Body Fluid Differential Tutorial
Nucleated blood cells will always have the same appearance on a cytocentrifuged smear as they do on a peripheral blood smear. true or false
False Cytocentrifugation removes the liquid portion of the fluid as the cells are deposited on the slide. This may introduce artifact, which can stretch the cytoplasm and distort nuclear shapes as compared to the same cells in the peripheral blood.
Variation for lymphocytes on a cytospin
The clover-leafing of the nuclei is a cytospin effect and is normal as long as the chromatin is mature, the nuclear:cytoplasmic ratio is normal, and overall size is normal. larger cells seem flattened and a bit more open in appearance than they would on a peripheral smear.
Cytocentrifugation of body fluid samples can cause some morphologic
artifacts, as shown in the image on this page. The technique can stretch and distort cellular and nuclear morphology and allow nucleoli to appear more prominent than would normally be seen in peripheral smears.
Atypical Lymphocytes vs. Monocytes atypical lymphocytes: blue arrows monocytes (red arrows)
atypical lymphocytes: have a more basophilic cytoplasm than the normal, smaller lymphocytes. They also have a more regular nuclear shape compared to the monocytes (red arrows). The lymphocytes also have a more regular cytoplasmic border without the blebs and pseudopods present in the monocytes. Another key feature in the differentiation of these two cell types is the vacuolation present in the cytoplasm of the monocytes, which is not present in the lymphocytes.
The cytospin process works by
wicking fluid into a filter while fluid samples are spun into a central column and deposited in a mono-layer onto a defined area of a slide. This allows the cells to be concentrated for appropriate identification.
cytospin preparation of a cerebrospinal fluid (CSF).
blue arrow: slightly activated normal lymphocytes cytoplasm is pastel blue and non-granular, chromatin is a bit looser than the chromatin of a normal lymphocyte on a peripheral blood smear, but it has the same clumped appearance that is characteristic of normal lymphocytes.
Cytocentrifugation (also known as "cytospin") provides the best method for both
concentrating cells in body fluid samples and maintaining cellular morphology.
Preparation of body fluid smears for microscopic examination requires
concentration techniques that preserve cell integrity and morphology
Adding a drop of 11% or 22% albumin to the volume of a serous fluid sample being cytocentrifuged aids in (Albumin should not be added to _____ samples as they inherently have sufficient protein to preserve cellular integrity).
preserving the cellular morphology. synovial fluid
Lymphocytes v. Monocytes
red arrow: monocyte blue arrow: lymphocyte lymphocytes: have a more regular cytoplasmic border without the cytoplasmic blebbing and pseudopods present in monocytes. Both cells have blue cytoplasm; however, the monocyte has a grainy, gritty texture that is absent in the lymphocyte. fine red cytoplasmic granules present in the monocyte that are not apparent in the lymphocytes. regular nuclear shape of the lymphocytes versus the more complex nuclear shape of the larger monocyte. . The lymphocyte chromatin is denser and clumped.
Neutrophils in a cytocentrifuged smear will look
the same as in peripheral blood.
prior to preparing the cytocentrifuge slide, as the volume of sample used is dependent on the cell count.
The nucleated cell count must be performed