Cytology of Inflammation

What is cytology?

microscopic examination of individual cells from tissue or fluids

What are the disadvantages to cytology?

cannot assess invasion or grade, moderately sensitive

What are the requirements for shipping cytology samples?

room temp, air dried, unstained; if fluid put in EDTA on ice

What should you separate when shipping cytology samples?

formalin

What should you include on cytology sample submission form?

pertinent history

What are platelets evidence of?

blood contamination

What is erythrophagia evidence of?

acute hemorrhage

What are heme-breakdown products (hemosiderin and hematoidin) evidence of?

chronic hemorrhage

Where are neutrophils typically seen?

acute inflammation and bacterial infections (first responders)

Due to neutrophils being fragile, what is a common artifact to see?

nuclear streaming due to rupturing of cells during smear preparation

What are degenerate neutrophils?

nuclear swelling in tissue secondary to bacterial toxins

What are toxin neutrophils?

Dohle bodies seen in blood with accelerated granulopoiesis secondary to inflammation

What is the morphology of a “typical” macrophage?

round nucleus with pale gray or light blue cytoplasm often abundantly vacuolated

What is the morphology of a epithelioid macrophage?

larger and more basophilic that may form clusters; look similar to epithelial cells

What is the morphology of a multinucleated giant cell?

results from the fusion of macrophages, foreign bodies, chronic inflammation

What is a plasma cell?

differentiated B-cells that produce Ig, eccentric nuclei and deeply basophilic cytoplasm with a golgi zone

What is a neutrophilic inflammation?

most common inflammation, acute bacterial/septic inflammation

What is karyopyknosis/karyorrhexis?

condensation of chromatin during cellular death seen in neutrophilic inflammation

What is degenerate change?

changes in nuclear morphology secondary to bacterial toxins seen in neutrophilic inflammation; nuclei swell, lose their distinct lobulation, and become more pale

What is an eosinophilic inflammation?

usually acute but can be chronic; due to parasitic infection or hypersensitivity reactions

What is a granulomatous inflammation?

macrophages ± multinucleated giant cells ± lymphocytes and plasma cells; commonly caused by foreign body

What is a pyogranulomatous inflammation?

same as granulomatous inflammation PLUS neutrophils = macrophages ± multinucleated giant cells ± lymphocytes and plasma cells AND neutrophils; same differentials (foreign body or atypical bacteria)

What is filamentous bacteria?

slender bacilli with beaded appearance; actinomyces, nocardia, fusobacterium spp.

What is mycobacteria spp.?

negatively staining bacteria, acid fast; (pyo)granulomatous inflammation that can be zoonotic

What is dimorphic fungi?

exist as both yeast and mold depending on temperature “mold in cold and yeast in the beast”

What is blastomyces?

endemic around mississippi an ohio river basins; look like big blue balls with broad based budding; dogs » cats - NOONOTIC potential avoid fungal culture

What is cryptococcus spp.?

spread by pigeon droppings; lesions on nose or skin, cell has a purple center with narrow-based budding ± thick mucoid capsule

What is histoplasma?

spread by bird and bat droppings is known to affect visceral organs more than cutaneous skin, morphologically seen as round to slight oval yeast with thin clear halo capsule

What is sporothrix?

most common in cats (zoonotic), cutaneous form most common via puncture; morphologically seen as cigar-shaped yeast

What is coccidiodes spp?

endemic in southwest, seen as LARGE blue cells; avoid fungal culture because of zoonotic potential