CYTO-DIAGNOSIS OF PLEURAL EFFUSIONS: A COMBINED APPROACH TO MORPHOLOGICAL FEATURES IN ROUTINELY STAINED CYTOLOGY SMEARS AND CELL BLOCK TECHNIQUE

Abstract

Introduction: Pleural cavity is a potential space between the parietal pleura and visceral pleural. It consists of some amount of uid called pleural uid which is normally less than 25ml. Pleural uid is produced by parietal lining and absorbed by visceral lining. Fluid is produced by plasma ltration through capillary endothelial cells. Aims & Objectives:Acombined approach of cytology and cell block technique in diagnosing the cause of pleural effusion. To evaluate the utility of cell block preparation over the conventional smear in the cytodiagnosis of serous effusions. Material & Methods: The present study was conducted on patients having pleural effusions. The cases and specimens were selected from the outdoor as well as indoor patients admitted in a tertiary care centre of North India and also from those sent directly to Pathology department from other hospitals. The duration of study was from January 2019 to September 2020. The specimens obtained were processed in the biochemistry, cytopathology and histopathology laboratory in the Pathology department of GSVM Medical College, Kanpur. Result And Analysis: Out of 100 cases studied it was found that 83 (83%) cases were of reactive pleural effusion and 17 (17%) cases were of malignant pleural effusions.Out of 17 malignant effusion, 16 (94%) cases were exudative, while 1 (6%) case was transudative.Only 8 cases of adenocarcinoma were diagnosed on smear examination, while 11 cases were diagnosed on cell block examination. 3 cases of poorly differentiated carcinoma were diagnosed on conventional smear and 5 cases on cell block examination.Out of total 17 malignant pleural effusions diagnosed by cell block, only 12 cases were diagnosed by conventional smear examination. Hence diagnostic yield increased by 30% using cell block preparations. Conclusion: Thus it was concluded that routine centrifuge is not satisfactory in reporting uids with scant cellularity. Hence for uids with scant cellularity cell block preparation is a useful method. Also the morphology of the cells were well appreciated by cell block as compared to routine centrifuge, thus aiding in accurate diagnosis. In this study the diagnoses which were missed or incompletely diagnosed on conventional smear were diagnosed by cell block.