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Cystic material: Cystic lesions often have a thick blue, purple or pink background that may be scalloped. Cholesterol crystals are a hallmark of cell degeneration that occurs commonly in cystic lesions. These appear cytologically as rectangular, |
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Prostatic carcinoma cells are surrounded by globular, blue/purple necrotic material. Necrosis: Necrotic debris is seen as amorphous, globular, blue/purple/gray material |
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A macrophage is seen with a central purple nucleus. Red blood cells, blue/green hemosiderin, and golden hematoidin crystals are present within the cytoplasm. Hemorrhage: Blood often is present in the background of samples as a consequence of sampling, which may be supported if platelets are present. Prior hemorrhage within the lesion is confirmed when macrophages are erythrophagocytic, and/or contain heme breakdown pigment such as hemosiderin or hematoidin |
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Extracellular matrix,Note the bright pink, smooth, streaming matrix material intimately associated with spindle cells (synovial cell sarcoma).Extracellular matrix is mostly bright pink and may be smooth, fibrillar or stippledis most common with mesenchymal proliferation, but basement membrane of epithelium can appear similarly |
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Cytoplasmic fragments, Note the small round fragments of pale blue cytoplasm surrounding lymphocytes in a case of canine lymphoma.Cytoplasmic fragments: Fragments of cytoplasm may be seen with any cell type; however, they are most commonly associated with lymphocytes (and have previously been called ‘lymphoglandular bodies’) |
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Mineralization: Mineralized debris is seen as clear, irregular/gritty, refractile aggregates, and often is seen outside the plane of focus of cells in the sample. It may be seen in chronic, cystic, or necrotic lesions. The material is seen in different planes of focus. |
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Glove powder, Note the characteristic cross in the center of the crystals starch crystals are round with a characteristic cross in the middle and should be distinguished from mineralized debris |
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Precipitation of stain appears as variably coarse, granular pink/purple material. It may be seen in the background, but can cover cells, and care should be taken to distinguish it from cytoplasmic granules, or even intracellular bacteria. |
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Ultrasound/lubricant gel, Bright purple granular material (ultrasound gel) surrounds transitional epithelial cells in a catheter urine sample from a dog. |
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Precipitation of stain. Geometric crystals may form incidentally in the background of thick samples. It may be seen in the background, but can cover cells, and care should be taken to distinguish it from cytoplasmic granules, or even intracellular bacteria. Crystals may form incidentally in the background of thick samples, making geometric patterns |
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Nuclear material, Note the streaming pink nuclear material from lysed cells in an ovarian granulosa cell tumor. |
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Bare nuclei, Nuclei from lysed cells (arrows) appear puffy and lack surrounding cytoplasm. |
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Apoptotic cells,Apoptotic cells have pyknotic nuclei with deeply basophilic, dense chromatin (arrow). |
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Hemoglobin crystals,These crystals are needle‐shaped and the color of red blood cells. Note the bloodassociated neutrophils. the latter forming if samples are exposed to humidit |
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Hemoglobin crystals, These crystals, variably sized, and pink/orange. the latter forming if samples are exposed to humidit |
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Formalin artifact results in a pale, homogeneous blue appearance to cells, and cellular detail is obscured |
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Capillaries, Linear pink capillaries course across the sample. |
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Pink, linear capillaries with elongated basophilic nuclei seen in rows. Note the red blood cell travelling within the capillary (arrow). |
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Skeletal muscle is deep blue and has subtle parallel cross‐striations. |
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Normal mesothelium Note the pink fringe border. |
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Macrophages (arrows) and lymphocytes (arrowheads). Note erythrophagia within a macrophage (lower left). |
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Apoptotic/pyknotic nuclei,Two apoptotic neutrophils (lower right) with multiple variably sized, deeply basophilic, pyknotic nuclear fragments. Komórki apoptotyczne/pyknotyczne dużo częściej w steylnych zapaleniach |
