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Cytology of Body Fluid

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Cytology of Body Fluid

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    1. Cytology of Body Fluid

    4. differences between transudate and exudate

    5. Diagnostic role of effusion cytology It is very useful for diagnosis of premalignant and malignant tumors, especially metastatic tumors. It is very useful for diagnosis of inflammatory conditions (septic effusion, or chronic specific inflammation e.g. TB

    6. Respiratory Tract Urinary Tract Oral Cavity Gastrointestinal Tract Effusions (pleural, pericardial, joint) Cerebral Spinal Fluid Amniotic fluid Many other body sites

    7. Examination of body fluid Gross exam Total cell count Microscopic exam Any other special test (Chemistry, Microbiology, cytology ( Test are performed in various areas of lab based on what the physician orders. Body fluids sterile vs. non-sterile

    8. Sample collection FNA of effusion fluids Tapping

    10. Fixation 1ml of heparin + 100ml of effusion fluid to prevent clotting N.B.: do not use alcohol in fixation of fluid before spread cytological smear on glass slides

    11. Types of staining smears PAP Gram Stain Hx & E Cell block for remnant sediment and histopathological examination. Other special stains for the most suspected diseases, to confirm diagnosis.

    13. 1- Cerebrospinal Fluid Fluid surrounding brain and spinal cord Sterile Specimen collection: by Lumbar puncture Collect 3-5 vials, each tube has a designated department. Gross exam: Turbidity, Color, microscopic exam, cell count

    14. CSF cell differential Numerate and differentiate cells seen Lymphocytes: usually are few; increased with viral, fungal, bacterial meningitis, or nervous system disease Monocytes: Less than 2% of normal CSF, increased with TB meningitis, viral encephalitis, subarachnoid hemorrhage.

    15. PMN: are few, associated with Viral and acute bacterial inflammation. Macrophages: are few in number associated with malignancy, hemorrhage, inflammation Eosinophils/Basophils: not normally seen in CSF

    16. Plasma cells: not normally present; associated with viral disorders, and Hodgkin's diseases. Red Blood Cells: Few to none present Mesothelial cells: not present Malignant cells: will see with malignant disease and infiltrate.

    17. Effusion: Transudate Exudates Lab analysis: Gross exam, cell count, etc. Differential: PMN, Lymph, Mono, etc.

    18. Cells unique to the lungs: Mesothelial cells RBCs and WBCs: are limited, if increased without traumatic tap ----- indicates infarction Cytology exam: useful in identifying malignancy or abnormal morphological cells.

    19. 3- Peritoneal Fluid Abnormal accumulation of fluid (effusion) in peritoneal cavity: Ascites Ascites: a condition in which fluid accumulates within the peritoneal space. Must have an accumulation of > 100ml (several 100) before effusion can be detected on physical exam.

    20. Removal procedure- paracentesis Lab analysis: distinguish between transudate and exudates, gross exam, cell count, sedimentation, chemical analysis

    21. Physical Characteristics Peritoneal Fluid Appearance: Color and clarity. Color and clarity can indicate certain infections and diseases. Total Cell Count: Assist in diagnosis of certain diseases by determining total RBC and WBC number.

    22. Lymphocytes: CHF, liver cirrhosis, nephrotic syndrome Mesothelial Cells: Associated with TB effusions Malignant cells: seen with malignancy

    23. Pericardial Fluid: accumulation of fluid of the lining of the heart (effusion) Cause: neoplasm, infections, collagen disease, renal disease, Cardiovascular disease. Gross Exam: Report appearance (bloody, clear, cloudy)

    24. Measure pH: pH less than 7.0 associated with infection or rheumatoid disorder. Cell count: see limited RBCs and WBCs Evaluate sedimentation

    25. Examine physical, chemical and microscopic detail Count number of sperm, report morphology and motility Specimen must be a fresh collection-clean, sterile container. Gross Exam: Color, pH, Volume, and viscosity. Agglutination study

    26. Joint Fluid: normally clear, viscous Functions as a lubricate and transports nutrient Arthrocentesis: aspirate of the joint fluid, aseptic technique Lab Assay: Gross exam, microscopic exam, Gram stain, cultures,...

    27. Appearance: clear, transparent, viscous Viscosity test Mucin Clot test Note crystals (intracellular vs. extra cellular) Slide exam: usually performed on concentration of the fluid using Giemsa or Papnicolaou

    28. Thank You

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