Red-Cell and Plasma Lipids in Acanthocytosis

Total Page:16

File Type:pdf, Size:1020Kb

Red-Cell and Plasma Lipids in Acanthocytosis RED-CELL AND PLASMA LIPIDS IN ACANTHOCYTOSIS Peter Ways, … , Claude F. Reed, Donald J. Hanahan J Clin Invest. 1963;42(8):1248-1260. https://doi.org/10.1172/JCI104810. Research Article Find the latest version: https://jci.me/104810/pdf Journal of Clinical Investigation Vol. 42, No. 8, 1963 RED-CELL AND PLASMA LIPIDS IN ACANTHOCYTOSIS * By PETER WAYS,t CLAUDE F. REED, AND DONALD J. HANAHAN WITH THE TECHNICAL ASSISTANCE OF DOLORES DONG, SUSAN PALMER, MARION MURPHY, AND GERALDINE ROBERTS (From the Departments of Biochemistry and Medicine, University of Washington, Seattle, Wash., and the Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, N. Y.) (Submitted for publication January 18, 1963; accepted April 11, 1963) The rare syndrome of acanthocytosis was first tological, and gastrointestinal) are all secondary described in 1950 by Bassen and Kornzweig (1) to the absence of low-density lipoprotein (6, 7). and two years later by Singer, Fisher, and Perl- This is still conjectural, however, and the bio- stein (2). The principal manifestations reported chemical defect responsible for the disease has not were steatorrhea, "atypical" retinitis pigmentosa, been elucidated. progressive neurological deficits, and "thorny" The clinical and chemical abnormalities of acan- red cells. The most complete case reports to date thocytosis suggested that it might be an ideal syn- are those of Meir, Schwartz, and Boshes (3) and drome in which to seek abnormalities in red-cell Rey (4), who well review the clinical aspects. lipids. Values previously reported for total red- The erythrocytes of affected individuals have char- cell lipids in one case (3) and for red-cell choles- acteristic, spikelike excrescences, a normal or de- terol and total phospholipid (6) in another were creased life-span, probably normal osmotic fragil- probably normal (normal values were not given), ity, normal acid fragility, increased susceptibility but the possibilities of qualitative changes were to mechanical trauma, and an increased rate of not investigated. In the present study, red-cell destruction in lysolecithin hemolysis tests (2-5). and plasma lipids from three patients with the Recently, it has been demonstrated electropho- disorder were examined, and abnormalities in both retically, immunologically, and by ultracentrifu- the distribution of phospholipids and in the con- gation that beta or low-density lipoproteins are tent of esterified linoleic acid have been found. absent or very low in acanthocytosis (4, 6, 7), thus Part of these studies have been previously re- explaining the low levels of plasma total lipid, ported in preliminary form (10), and subsequently cholesterol, and phospholipid noted earlier (3, 8, Phillips (11) has reported partially confirmatory 9). Striking vacuolization of the intestinal ab- studies on red-cell and plasma lipids in acantho- sorptive cell has also been described, and histo- cytosis. chemical techniques have shown lipid in these vacuoles (4, 6, 7). METHODS On the basis of these findings, it has been sug- Patient 1 was a preadolescent male,1 not previously gested that acanthocytosis is primarily a disease of reported, with well-documented acanthocytosis (see Ap- pendix). Patient 22 was reported in abstract form by lipid or lipoprotein metabolism and that the prin- Mabry, DiGeorge, and Auerbach (7, 12). Patient 3 3 cipal clinical manifestations (neurological, hema- was reported by Mier and associates (3). Table I lists the principal manifestations of acanthocytosis found in * This study was assisted by grants from the American each of these patients. Heart Association, supported by the Washington State Blood was drawn into acid citrate dextrose,4 refrig- Heart Association; by grants from the Life Insurance erated at 40 C, and transported as directly as possible to Medical Research Fund, the Multiple Sclerosis Society, and the U. S. Public Health Service (H-7326); and by 1 Under the care