Cytopathology of Effusions & Fluids Flashcards
Dr. Short
Where do you put fluid you collect? How many slides do you create?
EDTA - cytology
RTT - microbiology
leave 1-2 unstained to send out if necessary
What are the types of effusion?
pleural effusion
pericardial effusion
ascites
What is this?
mesothelial cells
What do mesothelial cells do?
line body cavities (pleural, peritoneal, pericardial)
present in most effusions & become easily activated with inflammation or fluid accumulation
What kind of cell?
mesothelial cell- activated - pink fringe
multinucleated especially when activated
What are characteristics of transudates?
low in nucleated cells, low protein count
typically associated with changes in oncotic pressure, lymphatic obstruction, or venous stasis
decreased oncotic pressure = increase hydrostatic pressure
Transudate or exudate?
transudate
What are the characteristics of a protein rich transudate?
Transudate, modified transudate, or exudate?
modified transudate
What are characteristics of exudates?
high cell count and increased protein
Transudate, modified transudate, or exudate?
exudate - more cellular
What is FIP and its effect on a cat?
yellow, viscous fluid
globulins greater than 50%
How do you test for FIP?
PCR or the Rivalta test which is old school
not specific, but sensitive - mix 1 drop white vinegar with 5 mL distilled water, then add 1 drop effusion
What is a positive Rivalta test look like?
if precipitates with floating or slow descent
What are fluid characteristics of bile peritonitis?
mixed population (may be septic or sterile), green-black/yellow globular material within macrophages and extracellularly
How can one get bile peritonitis?
gallbladder rupture - trauma, GDV, cholelithiasis, ruptured mucocele
What is the blue arrow pointing to?
white bile
This fluid was collected from an animal. What is a likely differential?
bile peritonitis
WHat are causes of hemorrhagic effusions?
neoplasia !!
trauma
torsion
coagulopathy
GI ulceration
idiopathic pericardial effusion
What are characteristics of hemorrhagic effusions?
lots of red blood cells, blood leukocytes, macrophages
TP > 3, pink/red, cloudy
PCV or effusion may be close to peripheral blood
Fluid type?
hemorrhagic effusion - hemangiosarcoma
What are causes of chylous effusion?
- idiopathic
- lymphatic obstruction (lymphoma, thymoma, lymphangiectasia, ruptured lymphatic)
- R sided heart failure
- trauma
What are characteristics of chylous effusion?
variable nucleated cell count
acute: small lymphocytes
chronic: mixed population
white, opaque, even after centrifugation
What confirms chylous effusion?
triglyceride count of effusion >100
Effusion?
chylous
What are characteristics of neoplastic fluid?
reactive mesothelial cells, neoplastic cells
TP: 2.5-5
What is neoplastic fluid typically associated with?
lymphoma, histiocytic sarcoma, carcinoma (common), mesothelioma (rare)
Fluid type?
neoplastic
What is synovial lining made of?
A cells (resident macrophages) and B cells (synoviocytes)
How do you get synovial fluid?
arthrocentesis - likely need sedation and aseptic technique
What is the goal in getting synovial fluid?
some fluid, not all!!
How do you analyze synovial fluid?
What is the majority of synovial fluid?
mononuclear cells >95%
How do you evaluate synovial fluid on cytology?
Fluid type?
synovial
What are characteristics of suppurative fluid?
cloudy appearance, normal to increased TP
- >10-100 neutrophils
overall increased numbers of wbcs, infectious and noninfectious causes
What are infectious causes for suppurative?
What are noninfectious causes of suppurative inflammation in the joint?
What is this?
ragocytes - neutrophils with phagocytized immune complexes
Infectious or noninfectious?
infectious arthritis
Infectious or non-infectious?
non-infectious arthritis
What are characteristics of non-suppurative joint disease?
clear-orange
normal to decreased TP
normal to decreased viscosity
DJD - less severe changes seen
What is the predominant cell in non-suppurative joint disease?
mononuclear cells
This was taken from a joint. Classify it
non-suppurative joint disease - DJD
What are characteristics of hemoarthosis?
red, cloudy (yellow color indicates previous hemorrhage that has resolved), increased TP, decreased viscosity
What are causes of hemarthrosis?
recent trauma
coagulopathy
neoplasia
What is the most common neoplasia in the joint?
histiocytic
What does normal CSF look like?
clear, viscous - limited to few mononuclear cells and lymphocytes
What are some pathologies of CSF?
elevated protein: plasma or cellular leakage across BBB, localized tissue damage or necrosis, nonspecific for etiology
pleocytosis: neutrophilic, eosinophilic
What happens with granulomatous meningoencephalitis?
mixed mononuclear pleocytosis, with dominant lymphocytes
most common CNS disorder
How do you sample from the respiratory system?
transtracheal wash and bronchoalveolar lavage
What do you typically see on cytology with transtracheal wash and bronchoalveolar lavage?
typically mutinous, mucous casts
eosinophilic in inflammatory conditions
curschmann spirals - normal for chronic mucus
Describe tracheal wash: samples. indications, contains, perform, kind of cells
Describe bronchoalveolar lavage: samples. indications, contains, perform, kind of cells
What is this?
curshman’s spiral - cast of mucus plug from airway
