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6 advantages of cytology.
provides useful clinical information, inexpensive, non-invasive, rapid interpretations, and samples can be collected from a variety of sites and many different tissues
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3 limitations to cytology.
no tissue architecture so surgical margins and vascular invasion cannot be evaluated, attention to detail in sampling and preparation is key, some tissues may not exfoliate readily
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4 useful methods of sample collection for cytology.
fine needle aspirate (FNA), ultrasound to guide FNA, impression smears, gentle tissue scraping
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Make sure to always sample ___________ within a lesion when evaluating with cytology.
several sites (to get a representative sample)
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What are two methods of preparing the sample for cytology evaluation?
spreading the sample b/w two slides (squash preparation), push technique (blood smear preparation technique)
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For fluid samples being sent to a reference laboratory, make _____________ and let them __________; these will be submitted with...
one or two direct smears; air dry; the fluid
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Prepare slides away from ________ to avoid...
formalin; fixation and staining artifacts
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If slides are to be sent to a reference laboratory, send ________, __________ slides; always remember to include the... (4)
air-dried; unstained; signalment, history, sites from which sample was collected, and preliminary differentials
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Inflammation is characterized by a _____________ of cells, including... (7); the type of inflammation is indicated by...
mixed population; neutrophils, lymphocytes, plasma cells, eosinophils, mast cells, monocytes, and macrophages; the predominant inflammatory cell type
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5 degenerative changes in neutrophils.
nuclear pyknosis, karyolysis, karyorrhexis, cytoplasmic basophilia, and vacuolization
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What are degenerative neutrophils indicative of?
bacteria or other etiologic agents, such as fungi
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Hyperplastic cells resemble normal cells, but...
they appear more immature
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Hyperplastic cells have a _________ N:C ratio; neoplastic cells have a __________ N:C ratio.
constant; variable
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Neoplasia is characterized by the presence of cells that are...
not normally expected from the site of collection
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Neoplastic criteria are features of ______________.
rapid multiplication
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Discrete cell tumors, or round cell tumors, are _____________.
solid tissue masses
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Mast Cell Tumors
Type-
Cell shape-
Nucleus-
Granules?-
Other defining characteristics-
- Type- Round cell tumor
- Cell shape- round to oval
- Nucleus- Central, aggregated chromatin
- Granules?- cytoplasmic
- Other defining characteristics- may be accompanied by eosinophils
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Lymphoma
Type-
Cell shape-
Nucleus-
Granules?-
- Type- Round cell tumor
- Cell shape- round cells with high N:C ratio
- Nucleus- prominent nucleoli
- Granules?- NONE
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Histiocytoma
Type-
Cell shape-
Nucleus-
Granules?-
Other defining characteristics-
- Type- Round cell tumor
- Cell shape- round, oval, or irregularly shaped
- Nucleus- Eccentric
- Granules?- NONE
- Other defining characteristics- spontaneously regress when infiltrated by lymphocytes- may not need treatment
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Localized soft tissue mesenchymal neoplasm that usually presents as a large, locally-invasive subcutaneous mass common in Rottweilers.
Histiocytic sarcoma (malignant)
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Histiocytic sarcoma
Type-
Cell shape-
Nucleus-
Granules?-
Other defining characteristics-
- Type- round cell tumor
- Cell shape- large, pleomorphic mononuclear cells w/ marked anisocytosis
- Nucleus- anisokaryosis, prominent nucleoli
- Granules?- none
- Other defining characteristics- vacuolated cytoplasm
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Extramedullary plasmacytoma
Type-
Cell shape-
Nucleus-
Granules?-
Other defining characteristics-
- Type- round cell tumor
- Cell shape- round to oval
- Nucleus- eccentric; binucleated is common
- Granules?- none
- Other defining characteristics- perinuclear clear zone
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If a malignant neoplasm is of epithelial origin, it is known as a ________.
carcinoma
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If a malignant neoplasm is of mesenchymal origin, it is known as a ___________.
