Respiratory & Ocular Cytology

Question 1

What are the preservatives that can be used if the delay to send BAL samples is >24hrs?

Answer 1

serum (4 drops/mL)

EDTA (stops clotting of cells but does not prevent breakdown of cells)

Question 2

BAL sample- normal or abnormal?

Answer 2

Normal

Question 3

Is this a normal BAL?

Answer 3

No, oropharyngeal contamination indicated by large bacillus bacteria = conchiformibius

Question 4

Inflammation or not?

What level of NT need to be present for inflammation to be determined?

Answer 4

Inflammation, non-degenerate NT

>5% NT

Question 5

What are the causes of non-septic neutrophilic inflammation?

Answer 5

Tissue irritation & necrosis (2nd to an inhaled toxin)

ARDS

Inflammatory airway disease & recurrent airway obstruction in horses

neoplasia

Question 6

BAL from a horse.

Classify this via cytology.

What are the possible causes?

Answer 6

septic neutrophilic inflammation

Causes: bacterial, fungal, protozoal, viral, nematode

Question 7

BAL from a dog.

Classify.

What are the possible causes?

Answer 7

mixed/pyogranulomatous inflammation (mainly macrophages & lymphocytes, NT vary)

Causes: chronic inflammation/infection (bronchitis, RAO aka heaves, fungal/protozoal, viral (syncytial cell forming), foreign material, lipid pneumonia

Question 8

BAL in a horse with chronic recurrent airway obstruction.

Classify.

Answer 8

mixed inflammation (multinucleated macrophage)

Question 9

What percent of eosinophils need to be present in order to have eosinophilic inflammation in dogs, cats, and horses?

Answer 9

dog >5-10%

cat >20%

horse >1%

Question 10

What are the potential differentials for eosinophilic inflammation?

Answer 10

• Parasitic migration
• Eosinophilic bronchopneumopathy
• Lymphomatoid granulomatosis
• Inflammatory airway disease in horses
• Allergic / hypersensitivity reactions

Question 11

What is the most common cause of eosinophilic inflammation in the respiratory system?

Answer 11

• Allergic / hypersensitivity reactions
▫ Most common (unknown initiating cause)
▫ Siberian Huskies and Alaskan Malamutes

Question 12

Classify the BAL fluid.

Answer 12

Eosinophilic inflammation

Question 13

What is shown in the picture that is commonly associated with eosinophilic inflammation?

Answer 13

Curschmann’s spiral

(also goblet cells aka increase mucus production)

Question 14

What is seen in this BAL cytology?

Answer 14

Nematode

Question 15

Classify the BAL.

What are the possible causes?

Answer 15

Hemorrhage (hemosiderin laden reactive macrophage)

Causes: EIPH, asthma, trauma, coagulopathies, THE, neoplasia

Question 16

Are neoplastic cells in BAL common?

What are the two common forms of neoplasia identified?

Answer 16

no, rare

bronchogenic carcinomas, angiocentric T-cell lymphoma (aka lymphomatoid granulomatosis)

Question 17

Classify this BAL.

Answer 17

Neoplastic (multinucleated cells)

Question 18

chalazion

Answer 18

lipogranuloma

Question 19

Hordeolum

Answer 19

purulent in the eye

Question 20

What are the two most common neoplasms in the eye?

Answer 20

Meibomian gland adenomas

sebaceous epithelioma

Question 21

Tissue aspirate from the eye.

Classify.

Answer 21

Inflammatory

chalazion/hordeolum

Question 22

What are these cells typically associated with?

Answer 22

eosinophilic inflammation

Question 23

What collection technique would you perform for an ocular mass vs. placque?

Answer 23

mass: aspirate
plaque: skin scraping

Question 24

What malignant neoplasm of the eye is most common in both SA & horses?

Answer 24

SCC

Question 25

Classify this ocular aspirate.

Answer 25

SCC (robin’s egg cytoplasm)

Question 26

What are the normal findings in an ocular scraping?

Answer 26

superficial squamous epithelium

occasional lymphocyte

melanin granules

Question 27

Classify this eye scraping.

What is the likely causative agent?

Answer 27

Bacterial neutrophilic inflammation

Chlamydia (discrete basophilic inclusions in EPITHELIAL CELLS)

Question 28

What is the likely causative agent in this eye scraping?

Answer 28

mycoplasma

Question 29

When this is seen on ocular cytology, what do you suspect is the primary problem?

Answer 29

KCS (mucus cells)

Question 30

Classify the lesion based on the ocular cytology.

What are the possible causes and what is most likely for outdoor animals?

Answer 30

Lymphocytic / Plasmacytic Conjunctivitis

Causes: acute stage viral infection, follicular conjunctivitis (#1 outdoor animals), allergic/immune

Question 31

What are the common viral agents of conjunctivitis?

Which can inclusions be seen?

Answer 31

Feline herpes

Canine distemper (may see inclusions)

Equine adenovirus

Question 32

How does the type of inflammation change overtime with viral infections?

Answer 32

Acute: Lymphocytic /plasmacytic

Chronic: NT

Question 33

Classify the type of inflammation seen in this ocular cytology.

What are the common causes in the cat and horse?

Answer 33

eosinophilic inflammation

Allergic/HS & immune mediated for both, horse- habronema/onchocerca

Question 34

Corneal cytology in a horse. Likely Dx?

Answer 34

Keratomycosis

Question 35

What are the common causes of neutrophilic keratitis?

Answer 35

bacterial

fungal (horse)

Question 36

Classify this corneal cytology.

Possible causes?

Answer 36

Pyogranulomatous inflammation

Causes: pannus (GSH, immune-mediated), KCS, FB

Question 37

A horse presents with a white/flesh colored raised lesion on the cornea. Corneal cytology is shown.

Classify the lesion.

Possible causes?

What species are these lesions commonly seen in?

Answer 37

Eosinophilic inflammation

allergic, parasitic, immune-mediated

cats & horses

Question 38

The following corneal scraping cytology was obtained from a horse.

Classify the lesion.

Are similar lesions common in small animals?

Answer 38

Neoplastic (likely SCC)

not common in small animals, but can see in the cow