Body Fluid Differential Tutorial (Online Course)

(based on 1428 customer ratings)

Author: MaryBeth Helfrich, MT(ASCP)
Reviewer: Paul Fekete, MD, FCAP

If you have forgotten the art of differentiating choroid plexus cells from ependymal cells or viral lymphocytes from fluid monocytes, you are in luck! This course provides a thorough morphologic identification of over 40 cell types and disease states to recharge your memory. The course features over 100 crystal clear, perfectly stained body fluid images to illustrate both basic and advanced cellular morphology - perfect for a comprehensive, detailed review which can help refresh any technologist, both in or out of the hematology laboratory. The course is P.A.C.E. approved for 2 full credit hours to help reach your continuing education credit requirements. Enjoy learning and/or reviewing the key identification characteristics of body fluid cells in a user-friendly and fun format. Enroll today!

See all available courses »

Continuing Education Credits

Objectives

  • Compare and contrast the morphology of cells found in normal cerebrospinal fluid (CSF), normal pleural fluid, normal peritoneal fluid, and normal synovial fluid.
  • Identify the morphology of cells found in bronchoalveolar lavage (BAL).
  • Distinguish abnormal/reactive/infected cell morphology in fluids.
  • Recognize malignant cell morphology in body fluids.
  • Discuss appropriate scenarios for hematology/pathology review.

Customer Ratings

(based on 1428 customer ratings)

Course Outline

  • Cytocentrifugation Morphology
      • Cytocentrifugation of Body Fluid Samples
  • Cell Types Common To Most Types of Body Fluids
    • Neutrophils
      • Neutrophils
      • Neutrophils, continued
      • Eosinophils vs. Neutrophils
      • Nucleated blood cells will always have the same appearance on a cytocentrifuged smear as they do on a peripheral blood smear.
    • Lymphocytes, Atypical Lymphs, Plasma Cells
      • Normal Lymphocytes
      • Lymphocytes
      • Lymphocytes vs. Monocytes
      • Atypical Lymphocytes vs. Monocytes
      • Lymphocytes and Atypical Lymphocytes
      • Atypical Lymphocytes
      • Viral Lymphocytes
      • Lymphocytes and Plasma Cells in Body Fluids
      • The image on the right is a representative field from a cytospin preparation of a CSF from a patient with a viral infection. Identify the cell indicat...
    • Monocytes and Macrophages
      • Monocytes
      • Monocytes vs Lymphocytes
      • Monocytes and Macrophages
      • Macrophages
      • Phagocytosis
      • Hemosiderin
      • Histiocytes
      • Macrophages are the phagocytes that originate from lymphocytes.
  • Cells Found in Cerebrospinal Fluid
    • Cerebrospinal Fluid: Non-Blood Cells
      • Ependymal Cells
      • Ependymal Clumps
      • Choroid Plexus Cells
    • Cerebrospinal Fluid: Bone Marrow Contamination
      • Bone Marrow Contamination in CSF
      • What is the identification of this cellular clump found in CSF? Note the presence of many similar-appearing nuclei without distinct lines of demarcati...
  • Cells Found in Pleural and Peritoneal Fluids
    • Mesothelial cells
      • Mesothelial Cells
      • Mesothelial Cells, continued
      • Reactive Mesothelial Cells
  • Cells Found in Synovial Fluids
      • Synovial Lining Cells
      • Synovial Lining Cells, continued
  • Cells Found in Bronchoalveolar Lavages
    • Bronchial Lining Cells
      • Bronchial Lining Cells
      • Bronchial Lining Cells, continued
      • Match the following cell types to the body fluids in which they may be seen when the fluid is observed on a cytocentrifuged preparation.
  • Infectious Organisms in Body Fluids
      • Infectious Organisms in Body Fluids
    • Bacteria
      • Intracellular and Extracellular Bacteria
      • Intracellular Bacteria
      • Peritoneal Lavage Trauma
      • Trauma STAT
      • Septic Arthritis
    • Fungus
      • Yeast
      • Candida albicans - Germ Tube Formation
      • Hyphae
    • Toxoplasma
      • Central Nervous System (CNS) Toxoplasmosis
      • Central Nervous System (CNS) Toxoplasmosis, continued
      • The elements indicated by the arrows were observed on a Wright-stained smear of a synovial fluid. What is the likely identification of the elements an...
  • Malignant Fluids with Leukemia and Lymphoma.
      • Leukemic Fluids
    • Lymphoid Leukemia / Lymphomas
      • Acute Lymphoblastic Leukemia (ALL): L1 Morphology
      • Central Nervous System (CNS) Relapse: L2 Acute Lymphoblastic Leukemia (ALL)
      • Burkitt Lymphoma
      • Non-Hodgkin Lymphoma
      • Anaplastic Large Cell Lymphoma (ALCL)
    • Myeloid Leukemias
      • Acute Myeloid Leukemia (AML)
      • Acute Myeloid Leukemia (AML), continued
      • Acute Monoblastic Leukemia (AMoL)
      • Prominent vacuolation involving the cytoplasm of abnormal lymphoblast-like cells seen in a body fluid preparation is a distinctive feature of Burkitt ...
  • Malignant Fluids with Metastatic Tumor
      • Metastatic Tumors in Fluid Cytospins.
      • Adenocarcinoma in Peritoneal Fluid
      • Alveolar Rhabdomyosarcoma (ARMS) in Plerual Fluid
      • Atypical Teratoid/Rhabdoid Tumors (ATRT) in Cerebrospinal Fluid
      • Metastatic Melanoma in the Cerebrospinal Fluid (CSF)
      • Primitive Neuroectodermal Tumor (PNET) in Cerebrospinal Fluid
      • Medulloblastoma in Cerebrospinal Fluid
      • Neuroblastoma in Pleural Fluid
      • Neuroblastoma Tumor Clump vs. Mesothelial Cells in Pleural Fluid
      • Retinoblastoma in Cerebrospinal Fluid
      • Match the morphologic characteristics with the listed cell type.
  • References
      • References