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Degenerative neutrophils, |
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Epithelial cells, prostatic carcinoma, dog, Cells are cohesive and ‘sticky’ with prominent intercellular borders.Cells of epithelial origin often exfoliate in large numbers, and are seen mostly in cohesive sheets whereby cells share prominent intercellular borders with each other, like bricks and mortar |
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Mesenchymal cells, leiomyosarcoma, cat, Mesenchymal cells exfoliate variably well. They generally are fusiform or spindloid with tapering ends |
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Mesenchymal cells, osteosarcoma, dog, The neoplastic mesenchymal cells are round. Note the normal, multinucleated osteoclastsome cells of mesenchymal origin are round |
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Anaplastic carcinomas often lose the ability to form cell junctions, and may appear as individualized or round cells Poorly cohesive carcinoma (hepatocellular carcinoma), |
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Melanoma cells may be round or spindloid, seen individually, in aggregates or sheets and may be associated with extracellular matrix Melanoma, dog, The cells are vaguely cohesive, round to spindloid, and associated with pink extracellular matrix. Note the green/ black pigment in some cells, and the mitotic figure (lower left). |
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Włókniak Dobrze zróżnicowane, monomorficzna populacja komórek |
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[image] Kot skóra kryterium |
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Multinucleation, anaplastic sarcoma with giant cells, cat |
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Gruczolak, dobrze zróżnicowane komórki nabłonka |
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[image] Płyn pies kryterium |
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Anisocytosis, mesothelioma, |
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[image] Okolica odbytu pies kryterium |
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Cell piling, perianal gland carcinoma, dog, The cells are overlapping, crowded, and disorganized. |
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[image] Płyn pies kryterium |
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Cell cannibalism, mesothelioma, dog A mitotic neoplastic cell has phagocytosed another neoplastic cell (arrow). |
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High N/C ratios, mammary carcinoma, |
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Anisokaryosis, transitional cell carcinoma |
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Cytology of giant cells: many roundish and spindled histiocytic multinucleated cells (giant cells), in the attempt to eliminate a large foreign body represented by cluster of corneocytes |
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Komórki typu ciał obcych Komórki typu Langerhansa |
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nuclei of giant cells can be haphazardly distributed in the centre of the cell or arranged at the periphery in a horseshoe shape . The former giant cells are named foreign body cells and are those most frequently observed in skin cytology when an exogenous material is present. |
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Langhans cells, are rarer and typically observed in immunological diseases linked to fungal infection, mycobacteriosis or in all cases of a granulomatous reaction |
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Jak odróżnić komórki olbrzymie od nowotworowych |
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Jądra różnych rozmiarów i atypia jądrowa,(nieregularne makrojąderka, liczne jąderka), whereas in histiocytic infl ammatory giant cells the nuclear size is uniform, with regular chromatin and inconspicuous nucleoli. |
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Cytology of neutrophilic and macrophagic inflammation: segmented neutrophils and vacuolated macrophages collected from a sterile lesion |
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Cutaneous lymphoma . Large, neoplastic lymphocytes are accompanied by many neutrophils. Neutrofile mogą dominować |
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Melanocytomas often are highly cellular and comprise aggregates of round to spindloid melanocytes. They have a moderate volume of cytoplasm containing a variable amount (often abundant) of green/black melanin pigment granules. Nuclei are ovoid with stippled chromatin and small basophilic nucleoli. Anisocytosis/ anisokaryosis are mild, and N/C ratios are low. |
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Czerniak Many tumors will contain green/black melanin pigment granules Cells may be round or spindloid, and arranged individually, in sheets or aggregates. In general, malignant melanomas have many criteria of malignancy, including marked anisocytosis/anisokaryosis, prominent basophilic nucleoli, and mitotic figures. |
