Cytology 3

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Questions and Answers

Most effusions are not noticed by the pet owner until ____________

They vomit blood

The have melena

They are dead

They are severe (correct)

What is characteristic of synovial fluid?

It has high viscosity

It has high turbidity

It does not clot (correct)

It clots when contaminated with blood

What is the primary cell type in exudates?

Neutrophils (correct)

Lymphocytes

Eosinophils

Mononuclear cells

Why is it important to examine cytology samples quickly?

To prevent cell degeneration Signup and view all the answers

What is the purpose of adding EDTA to a sample?

To prevent clotting Signup and view all the answers

What is the typical protein concentration in synovial fluid?

Low Signup and view all the answers

What is the primary use of the mucin clot test?

To evaluate joint health Signup and view all the answers

What is the typical composition of cells in synovial fluid?

90% mononuclear and less than 105neutrophils Signup and view all the answers

What is the significance of using relatively clear samples for automated TNCC?

To reduce counting debris Signup and view all the answers

Which cell type is typically present in variable numbers in effusions?

Mesothelial cells Signup and view all the answers

What is the purpose of classifying effusions based on TNCC and TP?

To help determine the general mechanism of fluid accumulation Signup and view all the answers

What is the characteristic of transudates in terms of appearance and protein concentration?

Clear, low protein concentration Signup and view all the answers

What is the potential source of error in both manual and automated cell count methods?

All of the above Signup and view all the answers

Which of the following cells can be the predominant cell in effusions associated with inflammation?

Neutrophils Signup and view all the answers

What is the purpose of using the Unopette system in manual cell count?

To count WBCs Signup and view all the answers

What is the recommended method for determining total protein in opaque fluids?

Using the supernatant Signup and view all the answers

What is the primary reason why pet owners may not notice effusions until they are severe?

Because the pet may not display symptoms until the effusion is severe Signup and view all the answers

What is the purpose of radiographs and ultrasound in the diagnosis of pleural effusions?

To determine the extent and location of the effusion Signup and view all the answers

What is the typical characteristic of pleural effusions?

They are typically abundant and bilateral Signup and view all the answers

What is the purpose of collecting a sample of effusion in an EDTA tube?

To perform a total nucleated cell count Signup and view all the answers

What is the purpose of making sediment smears on non-turbid samples?

To prepare the sample for examination Signup and view all the answers

What is the purpose of performing a fluid analysis with cytologic examination?

To obtain information for diagnosis, prognosis, and treatment Signup and view all the answers

Lines the plural, peritoneal and visceral surfaces

Mesothelial cells Signup and view all the answers

When do problems arise

When more fluid is coming in than going out Signup and view all the answers

Clinical signs of pleural effusion

All of the above Signup and view all the answers

List the 5 clinical signs of pleural effusion

dyspnea, crouched sternal recumbency, extension of the head and neck, open mouth breathing, forceful abdominal contractions Signup and view all the answers

Pleural effusions are typically

Both A and B Signup and view all the answers

Sample preparation depends on the (clear or cloudy) and __of the fluid

Character, quantity Signup and view all the answers

• Whether it will be evaluated in the hospital lab or sent to a pathologist, what must you do

Call and ask for directions Signup and view all the answers

Study Notes

Evaluation of Effusions

Total Nucleated Cell Count (TNCC) can be done using automated or manual methods
Automated method may count debris, so only relatively clear samples should be used
Manual count utilizes the Unopette system for WBC count
Cell clumping, cell fragmentation, and noncellular debris can cause errors with both methods
Total Protein (TP) is used to classify effusions as transudates, modified transudates, or exudates
TP can be estimated by refractometry or biochemically

Cells Seen in Effusions

Neutrophils: present in most effusions, can be the predominate cell in effusions associated with inflammation
Mesothelial cells: line the pleural, peritoneal, and visceral surfaces, present in variable numbers in effusions
Macrophages
Lymphocytes
Eosinophils
Mast cells
Erythrocytes
Neoplastic cells
Microfilaria
Basket cells: ruptured nucleated cells with eosinophilic chromatin spreads

Classification of Effusions

Classification is based solely on TNCC and TP
Classification helps determine the general mechanism of fluid accumulation
Helps in differentiating infection from neoplasia
All findings must be interpreted with historical, physical, and clinical findings to achieve a definitive diagnosis

Transudates

Clear, colorless fluid
Low protein concentrations (<7,000)
Neutrophils are the predominant cell type
Occasionally, an exudate develops due to abundant exfoliation of cells from a tumor or chylous effusion

Synovial Fluid

Arthrocentesis
Synovial fluid does not clot
Blood contaminates will clot unless processed immediately or added to EDTA
Limited tests due to small yield

Sample Handling and Test

Color: straw yellow
Turbidity: non-turbid
Viscosity: sticky
Cytology: normal morphology (90% mononuclear cells, <10% neutrophils)
Mucin clot test (heparin)
Cell count if enough fluid is available
Useful in confirming the presence and type of primary CNS disease

Cerebrospinal Fluid (CSF)

Color: colorless and transparent
TNCC
Protein concentration: normally very low
50mg/dl of albumin
Cytologic examination: should be done as fast as possible (within 15 minutes) because cells begin to degenerate quickly
Cell types: Mononuclear cells (Lymphocytes 95-100%)

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