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Cytodiagnostics (Spring 2016) > L8: Liver Cytology (Beatty) > Flashcards

L8: Liver Cytology (Beatty) Flashcards

1
Q

Cholangiohepatitis localizes periportally in the liver

A

:)

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2
Q

Collect larger liver biopsy if fibrosis is expected or to increase sensitivity of diagnosis of chronic hepatitis

A

:)

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3
Q

Sensitivity of wedge biopsies better than core biopsies

A

:)

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4
Q

General advice on liver biopsy:

A
  • 14 g needle for most dogs (16 g in small dogs)
  • collect multiple samples from multiple lobes
  • get biggest sample you can get safely
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5
Q

Which liver diseases more accurately dx with a wedge biopsy vs. Trucut core biopsy?

A
  • hepatitis/cirrhosis
  • fibrosis
  • cholangitis
  • portovascular anomaly
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6
Q

When is a FNA preferred over bigger biopsy?

A
  • hepatic lipidosis
  • vacuolar hepatopathy
  • lymphoma
  • neutrophilic hepatitis
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7
Q

Cytology has POOR correlation w/ histo when lesions are:

A

Focal or multifocal

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8
Q

When is FNA not preferred?

A
  • lymphocytic inflamm.
  • fibrosis
  • cirrhosis
  • portovascular anomalies
  • focal mass
  • early metastasis
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9
Q

US-guided mass FNA useful to distinguish:

A
  • inflammatory lesions
  • hyperplastic lesions
  • neoplastic lesions
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10
Q

8 diagnostic categories of hepatic cytology

A
  • nondiagnostic
  • normal
  • degenerative/metabolic
  • pigment abnormalities
  • extramedullary hematopoiesis
  • inflammation
  • hyperplasia
  • neoplasia
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11
Q

Normal liver appearance on cytology

A
  • epithelial
  • polyhedral cells w/ round to oval nucleus and coarse chromatin
  • single nucleolus
  • rare mast cells
  • dk. Blue pigment can be accumulation of bile pigment or lipofuscein (wear and tear pigment)
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12
Q

Nuclear crystals can be sign of hepatic hyperplasia

A

:)

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13
Q

Vacuolar degeneration

A
  • common change in liver of dogs and cats
  • mild, moderate, or severe
  • distinct or indistinct
  • indistinct due to water or glycogen accum.; looks foamy
  • distinct due to lipid accum. (More common in cats); mild normal but if severe, can indicate hepatic lipidosis
  • unregulated diabetes in dogs common cause
  • other causes: cushings, steroid hepatopathy, toxic insult, neoplasia
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14
Q

Hepatic pigments

A

1) Lipofuscein (blue/purple; older animals)

2) Bile (dk blue; cholestasis)
3) copper (refractile)
4) Hemosiderin (iron storage dz, etc.)

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15
Q

Bile cast

A

Due to accumulation of bile in a blocked bile duct

  • will see these BEFORE liver enzymes increase!
  • looks dk blue/black
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16
Q

Cholangitis

A

Inflamm. Of the biliary tree

17
Q

Hepatitis

A

Inflamm. Of hepatocytes

*cannot tell difference b/w hepatitis and cholangitis on cyto

18
Q

failure to detect lymphocytic inflammation in a FNA can’t be used to definitively exclude underlying inflamm. Dz

A

:)

19
Q

Lymphocytic portal cholangitis most common in what age cats?

A

> 10 yr

20
Q

Cats most often get small cell lymphoma

A

:)

21
Q

Lymphoma most common in cats of what age?

A

> 10 yr

22
Q

Chronic cholangitis is most common in cats of what age?

A

Middle age (9yr)

23
Q

Lymphocytic cholangitis most common in cats of what age?

A

Young to mid

24
Q

False positives for hepatic inflammation

A
  • leukocytosis
  • EMH
  • leukemia
  • abd. Effusion

TRUE inflamm. Will be neutrophilic, lymphocytic, or pyogranulomatous

25
Q

Hard to differentiate hyperplasia vs. well-differentiated neoplasia in the liver

A

:)

26
Q

Chars. Of nodular hyperplasia

A
  • idiopathic
  • common in older dogs
  • no CS
  • increased ALP
  • nodules vary in size and #
  • may be mistaken for regenerative nodules
27
Q

Most commonly diagnosed liver neoplasm**

A

Lymphoma (met. Dz more common than 1ary liver neoplasia)

28
Q

Primary Neoplasia of the liver

A
  • hepatocellular (dogs)
  • bile duct (cats)
  • anaplastic carcinoma
  • neuroendocrine
  • sarcoma
  • myeloproliferative
  • round cell
29
Q

Hepatocellular carcinoma usually on the left side of the animal

A

:)

30
Q

May need histo to differentiate b/w normal, hyperplasia, adenoma, or well differentiated carcinoma in the liver

A

:)

31
Q

If lymphoma involves the liver, what stage is it?

A

4

32
Q

Indications for liver biopsy

A
  • icterus in plasma
  • colorless/gray feces
  • clinical icterus (>2.0 bilirubin)
  • ammonium biurate crystals in urine
  • hepatomegaly on rads/US
  • evidence of liver masses

Cytodiagnostics (Spring 2016) (12 decks)

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