CYTOLOGY OF BODY FLUIDS

Body fluid includes,

- Samples with low cell contents such as urine and CSF.
- Samples accumulated in serous cavity,
- pleural,pericardial, and periotoneal.
- Preservation of fluid specimen prior to processing.
- Preservation is essential for accurate cytologic interpretation.
- Samples may be without preservation can be sent to the lab when;
1) When facility for immediate preservation is available.
2) When delay is anticipated sample is prefixed and sent to lab
- Duration between collection and preparation before cellular damage depends on
> PH, protein,content,enzymatic activity or absence of bacteria.
USEFUL GUIDELINE TO GET ACCPTABLE RESULTS

a) Specimen with high mucus contents

- Sputum,brochial aspirates and mucocele fluids
- Refrigeration slows down autolysis by bacteria
- Mucus coats the cells prevents rapid degeneration
NB: When diluted by saliva cells re not well protected
b)Specimen with high protein content(e.g pleural,peritoneal or pericardial)
- Can be preserved for 24-48hrs. Protein rich fluid where cells are bathed acts as a tissue culture.
- Preserve cellular morphology
c) Specimen with low mucus or protein content
(e.g. urine and CSF)
- Preserved for 1-2 hrs even in refrigeration of urine.
USEFUL GUIDELINE TO GET ACCPTABLE RESULTS

- Centrifuge urine for 10minutes.

- Place one or 2 drops of sediment on a glass slide
- Spread the material and fix immediately
CSF
- Usually a small volume of fluid obtained
- Process immediately
- If delay in processing is anticipated add an equal amount of ethyl alcohol.
- Due to low volume cellularity process by cytocetrigugation
USEFUL GUIDELINE TO GET ACCPTABLE RESULTS

CYTOCENTIFUGATION
- Useful in fluid sample with low cellular component.
- Centrifuge in cytospin
- Cells are sedimented directly on to the microslides.
d) Specimen with low PH
e.g. gastric material)
- Specimen collected in ice
- Process within minutes
- If delayed cells are destroyed by HCL
CYTOPREPARATION TECHNIQUES OF SEROUS EFFUSIONS

- Effusion accumulated in serous activities

- Commonly- Peritoneal ,pleural, pericardial.
- Benign process e.g. TB can be recognized cytologically
- Most important is recognition of malignant cells.
ESSENTIAL REQUIREMENTS
- Fleshly tapped specimen
- Immediate processing
- Rapid fixation of slides
Collection and preservation
- Pleural , peritoneal pericardial fluids
- Obtained in tubes or by syringes
- Collected in plain or prer-heparinized container.
CYTOPREPARATION TECHNIQUES OF SEROUS EFFUSIONS

Peri- heparinized
* Prevents coagulation
* Cells do not deteriorate rapidly
* Better adherence of cells to the slide
* Fleshly tapped specimens- preffered
- If facility allows process immediately
- Preserve in refrigerator for up to 24-48hrs.
- Also allowed in pre-fixation in 50% ethanol
- Spray fixative recommend for posting into distant laboratory
- Albunized slides are recommended for pre-fixed specimens
CYTOPREPARATION TECHNIQUES OF SEROUS EFFUSIONS

GROSS EXAMINATION
- When specimen is received in the lab
NOTE; Amount of fluid received
NOTE; Gross appearance,clear,tansparent,straw coloured.
color,mucoid or haemorragi
- Appearance of fluid helps in diagnosis
PROCESSING
Routine processing
- 10-15mls is centrifuged for five minutes
- If volume too small, add equal amount of normal saline centrifuge
CYTOPREPARATION TECHNIQUES OF SEROUS EFFUSIONS

- If there is fibrin clot already

*Use applicator stick to break clot
* If clot too large – process as cell block
After centrifugation
- Place one or two drops of sediment on a slide
- Place another slide to the slide
- Allow the sediment to spread
- Gently pull slide apart (opposite direction)
- Immediately fix the specimen on the slide
Sparsely cellular fluid
- Clear – sparsely cellular fluid
- On centrifugation yields scanty or no sediment
CYTOPREPARATION TECHNIQUES OF SEROUS EFFUSIONS

Solution; Cytospin
- Concentrates the sediment on a slide
HAEMORRAGIC FLUID
- Carnoy’s fixative is used to lyse RBC in haemorrhagic
Cell block preparation
- There many methods of cell block preparation
- Most popular – plasma thrombin cell block preparation
- Plasma and thrombin used.
- Forms clot that are emashed with cells
- Clot processed as tissue block