Serous Effusion Cytology in Sudanese Patients

Abstract

The purpose of this study was to determine the etiology and cytological patterns of serous effusions among Sudanese patients. Methods and Results: This descriptive study was carried out in hospitals of Khartoum state in the period from February 2019 to June 2020. One hundred and seventy-eight patients “clinically and/or radiological” diagnosed as having an accumulation of serous effusions were included in this study. Smears were prepared and stained according to the conventional pap staining procedure. The majority of the study population (121[68%]) had malignant effusion (MEs), and the other group (57[32%]) - benign effusions (BEs). Among patients with MEs, breast cancer was the major etiology (75[62%]), followed by lung (23[19%]), GIT (12[9.9%]), and thyroid cancers (11[9.1%]), while among patients with BEs, parapneumonic conditions were the main factor (28[49.1%]), followed by tuberculosis (18[31.6%]) and pulmonary embolism (11[19.3%]). The majority of patients with MEs were pleural effusion (109[90.1%]), followed by peritoneal effusion (12[9.9%]), whereas no patients in this group had pericardial effusion. Pleural effusion (29[50.9%]) was also the major one among patients with BEs, followed by peritoneal (21[36.8%]) and pericardial effusions(7[3.9%]). Conclusion: Malignant serous effusion is commonly seen among patients with malignant tumors; pleural effusions presented a large proportion, especially among females with breast cancer. Thoracentesis and cytological methods (i.e., conventional smear and cell block technique) should be the first line for the diagnosis of malignant pleural effusions, along with confirmatory adjunct techniques such as immunohistochemistry and immunocytochemistry.