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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