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122 Cards in this Set
- Front
- Back
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Is cytology considered an invasive or non-invasive procedure?
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Non-invasive
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Cytology is most useful when the _____ and ______ work together.
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Clinician and cytologist
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What are the 3 advantages to cytology?
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1) Rapid
2) Economical 3) May get specific diagnosis |
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What are 3 disadvantages to cytology?
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1) Small sample
2) No tissue architecture 3) Requires practice |
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What are 2 reasons cytology may not lead to a diagnosis?
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1) Sample is inadequate or non-representative
2) Cell types present could be interpreted in more than one way |
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What is the first thing you do when examining a cytology slide?
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Look at entire specimen- spend a lot of time on low magnification
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What cells should you evaluate when examining a cytology slide?
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Only Intact nucleated cells
-Lots of smashed distorted cells |
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What size needle and syringe do you use for a solid tissue aspiration?
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22-25 g needle
3-12 cc syringe (depends on size and character of mass) |
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What is the non-aspiration technique of solid tissues?
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Move needle quickly through lesion and push into mass like a tattooing needle, like taking a biopsy expel contents onto slide
(called tattooing method) |
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What does she mean by redirect needle several times?
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Stick needle in pull back, then don't take needle out but redirect it and pull back again-gets more representative sample
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What are 2 advantages of the non-aspiration technique for solid tissue aspiration?
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1) May keep tissue architecture
2) Don't destroy cells bc no suction |
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Once you collect a sample for cytology, how do you prepare the slide?
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Take needle off and get air in syringe then put needle on and blow through onto slide and smear like with blood smears-want a nice monolayer
-Always make several slides |
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How should you dry cytology slides?
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Air dry
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Do you want to fix or stain a cytology slide when submitting it to a lab?
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No, don't fix or stain
-but stain at least one to look at in-house |
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What should you mail cytology slides in to the lab? What else do you need to provide for the lab?
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Plastic or styrofoam mailers, do not use cardboard!
-Provide good history and description of lesion -Submit several slides |
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You can make ______ smears from external lesions and masses removed surgically
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Impression smears
-Works best if ulcerated or open somehow -Make before put mass in formalin |
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If you have crust on a lesion and want to make an impression smear what should you do?
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Make one w/o cleaning, then clean with saline and make another
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If a lesion is ulcerated, why is it important to aspirate the tissue underneath instead of just making an impression smear?
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On top may just have inflammatory cells and blood but neoplasm e.g. squamous cell carcinoma underneath
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Do you blot off fluid and blood before you make an impression smear?
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yes
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What should you do if want to make a scraping of the cornea or conjunctiva?
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Numb the eye first it will only sting for a second, then use e.g. back of needle and scrape
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What kind of lesion would you maybe prefer to do a scraping on instead of an aspirate?
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When the lesion is flat and can't get an aspirate
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What are some things you ask yourself as you look over cytology?
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Are cells present normal?
Is process inflammatory or non-inflammatory? If inflammation, what type? If non-inflammatory, are criteria of malignancy present If malignant, what type? |
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Where are mesothelial cells located?
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Line body cavities
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Is a reactive mesothelial cell normal?
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Yes, just indicates increased fluid or inflammation in body cavity
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You are looking at a cytologic slide and see neutrophils whose borders are unclear and look like they're in bad shape and if you look really close you can see bacteria, what's going on?
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When neutrophils encounter bacteria they release granules that destroy the bacteria and themselves= degenerative neutrophils
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What do you call inflammation that only has neutrophils present?
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Suppurative or neutrophilic inflammation
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What do you call inflammation that has some neutrophils and some macrophages?
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Pyogranulomatous inflammation
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When do you say septic suppurative inflammation instead of suppurative?
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Septic is when you can see bacteria, if don't see bacteria don't say suppurative non-septic bc just cause don't see them doesn't mean they're not there
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What do you call inflammation that has a few neutrophils and lots of normal looking small, mature lymphocytes?
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Lymphocytic
-More commonly responding to viruses or antigenic stimulation NOT bacteria |
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You see a cytologic slide with some eosinophils, neutrophils and a couple lymphocytes, how would you classify this inflammation? Causes?
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Eosinophilic bc usually not many at all
-Parasite or allergies |
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You see a cytologic slide with a bunch of degenerative neutrophils, some macrophages, and lots of bacteria, how would you classify this inflammatory reaction?