Additional Information

Level of Instruction: Intermediate
 
Intended Audience: This course is intended for laboratory professionals who have experience with peripheral blood morphology and basic experience with body fluid differential analysis.  This tutorial will provide a review of normal and abnormal body fluid morphology utilizing Wright-Giemsa stained cytospin preparations from cerebrospinal fluid (CSF), pleural, peritoneal and synovial fluids as well as bronchial alveolar lavage (BAL) samples.
 
Author Information: Marybeth Helfrich, MT(ASCP) is currently a Laboratory Technologist Specialist for the Hematology/Oncology Laboratory at Childrens Hospital of Philadelphia. She received her BS, MT from Temple University in Philadelphia and has nearly 40 years of experience in both adult and pediatric hematology and oncology settings. She is a regular presenter for ASCLS-PA, has been a presenter for ASCP (local and national), and the Texas Teleconference network. She is responsible for hematology morphology instruction and training for medical technologists and fellows. She is also a regular developer of morphology tutorials for in-house continuing education activities.

Reviewer Information: Paul Fekete, MD, FCAP is the President and CEO of MediaLab, Inc. He received his MD from Ohio State University and completed his clinical pathology residency at Emory University in Atlanta. He has served as an Assistant Professor of Pathology at Emory and as the Director of Laboratories for Gwinnett Medical Center in Lawrenceville, GA. He is currently President of Gwinnett Pathology Associates PC, Gwinnett Medical Center. Dr. Fekete is a member of Alpha Omega Alpha Honor Medical Society and a Fellow of the College of American Pathologists.

Body Fluid Differential Tutorial Keywords

These are the most common topics and keywords covered in Body Fluid Differential Tutorial:

leukemic synovial white blood cells morphology intracellular myeloid red blood cells mesothelial cells monocyte nucleus protocols cytospin clinical fungal cytospin technique identification effusion pericardial nuclear cavity blood macrophage albicans textures nuclei primitive irregularity translocation neutrophils cytospin preparations lymphoblasts laboratory infectious microbiology tumors cytoplasm bronchial tumor mesothelium macrophages nuclearcytoplasmic fused hospital vacuolated samples rbcs mycobacteria artifact trauma bals melanoma cilia histiocytes depicts hyphae alveolar bone marrow granulation cellular nervous cytospins histiocyte burkitts non-granular vacuolation wbcs ependymal diagnosis lymphocytes candida neuroblastoma peripheral blood smears clusters nucleoli lavage hospitals reactive basophilic metastatic pathology acute mononuclear cells lymphoma vacuoles toxoplasmosis differential multinucleate spinal lymphoblastic lymph leukemia lymphocyte mesothelial cell cerebrospinal monocytes ventricles infection saline chemotherapy choroid rhabdomyosarcoma numbers softer shaggy generous bacteria neural mesothelial cells malignant arthritis differentials abnormal sterile cytospin preparation serous effusions laboratorians meningitis lavages plasmacytoid cerebrospinal fluid brain diplococci iron hemorrhage cavities pleural chromatin clumps bacterial nerve peritoneal respiratory body membranes hematology adenocarcinoma proportions photos wright multinucleated pneumonia infections bowel neuroectodermal circulating lymphoid cytoplasmic peripheral blood smear granules burkitt hemosiderin fluids demarcation rectangular histocytes bi-nucleate disease immature organisms



csf 10 sml


synovial clump sml


burketts sml


anaplastic large cell 2 sml


csf atyp lymph vs mono sml2


trauma pert lavage sml2


corrected normal csf 1 sml2


lymhoblasts sml