of Dr. Charles U. Lowe, Buffalo, N. Y. contract DA-49-007-MD-632 with the Research and De- 2 Original material kindly furnished by Dr. Arthur velopment Division, Office of the Surgeon General, De- McElfresh of St. Christopher's Hospital, Philadelphia, Pa. partment of the Army. 3 Blood obtained through the kindness of Dr. M. Mier, t Established Investigator, American Heart Association. Chicago, Ill. This study was begun during tenure of U. S. Public 4 Formula A. National Institutes of Health, Bethesda, Health Service postdoctoral research fellowship HF 9957. Md. 1248 1249 RED-CELL AND PLASMA LIPIDS ACANTHOCYTOSIS C:0.0 0 CO~~~~~~~U00 C4 o .410o ~ CoCO . C CU 4, S 0~~~~C 02 '..CC.2 0 4 0 tic o.>o.2 - C6 7 24 ..- 0 @2 20~ ~ ~ ~ ~ ~~~~6 c 0~ ~ ~~~~~~4 41 co00v0 CO) coco.' ~ 02 A v~2.<C 04 04~~22 Cl)~~ ~ ~ ~ ~ C) Oa 4i~~~~~~~~~~~~~~~~~~ C4 0 24>2042.- ~~~4.i ~ ~ ~ ~ ~ ~ ~ ~ 4 .6 co ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~~~ Cd>.4) 4iU ~ 4 CU - 2. 0 R m- S c co 1 0 0 to .- 02 co... 4,>~~~~~~~~~~~~~~~~~~~~~~~~~~4 C 4.2l.O 0 0 cd%0 4 0 4i~~ ~ ~ ~ ~ ~ *4-) *~~~~~~~~~~ 1l 1250 PETER WAYS, CLAUDE F. REED, AND DONALD J. HANAHAN one of our laboratories. The longest interval between nol and 0.04 ml of concentrated sulfuric acid, and then the time of blood collection and red-cell extraction (or refluxing 4 hours at 60° to 70° C. The methyl esters in one instance, freezing) was 15 hours. We have dem- were extracted with petroleum ether, washed with water onstrated that there is no significant change in red-cell four times, dried over anhydrous sodium sulfate, and then total lipids, lipid phosphorus, phospholipid distribution, or dissolved in redistilled hexane. Gas-liquid chromatogra- fatty acid composition during storage at 40 C in acid phy -of the methyl esters was performed on either a citrate dextrose for this length of time. Plasma and red Barber-Colman model 15 or a Pye-Argon gas chromato- cells were separated by centrifugation at 40 C, and the graph with ethylene glycol succinate as stationary phase cells washed three times and resuspended in cold 0.9% at column temperatures of 1650 to 1720 C and gas inlet NaCl to a hematocrit of approximately 50. After mixing, pressures of 12 to 20 pounds per square inch. Methyl samples were pipetted for red-cell counts, lipid extrac- esters of myristic, palmitic, stearic, oleic, and linoleic acids tions, and hematocrit. The extraction and subsequent pure by thin-layer and gas-liquid chromatography were analysis of total lipid, cholesterol, and phospholipids in used to standardize the instrument, and the molar per- the Rochester laboratory have been described (13). In centages for these five compounds are correct to ± 2%o. the Seattle laboratory, red cells from Patient 1 were In calculating methyl arachidonate and longer-chain similarly extracted. In Patient 3, however, after the re- methyl esters for which standards were not available, the extraction with chloroform, nonlipid impurities were re- molar percentage of each ester was assumed to be propor- moved by dissolving the lipid in chloroform:methanol:0.1 tional to its peak area when the Pye-Argon equipment M KCl 8:4:3 (final relative volumes). After shaking, was used, and proportional to peak area divided by molec- cooling to 4° C, and rewarming to 250 C, clean separa- ular weight with the Barber-Colman instrument (flame de- tion occurred, and the chloroform layer was recovered. tector. Red-cell ghosts were prepared in 20-milliosmolar All extractions were performed in duplicate. pIhosphate buffer at pH 7.4 by the method of Dodge, In Seattle, lipids were fractioned on silicic acid col- MIitchell, and Hanahan (16), and red-cell counts were umns (2 g silicic acid and 1 g of Johns-Manville Hi- done on a Coulter electronic counter. Fatty acid esters Flow Super Cell per 1 mg lipid phosphorus). Neutral were quantitated by dissolving the lipid in chloroform and lipids were removed with chloroform. The first phospho- measuring infrared absorption at 5.75,u in 1-mm NaCl lipid peak, eluted with chloroform: methanol (C: M), 9: 1 