Cytology of Cells Flashcards
Fluid Analysis
Note color, clarity, odor
Total protein - refractometry
Cell count (manual system, electronic cell counter)
Sediment cells if count
what are the important components of body cavity fluid analysis
cell concentration
protein concentration
types of cells present (inflammatory, organisms, neoplastic)
transudate
passive accumulation o fluid: low proteins and cells
prue transudates
form due to hypoalbuminemia
modified transudates
form due to impaired blood of lymph flow
exudates
form due to increased capillary permeability (inflammation)
high protein and cell count
properties of transudate
Appearance: Clear
Total Protein:
properties of exudate
Appearance: Cloudy
Total Protein: >3 g/dl
NCC: >6,000/μl
Clot form: Yes
fluid analysis: special biochemical tests
Creatinine if suspect uroabdomen
Triglyceride if suspect chylous effusion
Bilirubin if suspect bile leakage
T/F if removing fluid from thoracic cavity, best to use catheter, rather than needle, to avoid pneumothorax
true : pneumothoraxes are bad
what can happen if you accidentally aspirate liver when removing fluid from the thoracic cavity
may confuse hepatocytes with neoplastic cells
common in cats-sits pretty far forward
push films
similar to blood film
advantage: big cells at edge; disadvantage, cells often broken at edge
pull films
Place a drop of fluid on slide, place another slide on top, allow drop to spread, pull slides gently apart.
advantage, cells nicely spread out; disadvantage, no concentration of big cells
what is the only disabvantage of using diff quik
may not stain mast cell granules (~10% dont stain)
T/F all bacteria stain blue on wright’s stain
true
why can gram stains be misleading
when bacteria die, gram + may appear as gram -
types of inflammation
suppurative: neutrophils
mixed: segs, lymphs, macs, maybe eos
mononuclear: macrophages, lymphs
what is a potential cause of mononuclear inflammation
foreign body
mycobacterium
if you see different types of bacteria what is your best guess as to where they are coming from
Gut
Enterocentesis vs septic peritonitis
How many inflammatory cells present in fluid?
Clinical condition?
Leukogram?
- Expect inflammatory leukogram & likely neutropenia and left shift w/ GI rupture.
organisms of than bacteria to look for
systemic fungal diseases (Histoplasmosis, Cryptococcosis, Blastomycosis, Coccidiodomycosis)
Leishmaniasis or Toxoplasmosis
what cells are the bane of body cavity fluid cytology
mesothelial cells
look like neoplastic epithelial cells
how to distinguished mesothelial cells from neoplastic cells
Look at the number of these cells, usually with carcinomas see a lot more neoplastic cells
May see 3-4 clumps of mesothelial cells
Still very subjective
discrete
cells not hooked to each other
Cell types encountered in neoplastic effusions
lymphoblasts
carcinoma cells
criteria of malignancy
Variable nuclear size (anisokaryosis)
Large multiple nucleoli
Abnormal mitoses
Nuclear molding (Binucleate cell and one nucleus conforms the shape of the other)
whats your diagnosis when see epithelial cells of variable sizes and prominent nuclei
pos. carcinoma
what is the only disease that will have a higher Glob than albumin concentration with abdominal effusion
FIP
high protein count with cell count lower than 20,000 what should you be thinking
FIP
what is characteristic of FIP on cytology
background stained-amourphous protein:
• so proteinacious that it will peal up
• Stain sticks to protein (don’t confuse with bacteria- neutrophils would be falling apart)
think FIP with:
High protein, relatively low cell concentration!!!
T/F in almost all fluids the cholesterol will be higher than triglycerides
true
chylous effusion
acute: predominantly small lymphocytes
longstanding: more inflammatory cells (neutrophils and macrophages)
how can you confirm the presence of chyle
cholesterol: triglyceride ratio
compare triglyceride in fluid with serum (chyle high in triglycerides if eating)
if chylous effusion is secondary to lymphoma
lymphoblasts are usually present
what can brown fluid in the abdomen indicate
old blood
bile-more likely (measure bilirubin)
2 year old cat with anorexia, weight loss, dyspnea
TP: 3.6, NCC- 15,700
Lymphoma
T/F Do not expect to see sarcoma cells exfoliate into body cavity effusions. Only lymphomas and carcinomas tend to exfoliate.
true
8 yr old German shepherd
Acute weakness, enlarged abdomen Pale mucous membranes, dyspnea
CBC- regenerative anemia, acanthocytes seen on smear
PCV - 18%
TP - 5.8 g/dl
Abdominal fluid analysis Red, cloudy TP - 6 g/dl NCC - 10,000/μl PCV - 24%
Dx: Hemangiosarcoma ruptured leading to hemoabdomen
what should you be thinking with an inflammatory leukogram more bands than segs (bone marrow not keeping up)
peritonitis, septicemia- (severe demand for neutrophils)
overwhelming inflammatory focus someplace
hypoglycemia in the face of degenerative left shift suggests
septicemia
hypoalbuminemia
pure transudate
cardiomyopathy
modified transudate, mixed cells
lymphoma
lymphoblast in effusion
cacinoma
neoplastic epithelial cells in effusion
Feline infectious peritonitis
high protein, low cell concentration, mixture of cells
bacterial infections
high cell concentration-neutrophils
bacteria
chylous effusions
small lymphocytes acutely, then mixed
uroabdomen
cells variable, CREA high
T/F cell counts are helpful in joint fluid analysis because it is difficult to estimate
true
normal cell values
what cells are predominant in joints
large mononuclear:
- macrophages
- synovial lining cells
types of inflammatory joint fluid
suppurative
mononuclear
suppurative joint fluid
usually immune-mediated
if septic difficult to see bacteria
mononuclear joint fluid
degenerative disease or trauma
immune mediated joint inflammation
Low to high cellularity
Increase in nondegenerate neutrophils
Usually multiple joints
infectious joint inflammation
High cell count.
Usually nondegenerate neurophils
Typically do not see the infectious agent
Usually single joint
joint trauma
usually single joint
