Digital cytology: The future of clinical pathologyApril 12, 2019It's Friday afternoon and Mr. Rush is in your practice again with Smoosh, his nine-year-old boxer who has been lethargic for the past month. Last week's blood work revealed mild lymphocytosis, mild non-regenerative anemia, and high-normal calcium. During today's follow-up, you palpate bilaterally enlarged submandibular lymph nodes. Not surprisingly, Mr. Rush is short of time and patience. You collect lymph node aspirates, tell him you'd like to take a look under the microscope, and return to the treatment area to stain the slides. Looking through the scope, you see the cells are relatively homogeneous. Most of the lymphocytes appear smaller than normal and are darkly stained; however, a fair amount of plasma cells and neutrophils are present. The blood work, breed, and lethargy are worrisome for lymphoma, but Smoosh is getting older and he is long overdue for a dental. Should you push for flow cytometry or a lymph node biopsy? Or are you overreacting, just like the lymph nodes? The cytology doesn't seem normal, but it's a tough call. It looks as though you have two choices: one, push for a bigger workup, or two, send the slides to a pathologist. You wonder what Mr. Rush will say when …
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