cells with a Perkin-Elmer model 21 infrared spectro- (vol: vol), comprised 1 to 2%o of the total lipid phos- photometer. Calculations were made from the optical phorus. Although not fully characterized, it has the mo- density of appropriate standards. This method has been bility on paper chromatograms of phosphatidic acid or shown to be linear between 2 and 22 ,uEq fatty acid ester "polyglycerol phosphatide" (14). The next peak, eluted per ml for triolein, dimyristoyl lecithin, and cholesterol with C: M, 5: 1, or 6: 1, contained primarily phospha- palmitate. Plasmalogens (17), ultracentrifugation of tidyl ethanolamine with some phosphatidyl serine.5 The plasma lipoproteins (18), lipid phosphorus, nitrogen, third peak, eluted with the first four to five column vol- total solids, and cholesterol (15) were done by established umes of C: M or ethyl acetate: methanol, 5: 4, was pre- procedures. dominantly phosphatidyl serine by paper chromatography, Certain of the total lipid analyses and phospholipid par- but also contained phosphatidyl inositol and other com- titions were performed in both laboratories on different pounds as yet unidentified. Continuing the same solvent, samples of the same blood. When such data have been a large fraction was then eluted, the first two-thirds of it averaged, this is indicated in the tables. chromatographically pure lecithin. Subsequently, a mix- ture of lecithin and sphingomyelin appeared, the solvents RESULTS were changed to C: M, 1: 9, and the final peak, approxi- mately 90% sphingomyelin and 10% lecithin, emerged. Red-cell and plasma lipid studies in patients with Each peak containing more than one phospholipid was re- acanthocytosis chromatographed on paper by the method of Reed, Swisher, Total lipids and phospholipid distribution. Pre- Marinetti, and Eden (13), and lipid phosphorus was eluted quantitatively. These data, in addition to molar vious publications have characterized and quanti- nitrogen: phosphorus and molar fatty acid ester: phos- tated the major lipid classes in human red cells (13, phorus ratios, were used to arrive at the final phospho- 15, 19-21).
Recommended publications
  • Morphological Study of Human Blood for Different Diseases
    Research Article ISSN: 2574 -1241 DOI: 10.26717/BJSTR.2020.30.004893 Morphological Study of Human Blood for Different Diseases Muzafar Shah1*, Haseena1, Kainat1, Noor Shaba1, Sania1, Sadia1, Akhtar Rasool2, Fazal Akbar2 and Muhammad Israr3 1Centre for Animal Sciences & Fisheries, University of Swat, Pakistan 2Centre for Biotechnology and Microbiology, University of Swat, Pakistan 3Department of Forensic Sciences, University of Swat, Pakistan *Corresponding author: Muzafar Shah, Centre for Animal Sciences & Fisheries, University of Swat, Pakistan ARTICLE INFO ABSTRACT Received: August 25, 2020 The aim of our study was the screening of blood cells on the basis of morphology for different diseased with Morphogenetic characters I e. ear lobe attachment, clinodactyly Published: September 07, 2020 and tongue rolling. For this purpose, 318 blood samples were collected randomly. Samples were examined under the compound microscopic by using 100x with standard Citation: Muzafar Shah, Haseena, method. The results show 63 samples were found normal while in 255 samples, different Kainat, Noor Shaba, Sania, Sadia, et al. types of morphological changes were observed which was 68.5%, in which Bite cell 36%, Morphological Study of Human Blood for Elliptocyte 34%, Tear drop cell 30%, Schistocyte 26%, Hypochromic cell 22.5%, Irregular Different Diseases. Biomed J Sci & Tech Res contracted cell 16%, Echinocytes 15.5%, Roleaux 8%, Boat shape 6.5%, Sickle cell 5%, Keratocyte 4% and Acanthocytes 1.5%. During the screening of slides, bite cell, elliptocyte, tear drop cell, schistocytes, hypochromic cell, irregular contracted cells were found 30(1)-2020.Keywords: BJSTR.Human MS.ID.004893. blood; Diseases; frequently while echinocytes, boat shape cell, acanthocytes, sickle cells and keratocytes Morphological; Acanthocytes; Keratocyte were found rarely.
