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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, ...
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 (...
Pericardial sac Technique

22 to18 G needle
Connection
3 ways stopcock
5 to 20 cc syringe

Right lateral
recumbency
No sed...
Pericardial sac
Technique
Sample management
EDTA tube
Direct smear
Sedimentation or low rpm
centrifugation
Fixation and rapid stain
Immunocytochemic...
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
Pro...
Mesothelial cells

Basophilic mesothelial, binucleated, with mitosis
Clear mesothelial, vacuolated and sometimes
granulate...
Septic effusions

Septic peritonitis
Feline infectious peritonitis
FIP
Yellow, viscous
Some neutrophils
Activated
macrophages
Red cells
Some lymphocytes
Mesoth...
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

Inflam...
Chylous and pseudochylous
effusion

Chyle

Pseudochyle

Triglycerides
Cells

Cholesterol
Necrotic debris
Cells
Cells
Chyle

Pseudochyle

Small lymphocytes
Neutrophils
Macrophages

Inflammatory cells
Neoplastic cells
Neutrophils
Lymph...
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 be...
Neoplastic effusion

Mesothelioma
Large group
Cytoplasmic
vacuolation
Visible junctions
Central nucleus

Carcinoma
Large g...
Neoplastic effusion
Mesothelioma (rare)
Pleural
Pericardial

Lymphoma
Carcinoma
Mast cell
Sarcoma (exfoliation rare)
Heart...
Carcinoma

Pulmonary metastasis from mammary carcinoma
Carcinoma

Peritoneal effusion, Intestinal Carcinoma
Sarcoma

Pulmonary artery hemangiosarcoma
Mesothelioma
Questions ?
F.Carrani 2008
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(9) body fluids

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Cytology of body fluids

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Transcript of "(9) body fluids "

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