LabCE Course - Body Fluid Differential
Viral infection
Atypical lymphocytes are found in
Intracellular and extracellular bacteria
Bacterial meningitis
Peritoneal lavage trauma
Blunt force trauma to the chest and abdomen
Trauma STAT
Bowel is torn or punctured, an incredibly large amount of bacteria and foreign matter is released into the peritoneal space
False
Nucleated blood cells will always have the same appearance on a cytocentrifuged smear as they do on a peripheral blood smear.
Macrophages
Older monocytes that have migrated out of peripheral blood
Macrophages
Older monocytes that have migrated out of the peripheral blood, do NOT originate from lymphocytes
Bronchial lining cells
Cells may appear in sheets and clumps on cytospin preparations
Septic Arthritis
Due to Haemophilus influenza infection
Reactive mesothelial cells
Due to the presence of a bacterial, viral, or fungal infection, or metastatic tumor
Synovial lining cells
Produce synovial fluid, which lubricates the joints.
Burkitt lymphoma
Prominent cytoplasmic vacuolation
True
Prominent vacuolation involving the cytoplasm of abnormal lymphoblast-like cells seen in a body fluid preparation is a distinctive feature of Burkitt Lymphoma
Yeast
Eventually identified as Candida albicans
Malignant cells
High nuclear/cytoplasmic (N/C) ratio, irregular nuclear membrane, non-uniform appearance
Malignant cells
High nucleus/cytoplasm ratio, irregular membrane, non-uniform
Hemosiderin - a storage form of recycled iron
Intra-alveolar bleeding that was causing both the drop in hemoglobin and the pneumonia symptoms
Reactive mesothelial cells
Low N/C ratio, smooth nuclear membrane, uniform
Reactive mesothelial cells
Low N/C ratio, smooth nuclear membrane, uniform appearance
Phagocytosis
Macrophage (specifically an erythrophage) that has both freshly ingested intact RBCs as well as a few "ghost" RBCs that are partially digested
Ependymal clump
Many similar appearing nuclei w/o distinct lines of demarcation between cells
Mesothelial cells
May have small pinpoint vacuoles, they do not have the larger "foamy" vacuoles seen in macrophages or histiocytes.
Central Nervous System - Toxoplasmosis
Recently received a bone marrow transplant for recurrent central nervous system (CNS) Burkitt lymphoma, neutrophil clusters, ovoid inclusions were noted (see arrow) as well as free banana-shaped organisms
Cytocentrifugation
Removes liquid portion of fluid as cells are deposited on slide, may introduce artifact, which can stretch cytoplasm and distort nuclear shapes as compared to same cells in peripheral
Atypical (reactive) viral lymphocyte
Representative field from a cytospin preparation of a CSF from a patient with a viral infection. Identify the cell indicated by the arrow.
Histiocytes
Some institutions designate large multinuclear macrophages as histiocytes.
Bacteria; perform a Gram Stain
The elements indicated by the arrows were observed on a Wright-stained smear of a synovial fluid. What is the likely identification of the elements and what would you do to confirm the finding?
Choroid Plexus Cells
They are found in the ventricles and are part of the blood-brain barrier
Ependymal cells
They produce CSF and are involved in circulating the CSF over the brain, ventricles, and the spinal cord. Often seen in hydrocephalus or chronic ventricular infection.
Ependymal clump
What is the identification of this cellular clump found in CSF? Note the presence of many similar-appearing nuclei without distinct lines of demarcation between cells.