    [Show full text]
  • Drinking Water Health Advisory for the Cyanobacterial Toxin Cylindrospermopsin
    United States Office of Water EPA- 820R15101 Environmental Mail Code 4304T June 2015 Protection Agency Drinking Water Health Advisory for the Cyanobacterial Toxin Cylindrospermopsin Drinking Water Health Advisory for the Cyanobacterial Toxin Cylindrospermopsin Prepared by: U.S. Environmental Protection Agency Office of Water (4304T) Health and Ecological Criteria Division Washington, DC 20460 EPA Document Number: 820R15101 Date: June 15, 2015 ACKNOWLEDGMENTS This document was prepared by U.S. EPA Scientists Lesley V. D’Anglada, Dr.P.H. (lead) and Jamie Strong, Ph.D. Health and Ecological Criteria Division, Office of Science and Technology, Office of Water. EPA gratefully acknowledges the valuable contributions from Health Canada’s Water and Air Quality Bureau, in developing the Analytical Methods and Treatment Technologies information included in this document. This Health Advisory was provided for review and comments were received from staff in the following U.S. EPA Program Offices: U.S. EPA Office of Ground Water and Drinking Water U.S. EPA Office of Science and Technology U.S. EPA Office of Research and Development U.S. EPA Office of Children’s Health Protection U.S. EPA Office of General Counsel This Health Advisory was provided for review and comments were received from the following other federal and health agencies: Health Canada U.S. Department of Health and Human Services, Centers for Disease Control and Prevention Drinking Water Health Advisory for Cylindrospermopsin - June 2015 i TABLE OF CONTENTS ACKNOWLEDGMENTS.....................................................................................................................I
    [Show full text]
  • TOPIC 5 Lab – B: Diagnostic Tools & Therapies – Blood & Lymphatic
    TOPIC 5 Lab – B: Diagnostic Tools & Therapies – Blood & Lymphatic Disorders Refer to chapter 17 and selected online sources. Refer to the front cover of Gould & Dyer for normal blood test values. Complete and internet search for videos from reliable sources on blood donations and blood tests. Topic 5 Lab - A: Blood and Lymphatic Disorders You’ll need to refer to an anatomy & physiology textbook or lab manual to complete many of these objectives. Blood Lab Materials Prepared slides of normal blood Prepared slides of specific blood pathologies Models of formed elements Plaque models of formed elements Blood typing model kits Blood Lab Objectives – by the end of this lab, students should be able to: 1. Describe the physical characteristics of blood. 2. Differentiate between the plasma and serum. 3. Identify the formed elements on prepared slides, diagrams and models and state their main functions. You may wish to draw what you see in the space provided. Formed Element Description / Function Drawing Erythrocyte Neutrophil s e t y c Eosinophils o l u n a r Basophils Leukocytes G e Monocytes t y c o l u n Lymphocytes a r g A Thrombocytes 4. Define differential white blood cell count. State the major function and expected range (percentage) of each type of white blood cell in normal blood. WBC Type Function Expected % Neutrophils Eosinophils Basophils Monocytes Lymphocytes 5. Calculation of the differential count? 6. Define and use in proper context: 1. achlorhydria 5. amyloidosis 2. acute leukemia 6. anemia 3. agnogenic myeloid metaplasia 7. autosplenectomy 4. aleukemic leukemia 8. basophilic stippling 9.
