FLUID MORPHOLOGY

FLUID MORPHOLOGY
Fluid Analysis
1. Types
- CSF
- peritoneal
- pericardial
- pleural
- synovial
2. Heme Analysis
- quantitative
- qualitative
Fluid Morphology
Overall purposes =
1. Screen for microorganisms
2. Screen for potential malignancies
CNS
CNS Bacteria
Ascitic Fluid
Ascitic Fluid –
Benign Mesothelial Cells
About Benign Mesothelial Cells
1. Quiescent Mesothelial cells = smooth borders
2. Reactive Mesothelial cells =
- Blebbed cytoplasm
- Vacuoles
- Multinucleated
Reactive Mesos
Reactive Mesos
Quiescent Mesos
Lining Cells
1. Mesothelial cells – line pleural, pericardial and
peritoneal cavities.
2. Synoviocytes – line joints
3. Ependymal cells – line CNS ventricles
Synovial Fluid
Synoviocyte
Pleural Fluid
Pleural Fluid –
Increased Macrophages
Comparing mesothelial cells
with macrophages
Mesos Vs. Macros
- Cytoplasmic colour
- Cytoplasmic vacuolation
- Nuclear size and shape
CNS
CNS -- DLBCL
Likely Malignant Or Not?
- ‘Ugly’ = asymmetric, irregular nuclear
shapes/sizes
- Clumping = non-heme cancers tend to clump
- Not clumping, homogenous = heme cancers
- High grade vs. low grade = maturity of cell – ie.
chromatin ‘fineness’
NOTE: Above are ‘soft features’ – ie. guidelines
Pleural Fluid
Pleural Fluid – Multiple Myeloma
Pleural Fluid
Pleural Fluid – Lung Adenocarcinoma
CSF – Iron Laden Macrophages
Hematoidin Crystal
Ascitic Fluid
Ascitic Fluid – Ovarian Cancer
Ascitic Fluid
Ascitic Fluid – Breast Cancer
CSF
CSF -- Fungi
Pleural Fluid
Pleural Fluid
Pleural Fluid -- DLBCL
Pleural Fluid
Pleural Fluid –
Primary Effusion Lymphoma
HHV-8 in-situ hybridization
Pleural Fluid
Pleural Fluid –
Merkel Cell
Carcinoma
Ascitic Fluid
Ascitic Fluid – Bladder Cancer
Summary
1. Microrganisms
a. Bacteria
- intracellular vs extracell
b. Fungi
2. Malignancies
a. Non-Heme Malignancies
- clumped and ‘ugly’,
non-uniform cells
b. Heme Malignancies
- unclumped and
homogenous cells