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Septic, suppurative inflammation w/ degenerate neutrophils
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*What are toxic neutrophils? Compare to degenerative.
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Toxic neutrophils are in the blood (degenerative are not encountering bacteria in tissues) and get their morphologic characteristics when they’re being made, made like that in bone marrow bc there’s some intense inflammatory mediators; degenerative neutrophils are in the tissues attacking bacteria
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You have a slide that looks like there's bacteria on it, but there's no neutrophils, is this septic?
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No! have to have a neutrophilic response at least see degenerate neutrophils
-Probably stain precipitate |
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True or false. Inflammation is the same as infection.
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False!
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What are 9 morphologic criteria of malignancy?
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1) Cell pleomorphism-size and shape
2) Nuclear pleomorphism-size and shape 3) Increased nuclear to cytoplasmic ratio 4) Multiple nuclei 5) Nuclear molding 6) Large, multiple, or angular nucleoli 7) Increased numbers of abnormal mitotic figures 8) Coarsely clumped chromatin 9) Increased cytoplasmic basophilia -Most malignancies do not have all criteria and some of these can be found in tumors that are not malignant, more you see more likely malignant |
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Is there a cell that already has such a big nucleus that it can’t get any bigger with malignancy than it already is?
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Lymphocytes
-other cells see enlargement of nucleus |
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What are 2 cells that can normally have multiple nuclei?
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Megakaryocytes
Hepatocytes |
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What's the point of determining what type of malignancy a tumor is?
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Allows us to predict behavior of tumor
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*What are 5 characteristics of epithelial cell tumors?
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1) See cells in clusters bc of cell-to-cell adhesion
2) Large 3) Distinct cell borders 4) Generally round nucleus 5) Moderate to abundant cytoplasm |
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What is your next step after diagnosing metastatic mammary adenocarcinoma?
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Take thoracic radiographs-tend to metastasize
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If you see a homogenous cell population and it seems like all your seeing are nuclei, what's high on your differentials?
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Benign endocrine tumor
-Endocrine tumors see the "naked nuclei" |
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What are 5 mesenchymal cell characteristics?
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1) Usually single, may be in small clumps (matrix)
2) Indistinct cell borders 3) Spindle-shaped to polygonal (when can see) 4) Nuclei oval or round 5) Moderate amounts of cytoplasm |
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Why may cytology not be very helpful in diagnosing a mesenchymal cell tumor?
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Bc they produce matrix (chondroid, osteoid, collagen) so the cells don't exfoliate very well so may not get many cells on cytology
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What kind of tumor are lipomas?
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Mesenchymal cell, so can cluster etc.
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Why do lipomas sometimes not appear on cytology?
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Because fat dissolves in alcohol, but sometimes will see outline
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What are the 2 characteristics of round or discrete cell characteristics?
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1) Single, small to medium-sized cells
2) Distinct cell borders |
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What are the 5 round or discrete cell tumors?
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1) Mast cell tumors
2) Lymphomas (includes plasma cell tumors) 3) Histiocytomas 4) Transmissible venereal tumors 5) Melanomas |
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Histiocytomas are common in _____ dogs.
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Young
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How do you tell histiocytes from lymphocytes?
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Histiocytes have more cytoplasm
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What is the treatment for histiocytomas?
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Nothing go away on their own by inciting inflammatory response so can see neutrophils
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In mast cell tumors you usually also see what cell type?
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Eosinophils
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What is the big difference b/w dip quick and wright's giemsa stain?
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Dip-quick doesn't stain mast cells and wrights does
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True or false. Melanomas are always covered w/ black pigmentation on cytology.
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False, sometimes just a few tiny black pigment granules
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Often melanomas present as distinct cells but sometimes look more like ________ cells.
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Mesenchymal cells and appear spindle shaped
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What are 3 characteristics of plasma cells?
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1) Eccentric nucleus
2) Prominent Golgi 3) Basophilic cytoplasm |
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How do transmissible venereal tumor cells appear?
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NO granules
Vacuoles in cytoplasm Greyish/blue cytoplasm Round to oval nucleus |
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When fluid samples are put in EDTA it preserves ______.