    [Show full text]
  • Prof. Salma Afrose
    Drop of Blood – Unravels Mysteries Prof. Salma Afrose Department of Hematology Dhaka Medical College Peripheral Blood Film (PBF) PBF is a laboratory workup that involves cytology of Peripheral blood cell smear on a slide Clinical history Physical examination Lab investigation Diagnosis Importance of PBF Basic & highly informative hematological tool for • Screening • Diagnosis • Monitoring disease progression & • Therapeutic response So for successful clinical practice understanding interpretation of PBF is essential Indication • Clinical request from attending clinician (based on clinical suspicion) • Sometimes from laboratory due to abnormal finding on an automated counter • Unexplained cytopenia • Unexplained leukocytosis, lymphocytosis, monocytosis • Unexplained hemolysis or jaundice • Sepsis • Liver failure • Hematological malignancies • Severe bacterial sepsis • Parasitic infection • Anemia evaluation Clinical indications for examination of PBF • Features suggestive of anemia, unexplained jaundice, or both • Features suggestive of sickle cell disease – dactylitis or sudden splenic enlargement and pallor in a young child or, in an older child or adult, limb, abdominal, or chest pain • Features suggestive of thrombocytopenia (e.g. petechiae or abnormal bruising) or neutropenia (e.g. unexpected or sever infection) • Features suggestive of a lymphoma or other lymphoproliferative disorder – lymphadenopathy, splenomegaly, enlargement of the thymus (a mediastinal mass on radiology) or other lymphoid organs, skin lesions suggestive of infiltration,
    [Show full text]
  • Acanthocytosis—Biochemical and Physiological Considerations
    ANNALS OF CLINICAL AND LABORATORY SCIENCE, Vol. 10, No. 3 Copyright © 1980, Institute for Clinical Science, Inc. Acanthocytosis—Biochemical and Physiological Considerations JAMES J. BIEMER, M.D. Pathology Department, St. Joseph’s Hospital, and University of South Florida, College of Medicine Tampa, FL 33677 ABSTRACT Acanthocytosis represents an unusually pathological variant of red cell morphology which is encountered in a diverse group of inherited and ac­ quired disease states. While the morphological features are similar in all instances, the biochemical lesions frequently differ. Most demonstrable abnormalities involve lipids although those acanthocytes associated with the McLeod phenotype are probably due to an alteration in a membrane protein. Acanthocytes, regardless of their etiology, usually have a decreased survival in the circulation owing to splenic sequestration and destruction. Introduction Young red cells, known as reticulocytes, with a frequently folded excess mem­ A great deal of interest has been gener­ brane, persist approximately two days in ated by observation of the wide array of the peripheral blood while their cyto­ pathological and physiological forms that plasmic organelles are discharged, and can be assumed by the normally bicon­ each undergoes remodeling with sym­ cave human red blood cell, the discocyte. metrical membrane loss to assume its To survive its normal 100 to 120 days’ life normal discocyte configuration. As the span, the red cell must undertake a con­ cell ages, a series of changes occur includ­ tinuous circulatory journey, approximat­ ing additional membrane loss, increased ing 175 miles, frequently requiring corpuscular hemoglobin concentration negotiation of capillaries and slit-like because of water and cation loss, de­ spaces as small as 1/20 its diameter.
