Cytomorphological study of peritoneal fluid in suspected cases of malignancy

Abstract

Cytology of body fluid is one of the oldest methods that is widely accepted. Though the pleural fluid cytology is well documented, data on peritoneal fluid cytology is sparse. It has a distinct value in confirming or disapproving malignant lesion. Most of the laboratories use cytospin smears for cytological study. While cytospin smears without doubt is a good method for cytodiagnosis, it can be complemented with cellblock for a more accurate diagnosis. Cellblock is a diagnostic modality which can help in pointing the cause for effusion and also in staging, prognosis and therapy of many malignant conditions. The aim of this study is to (1) analyse the cytomorphology of peritoneal fluid using cytospin and cellblock technique and (2) to assess the utility of cellblock method in identifying malignant cells in peritoneal effusion and wash samples. A total of 53 ascitic fluid and peritoneal wash samples that were clinically suspected of malignancy were studied. Each of the samples were processed by cytospin smear and cell block method. The results were interpreted by descriptive analysis. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the cytological test was 96.15%, 100%, 100%, 96.42% and 98.11% respectively. Cellular yield for malignancy was 3.85% more by the cellblock method. Cellblock can provide an additional information which can aid in increasing the sensitivity of cellblock. It can complement cytospin smears, especially to detect malignant cells in peritoneal fluid. A combined approach of cytospin and cellblock can help in a more accurate diagnosis.