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Torbiel naskórkowa Samples vary greatly in appearance but almost all contain many anucleated squamous epithelial cells and aggregates of keratinized debris |
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Torbiel naskórkowa Keratinized debris isstudded with aggregates of refractile, mineralized debris. |
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Torbiel naskórkowa Pigmented hair shafts - łodyga włosa Note the different plane of focus from other material |
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Torbiel naskórkowa pęknięta Zapalenie mieszane w reakcji na keratynę |
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Trichoblastoma note the brigt pink cell membrane material • Variably cellular, tight sheets of uniform cuboidal epithelial cells. • Cells distributed in papillary arrangements and may be associated with bright pink, smooth extracellular matrix (basement membrane). • Scant volume of medium-blue cytoplasm and may contain melanin pigment in some tumors. • Nuclei are round and centrally located with small or inapparent nucleoli. • Anisocytosis/anisokaryosis are mild, and N/C ratios are high. • Cystic material may predominate. • There may be pleomorphism. |
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Basal cell carcinoma, Note the cell piling and prominent nucleoli Podobne do trichoblastom ale cechy złośliwości: 1.Cellular piling and crowding 2.Anisokaryosis 3.Prominent basophilic nucleoli Pleomorphism can be seen in benign cutaneous basilar epithelial neoplasms (usually <30% of cells), and histopathology is required for definitive diagnosis |
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Sweat gland adenomas 1. Arkusze sześciennych do krótkich kolumnowych komórek nabłonka. 2. Jądra okrągłe i ekscentrycznie położone, a chromatyna jest zagęszczona. 3. Granice międzykomórkowe często są słabo zdefiniowane. 4. Anizocytoza/anizokarioza są łagodne 5. Te guzy mogą być podobne do guzów skóry podstawnokomórkowych mogą ulec cystowaceniu. |
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Sweat gland adenocarcinomas 1. Spójne arkusze i gniazda komórek. 2. Komórki okrągłe, z niewielką do umiarkowanej objętością jasnoniebieskiego cytoplazmy i często ekscentrycznie położonymi jądrami. 3. Anizocytoza/anizokarioza są umiarkowane do znacznego stopnia, a stosunki N/C są umiarkowane do wysokich. |
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Sebaceous adenomas exfoliate variably well as uniform sheets of tightly cohesive cells with abundant clear, foamy cytoplasm. Nuclei are centrally located with condensed chromatin and small or inapparent nucleoli. Nodular sebaceous hyperplasia appears cytologically similar. |
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Sebaceous epitheliomas exfoliate well, and comprise well‐differentiated basal epithelial cells, intimately associated with nests of mature sebaceous epithelial cells. Basilar epithelial cells often predominate; however, the ratio of the two populations varies, with no effect on biologic behavior |
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Rak z gruczołów łojowych Often highly cellular, with large cohesive sheets of epithelial cells that have prominent intercellular borders. The cells have clear to medium blue cytoplasm with numerous fine clear vacuoles and round, central nuclei with stippled chromatin and prominent nucleoli. Anisocytosis/anisokaryosis are moderate to marked, and N/C ratios are high. |
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Przerzut raka płucaCarcinomas may metastasize to the skin. These mostly appear as cohesive sheets of cells with prominent intercellular borders; however, anaplastic variants may lose cohesion. Criteria of malignancy often are marked, including anisocytosis/anisokaryosis, high N/C ratios and increased mitotic activity |
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Squamous papillomas are characterized by polygonal squamous cells that have abundant cytoplasm containing bright‐pink keratohyaline granules. Nuclei are large, round, and pyknotic with condensed chromatin. Squamous papillomas frequently are inflamed |
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SCC Note the sky-blue cytoplasm, immature nuclei, and perinuclear vacuolation. Variably cohesive sheets of cells that range from polygonal to round. They often have prominent criteria of malignancy, with marked anisocytosis and anisokaryosis. The cells frequently have keratinized cytoplasm, which appears as bright sky‐blue andhyalinized. Keratinized squamous cells should have small, pyknotic nuclei with dense chromatin. The finding of large, immature nuclei in keratinized cells suggests nuclear to cytoplasmic dissociation, and can be seen with both neoplasia and dysplasia. Perinuclear vacuolation is a common finding in SCC. |
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Reactive fibroplasia, Note the accompanying inflammation. Is characterized by variable numbers of spindle cells. These cells often have a maturational gradient, ranging from mature cells with a scant volume of cytoplasm and elongated nuclei, to plump spindle cells with abundant deep‐blue cytoplasm and ovoid nuclei with stippled chromatin. The reactive response can be florid, and differentiating Reactive fibroplasia from spindle cell neoplasms is not always possible with cytology |