    [Show full text]
  • Anemia Evaluation and Diagnostic Tests
    Anemia Evaluation and Diagnostic Tests a b,c, Michael J. Cascio, MD , Thomas G. DeLoughery, MD, MACP, FAWM * KEYWORDS Red cell indices Schistocytes Microcytic Macrocytic Cytogenetics Anemia Diagnostic testing KEY POINTS Both the red cell indices and blood smear can offer clues to diagnosis and help to guide laboratory testing. Classification of anemia by either size of the red cell or mechanism (decreased production or increased loss) can narrow down the differential diagnosis. New molecular technologies may offer improved diagnostic sensitivity and specificity. ANEMIA: DEFINITION Although anemia is common, the exact cutoff to establish a diagnosis can be elusive. The standard definition is population-based and varies by gender and race. Current hemoglobin cutoff recommendations range from 13 to 14.2 g/dL in men and 11.6 to 12.3 g/dL in women.1 Data from large population studies suggests that hemoglobin levels for African Americans tend to be 0.8 to 0.7 g/dL lower, perhaps owing to the high frequency of alpha-thalassemia in this population.2 Another important factor is the trend of hemoglobin. For example, a patient with previous hemoglobin values at the higher end of the normal range, who now presents with a hemoglobin concentra- tion at the lower end of the normal range, can now be considered anemic. SYMPTOMS AND SIGNS OF ANEMIA In general, the signs and symptoms of anemia are unreliable in predicting the degree of anemia. Several factors determine the symptomatology of anemia, with time of The authors report no conflict of
    [Show full text]
  • Peripheral Blood Smear Examination
    Board Review- Part 1: Benign HemePath Peripheral Blood Smear Examination Elevated MCV = Macrocytosis MCV > 100um3 • B12/Folate deficiency, aplastic anemia, MDS • Autoimmune hemolytic anemia • Liver disease, hypothyroidism, alcoholism • Cold agglutinin disease Decreased MCV = Microcytosis MCV < 80um3 • Iron deficiency • Thalassemias • Anemia of chronic disease • Hemoglobinopathies – C, E, S, D Iron Panel Interpretation Cause of Serum TIBC Percent anemia iron saturation Iron ↓ ↑ ↓ deficiency Thalassemias ↑ / N ↓ / N ↑ / N Sideroblastic ↑ ↓ / N ↑ anemia Chronic N/↓ ↓ N disease Pathologic Red Blood Cells in Peripheral Blood Smears Type of Cell Underlying Change Disease States Acanthocyte (spur cell) Altered cell membrane lipids Abetalipoproteinemia, liver disease, postsplenectomy, McLeod phenotype Bite Cell (degmacyte) Heinz body pitting by spleen G6PD deficiency, drug-induced oxidant hemolysis Ovalocyte (elliptocyte) Abnormal cytoskeletal proteins Hereditary elliptocytosis Rouleaux Circulating paraprotein Paraproteinemia Schistocyte (helmet cell) Mechanical destruction in DIC, TTP, HUS, prosthetic heart microvasculature valves Spherocyte Decreased membrane Hereditary sphereocytosis, redundancy immunohemolytic anemia (warm Ab) Stomatocyte Membrane defect with Hereditary stomatocytosis, liver abnormal cation permeation disease Target Cell (codocyte) Increased redundancy of cell Liver disease, beta thalassemia membrane postsplenectomy, Hgb C/D/E/S Burr Cell (ecchinocyte) Altered membrane lipids Usually artifactual but maybe uremia Tear Drop
    [Show full text]
  • Compendium of Urinalysis Urine Test Strips and Microscopy
