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    AMVAC 2

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    Smaranda Ciocoiu

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    © All Rights Reserved
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    AMVAC 2

    Uploaded by

    Smaranda Ciocoiu
    2 views61 pages

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    2 views61 pages

    AMVAC 2

    Uploaded by

    Smaranda Ciocoiu

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 61

    Taking samples from the liver and make a cytology

    Stephan Neumann
    Dipl. ECVCP
    Definition

    • Structure, function
    and pathology of
    cells
    Where do we • All forms of skin
    tumors
    • Vaginal swab

    use cytology? • Bladder


    • Nasal discharge • Sediment
    • Tumor versus
    aspergillosis
    • Bone marrow

    • Conjunctiva
    • Liver
    • -
    • Ear
    • Malassezia • -
    • -
    Cytology advantages vs
    disadvatages

    • Advantage
    • Prompt diagnosis (< 5min)
    • Minimal invasive
    • Reduced anesthetic risk
    • No bleeding risk

    • Disadvantage
    • No tissue architecture
    • Blood contamination
    Accordance between
    cytology and histology

    • Liver diseases in general


    • 28% (25 dogs and 7 cats)
    Fondacaro et al. 1999
    • 66% (44 dogs)
    Kristensen et al. 1990
    • Liver tumors
    • 80% (10 dogs and cats)
    Cole et al. 2002
    • 92% (13 dogs and cats)
    Roth 2001
    • Skin tumors
    • 90% (243 dogs and cats)
    Ghisleni et al. 2008
    Steps of cytology
    • Choose the right technique
    • Prepare the patient
    • Prepare the slide
    • Collect the sample
    • Stain

    5 min
    Right technique

    • FNA
    • 21-25g cannula, Menghini
    needle
    • 3-20 ml syringe
    • Aseptic preparation if
    microbiology

    • Technique >>>>>>>
    Technique

    remove
    stick

    remove
    syringe
    suck

    blow
    no vacuum
    Blood smear technique

    From: Diagnostic Cytology and Hematology of the Dog and Cat.


    By: Cowell, Tyler and Meinkoth
    Squash prep technique

    From: Diagnostic Cytology and Hematology of the Dog and Cat.


    By: Cowell, Tyler and Meinkoth
    Preparation

    Smear Air drying Staining


    Giemsa
    Diff-Quick
    Stainings

    • Romanowsky Staining
    • Giemsa
    • Diff-Quick
    • Methylen Blue
    • Papanicolaou
    • Gram
    • Ziehl-Neelsen
    Cytological examination

    • 10X, 40x und 100X Oil immersion

    • Cellularity
    • Background

    • Cells
    • Criteria for malignancy
    • Bacteria
    Guidelines

    • Inflammation yes or no?


    • Bacteria yes or no?
    • Tissue type
    • Tumor cells yes or no?
    • Malignancy yes or no?
    Bacterial infection

    Been JV, Linssen CFM, van Iwaarden JF, et al


    Massive bacterial cell invasion and reactive type II pneumocytes
    in bronchoalveolar lavage fluid from a preterm neonate
    Archives of Disease in Childhood - Fetal and Neonatal
    Edition 2007;92:F319.
    Tissue types

    • Epithelio-glandular
    • Round – polygonal cells
    • Central nuclei
    • Cells in clusters
    • Mammary gland, liver

    • Mesenchymal
    • Spindle shaped cells
    • Oval nuclei
    • Thin cytoplasm

    • Round cells
    • Round cells
    • Like blood smear
    • Mast cells
    • Histiocytes
    • Lymphocytes
    Criteria for malignancy

    1. Cell size
    • Anisocytosis
    • Abnormal cell localization
    2. Nucleus size
    • Anisonucleosis
    3. No. of Nuclei
    • Polynuclei
    4. No. of nucleoli
    • Polynucleoli
    5. Cytoplasm
    6. Mitotic figures
    Mitotic figures
    Report

