(9) body fluids

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Cytology of body fluids

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(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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