    Compendium of urinalysis Urine test strips and microscopy Main disease indications Urinary Tract Infection Interesting facts Are you aware of that … • More than 500 million people – 10% • One in 20 deaths is caused by diabetes; of the world’s population – have some 8,700 deaths every day; six every min- form of kidney damage 1 ute 3 • Urinary tract infections are the sec- • By 2030, almost 23.6 million people will ond most common type of infection in die from cardiovascular disease, mainly the human body 2 heart disease and stroke 4 1 22 Content 1 Main disease indication Urinary tract infection 8 Kidney disease 10 Diabetes 14 2 From urine fortune telling to real time diagnosis History of urinalysis 18 Application areas for urine test strips 20 Pre-analytical treatment and test procedure 22 3 Characteristics of urine test strips from Roche Composition and benefit of the test strip 28 Parameters of urine test strips 32 Detection of microalbuminuria with micral-test 56 4 Drug interferences in urine Influencing factors 60 5 Automated urinalysis Urine test strip systems 64 6 Urine microscopy in differential diagnosis Microscope 70 7 Urine particles and formed elements Blood cells 74 White blood cells 74 Red blood cells 76 Epithelial cells 78 Squamous epithelial cells 78 Renal tubular cells 79 Transitional epithelial cells 80 Atypical cells 81 Casts 82 Hyaline casts 82 Granular casts 84 Pigmented casts 85 Waxy casts 86 Red blood cell casts 87 White blood cell casts 88 Epithelial cell casts 88 Fatty casts 89 Cylindroids 90 Rare casts 90 Pseudo
    [Show full text]
  • Essentials of Fluid Cytology
    ESSENTIALS OF FLUID CYTOLOGY Gia-Khanh Nguyen 2009 ESSENTIALS OF FLUID CYTOLOGY Gia-Khanh Nguyen, M.D. Professor Emeritus Department of Laboratory Medicine and Pathology Faculty of Medicine and Dentistry University of Alberta Edmonton, Alberta, Canada First edition, 2009. All rights reserved. Legally deposited at Library and Archives Canada. ISBN: 978-0-9780929-3-1 2 TABLE OF CONTENTS Preface 4 Contributors 5 Acknowledgements and Related material by the same author 6 Dedication 7 Abbreviations 8 Chapter 1: Serous effusions 9 Chapter 2: Peritoneal and Pelvic washings 60 Chapter 3: Cerebrospinal fluid 71 Chapter 4: Urine in urinary tract lesions 84 Chapter 5: Urine in non-neoplastic renal parenchymal diseases 114 3 PREFACE This monograph “Essentials of Fluid Cytology” is written for practicing pathologists in community hospitals, residents in pathology and cytotechnologists who want to have a quick review of the cytopathology of serous effusions, peritoneal and pelvic washings, cerebrospinal fluid and urine in neoplastic and non-neoplastic diseases of the kidney and lower urinary tract. Cytologic manifestations of lesions commonly encountered in day-to-day practice are discussed and illustrated. In keeping with the goals of the author’s cytology monograph series, the text is concise and contains only relevant information. Immunohistochemical features of neoplasms that are important for tumor typing and differential diagnosis are stressed. And for most lesions, cytologic and histologic images are presented side by side for easy comparison. For improvement of the future editions of this monograph, comments and suggestions from the reader will be highly appreciated. Gia-Khanh Nguyen, M.D. Surrey, British Columbia, Canada Email: [email protected] Summer 2009 4 CONTRIBUTORS Catherine M.
