(9) body fluids
DESCRIPTION
Cytology of body fluidsTRANSCRIPT
Fluids cytology
Dr. Francesco Carrani M.V.
Anatomy
Pleural spacePeritoneal spacePericardial sac
Mesothelial cells
Cerebro spinal spaceJoint cavity
Pathogenesis
Transudate Exudate Neoplastic Hemorragic
Various (urine, bile, chyle)
P imbalanceInflammationCompressionTrauma
Pleural space
Clinical signsdyspnea
30 – 60 ml/kgClinical emergency
Pleural space
Pleural space Technique
22 to18 G needleConnection3 ways stopcock2.5 to 20 cc syringe
Oxygen !!!!
Pleural space Technique
22 to18 G needleConnection3 ways stopcock2.5 to 20 cc syringe
Oxygen !!!!
Peritoneal space
AscitesHigh volumeCells dilutionEtiology
Heart failureHepatic failureTumorsTrauma
Peritoneal space Technique
22 to18 G needleConnection3 ways stopcock5 to 20 cc syringe
Peritoneal space Technique
Pericardial sac
Idiopathic hemopericardiumNeoplastic effusion
HemangiosarcomaChemodectomaLymphoma
TransudateExudate (septic)
Pericardial sac Technique
Right lateral recumbency
No sedation or minimal
22 to18 G needleConnection3 ways stopcock5 to 20 cc syringe
Pericardial sac Technique
Sample management
EDTA tubeDirect smearSedimentation or low rpm centrifugationFixation and rapid stainImmunocytochemical staining
Cytological examination
It is the only test allowing
Cells evaluationHISTO
Cytology The cells
Mesothelial cellsMacrophagesRed cellsNeutrophilsLymphocytesEosinophilsMast cells
Mesothelial cells
Flat ephiteliumLarge cellsCentral and round nucleusMore peripheral in activated cellsBinucleatedProminent nucleolusBasophilic cytoplasmPinkish cytoplasmic expansion
Basophilic mesothelial, binucleated, with mitosisClear mesothelial, vacuolated and sometimes granulated cytoplasm (macrophages)
Mesothelial cells
Septic effusions
Septic peritonitis
Feline infectious peritonitis
FIPYellow, viscousSome neutrophilsActivated macrophagesRed cellsSome lymphocytesMesothelial cellsNo Bacteria
Septic effusions
Septic pleuritis
Septic effusions
Septic pleuritis from actinomices bacteria
Chylous and pseudochylous effusion
MilkyTriglycerides (chyle > serum)Cholesterol (chyle < serum)
ChyleHeart diseaseTraumaInflammationHerniaVenous thrombosis
Pseudochyle
InflammationNeoplasia
Chylous and pseudochylous effusion
ChyleTriglycerides Cells
PseudochyleCholesterolNecrotic debrisCells
Chylous and pseudochylous effusion
Cells
ChyleSmall lymphocytesNeutrophilsMacrophages
PseudochyleInflammatory cellsNeoplastic cellsNeutrophilsLymphocytes
Chylous effusion
Eosinophilic backgroundSmall lymphocytesNeutrophilsMacrophagesLipid droplets
Bile effusion
Amorphous materialBluish blackGolden yellowMacrophagic 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
Mesothelioma
Large groupCytoplasmic vacuolationVisible junctionsCentral nucleus
CarcinomaLarge groupCytoplasmic vacuolationTight junctionsEccentric nucleus
Neoplastic effusion
Mesothelioma (rare) Pleural Pericardial
LymphomaCarcinomaMast cellSarcoma (exfoliation rare)
Heart base hemangiosarcoma
Poor prognosis
Neoplastic effusion
Carcinoma
Pulmonary metastasis from mammary carcinoma
Carcinoma
Peritoneal effusion, Intestinal Carcinoma
Sarcoma
Pulmonary artery hemangiosarcoma
Mesothelioma
F.Carrani 2008
Questions ?