    • Description
    • Macroscopic, eg. fat drops
    • Microscopic, background, cells, artefacts
    • Interpretation
    • Diagnosis
    • Differential diagnosis
    • Comments
    • Etiology
    • Prognosis
    • Further investigations
    • Histo
    • Immunhisto
    • ......
    Ultrasonography and cytology goes hand in hand
    Ultrasonography

    • Investigation of

    • Liver surface and size


    • Parenchyma
    • Vascular system
    • Biliary system
    • Abdominal cavity
    • Guided biopsy
    Liver surface
    • Irregular surface
    • Tumor
    • Hepatitis, chronic
    • Fibrosis, Cirrhosis

    HCC Hemangiosarcoma
    Liver edges

    • Diffuse liver enlargement


    • Lipidosis
    • Steroid hepatopathy
    • Vacuolar liver disease
    • Amyloidosis
    • Lymphoma
    Liver echogenicity

    • Diffuse liver hyperechogenicity


    • Chronic hepatitis
    • Lipidosis
    • Vacuolar liver disease
    • Fibrosis, Cirrhosis
    • Diffuse liver hypoechogenicity • Diffuse liver mixed echogenicity
    • Steroid hepatopathy
    • Acute hepatitis
    • Fibrosis, Cirrhosis
    • Amyloidosis
    • Neoplasia
    • Congestion
    • Lymphoma

    moderate Hepatitis Lymphoma


    • Focal liver hyperechogenicity • Focal liver hypoechogenicity
    • Granuloma • Regenerative nodules
    • Abscess • Abscess
    • Regenerative nodules • Neoplasia
    • Neoplasia

    Lymphoma Abscess
    Liver vessels
    Shunt diagnosis
    Gallbladder and common bile duct

    < 2mmm

    sludge
    normal

    Cholecystitis

    dilated bile ducts calzified mass


    Hemangiosarcoma

    HCC
    Collection and preparation of material
    Guidelines for liver cytology
    Guidelines for liver cytology
    1. Cell size
    2. Nucleus size
    3. Nucleus-cytoplasm-ratio
    4. Nuclei per cell
    5. Chromatin pattern
    6. Colour of cytoplasm
    7. Intra- and extra-cellular bile pigment
    8. Percentage of cell necrosis
    9. Non hepatocytes
    Cholestasis
    Fibrosis
    Hepatitis

    • Leucocytes > than expected


    • Leucocytes in clusters of hepatocytes

    • Suppurative = neutrophils
    • Non-suppurative = lymphocytes
    and plasma cells
    Liver tumor

    • Primary tumors
    • Hepatocellular carcinoma
    • Cholangiocarcinoma
    • Secondary tumors
    • Lymphoma
    • Mastocytoma
    • Histiocytoma
    • Metastasis
    Liver tumor
    Fibrosarcoma
    Hepatocellular carcinoma
    LYMPHOMA

    • > 70% lymphoblasts

    E. Teske, EJCAP - Vol. 19 - Issue 2 October 2009


    B-cell lymphoma
    T-cell lymphoma
    9-year old benese mountain dog „Fine“

    • Inappetence
    • Lameness
    • Fever
    Malignant Histiocytosis in Bernese Mountain Dogs

    Origin: Neoplastic
    Breed-specific: Multisystemic: Affects
    proliferation Aggressive: Rapidly
    Primarily affects multiple organs (liver,
    of histiocytes (immune progressive and highly
    Bernese Mountain spleen, lungs, lymph
    cells, macrophage malignant.
    Dogs. nodes, bone marrow).
    lineage).

    Clinical signs: Weight Diagnosis: Cytology,


    Lesions: Nodular
    loss, lethargy, anorexia, biopsy, Prognosis: Poor, often
    masses, splenomegaly,
    fever, organ immunohistochemistry fatal despite treatment.
    hepatomegaly.
    enlargement. (CD18 marker).

    Treatment: Palliative,
    chemotherapy; limited
    effectiveness.

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