“CELL BLOCK AS A BETTER DIAGNOSTIC TOOL IN DIAGNOSIS OF LUNG CANCER FROM EXUDATIVE PLEURAL FLUID”

Abstract

Introduction: The cytological examination of serous effusions helps in diagnosis, staging, management and prognostication of patients with various malignancies. But cytological method has disadvantage of lower sensitivity in differentiating reactive atypical mesothelial cells from malignant cells. Aim: The aim of this study is to compare the cytomorphology of pleural exudative uids by conventional smear (CS) method and cell block (CB) method and also to assess the utility of their combined approach. Furthermore, immunohistochemistry is used in differentiating the benign from malignant tumour cells in exudative pleural effusions. Materials and Methods: It is a cross sectional study. 38 pleural exudative uid samples were subjected to evaluation by both CS and CB methods over a period of 1 year. Cellularity, architecture patterns, morphological features and yield for malignancy were compared. Chi-square and P-value were calculated, p value <0.05 considered as signicant relationship. Results: CB method provided higher cellularity, better architectural patterns and additional yield for malignancy as compared to CS method. pvalue found to be <0.0318,and it is statistically signicant. Conclusion: The present study shows that it is advisable to routinely make CBs in every cases that were suspicious for malignancy by conventional smear examination method. Use of immunohistochemistry further aided in diagnosing and differentiating the benign cells from malignant cells in exudative pleural effusions.