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Włókniak Fibromas often exfoliate poorly. When present, cells are spindloid, and seen individually or in small aggregates, that may be accompanied by pink extracellular matrix.The cells have a scant volume of pale cytoplasm that forms delicate bipolar tendrils and wisps. Nuclei are elongated, with granular chromatin and small basophilic nucleoli. Anisocytosis/anisokaryosis are mild, and N/C ratios are high. These often are cytologically indistinguishable from reactive fibroplasia. |
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Fibrosarcomas exfoliate variably well, either individually or in aggregates. The background often contains brightpink extracellular matrix (Figure 3.41). The cells have a variable volume of cytoplasm forming tendrils and wisps, and may contain fine pink granules or clear vacuoles. Nuclei are ovoid to elongated, with finely granular chromatin and prominent nucleoli. Anisocytosis/anisokaryosis often are marked, and multinucleation and mitotic figures may be present |
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Keloidal fibromas and fibrosarcomas contain aggregates of spindle cells often centered around characteristic, polygonal to rounded aggregates of bright‐pink, smooth collagen. Differentiating keloidal fibromas from keloidal fibrosarcomas cytologically is difficult; however, anisokaryosis often is greater in fibrosarcomas. |
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Heamangiopericitoma Note the cells emanating from linear, streaming capillaries. Frequently highly exfoliative with aggregates of spindle cells often centered around capillaries. Cellshave pale‐blue cytoplasm forming delicate wisps and tendrils, which may contain fine, clear vacuoles. Nuclei are ovoid with granular chromatin and small nucleoli. Anisocytosis/anisokaryosis are mild, and N/C ratios are moderate to high. Multinucleated cells with peripheralized nuclei forming a ring (‘crown cells’) may be seen and are suggestive of perivascular wall tumors. |
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Obłoniak crown cells. Frequently highly exfoliative with aggregates of spindle cells often centered around capillaries. Cellshave pale‐blue cytoplasm forming delicate wisps and tendrils, which may contain fine, clear vacuoles. Nuclei are ovoid with granular chromatin and small nucleoli. Anisocytosis/anisokaryosis are mild, and N/C ratios are moderate to high. Multinucleated cells with peripheralized nuclei forming a ring (‘crown cells’) may be seen and are suggestive of perivascular wall tumors. |
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Obłoniak. Frequently highly exfoliative with aggregates of spindle cells often centered around capillaries. Cellshave pale‐blue cytoplasm forming delicate wisps and tendrils, which may contain fine, clear vacuoles. Nuclei are ovoid with granular chromatin and small nucleoli. Anisocytosis/anisokaryosis are mild, and N/C ratios are moderate to high. Multinucleated cells with peripheralized nuclei forming a ring (‘crown cells’) may be seen and are suggestive of perivascular wall tumors. |
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Hemangiomas Note the bloody background, spindle cells with fine tendrils and the mast cell frequently have a densely bloody background, and may only yield a small number of cells. When cells are present, they mostly are individualized spindle cells, with a scant volume of pale‐blue cytoplasm that forms delicate bipolar tendrils and wisps Nuclei are ovoid to elongated, with finely granular chromatin and small, single basophilic nucleoli. Anisocytosis/anisokaryosis are mild, while N/C ratios are high. Low numbers of well‐granulated mast cells may be present. Macrophages may be present, with evidence of chronic hemorrhage |
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Naczyniakomięsak skóry Note the prominent nucleoli. Frequently have a densely bloody background, and are variably exfoliative. Cells are spindloid, with a moderate volume of medium‐blue cytoplasm. Erythrophagia may be seen in neoplastic cells. Nuclei are ovoid with granular chromatin and prominent basophilic nucleoli. Anisocytosis/anisokaryosis are marked, and N/C ratios are high. These tumors are difficult to differentiate definitively from other sarcomas cytologically. |
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Myxomas Note the dense pink, streaming mucinous background. have a thick, pink‐stippled background of extracellular matrix, often distributing the cells in a streaming pattern. Cells are spindloid, with a scant volume of pale‐blue cytoplasm forming delicate wisps. Nuclei are elongated with finely granular chromatin and small basophilic nucleoli. Anisocytosis/ anisokaryosis are mild and N/C ratios are high. |
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Myxosarcomas Note the dense pink stippled, mucinous background and prominent anisokaryosis. have a similar thick, pink‐stippled myxoid background as myxomas. The cells have more prominent criteria of malignancy, particularly anisokaryosis and larger basophilic nucleoli |
