----start----- labmed review 2/23/98 quick IDs - should be able to ID basic cell types. Dr Feldsburg used the term "rouleaux formation" and said you should be able to tell it apart from agglutination. rouleaux is when you see rbcs stacking on edge - common in horses as a normal finding. just a tendency of the cells to stack. cats do it a bit. dogs don't - if you see it in dogs,usually they have high fibrinogen or protein in plasma. agglutination is more random clumping. slide: rouleaux, neutrophil, lymphocytes slide: monocytes - lobulated nuclei, loose chromatin, discrete vacuoles in bluish cytoplasm. slide: goat neutrophil slide: plasma cell - small round nucleus, coarse chromatin, pale nuclearhalo, intenseblue cytoplasm. lymphocyte - scant cytoplasm, round nucleus, high n:c rato slide: neutrophil w/mild toxic change - increased stickiness, frothy cytoplasm. slide: lymphocyte slide: a mess. neutrophils, eosinophils w/irreg sized granules seen in dogs, basophils with purple granules slide: eosinophils that are atypical - granules look like vacuoles b/c they aren't picking up stain. this is a greyhound. slide: neutrophil, rbcs with heinz bodies -little mushroom caps sticking out the side of the cell. slide: RBCs that are showing uneven spiculation - acanthocytes slide: plasma cell slide: cow lymphocyte - bigger than typical small lymphocyte. dense coarse chromatin, scant blue cytoplasm. high n:c ratio slide: cat WBC with lavendar granules - basophil. has little round muddy lavendar colored granules. eosinophils in cats have rod shaped granules slide: dog basophil, dog mast cell - slide: many neutrophils, one mast cell. slide: nRBCs, polychromatophilic RBCs slide: feline bone marrow- mast cells present slide: neutrophils, rbcs -eccentrocytes (oxidant injury) - important to recognize this. treat very differently from treatment for spherocytosis due to immune mediated disease. slide: shpherocytes - perfectly round rbcs, no tags of clear membrane hanging off them. spherocytes indicate immune mediated dz. slide: neutrophils with dark, loose chromatin. cytoplasm is blue/frothy, some dohle bodies, - toxic change slide: cat eosinophil with rod shaped granules that look blue here due to slide. slide: cat basophil - won't hae to ID - hard to see on kodachrome. slide: monocyte - donut shaped nucleus, loose chromatin, bluegrey cytoplasm, discrete vacuoles. also see spherocytes on this slide. slide: acanthocytes - slide: neutrophil among rouleaux formations of RBCs common w/inflammatory dz asfibrinogen goesup. slide: horseeosinophil slide: eccentrocytes slide: lymphocyte slide: cat basophil slide: cat eosinophils - easy to see. slide: non mammalian rbcs with nuclei, fuzzy blue basophil that looks like a mast cell. slide: dog basophil, neutrophil slide: monocyte, spherocyte slide: schistocyte (red cell fragment) slide: cat wbc with round nucleus, one large vacuole, granular cytoplasm - mast cell - think neoplasia. also, RBCs appearing as elliptocytes/ovalocytes - cats do that readily when ill. slide: neutrophil with ehrlichia inclusions that are dark blue, in contrast to purple chromatin. slide: lymphocyte with heart shaped nucleus, pale cytoplasm, and a few granules in one area.dense chromatin. slide: RBC with nuclear fragments - animal on steroids - these are howell-jolly bodies. slide: acanthocytes slide: blister cells, helmetcell --> both of these terms can also be replaced by keratocyte. indicate shear stress due to fibrinogen deposition. slide: cat basophil. granules are round,muddy lavendar. slide: horse eosinophil slide: cat with elliptical acanthocytes, a couple of heinz bodies slide: howell-jolly bodies slide: skeletal muscle slide: platelet clumping that might affect histogram -clumps merge into red cell histogram. sometimes you see huge clumps. slide: platelets that are bigger than the RBCs - these get counted as RBCs. slide: pelger-hewitt anomaly - granulocytes lack segmentation of nucleus. appears to have marked left shift, but really don't. slide: red cells stained with retic stain - there are spherocytes and reticulocytes present (would hve been polychromatophilic cells). spindle cell tumors: long cytoplasmic processes, spindle cell shape, nonadherentcells, elongate/stellate in shape. round cell tumors: round cells, nonadherent epithelial cell tumors: can be round,but are adherent. carcinoma often incites inflammatory response and neutrophils will invade. criteria of malignancy - anisocytosis, anisokaryosis, variable N:C ratio, etc. also they're in an LN where they do not belong. hallmark of epi tumor is the adherence of the cells to eaach other. blood smear from dog with tWBC 350,000 - counted along with RBC in machine, will affect MCV and other indices. CLL -high count of mature, quiescent lymphocytes. chronic myeloproliferative dz - unexplained rise in cell counts - polycytehemia vera, essential thrombocytemia, chronic granulocytic leukemia -- these are very very rare. first rule out for high neutrophil count should be infection/inflammation, not leukemia. slide: cat w/essential thrombocytemia - more platelets than RBCs AMPD - blasts in marrow must account for >30%.this is how you define an acute myeloid leukemia. you can do special stains to figure out if the cells are truly of myeloid lineage. slide: iron stain - using prussian blue stain - mphages full of hemosiderin look aqua, showing adequate iron stores. urine slides: red blood cells - small, round, yellow. some are crenated, some are not. in center of slide - clump of epithelial cells. these look atypical and suspicious for malignancy - adherent to each other, marked anisocytosis - would probably want to look further. but just be able to say they are epi cells. crystals - ammonium biurate - won't have to ID - brown, with spiny processes - sometimes seen in dalmations. seen in animals w/liver dz/portosystemic shunts. high ammonia, hepatic encephalopathy, etc. won't have to know but clinically relevant - hippuric acid-like crystals - calcium oxalate monohydrate.tiny crystals - this is at 40x. this means the animal was exposed to ethylene glycol. flat look to it, morphologically described as picket fence crystals. small and not easily seen. ca oxalate dihydrate, btw, are not a big deal. free catch urine with many squamous epi cells. flat cells,sometimes folded up, some nucleated, most not. calcium oxalate dihydrate: small, square, diamond shaped calcium carbonate - common in horses. round. triple phosphate/struvite - coffin lid morphology. clinically irrelevant. cast blood - eosinophils in dog blood with irreg sized granules. -----end-----