Cytology of the Respiratory Tract

Question 1

What organisms is this, obtained via a nasal swab on a cat?

Answer 1

Cryptococcus neoformans:

Large yeast w/ thick capsule and narrow-based budding

Usu accompanied by suppurative to mixed inflammation

Question 2

This organism sometimes causes nasal infections in dogs and appears grossly as polyps. What is it?

Answer 2

Rhinosporidium seeberi

• Round to oval spores (5-15um) w/ sl. refractile capsule and double cell wall
• Often contain several eosinophilic globules
• Sporangia (30-300um) contain numerous small, round endospores
• Accomapnied by mixed cell inflammation in ‘rosettes’

Note: for size reference, neuts are usu ~12-14um

Question 3

What is a possible organism causing this fungal rhinitis?

Answer 3

Aspergillus – has branching, septate, non-pigmented hyphae

Often accompanied by neutrophilic or pyogranulomatous inflammation

Rarely found in nasal exudates, usu ID’d in FNA or bx samples

Question 4

What does this nasal flush from a cat indicate?

Answer 4

Lymphoma – predominance of large lymphocytes w/ criteria of malignancy

Question 5

What are tracheal washes good at detecting?

Answer 5

Inflammatory diseases of airways

Question 6

What part of your tracheal wash (TTW, TTA, ETW) or bronchoalveolar lavage (BAL) should you use to make squash prep?

Answer 6

The mucus – cells are often concentrated/embedded in the mucus

Question 7

What is this, sometimes found in tracheal washes?

Answer 7

Curschmann’s spirals – mucus casts of small bronchi

Formed w/ inc’d mucus secretion and/or lower airway obstruction –> classic finding in ‘COPD’ and inflammation in general but not specific for any single dz process

Question 8

What is this? (from tracheal wash)

Answer 8

Curschmann’s spirals

Question 9

Who dis?

Answer 9

Ciliated columnar epi cell (resp epithelium)

Question 10

Who dis?

Answer 10

Ciliated columnar epi (resp epi)

Question 11

Who di mo-fo from a tracheal wash?

Answer 11

Goblet cell

Question 12

Who are these fools? (normal residents of lungs, from tracheal wash)

Answer 12

Alveolar macrophages

Question 13

Who dis dude?

Answer 13

Alveolar macrophage

Question 14

What up here? (BAL from a cat)

Answer 14

Alveolar macrophages contain carbon particles from smoke (anthracosis)

Question 15

Who dis? What are its characteristics?

Answer 15

Simonsiella sp.

• gram negative filamentous bacteria
• combine to form characteristic segmented structures
• are part of the normal microflora of the oral cavity of most mammals and may appear as a contaminant in your tracheal washes or BALs
• may also be found in skin lesions (licking)

Question 16

Who is this oropharyngeal contaminant found in a TTW?

Answer 16

Simonsiella sp.

Question 17

What kind of contamination is this?

Answer 17

Lubricant gel contamination

Question 18

When do you see suppurative (neutrophilic) inflammation in a tracheal wash or BAL?

Answer 18

• infectious dz (bacteria, viral, fungal, protozoa)
• chronic obstructive pulmonary dz (COPD) or small airway inflammatory dz (SAID)
• neoplasia
• aspiration pneumonia
• inhalation pneumonia

Question 19

What is the most common type of inflammation in the lungs?

Answer 19

Suppurative inflammation

Question 20

What kind of inflammation is this? (tracheal wash)

Answer 20

Suppurative inflammation

This one is from a bacterial pneumonia

Question 21

What kind of inflammation is this?

Answer 21

Suppurative inflammation

Tracheal wash – bordetella infection

Question 22

What is a common cause of this kind of result w/ a tracheal wash –> marked septic suppurative inflammation: large numbers of bact with mixed bacterial types +/- foreign material like plant material or food particles

Answer 22

Aspiration pneumonia

Question 23

What are possible parasitic causes of eosinophilic inflammation in the lungs?

Answer 23

Lungworms

Dirofilariasis (heartworm)

Capillaria

Paragonimus kellicotti

Migrating ascarids and strongyles

Question 24

What are possible etiologies for an eosinophilic inflammation in the lungs?

Answer 24

Parasitic infections

Allergies/hypersensitivity (asthma; pulmonary infiltrates w/ eosinophils)

Fungal infections

Neoplasia (uncommon)

Bacterial infection (uncommon)

Question 25

What kind of inflammation is this? (TTW)

Answer 25

Eosinophilic inflammation

Clin dx in this case = asthma

Question 26

6 m F DSH

Hx pneum w/ no response to marbofloxacin (fluoroquinolone)

Rads = severe, diffuse mixed pulm pattern (interstitial to alv pattern w/ an underlying bronchial pattern)

You obtain a TTW with eosinophilic and this. Who these mo-fos?

Answer 26

Aelurostrongylus abstrusus – lungworm