    [Show full text]
  • Peripheral Blood Smear
    PERIPHERAL BLOOD FILM EVALUATION WHAT LIES BENEATH? งานประชุมวชิ าการ คณะสัตวแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่ 2563 Multi Systemic Disease Nawin Manachai (DVM., MSc., PhD.) Small Animal Clinic Department of Companion Animal and Wildlife Clinic Faculty of Veterinary Medicine Chiang Mai University • คำถำม ? ในช่วง 6 เดอื นทผี่ ่ำนมำท่ำนดู blood smear บ่อยแค่ไหน ? 1. อย่ำงน้อย 1 ครงั้ ตอ่ สปั ดำห ์ 2. อย่ำงน้อย 1 ครงั้ ตอ่ เดอื น 3. อย่ำงน้อย 1 ครงั้ ตอ่ 3 เดือน 4. อย่ำงน้อย 1 ครงั้ ตอ่ 6 เดือน 5.ไม่เคยดูเลย Peripheral blood smear (PBS) Screening Diagnosis • Hematological disorders • simply -anemia • safe -leukopenia -thrombocytopenia -unexplained cytosis -malignancies • Non-hematological disorders (hematologic manifestations in Early management Monitoring systemic disease) • Peripheral blood smear (PBS) Iron deficiency IMHA Megaloblastic anemia ITP Myelophthisis blood picture MAHA blood picture Hematologic malignancy Blood parasite infection What is included in a complete blood count (CBC) ? Scatter plot data Analyzer data Blood film microscopic review Provided by automated analyzers Provided by automated analyzers 5 Peripheral blood smear (PBS) 1. EDTA-blood 2. Glass slide 3. Coverslip 4. Fixative agent 5. Staining • Wright’s stain • Diff-quick 6. Light microscope 7. You Standard area… stacked RBCs on standard area Advantage zone of morphology Verify automate analyzer results Identify critical diagnostic features that analyzers cannot evaluate Identify morphologic abnormalities can be present even in patients with quantitatively normal results for all Peripheral blood film (smear) feathered edge hematologic parameters Make blood smears soon after collection to reduce the risk of artifacts Make a good quality smear 10X Always start from LOW POWER 10X 1. RBC distribution • degree of anemia • rouleaux formation • autoagglutination 2. WBC estimated number • 10-15 cell/LPF approximate to normal 3.
    [Show full text]
  • A Laboratory Guide to Clinical Hematology
    A Laboratory Guide to Clinical Hematology A Laboratory Guide to Clinical Hematology A Laboratory Guide to Clinical Hematology VALENTIN VILLATORO AND MICHELLE TO EDMONTON A Laboratory Guide to Clinical Hematology by Michelle To is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. Please be aware that the content for the entirety of this eBook is subject to a creative common license: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) You are free to: Share — copy and redistribute the material in any medium or format Adapt — remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms. Under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. Contents Authors & Editors ................................................................................................................................... xii Creative Commons License and Citation ............................................................................................... xiii Contact Information and Feedback ........................................................................................................
    [Show full text]
  • Acanthocytosis and Other Hematological and Serum Biochemical
    ACANTHOCYTOSIS AND OTHER HEMATOLOGICAL AND SERUM BIOCHEMICAL PAMMETERS M THE DIAGNOSIS OF CmHEMANGIOSARCOMA A Thesis Presented to The Faculty of Graduate Studies of The University of Guelph by MARGO SUSAN TANT (n partial fuifilment of requirernents for the degree of Doctor of Veterinary Science February, 1998 Q Margo Susan Tant, 1998 National Library Bibliotheque nationale du Canada Acquisitions and Acquisitions et Bibliographie Services seMces bibliographiques 395 Wellington Street 395, rue Weilingtori ûüawaON KIAM ûaawaON K1AON4 Canada canada The author has granted a non- L'auteur a accorde une licence non exclusive licence dowing the exclusive permettant à la National Library of Canada to Bibliothèque nationale du Canada de reproduce, loan, distribute or sell reproduire, prêter, distri'buer ou copies of this thesis in microfom, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/nlm, de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts fkom t Ni la thèse ni des extraits substantiels may be printed or othemise de celle-ci ne doivent être imprimés reproduced without the author's ou auttement reproduits sans son ~ermission. autorisation. ABSTRACT ACANTHOCYTOSIS AND OTHER HEMATOLOGICAL AND SERUM BIOCHEMICAL PARAMETERS iN THE DIAGNOSIS OF CANINE HEMANGIOSARCOMA Margo Susan Tant Advisor: University of Guelph, 1998 Dr. J. H. Lumsden A retrospective case-control study was conducted using the records of 80 dogs with visceral hemangiosarcoma (HSA) and 200 dogs with various diseases that had features simila.
    [Show full text]