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Anaplastic Sarcoma with Giant Cells Cells generally are spindloid with tapering ends, and have ovoid to elongated nuclei with granular chromatin and prominent nucleoli. Multinucleated giant cells may be round or spindloid with tendrils and wisps. These cells often have nuclei of varying size and shape, relative to osteoclasts or multinucleated macrophages, which have multiple, regular nuclei. |
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Tłuszczakomięsak There are numerous histologic subtypes of liposarcomas, resulting in a wide array of cytologic appearances. Welldifferentiated liposarcomas (Figure 3.53) contain neoplastic cells that vaguely resemble adipocytes, but are characterized by basophilic cytoplasm, and immature nuclei, with prominent nucleoli and moderate anisokaryosis. Poorly, or dedifferentiated liposarcomas (Figure 3.54) appear somewhat cohesive, and contain coarse, clear lipid vacuoles in their cytoplasm. Such a finding should raise suspicion for a liposarcoma, regardless of cell shape or arrangement. Anisocytosis and anisokaryosis are moderate to marked, and N/C ratios are high |
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Zapalenie ropno-ziarniniakowe diagnostyka różnicowa |
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DDx = acral lick granulomas, furunculosis, foreign body reactions, injection site reactions, infectious agents (especially fungi and atypical bacteria such as Mycobacterium spp. or Actinomyces; or secondary to rupture of epidermal cysts. |
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Vaccination reactions Note the abundant purple granular material in the background and phagocytosed by macrophages. mostly are characterized by a granulomatous or pyogranulomatous inflammatory response, with infiltration of lymphocytes and plasma cells in chronic lesions. Vaccine adjuvant is often (but not always) present in the background or phagocytosed by macrophages and appears as globular magenta to blue material. Reactive fibroblasts may be present. |
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Ropień Neutrophils are degenerative and contain intracellular bacteria.Abscesses generally are characterized by large numbers of degenerative neutrophils. When these changes are seen, close evaluation for infectious organisms is warranted. Intracellular organisms confirm a septic etiology (Figure 3.61). Many different infectious organisms can cause cutaneous abscesses. Sterile abscessation is less common. |
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Seromas/hygroma Macrophages contain phagocytosed proteinaceous material. Typically have a variably thick, blue/purple proteinaceous background, with low numbers of inflammatory cells scattered individually. The type ofinflammatory cells often reflects the time course of the lesion, dominated by non‐degenerative neutrophils acutely, and macrophages in the chronic stages. There may be evidence of hemorrhage |
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Calcinosis cutis Note the thick background and aggregates of refractile mineralized debris. Samples have a thick purple background with abundant aggregates of refractile, crystalline material. Nucleated cells usually are present in low numbers, mostly reactive macrophages, which may contain phagocytosed mineralized debris. |
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Calcinosis circumscripta makroskopowo Grossly, stained sides have a characteristic chalky appearance |
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Calcinosis cutis Samples have a similar appearance to those of calcinosis circumscripta, but usually are more cellular with greater numbers of inflammatory cells |
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Hypersensitivity reactions Hypersensitivity reaction, dog Note the mast cell. Frequently are dominated by eosinophils, with lesser numbers of mast cells and other inflammatory cells. Differential diagnoses may include eosinophilic granuloma or mast cell tumor. Useful findings to help differentiate from mast cell tumors include individualized cells (compared to aggregates of mast cells in neoplastic lesions), and well‐differentiated mast cells with many granules. |
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Ziarniniak eozynofilowy Note the abundant eosinophil granules in the background. Eosinophils predominate and frequently are found in aggregates. Many free eosinophil granules may be seen in the background. A variable number of other inflammatory cells may be present, with macrophages generally present in eosinophilic granulomas |
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Pemphigus Numerous acantholytic cells (arrows) accompanied by neutrophilic inflammation. lesions are characterized by acantholytic keratinocytes. These cells are round, with intensely staining magenta, granular cytoplasm and large, round, central nuclei. Neutrophils and other inflammatory cells are frequent findings. Although acantholytic cells are not pathognomonic for pemphigus (and can be seen in other chronic or immune‐mediated conditions), they are most common in this disease, and were present in 77% of cases in one study |
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