(9) body fluids
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This document discusses cytology techniques and findings for different body cavity fluids. It covers the anatomy of pleural, peritoneal, pericardial, and other spaces. Common etiologies that can cause fluid accumulation include transudates, exudates, and hemorrhage. Techniques are described for safely collecting fluid samples from these spaces using needles and syringes. The cytological appearance of different cell types like mesothelial cells, macrophages, and malignant cells are outlined. Specific conditions that can be identified include infections, chylous effusions, bile effusions, and different types of cancers. The cytological features that can help distinguish between mesothelioma and carcinomas are also summarized.
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(9) body fluids
- 1. Fluids cytology Dr. Francesco Carrani M.V.
- 2. Anatomy Pleural space Peritoneal space Pericardial sac Cerebro spinal space Joint cavity Mesothelial cells
- 3. Pathogenesis Transudate Exudate Neoplastic Hemorragic P imbalance Inflammation Compression Trauma Various (urine, bile, chyle)
- 4. Pleural space Clinical signs dyspnea 30 – 60 ml/kg Clinical emergency
- 6. Pleural space Technique 22 to18 G needle Connection 3 ways stopcock 2.5 to 20 cc syringe Oxygen !!!!
- 7. Pleural space Technique 22 to18 G needle Connection 3 ways stopcock 2.5 to 20 cc syringe Oxygen !!!!
- 8. Peritoneal space Ascites High volume Cells dilution Etiology Heart failure Hepatic failure Tumors Trauma
- 10. Peritoneal space Technique 22 to18 G needle Connection 3 ways stopcock 5 to 20 cc syringe
- 11. Pericardial sac Idiopathic hemopericardium Neoplastic effusion Hemangiosarcoma Chemodectoma Lymphoma Transudate Exudate (septic)
- 12. Pericardial sac Technique 22 to18 G needle Connection 3 ways stopcock 5 to 20 cc syringe Right lateral recumbency No sedation or minimal
- 14. Sample management EDTA tube Direct smear Sedimentation or low rpm centrifugation Fixation and rapid stain Immunocytochemical staining
- 15. Cytological examination It is the only test allowing Cells evaluation HISTO
- 16. Cytology The cells Mesothelial cells Macrophages Red cells Neutrophils Lymphocytes Eosinophils Mast cells
- 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. Mesothelial cells Basophilic mesothelial, binucleated, with mitosis Clear mesothelial, vacuolated and sometimes granulated cytoplasm (macrophages)
- 20. Feline infectious peritonitis FIP Yellow, viscous Some neutrophils Activated macrophages Red cells Some lymphocytes Mesothelial cells No Bacteria
- 22. Septic effusions Septic pleuritis from actinomices bacteria
- 23. Chylous and pseudochylous effusion Milky Triglycerides (chyle > serum) Cholesterol (chyle < serum)
- 24. Chylous and pseudochylous effusion Chyle Pseudochyle Heart disease Trauma Inflammation Hernia Venous thrombosis Inflammation Neoplasia
- 25. Chylous and pseudochylous effusion Chyle Pseudochyle Triglycerides Cells Cholesterol Necrotic debris Cells
- 26. Cells Chyle Pseudochyle Small lymphocytes Neutrophils Macrophages Inflammatory cells Neoplastic cells Neutrophils Lymphocytes
- 27. Chylous effusion Eosinophilic background Small lymphocytes Neutrophils Macrophages Lipid droplets
- 28. Bile effusion Amorphous material Bluish black Golden yellow Macrophagic inflammation
- 29. Neoplastic effusion Not all neoplasia produce effusion Not all neoplastic effusion carries diagnostic cells
- 30. Neoplastic effusion Non inflammatory cells Different from mesothelial cells
- 31. Neoplastic effusion False positive – non neoplastic mesothelial reactivity False negative – no exfoliation Distinction between Mesothelioma and Carcinoma
- 32. Neoplastic effusion Mesothelioma Large group Cytoplasmic vacuolation Visible junctions Central nucleus Carcinoma Large group Cytoplasmic vacuolation Tight junctions Eccentric nucleus
- 33. Neoplastic effusion Mesothelioma (rare) Pleural Pericardial Lymphoma Carcinoma Mast cell Sarcoma (exfoliation rare) Heart base hemangiosarcoma Poor prognosis
- 34. Carcinoma Pulmonary metastasis from mammary carcinoma
- 35. Carcinoma Peritoneal effusion, Intestinal Carcinoma
- 37. Mesothelioma