Some interesting cases from the body fluid bench (no really)!
#hemepath #hematology

Bone marrow contamination in CSF. More common in babies and elderly patients. Presence of blasts may cause concern for leukemic involvement. Look for nRBCs and immature grans.

Peritoneal fluid. Increased neutrophils, intracellular and extracellular bacteria in a patient with bacterial peritonitis.

BAL from a patient with Pneumocystis pneumonia. The clusters of organisms can look like stain precipitate/debris on low power. Focusing up and down on high power reveals the individual organisms.

Cryptococcus in CSF. The yeast forms vary in size and can be present in the absence of a significant inflammatory response.

Pleural fluid from a child with a mediastinal mass. Flow cytometry on the pleural fluid confirmed the diagnosis of T-ALL.

Breast carcinoma in CSF. The cells have abundant cytoplasm and may mimic mesothelial cells, but the nuclei are large compared to surrounding leukocytes - and mesos shouldn’t be present in CSF.

Beautiful recent case from @monakashim1: https://twitter.com/monakashim1/status/1289292676060327936?s=21