FLUID MORPHOLOGY

Fluid Analysis

1. Types

- CSF - peritoneal - pericardial - pleural - synovial - quantitative - qualitative

2. Heme Analysis

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