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Cell morphology
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True or false. If you want to perform a culture on a fluid sample you should put the fluid in EDTA.
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False, cannot culture samples in EDTA bc EDTA is bacteriostatic
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If you are sending fluid samples to an outside lab, what should you send other than just sample in purple (EDTA) and red top tubes?
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Make some direct or sediment smears form fresh fluid
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What can you do to evaluate fluid samples in house?
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Diff-quik or other Romanowsky-type stain will work
-Leave in stain longer if material is thick |
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How can you do a cell count on a fluid sample?
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Hemocytometer
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What are the 4 things you should evaluate with a fluid sample?
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1) Gross evaluation
2) Cell count 3) Total protein 4) Cytologic evaluation |
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What are 4 ways to classify effusions in a dog or cat?
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1) Appearance
2) Protein 3) Nucleated cells 4) Common cell types |
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What are the 3 classifications of effusions in a dog and cat?
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Transudate
Modified transudate Exudate |
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What color is a transudate?
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Clear, colorless
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What is the protein and cell count of transudates?
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Low protein <2.5
Low cell count <1500 |
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What are the common cell types of transudate?
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Non-degenerate neutrophils, large mononuclear cells
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What is the color of modified transudate?
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Variable; amber to white to red and frequently turbid
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What is the protein and cell count of modified transudate?
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Protein 2.5-7.5
Nucleated cells 1000-7000 |
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What are the common cell types of modified transudate?
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Nondegenerate neutrophils, large mononuclear cells, small lymphocytes
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What is the color of an exudate?
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Variable; amber to white to red and turbid to cloudy
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What is the protein and cell count of exudate effusions?
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Protein> 3.0 (high)
Nucleated cells >7000 (high) |
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What kind of cells are common in an exudate?
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Neutrophils
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What are 3 possible causes of transudate?
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1) Hypoalbuminemia (renal glomerular disease, hepatic insufficiency, protein losing enteropathy)-MOST COMMON
2) Leakage of low-protein lymph from intestinal lymphatics 3) Ruptured urinary bladder |
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What are 6 possible causes of modified transudate?
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1) Fluid leakage from lymphatics w/ high protein lymph or blood vessels
2) Cardiovascular disease*** 3) Liver disease 4) Neoplasia 5) Urinary bladder rupture 6) Chylous effusion |
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What is the gross appearance of chylous fluid?
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White bc of chylomicrons and maybe reddish from blood (can settle on bottom)
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What is the predominate cell type of chylous fluid?
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Lymphocytes
-Can see mixed w/ neutrophils and/or macrophages |
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If you find a chylous fluid then what should be your next step?
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Check the cardiovascular system bc decreased venous return can put pressure on thoracic duct and cause leakage
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What are some causes of chylous fluid?
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Ruptured thoracic duct
Increased pressure on thoracic duct causes leakage e.g. cardiovascular failure w/ decreased venous return |
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What are the 4 characteristics of FIP fluid?
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1) Often high protein (>3.5)
2) Moderate cell count (2000-6000) 3) Eosinophilic background due to high protein 4) Primarily non-degenerate neutrophils |
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What is the gross appearance of FIP fluid?
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Bright yellow
*look for this combined w/ high protein and moderate cell count |
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Are exudates inflammatory or non-inflammatory?
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Can be either
-if inflammatory may be septic or non-septic |
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Exudates may be secondary to _____.
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Neoplasia (these are usually called neoplastic effusions)
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True or false. Exudates indicate that there's either bacteria or neoplasia present.
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False, can be non-septic exudate such as bile peritonitis
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You are looking at cytology of a foals abdominal fluid and you see calcium carbonate crystals, what's your diagnosis?
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Ruptured bladder
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What is the medical term for urine in the abdominal cavity?
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Uroperitoneum
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How can you tell if hemorrhagic effusion is from the needle or previous bleeding?
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Look for evidence of erythrophagocytosis-golden brown pigment in macs or blue black pigment if happened earlier..
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Where are mesothelial cells normally located?
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Normal lining cells of abdomen, thorax, pericardium
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Why can the border of mesothelial cells appear fuzzy or halo like?
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Have microvilli around the outside
-Can be normally binucleated |
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Mesothelial cells are nearly always present in effusions and when there's increased fluid, what happens to the amount of mesothelial cells?
