LabCE Course - Body Fluid Differential

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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.


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