, hemosiderin
  7. Neoplastic
66
Q

Horses have ____ cell counts in cavity effusions

A

higher

67
Q

How do transudates form and what are some clinical conditions that would cause it?

A
  • Reduced oncotic pressure, increased hydrostatic pressure.

- Liver disease, Intestinal disease(Maldigestion, PLE), Renal (PLN), Iatrogenic

68
Q

Which biochemical test is used to diagnose chylous effusion?

A

triglycerides, 100 mg/dL

69
Q

How do exudates form and what are some clinical conditions that would cause it?

A
  • increased vascular permeability and inflammation
  • Septic exudate: Wounds, GI perforation, abscessed organs, iatrogenic
  • Non-Septic: long standing mod transudate, peritonitis (uroperitoneum, bile), FIP, FB, Neoplasia, pancreatitis
70
Q

What must be present to diagnose a septic exudate?

A

degenerate neutrophils

intracellular organisms

71
Q

Distinguish true hemorrhage from iatrogenic blood contamination in an effusion

A

Hemorrhage - phagocytized RBCs, hemosiderin (chronic)

Iatrogenic - platelets present

72
Q

most common neoplastic effusions?

A 
lymphoma
carcinoma
hemangiosarcoma
mesothelioma (binucleated) 
visceral MCT
73
Q

How to classify synovial fluid?

A

inflammatory - neutrophils

noninflammatory - mononuclear (in increased number)

74
Q

causes of decreased synovial fluid viscosity

A
  • breakdown by proteases
  • dilution (plasma fluid influx, lavage, injections)
  • synovium damage
75
Q

What is the cytologic appearance and predominant cell type in

  1. normal fluid
  2. non inflammatory joint disease
  3. inflam joint disease
A
  1. pink background(dense granular eosinophilic background) mononuclear cells predominate, neutrophils <10%
  2. too many mononuclear cells, or extremely reactive
  3. neutrophils predominate
76
Q

normal protein in joint fluid

A

> 2.5

77
Q

differentials for noninflammatory joint fluid

A

DJD!!!

Trauma, hemarthrosis, neoplasia

78
Q

how to diagnose DJD

A

need radiographs!!!

joint fluid is non-inflammatory, diagnosis often doesn’t include fluid sample

79
Q

What joint is usually affected in dogs with lymphoplasmacytic synovitis and with what orthopedic finding is it associated?

A

stifle, ligament pathology (CCL rupture)

80
Q

Reactive Polyarthritis (ex. ehrlichia infection)

A

immune complexes get stuck in capillarys -> joints -> inflammation and tissues destruction

81
Q

types of inflammatory neutrophilic joint inflammation?

A

infectious
immunologic
nonimmunologic

82
Q

most common inflammatory joint disease in dogs?

A

immunologic nonerosive idiopathic polyarthropathy

83
Q

erosive immunologic inflammatory arthropathy

A

**idiopathic (Rhuematoid)
or greyhounds(EPG)
or Feline chronic progressive (FCPP)

84
Q

The RF test

A

not very useful in diagnosing rhuematoid arthritis (Idiopathic erosive)

85
Q

Most common inflammatory joint disease in cats and what is its etiology?

A

Feline chronic progressive polyarthropathy

  • male cats
  • Viral associated, immune complexes lead to neutrophilic infiltration
86
Q

most common inflammatory joint disease of large animals

A

Septic Arthritis

87
Q

Respiratory washes are typically most useful for what type of infiltrate?

A

peribronchial infiltrate (bronchiolar/alveolar)

88
Q

What is the preferred additive for preserving respiratory wash samples during transport (>24h)?

A

add serum (4 drops per mL of BAL) or EDTA

89
Q

differentials for neutrophilic TTW

A

nonseptic: irritation/necrosis, ARDS, inflam airway in horses
Septic: bact, fungal, viral, nematode

90
Q

differentials for Mixed TTW

A

chronic inflammation or infection/FB. Bronchitis in dogs, heaves in horses, lipid pneumonia

91
Q

differentials for Eosinophilic TTW

A

allergy hypersensitivity, parasite migration, eos bronchopneumopathy, lymphomatoid granulomatosis, heaves

92
Q

differentials for hemorrhagic TTW

A

**Exercise induced pulmonary hemorrhage, asthma, trauma, coagopathies, thromboembolic disease, neoplasia

93
Q

common tumors of eyelids?

A

meibomian gland adenoma

sebaceous epithelioma

94
Q

species affected by ocular chlamydiosis

A

cats, horses, guinni pigs

95
Q

viral conjunctivitis affects which species? and causes what type of inflammation?

A

cats, dogs, horses

lymphoplasmocytic in acute stages and neutrophilic when chronic

96
Q

Eosinophilic conjunctivitis/keratitis affects which species?
What cells are present?

A

cats
horses

mast cells infiltrate with eosinophils

97
Q

which species are more commonly affected by squamous cell carcinoma of the cornea?

A

horse and cow

98
Q

Normal leukocyte on CSF

A

<5

99
Q

T or F
CNS ds causes consistent changes to CSF that are reproducible from animal to animal, and correspond to cause and severity of disease

A

false

100
Q

When is there a increased protein concentration with normal leukocyte count?

A

= albuminocytologic disocciation

- lesions that obstruct CSF flow, damage BBB, localized damage

101
Q

When is there increased neutrophils with normal leukocyte count

A
  • early/mild inflammatory ds
  • lesions don’t involve meninges
  • blood contamination
  • steroids
102
Q

Which diseases cause types of pleocytosis?

  • Neutrophilic
  • lymphocytic
  • eosinophilic
  • mixed
A
  • Neutrophilic: bacterial, acute alphaviral (EEE), GME, meningioma, SRMA
  • lymphocytic: viral, necrotizing, nonsuppurative meningoencephalitis, feline polioencephalomyelitis
  • eosinophilic: aberrant parasites
  • mixed: GME, chronic FIP
103
Q

In which situations would you prefer a AO vs. LS CSF tap?

A

sample distal to a lesion

LS if there’s a T3-L3 ruptured disk

104
Q

route of spread for mesenchymal cells

A

hematogenous

105
Q

what tumors can feel like lipomas

A

soft tissue sarcoma

MCT

106
Q

cells present in injection site sarcomas

A

lymphocytes

107
Q

what must synovial cell sarcoma be distinguished from?

A

histiocytic and soft tissue sarcoma

108
Q

synovial cell sarcomas

A

elbow, stifle, shoulder , locally invasive met 25% of the time

109
Q

breeds that get
histiocytic sarcoma
synovial myxoma

A

histiocytic sarcoma - rotties
synovial myxoma - doberman
both in stifle

110
Q

osteosarcoma is more malignant in which species?

A

dog

can be benign in cat/horse

111
Q

osteomas and chondromas like which bones

A

scull and flat bones

112
Q

6 round cell tumors

A
  • lymphoma
  • MCT
  • histiocytic
  • Melanoma
  • plasma cell
  • TVT
113
Q

how do round cell tumors typically met?

A

lymphatics

114
Q

defining features of plasma cells

A

eccentric nucleus, may see binucleation, marked anisocytosis

115
Q

difference histiocytoma and histiocytic sarcoma

A

cytoma - benign, hairless, hard or trunk, regresses spontaneously
sarcoma - bernese, secondary site liver and lung

116
Q

locations for TVTs

A

external genitalia
nasal cavity
mucous membranes

117
Q

poorer prognosis for MCT when at which locations

A

nailbed, scrotal, mucocutaneous

118
Q

which melanocytic tumors are more aggressive

A

digits

oral

Clinics! (19 decks)

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