L10: Resp. And Ocular Cytology Flashcards
BAL fluid must be concentrated by centrifuge for cytology
:)
Preservation of BAL sample
-if >24 hrs, preserve w/ at least 4 drops of patient/s serum per mL of BAL fluid
Normal TTW/BAL cyto findings
- small amt. mucus (looks blue)
- alveolar macs
- resp. Columnar Epithelial cells
*oropharyngeal contamination common
Signs of oropharyngeal contamination of BAL/TTW sample
- squamous epithelial cells
- Simonsiella sp. (look like big rods)
- lots more bacteria (extracellular)
Types of inflammation in BAL/TTW
- neutrophilic
- mixed (macs, neuts, lymphs)
- eosinophilic
Chars. Of neutrophilic inflammation of TTW/BAL
> 5-10% neuts in absence of blood contamination
-Can be infectious/septic (intracellular bact. Present, degenerate neuts) or non-infectious/non-septic
Causes of non-septic neutrophilic inflamm.
- tissue irritation
- tissue necrosis (2ary to inhaled toxin)
- ARDS
- Inflammatory airway dz
- Recurrent airway obstruction/heaves in horses
- Neoplasia
Causes of SEPTIC neutrophilic inflamm. W/ BAL/TTW
- bacterial
- fungal
- protozoal
- viral
- nematode
Chars. Of mixed/pyogranulomatous inflamm.
- primarily macs, lymphs w/ some neuts
- sign of chronic inflamm./infection
- Ddx: bronchitis, heaves, fungal, protozoal, viral, FB, lipid pneumonia
- macs become reactive, multinucleated
Chars. Of eosinophilic inflammation
> 5-10% eos in dogs, >20% in cats, >1% in horses
Assoc. w/ inc. mucus prod. (Appear as purple granules)
Causes:
- allergic/hypersensitivity rxn most common
- parasites
- eosinophilic bronchopneumopathy
- lymphomatoid granulomatosis
- inflamm. Airway dz in horses
- feline asthma
Causes of hemorrhage in TTW/BAL
- Exercise-induced pulm. Hem.
- asthma (chronic cough)
- trauma
- coagulopathies
- thromboembolic dz
- neoplasia
Cyto evidence:
- erythrophagia
- hemosiderin in macs
Neoplasia seen on TTW/BAL
- very rarely seen!
- Ddx: bronchogenic carcinomas, angiocentic T cell lymphoma w/ lymphomatoid granulomatosis
- can see eosinophilic inflamm. w/T cell lymphoma
Corneal tumors
- uncommon in SA
- SCC in LA can involve the cornea
Corneal eosinophilic inflamm.
-assoc. with white raised lesions
Ddx: immune-mediated, allergic/hypersensitivity, parasitic, eosinophilic conjunctivitis
Corneal pyogranulomatous inflammation ddx
Pannus (immune-mediated condition)
KCS
FB
Corneal neutrophilic keratitis
-usually has bacterial (more common in SA) or fungal cause (LA)
Eosinophilic conjunctivitis in cats ddx
Allergic/hypersensitivity
-assoc. with inc. mast cells, keratitis
Immune-mediated
-assoc. with steroid use
Eosinophilic Conjunctivitis in horses-
- similar to cats
- immune-mediated
- Habronema or Onchocerca
Ocular INFLAMMATORY tissue masses
1) Chalazion
- arises from meibomian gland
- lipogranuloma
- char. By many foamy macs with some neuts and lymphs
2) Hordeolum
- purulent
- arises from inflamm. Of the meibomian gland also
- char. Mainly by inc. Neuts
*can’t differentiate cytologically
Ocular NEOPLASTIC lesions
- Meibomian gland adenomas
- Sebaceous epithelioma
- SCC (LA)
- MCT
- Melanoma
Normal ocular scraping
- superficial squamous epithelium
- occasional lymphocyte
- melanin pigment (don’t confuse w/ bacteria)
Ddx of ocular neutrophilic inflamm.
- numerous agents
- can be 2ary to KCS, Distichiasis, traumatic injury, FB, neoplasia
Chlamydiosis
- common cause of neutrophilic conjunctivitis in cats, horses, guinea pig
- dz of the eyelids
- results in discrete, basophilic, cytoplasmic inclusions in epithelial cells seen in first 4-7 days of infection
Keratoconjunctivitis Sicca
- inc. # of goblet cells –> inc. mucus prod.
- or not enough aqueous prod.
- assoc. with neutrophilic inflamm./infection
Causes of lymphocytic/plasmacytic conjunctivitis
- acute stage of viral infections
- follicular conjunctivitis (which is usually caused by allergies or antigenic stim. From something else in env.)
- Allergic/immune-mediated
Chars. Of viral conjunctivitis
- Acute form –> lymphocytes, plasma cells predominate
- Chronic form –> neuts predominate
- FHV, K9 distemper, equine adenovirus can cause
TTW sample handling
- place in purple and/or red top
- prepare direct smears for cytology with MUCOID MATERIAL if present*
