Megakaryocytes in bronchoalveolar fluid (BALF) samples.

n/a.

Termites and asthma: is there a connection?

n/a.

Pulmonary actinomycosis: cytomorphological features.

Pulmonary actinomycosis is an uncommon infectious disease. Although the gold standard for diagnosis is histological examination with bacterial culture of lung tissue, cytology samples offer a fast and low-cost alternate diagnostic procedure. The cytology literature on this topic is limited to mostly case reports. Therefore, the aim of this study was to review cytological material in a series of patients with a diagnosis of pulmonary actinomycosis to characterize the main cytomorphological findings.  Different cytological respiratory samples including sputum smears, bronchoalveolar lavages (BALs), transthoracic or endobronchial fine needle aspiration cytology (FNAC) and cell block preparations were used for retrospective examination. For all cases patient age, gender, symptoms, and radiological chest findings were recorded. A total of 26 cytological respiratory samples (14 sputum smears, 9 FNAC, two BALs) including direct smears and 6 cell blocks from 9 patients were examined. In sputum smears the most remarkable findings were the presence of dark cotton ball masses with projections like spider legs and/or mouse tails (75% of the samples). Sulfur granules were observed in 4 (40%) of the sputum smears and within FNAC cases. Various respiratory cytology samples including sputum smears, FNAC and BALs can reveal cytomorphological findings diagnostic of pulmonary actinomycosis. Characteristic cytological findings compatible with a diagnosis of this infection include cotton ball masses and less frequently sulfur granules.

Corpora amylacea in sputum smears: Incidence and clinical significance.

OBJECTIVE: To examine conventional sputum smears for the presence of corpora amylacea (CA), determining their incidence and clinical significance. METHODS: A retrospective 4-year cohort study was undertaken of sputum samples from 1176 consecutive patients for the presence of CA. Variables such as age, sex, smoking status, and the presence or absence of haemoptysis were extracted from the medical record. A random group of 50 patients was selected as a control group, and a random group of 50 patients whose ages were below 49 years was also included as an age-based control. RESULTS: A total of 1075 of the initial cohort of consecutive patients were included in the study. from these, there were 6898 sputum smears, of which 1.91% (132 smears) contained CA, corresponding to 9.86% of the cohort of patients (106 patients). There was a strong, positive, statistically significant correlation between age and CA presence (τb  = .402, P < .001), which supports that CA are associated with older patients. The results of a binary logistic regression indicated that there was a significant association between age, diagnosis of chronic obstructive pulmonary disease and CA presence (χ2  = 49.051, df = 2, P < .001). CONCLUSIONS: The presence of CA in sputum smears is related to age, being much more frequent in older people. Moreover, CA are related to non-neoplastic lung diseases.

¿Hay suficiente número de plazas hospitalarias para las prácticas de nuestros alumnos de Formación Profesional / Do we have sufficient hospital placements for our pathology technician trainees?

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Hematoidin crystals in sputum smears: Cytopathology and clinical associations.

BACKGROUND: There has been limited correlation of hematoidin crystals (HC) in sputum with clinical and diagnostic characteristics, partly because they are difficult to recognize. The aim of this study was, therefore, to assess these relationships in a consecutive cohort of sputum samples from patients submitted to a cytology laboratory. METHODS: Adequate sputum samples from 489 individuals were enrolled in this study. These were fixed in ethanol, stained by the Papanicolaou method and examined microscopically. The normality of the distribution of the continuous variable (age in years) was examined using the Shapiro-Wilk normality test. As the data were not normally distributed, Kendall rank correlation was used to correlate age with the presence of HC. The Pearson's Chi-square test was used to determine if the proportion of cases with the presence of HC was different among the categorical data variables. A univariate binary logistic regression was used to determine the variables most strongly associated with HC presence. The results include odds ratios, 95% confidence intervals, Wald χ2 statistics, and corresponding P values, with statistical significance assumed at P ≤ 0.05. Analyses were performed using IBM SPSS Statistics 22. RESULTS: The presence of HC in sputum was associated with increasing age (P < 0.01), current smoking (P < 0.001), chronic occupational exposure to dust (P = 0.001), and hemoptysis (P < 0.001). These crystals were most prevalent in patients with a diagnosis of carcinoma (93.9%), bronchiectasis (48%), silicosis (16.0%), and chronic obstructive pulmonary disease (0.8%). Crystals were not found in patients with acute bronchitis, asthma, or lung infections, including viral and bacterial pneumonia. CONCLUSIONS: There are clear associations linked to the finding of HC in sputum that may be helpful in pointing to a specific diagnosis, such as the possibility of underlying carcinoma.

