Tissue and Fluid Samples: Why Are They Useful in Diagnosing Diseases?
Sampling of tissue and subsequent microscopic evaluation of tissue is described as collecting and interpreting a biopsy. The preparation and evaluation of tissue is performed by a board certified pathologist. Biopsies are used to evaluate masses and tumors, either inside the body, mouth or ears or on the external surface of the body (dermal or mammary tumors). Biopsy samples can also be collected from tissue that is red or hairless or ulcerated as a means of differentiating cancer (neoplasia) from inflammatory, traumatized or infected tissue.
Analysis of fluid or a tissue sample is a diagnostic tool used in conjunction with blood and urine tests and imaging (radiographs, ultrasound, CT Scan or MRI) to narrow down a list of potential diseases in a cat. Microscopic analysis of cells in fluid is referred to as cytology. Microscopic analysis of tissue (biopsy) is referred to as histopathology. Samples of fluid are “aspirated” with a needle and tissue can be sampled with a small needle and syringe or by an incision that allows tissue to be collected. Fine needle samples of tissue can be collected with direct visualization if accessible to the eye or via one of the imaging systems mentioned above. When a tumor is removed, the entire mass can be submitted to the pathologist to ensure that all tumor cells were removed. This is referred to as “checking margins” or making sure that “clean margins” are achieved , i.e. all of the cancer was removed.
Fluid samples are collected via a needle and syringe and often used to differentiate causes of abnormal free fluid accumulation in either the chest or abdomen of a cat. Protein levels, bacterial isolation and microscopic evaluation of cell types are the usual tests done on fluid. Some types of cancer will “shed” (exfoliate) cells into fluid and the exact cancer can be identified by microscopic evaluation of those cells. Lymphoma, the most common cancer in cats, usually exfoliates in the chest fluid if there is a lymphoma tumor in front of the heart. Feline Infectious Peritonitis (FIP) is a fatal viral (corona virus) disease that can cause abnormal fluid to accumulate in the chest or abdomen or both. FIP fluid has a characteristic yellow color, often contains a white blood cell type called macrophages and has high protein levels. Congestive heart failure or non-exfoliating cancers like adenocarcinoma, will cause a clear watery fluid to collect in either the abdomen or chest that is free of cells. Bacterial infection in the chest or abdomen (peritonitis) contains high levels of white blood cells (neutrophils or pus) called neutrophils and the causative bacteria can often be directly visualized inside the neutrophils or macrophages or may be grown on an agar plate (cultured) from the pus. Fluid extracted from around the brain or spinal cord (cerebrospinal fluid) can be evaluated for inflammatory or cancer cells.
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