sarcoma
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Epithelial neoplasms exfoliate ________, are arranged as __________, are shaped _____________, and have ___________ cytoplasmic borders.
easily; clusters; round or polygonal; well-defined
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Mesenchymal neoplasms exfoliate ________, are arranged as __________, are shaped _____________, and have ___________ cytoplasmic borders.
poorly; single cells; spindle or irrgularly; poorly defined
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In normal lymph nodes, the majority of cells are ___________ with a much smaller population of __________; other cell types may be present in small numbers.
small lymphocytes; medium and large lymphocytes
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Intermediate (medium) and large lymphocytes are ________ or _________ lymphocytes, similar in size or larger than __________.
immature; activated; neutrophils
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Hyperplastic lymph nodes have the following cells types present in significant numbers (from most to least)...
small lymphocytes, medium and large lymphocytes, plasma cells, macrophages
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Hyperplastic lymph nodes are ___________ secondary to a _________________________; there is a _________ population of lymphcytes, but _______ predominate.
enlarged; localized or systemic antigenic stimulation; heterogenous; small lymphocytes
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Lymphadenitis is characterized by __________________.
accumulation of inflammatory cells (neutrophils, eosinophils, macrophages)
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In ___________ lymphadenitis, >5% of the cells are neutrophils, which sometimes appear degenerate.
suppurative (neutrophilic)
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Most common causes of suppurative lymphadenitis.
bacterial agents
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Caseous lymphadenitis is a type of _____________ lymphadenitis.
suppurative
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Streptococcus equi can cause strangles in horses, which is a __________ lymphadenitis and potential rupture of ___________.
suppurative; parotid and mandibular lymph nodes
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In ____________ lymphadenitis, macrophages are the predominant cells.
granulomatous
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In __________ lymphadenitis, macrophages are neutrophils are the predominant cells.
pyogranulomatous
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Granulomatous and pyogranulomatous lymphadenitis often are associated with _______ or ____________.
fungal or mycobacterial infections
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Blastomycosis is a caused of ___________ lymphadenitis with ________.
pyogranulomatous; fungal yeasts (big, blue, broad-based bud= blasto)
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Histoplasmosis is a _______ infection of __________ that causes __________ and ____________ inflammation.
fungal; macrophages; pyogranulomatous; granulomatous
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Transudate is a ____________ effusion with a __________ cellular response.
non-inflammatory; minimal
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5 common causes of transudate effusions.
congestive heart failure, liver failure, protein-losing enteropathy, glomerular nephropathy, hypoalbuminemia
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Modified transudate is a __________ effusion that has a __________ plasma protein count and nucleated cell count.
non-specific; variable
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Transudate
total protein-
cell count-
SG-
- total protein- <2.5 g/dL
- cell count- <1000 cells/μL
- SG- <1.018
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Modified transudate
total protein-
nucleated cell count-
SG-
- total protein- 2.5-7.5 g/dL
- nucleated cell count- 1000-7000 cells/μL
- SG- 1.08-1.025
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Exudate is a(n) _________ effusion caused by ________________ from ___________.
inflammatory; inflammatory mediator release; tissue insult
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Exudate
total protein-
nucleated cell count-
SG-
- total protein- >3.0 g/dL
- nucleated cell count- >7000 cells/ μL
- SG- >1.025
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Color of effusions can indicate origin/ cellular contents:
Colorless-
Yellow-
Red,orange-
Green-
Brown,black-
White, tan-
White-
- Colorless- transudate, normal fluid
- Yellow- icterus
- Red,orange- bllood
- Green- bile
- Brown,black- melanin
- White, tan- inflammatory or neoplastic cells
- White- lipid from chylomicrons or cell membranes
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Transudate is usually _________, and its predominant cell type is ________.
clear, colorless; mononuclear cells
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Modified transudate is usually ___________, and its modified cell type is _________.
light yellow to orange, clear to cloudy; large mononuclear cells...variable
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Exudate is usually __________, and it prominent cell type is ________.
yellow-orange to tan to white, cloudy; neutrophils +/- bacteria, fungi
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