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Cytology of body fluids

Cytology of body fluids

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(9) body fluids (9) body fluids Presentation Transcript

  • Fluids cytology Dr. Francesco Carrani M.V.
  • Anatomy Pleural space Peritoneal space Pericardial sac Cerebro spinal space Joint cavity Mesothelial cells
  • Pathogenesis Transudate Exudate Neoplastic Hemorragic P imbalance Inflammation Compression Trauma Various (urine, bile, chyle)
  • Pleural space Clinical signs dyspnea 30 – 60 ml/kg Clinical emergency
  • Pleural space
  • Pleural space Technique 22 to18 G needle Connection 3 ways stopcock 2.5 to 20 cc syringe Oxygen !!!!
  • Pleural space Technique 22 to18 G needle Connection 3 ways stopcock 2.5 to 20 cc syringe Oxygen !!!!
  • Peritoneal space Ascites High volume Cells dilution Etiology Heart failure Hepatic failure Tumors Trauma
  • Peritoneal space Technique
  • Peritoneal space Technique 22 to18 G needle Connection 3 ways stopcock 5 to 20 cc syringe
  • Pericardial sac Idiopathic hemopericardium Neoplastic effusion Hemangiosarcoma Chemodectoma Lymphoma Transudate Exudate (septic)
  • Pericardial sac Technique 22 to18 G needle Connection 3 ways stopcock 5 to 20 cc syringe Right lateral recumbency No sedation or minimal
  • Pericardial sac Technique
  • Sample management EDTA tube Direct smear Sedimentation or low rpm centrifugation Fixation and rapid stain Immunocytochemical staining
  • Cytological examination It is the only test allowing Cells evaluation HISTO
  • Cytology The cells Mesothelial cells Macrophages Red cells Neutrophils Lymphocytes Eosinophils Mast cells
  • Mesothelial cells Flat ephitelium Large cells Central and round nucleus More peripheral in activated cells Binucleated Prominent nucleolus Basophilic cytoplasm Pinkish cytoplasmic expansion
  • Mesothelial cells Basophilic mesothelial, binucleated, with mitosis Clear mesothelial, vacuolated and sometimes granulated cytoplasm (macrophages)
  • Septic effusions Septic peritonitis
  • Feline infectious peritonitis FIP Yellow, viscous Some neutrophils Activated macrophages Red cells Some lymphocytes Mesothelial cells No Bacteria
  • Septic effusions Septic pleuritis
  • Septic effusions Septic pleuritis from actinomices bacteria
  • Chylous and pseudochylous effusion Milky Triglycerides (chyle > serum) Cholesterol (chyle < serum)
  • Chylous and pseudochylous effusion Chyle Pseudochyle Heart disease Trauma Inflammation Hernia Venous thrombosis Inflammation Neoplasia
  • Chylous and pseudochylous effusion Chyle Pseudochyle Triglycerides Cells Cholesterol Necrotic debris Cells
  • Cells Chyle Pseudochyle Small lymphocytes Neutrophils Macrophages Inflammatory cells Neoplastic cells Neutrophils Lymphocytes
  • Chylous effusion Eosinophilic background Small lymphocytes Neutrophils Macrophages Lipid droplets
  • Bile effusion Amorphous material Bluish black Golden yellow Macrophagic inflammation
  • Neoplastic effusion Not all neoplasia produce effusion Not all neoplastic effusion carries diagnostic cells
  • Neoplastic effusion Non inflammatory cells Different from mesothelial cells
  • Neoplastic effusion False positive – non neoplastic mesothelial reactivity False negative – no exfoliation Distinction between Mesothelioma and Carcinoma
  • Neoplastic effusion Mesothelioma Large group Cytoplasmic vacuolation Visible junctions Central nucleus Carcinoma Large group Cytoplasmic vacuolation Tight junctions Eccentric nucleus
  • Neoplastic effusion Mesothelioma (rare) Pleural Pericardial Lymphoma Carcinoma Mast cell Sarcoma (exfoliation rare) Heart base hemangiosarcoma Poor prognosis
  • Carcinoma Pulmonary metastasis from mammary carcinoma
  • Carcinoma Peritoneal effusion, Intestinal Carcinoma
  • Sarcoma Pulmonary artery hemangiosarcoma
  • Mesothelioma
  • Questions ? F.Carrani 2008