Citodiagnóstico del líquido sinovial / Synovial fluid cytodiagnosis

Las muestras de líquido sinovial constituyen un porcentaje muy pequeño del trabajo de rutina en un laboratorio de citología. No obstante, su examen microscópico permite observar diferentes tipos de células, partículas y estructuras que, por sus características morfológicas, pueden aportar datos relevantes desde el punto de vista del citodiagnóstico. El propósito de este trabajo es exponer ciertos aspectos referentes a la artrocentesis, la relación entre el aspecto macroscópico del líquido sinovial y determinados procesos patológicos, así como las diferentes técnicas para la realización de extendidos y su coloración. Se hace también una descripción de los principales hallazgos citológicos observados en una serie de enfermedades que afectan a las articulaciones sinoviales, como las infecciones (bacterianas y fúngicas), de tipo inflamatorio no infeccioso (osteoartrosis, artritis reumatoide, conectivopatías) y las tumorales, haciendo distinción entre los tumores primitivos y metastásicos, tanto neoplasias sólidas como hematológicas

Synovial fluid samples represent only a very small percentage of routine work in a cytology laboratory. However, its microscopic examination allows us to observe different types of cells, particles and structures that, due to their morphological characteristics, may provide relevant data for cytodiagnosis. We present certain aspects related to arthrocentesis, the relationship between the gross appearance of synovial fluid and certain pathological processes, as well as the different techniques for processing and staining the smears. Furthermore, we describe the main cytological findings in various pathological conditions of the synovial joints, such as infections (bacterial and fungal), non-infectious inflammatory type (osteoarthrosis, rheumatoid arthritis, connective tissue diseases) and tumoral, distinguishing between primary and metastatic, both solid and haematological neoplasms

Protozoan Cysts in Faecal Pellets of German Cockroaches (Blattella germanica), with Particular Emphasis on Lophomonas blattarum.

PURPOSE: The aim of this study was to investigate protozoan cysts and oocyts in the faecal pellets of the German cockroach (Blattella germanica), with emphasis on the prevalence of Lophomonas blattarum. METHODS: Thirty adult Blattella germanica (12 males; 18 females) were trapped near Madrid, Spain. Expelled faecal pellets were collected in the laboratory over 5 days in two plastic containers. Protozoan cysts from one container were weighted and those in the other used for morphologically identification. RESULTS: Protozoan cysts/oocysts per gram of faecal pellet were: Nyctotherus sp. (0.0019/g), Entamoeba (0.0007/g), Balantidium coli (0.0001/g), Lophomonas blattarum (0.00038/g). Observation of 189 protozoan cysts/oocysts indicated the following prevalence: Nyctotherus sp. 65 (34.4%); Gregarina spp. 34 (18%); Entamoeba sp. 24 (12.7%); Cryptosporidium sp. 17 (9%); Coccidia 16 (8.4%); Lophomonas blattarum 13 (6.8%); Balantidium coli 4 (2.1%); and unclassified 16 (8.4%). CONCLUSION: Lophomonas blattarum has previously been demonstrated in the gut of cockroaches, but this is the first assessment of the prevalence in Blattella germanica in faecal pellets. The presence of protozoa in faecal pellets provides some evidence for one step in a hypothesised route of respiratory infection whereby protozoa from household insects enter the respiratory tract.

[Synovial fluid cytodiagnosis]. / Citodiagnóstico del líquido sinovial.

Synovial fluid samples represent only a very small percentage of routine work in a cytology laboratory. However, its microscopic examination allows us to observe different types of cells, particles and structures that, due to their morphological characteristics, may provide relevant data for cytodiagnosis. We present certain aspects related to arthrocentesis, the relationship between the gross appearance of synovial fluid and certain pathological processes, as well as the different techniques for processing and staining the smears. Furthermore, we describe the main cytological findings in various pathological conditions of the synovial joints, such as infections (bacterial and fungal), non-infectious inflammatory type (osteoarthrosis, rheumatoid arthritis, connective tissue diseases) and tumoral, distinguishing between primary and metastatic, both solid and haematological neoplasms.

Ciliated nasal epithelial cells damage and human rhinovirus infection: cytological findings.

Human rhinovirus infection has been identified as the commonest cause of common cold. We were therefore interested in cytological assessment of nasal cells from patients with human rhinovirus infection. Cytological examination was undertaken of nasal smears from a group of 7 patients, 4 females and 3 males; aged between 27 and 14 years-old (average = 17.5), who had longstanding perennial rhinitis (in all cases 7 years or more). They presented at our research unit showing clinical symptoms of a common cold, including sore throat, nasal congestion, sneezing, and watery rhinorrhea. Serology and DNA real-time PCR demonstrated human rhinoviruses type A (5 cases) and C (two cases) as the cause of the infection. Nasopharyngeal swabs were taken, fixed with 96% ethanol and stained using the Papanicolaou method and Giemsa stain. Under light microscopy the Pap smears showed the presence of numerous detached ciliated nasal epithelial cells, with approximately one third of the cells showed destruction and irregular attachment of cilia, microvacuolated cytoplasm, and large red round intranuclear bodies, similar to inclusions, surrounded by clear halos, where the nuclear borders were visible. Ultrastructural examination of the cells indicated disappearance of cilia, or shortened, fragmented and disordered cilia. Large intranuclear bodies appeared as a compact mass similar, similar to the condensed chromatin, and separated from the nuclear membrane by a clear space (Figure 1B). No viral particles were observed in the cytoplasm or nucleus.   Our results confirm that human rhinovirus can alter the morphology of the ciliated nasal epithelial cells, principally causing alterations to the cilia and provoking nuclear changes.