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Increases the number of cells shed
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What is a big problem with reactive mesothelial cells in fluid from a body cavity?
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Reactive mesothelial cells may take on morphologic characteristics of malignancy
-binucleated, vacuoles |
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Reactive mesothelial cells can take on the characteristics of _______.
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Macrophages, can become phagocytic
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When performing a cell count of cytology, what do you count?
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# neutrophils
# large mononuclear cells |
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Why do horses have a higher volume of abdominal fluid than other species?
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Lots of guts so need lubrication
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Equine abdominal fluid has _____ cellularity and _____ protein concentration.
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Low, low
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What is the nucleated cell count normally of equine abdominal fluid? What cell types?
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less than 5,000
1:1 neutrophils to mononuclear cells, but there is LOTS of variability |
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What is a normal total protein of equine abdominal fluid?
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< 2.5 g/dl
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What does it mean if you see plant material and neutorphils in equine abdominal fluid?
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Gut rupture, seeing piece of feed from GI leaked into abdominal cavity and neutrophils are trying to phagocytize= septic, suppurative
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Equine abdominal fluid has nucleated cell count=10,800, total protein=6.6 and bacteria are visible, classify the fluid.
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Septic, suppurative, hemorrhagic
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What is normally seen on cytology of the GI tract (like if accidentally punctured GI)?
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Protozoa and bacteria, but no cells
-If in abdominal cavity would see neutrophils |
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What will you see if you accidentally got a pregnant mare tap and hit the amniotic fluid?
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Keratin fragments
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What is the normal gross appearance of joint fluid?
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Normally transparent to slightly yellow
-Viscous-sticky |
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What is the normal cell count and protein levels of joint fluid?
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Nucleated cell count- varies by joint, usually 3,000
Low protein: 1.8-4.8 |
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In joint fluid neutrophils are normally ____% of cells, large mononuclear cells predominate.
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12%
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In a normal joint, how are the cells oriented (RBCs)?
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Form lines bc of hyaluronins in the joint fluid
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How does a joint tap from a dog with degenerative joint disease appear?
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Not active inflammation more chronic so see large mononuclear cells
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What is the normal gross appearance of cerebrospinal fluid?
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Normally clear, colorless (like water)
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What is the cell count and protein of cerebrospinal fluid like?
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Very low cell count (<8) and protein
-Cells are normally mononuclear cells |
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What are 2 possibilities when there's a high cell count of lymphocytes in CSF?
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If large and more immature=lymphoma
If small and mature=viral encephalitis |
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What is a common problem with lymph node cytology?
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Lymphocytes are fragile and easily rupture
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What are 3 possible reasons for lymph node enlargement?
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1) Hyperplasia (normal w/ antigenic stimulation)
2) Inflammation 3) Neoplasia |
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**A normal lymph node is about ____-_____% small, mature lymphocytes.
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75-95%
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What are 3 possible reasons for lymph node enlargement?
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1) Hyperplasia (normal w/ antigenic stimulation)
2) Inflammation 3) Neoplasia |
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What cells do you normally see on cytology of normal lymph node?
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Small numbers of medium-sized and large sized-lymphocytes
75-95%=small, mature |
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**A normal lymph node is about ____-_____% small, mature lymphocytes.
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75-95%
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What will you see on cytology of a reactive lymph node (hyperplasia)?
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Still lots of small mature lymphocytes, some plasma cells, find relative increase in number of bigger cells and lots of plasma cells
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What cells do you normally see on cytology of normal lymph node?
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Small numbers of medium-sized and large sized-lymphocytes
75-95%=small, mature |
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What would you expect to see on cytology of a reactive and inflamed lymph node?
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Lots of plasma cells, eosinophils, melanin pigment-typical of itchy animal
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What will you see on cytology of a reactive lymph node (hyperplasia)?
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Still lots of small mature lymphocytes, some plasma cells, find relative increase in number of bigger cells and lots of plasma cells
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What would you expect to see on cytology of a reactive and inflamed lymph node in an animal w/ pruritus?
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Lots of plasma cells, eosinophils, melanin pigment-typical of itchy animal
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What will you see on cytology of lymphadenitis?
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Macrophages and neutrophils
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What do you see on cytology of lymphoma?
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Many large lymphoblasts, multiple nucleoli! maybe increased cytoplasm
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