Presentation on theme: "Cytological Examination: Part II"— Presentation transcript:
1 Cytological Examination: Part II Clinical Pathology
2 Microscopic Evaluation Scan at 10xDetermine if stained adequatelyAny localized or increased cellular areasScan for any large objects: parasites, foreign bodies, etc.Look at what type of cells are foundExamine at 40xEvaluate individual cellsExamine at 100x (oil immersion)Cell morphology, nucleus, chromatin, cytoplasm
3 Interpretation Inflammatory vs. Non-inflammatory Most important judgementMay not get a definitive diagnosis, but may be able to get a general idea/general process.Cytology may be helpful on what’s the next diagnostic step to takeCultureBiopsyRadsSerology
4 Inflammatory cells found in Cytology NeutrophilsMay resemble same as blood neutrophils.Be degenerativeHypersegmentedLymphocytesPlasma cellsActive lymphocytes that have a very basophilic cytoplasmEosinophilsMast cells- allergic inflammationMacrophagesLarge tissue monocytes.Have abundant blue cytoplasm with vacoules that may contain phagocytized cells or debrisOval to pleomorphic nucleusMesothelial cellsCells that line the pleural, peritoneal,a nd visceral surfaces.A type of macrophage
11 Classifications of Inflammation PurulentPyogranulomatousGranulomatousEosinophilicMay also be classified as duration:AcuteSubacuteChronic-activeChronic
12 Purulent Inflammation (Abscess) Most common type of inflammationUsually caused by bacteriaAlso called suppurative inflammationOver 70% neutrophils with a few macrophages and lymphocytes
13 Pyogranulomatous inflammation Also referred to as chronic/activeConsists of macrophages and 50-75% neutrophils
14 Granulomatous Inflammation Greater than 50-70% of cells are mononuclear (monocytes, macrophage, giant cells).Few neutrophilsAlso called chronic inflammation.
15 Eosinophilic Inflammation Consists of greater than 10% eosinophilsAllergic relatedMay see a few mast cells, plasma cells and lymphocytes
16 Selected Infectious agents of Cutaneous lesions Bacterial agentsTend to produce lesions characterized by >85% neutrophils, few macrophages, lymphocytes, and plasma cells.Rods, cocciCytology is helpful in determining what kind of culture or stain is needed.Fungal agentsTend to have more macrophages than bacterial lesions, but may be mixed (pyogranulomatous). Low numbers of lymphocytes.Sporothrix schenkiiHistoplasma capsulatumBlastomyces dermatidisCrytococcus neoformansCoccidiodes immitis
17 Sporiotrichosis: Sporothrix schenkii Organisms are round to oval or cigar shapedStain pale to medium-blue cytoplasm with a slightly eccentric pink or purple nucleus.Dimorphic fungus found in the environment worldwideInoculated into tissue via puncture woundsSuppurative to pyogranulamatousSkin lesions are characterized by multiple, non-painful, nonpruritic nodules that may ulcerate and drain purulent exudate.Dissemination is rare
18 Sporotricosis continued Diagnose via cytology, biopsy, fungal cultureEasier to diagnose in cats, tend to have more organismsInfected cats are highly contagious to humansTreatment includes long term antifungalsKetoconazoleItraconazolePrognosis is fair to good, but relapse is possible.
21 Histoplasma Capuslatum Round to oval- yeast-likeDark blue/purple staining nucleus surrounded by a thin haloCauses systemic diseaseCutanous lesions are rare, causes lungs or GI tract infectionsMost common in termperate and subtropical areas.Diagnosed through cytology, histopathology, fungal cultures, rads
23 Blastomyces dermatidis: Blatomycosis Caused by inhaling the conidiaCauses a disseminated infectionLymph nodesSkinBonesOther organsFound in mostly acidic soilsDiagnosed by cytology, histopathology, serology and fungal cultures.Most are single, blue, spherical and thick walled.Pyogranulamatous
25 Cyptococcus Neoformans: Cryptococcosis Found worldwideOrganism is inhaled and establishes infections in the nasal cavity, sinuses, skin and other organsSpherical, yeast-like organismsThick, clear mucoid capsuleMay be budding or non-buddingCats: URI signs, SQ swelling over bridge of nose, non-painful, may have CNS signsDogs: CNS signs and ophthalmic signs usually occur. Nodules on lips and nose.
28 Coicidiodes Immitis: Coccidiomycosis Dimorphic fungus and soil saprophyte endemic to desert areasOrganisms are inhaled and disseminate in bodySkin lesions are nodular, abscesses and draining tractsPainful lameness
29 Coccidiomycosis Continued Spherical with thick deeply stained wall.Diagnosis thought cytology, pyogranulamatous, histopathology, serology and fungal culture.Treated by long term systemic antifungals (8-12 months)Prognosis is unpredictableRelapses are commonFungal cultures are contagiousInfected animals are not considered contagious
30 Leishmania donovani: Leishamaniasis Protozoa transmitted by blood-sucking sandfliesEndemic to Central and South AmericaSporadic infections in the USA visceral and cutaneous disease that develops over months-yearsLesions are dark and small to large and ulcerated.Diagnose by imprints, scraping and FNAOrganism usually found in macrophagesSmall, round to ovalHas a very light blue cytoplasm, an oval nucleus, and a small dark kinetoplastUsually numerous organisms foundNot curableContagious to other dogs through vector
33 Epithelial Neoplasms Tend to exfoliate cells in sheets or clumps Cells tend to be large with moderate to abundant cytoplasmBenign epithelial tumorsPapillomaEpidermal inclusion cyst (epithelioma)Perianal gland adenomasMalignant epithelial tumorsPerianal gland adenocarcinomaSquamous cell carcinoma
35 Mesenchymal tumors: Spindle cell tumors Tend to exfoliate individual cells instead of clustersMay be difficult to differentiate from normal granulation tissue (spindle cells are plump).Difficult to differentiate from the different types of tumors on cytology.Benign forms:FibromasLipomasHemangiomaMalignant forms:FibrosarcomaLiposarcomaHemangiosarcoma
37 Discrete Round Cell Tumors Tend to exfoliate small to medium sized cells.Also called cutaneous round cell tumorsTypes:Mast cell tumorsCutaneous lymphosarcomaHistioctyomas Transmissable venereal tumor
40 Evaluation of Malignant Potential (Criteria of Malignancy) Variation of cell sizeVariation in nuclear sizeMultinucleatedIncreased nucleus: cytoplams ratioMitotic figuresVariation in nucleolar size/shapeCoarse Chromatin patternIf more than 3 criteria are recognized in a high percentage of cells, this is strong evidenc for malignancyIf 1-3 criteria are present, may be either benign or malignant and should be sent to pathologist or biopsied.
41 Submission of Cytologic Slides Send 2-3 air-dried unfixed smears and 2-3 stained smearsFluid samples should have smears prepared from them immediatelyAlso send EDTA and red top tubes filled with fluidMail in protective containersTimely transportation serviceEasy accesible and easy to collect cytologyTranquilization/anesthesia seldome needed for sample collectionQuick-sample can be prepared, stained, and microscopically evaluated in minutes.