Cytology of Body FluidSpeaker : Advisor : Date : 3.15.2006Edmund S, Cytology, Chapter 4: Pleural, pericardial, and peritoneal fluid Richard M DeMay, The art & science of cytopathology, Chapter 8: FluidLeopold G.Koss, Koss diagnostic cytology, Chapter 26: Effusion in the presence of cancer

OutlineRepresentation of the three body cavitiesCollection and preparation of specimen Benign elementsNon-neoplastic conditionsMalignant effusions---primary tumors ---metastatic tumorsDifferences Between Adenocarcinoma and Mesothelioma

Schematic representation of the three body cavities

Accumulation of fluids in body cavities

Differences Between a Transudate and an ExudateFeature Transudate ExudateGross appearance Watery, clear Cloudy, reddishSpecific gravity 1.015Protein 3.0 g/dlClots No YesCells Few; usually benign Many; can be malignant

Collection and preparation of specimen

Benign elementsMesothelial cells

Non-neoplastic conditionsEosinophilic pleural fluid

Tuberculous pleuritisMultinucleated macrophages

Systemic lupus erythematosus Cytology preparation: Lupus erythematosus cell (LE cell)LE cell

Malignant effusions---primary tumors

More and bigger cells, in more and bigger clustersCell-in-cell pattern

Malignant effusions---metastatic tumors

F4.27F4.28

Non-Hodginkin lymphomaLarge cell lymphoma Nuclei large than histiocyte Eccentric nuclei Abundant blue cytoplasm Best appreciated in Diff-QuikFollicular lymphoma Irregular nuclear contours Scant cytoplasm

lymphoblastic lymphoma Small to medium sized lymphocytes Fine powdery chromatin Scant cytoplasm

Differences Between Adenocarcinoma and Mesothelioma

C: cytoplasm; M: membrane; N: nuclear +++++++++++--------++---

E-cadherin

BerEP4

B72.3

Calretinin