D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section...

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D D irect irect M M icroscopic icroscopic S S omatic omatic C C ell ell C C ount ount Guidelines Guidelines Prepared By: Prepared By: Laboratory Development Laboratory Development Section Section Division of Division of Microbiology Microbiology Bureau of Foods Bureau of Foods Food and Drug Food and Drug Administration Administration November 1972 November 1972 Adapted to Slides By: Adapted to Slides By: DHHS,PHS,FDA,CFSAN,OC,DCP DHHS,PHS,FDA,CFSAN,OC,DCP Laboratory Quality Assurance Laboratory Quality Assurance Branch Branch January 2003 January 2003

Transcript of D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section...

Page 1: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

DDirect irect MMicroscopic icroscopic SSomatic omatic

CCell ell CCount Guidelinesount GuidelinesPrepared By:Prepared By:Laboratory Development Laboratory Development SectionSectionDivision of MicrobiologyDivision of MicrobiologyBureau of FoodsBureau of FoodsFood and Drug AdministrationFood and Drug AdministrationNovember 1972November 1972

Adapted to Slides By:Adapted to Slides By:DHHS,PHS,FDA,CFSAN,OC,DCPDHHS,PHS,FDA,CFSAN,OC,DCPLaboratory Quality Assurance BranchLaboratory Quality Assurance BranchJanuary 2003January 2003

Page 2: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

RRules for identifying and counting ules for identifying and counting somatic cellssomatic cells

• Leukocytes have a nucleus– Nuclear mass composition

• Recognizable form– One or more lobes– Lobes or units are bridged by nuclear material– Some cells are granular in appearance

• Some distortion is expected because of treatment

– Nuclear mass stains dark blue or blue-green

• Count nuclear mass that bears resemblance to a typical nucleus

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RRules cont’dules cont’d

• Cytoplasm normally surrounds the nucleus.– Stains light blue,– Not stained and appears as a clear zone, or– Disintegrated and not present.– Do not count cells without a stained nuclear mass

(ghost cell)

• Cell size.– Nuclear mass of a countable cell is ≥ 8 microns.– Fragments of a countable cell with at least 50% of

the nuclear mass visible and ≥ 4 microns.

Page 4: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

RRules cont’dules cont’d• Clump of cells

– Nuclear mass must be clearly delineated to count individual cell(s).

– If no clear delineation, count clump as one cell.

• Field boundaries– Do not over extend the field or strip boundaries– Count cells touching top or bottom edge of strip,

not both.

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Form FDA 2400d (6/05)Form FDA 2400d (6/05)DMSCC 25.g. Identifying and counting somatic DMSCC 25.g. Identifying and counting somatic cells.cells.

1. Cells possess a nucleus stained dark blue (bovine) or blue-green (caprine).

2. Cells generally 8 microns or larger (bovine, caprine may be smaller); do not count cells less than 4 microns; fragments counted only if more than 50% of nuclear material is visible.

3. Cluster of cells counted as one unless nuclear unit(s) are clearly separated; focus up and down to ensure that there are no bridges connecting nuclear masses.

4. Count cells touching only the top or bottom half of the strip.

5. IF IN DOUBT, DO NOT COUNT.

Page 6: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

AB

C

A, B and C are countable cells.

D is not a countable cell since it is less than 8 microns in diameter.Circled items are bacteria or artifacts that bear no resemblance to a typical nucleus and not counted. (3 cells) 1

8 microns

D

8 microns

Page 7: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B

A and B are countable cells. (2 cells)

2

Page 8: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

A is a countable cell. (1 cell)

3

Page 9: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B

A and B are countable cells. Both are surrounded by disintegrating cytoplasm, however the nuclear material remains intact and each resembles a typical nucleus. (2 cells)

4

Page 10: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

E

A

B

C

D

A – D are typical cells (multi-lobed nuclei).

E is cellular debris and not counted. (4 cells)

5

Page 11: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

Nuclear bridge

One cell with nuclear lobes connected by a nuclear bridge. (1 cell)

6

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CA

BD

A and C are cytoplasmic debris and not counted. B and D are typical cells. (2 cells)

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Page 13: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B

B is a countable cell.

A is a ghost cell (no nuclear material) and not counted. (1 cell)

8

Page 14: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

One cell with a disintegrating nucleus, however greater than 50% of the multi-lobed nuclear mass is visible. (1 cell)

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Page 15: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

E

A

B

C

D

A-E are typical cells. (5 cells)

10

Nuclear Bridge

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A

B

A is a typical cell with a multi-lobed nucleus.

B is a typical monocyte. Both are counted. (2 cells)

11

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A

A is a single cell with cytoplasm. (1 cell)

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Page 18: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B

C

D

E

F

Nuclear bridges

All are cells.

B and E are bi-lobed with nuclear bridges. (6 cells)

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A is less than 8 microns in diameter and not counted.

B has a disintegrating nucleus with greater than 50% of the nuclear mass visible and is counted.

C is a typical multi-lobed cell. (2 cells)

A

B

C

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Page 20: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A, C, and D are typical cells. Cell D is touching the top edge of the field and not counted.

B is cytoplasmic debris (less than 50% of nucleus present) and not counted. (2 cells)

A

B

D

C

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Page 21: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B

D

C

E

F

H

G

A-G are typical cells. Cell B is not counted as it touches the top edge of the field. (7 cells)

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Nuclear bridge?

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D

A

B

C

E

F

A, B, C, and E are typical cells.D is a cell with a large amount of disintegrating cytoplasm.F is debris, not a cell. (5 cells)

17

Page 23: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B C

A-C are typical cells.

18Blue-circled item is a bacteria or artifact that bears no resemblance to a typical nucleus and not counted as a cell. (3 cells)

Page 24: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

Cell C is not counted as it touches the top edge.

A

C

B

F

ED

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Cell A appears to be >8 microns.

B, D, E, and F are typical, countable cells. (5 cells)

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A

B

A and B are debris. (0 cells)

20

Page 26: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B

C

A is a typical cell.

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B and C are cytoplasmic debris. (1 cell)

Page 27: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

B

C

A D

A and D are typical cells.

Cell B is a fragment greater than 50% of original size.

Cell C has disintegrating nuclear material greater than 50% of original composition. (4 cells) 22

Page 28: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

A

B

C

D

A and B are typical cells.

C and D are cells showing early degeneration. (4 cells)23

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A

A is a typical cell. (1 cell)

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Page 30: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

B

C

A

E

D

A – E is a clump of typical cells. (5 cells)

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C

DB

A

I

FE

G H

J

A, B, and I are bi-lobed cells.

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E, F, G, and H are mononuclear cells. C is tri-lobed. D contains 4 nuclear masses.

J is a disintegrating cell. (10 cells)

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B

CA

DNuclear Bridges?

A, B, C, and D are typical cells. (4 cells)

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Page 33: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

B

A

A is a typical cell showing cytoplasmic degeneration.B is cellular debris. (1 cell)

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Page 34: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

B

A

C

A and B are typical cells, but A is touching the top edge and not counted.

29

C is a ghost cell. (1 cells)

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A is a disintegrating cell.

A

B

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B is typical. (2 cells)

Page 36: D irect M icroscopic S omatic C ell C ount Guidelines Prepared By: Laboratory Development Section Division of Microbiology Bureau of Foods Food and Drug.

Final Count

• The total count for 30 slides of one strip count = 88 cells