COMPARATIVE STUDY FOR THE USE OF DIFFERENT TECHNIQUES IN SEROUS FLUID CYTOLOGY

BACKGROUND: Cytologic techniques have been universally recognized as the most important diagnostic tool in the recognition of malignant tumors in effusions. The diagnosis of cancer in a pleural, pericardial, or peritoneal fluid is of capital importance for the patient and the attending physician or surgeon. It helps in staging, prognosis and management of patients of malignancies, and also give information about various inflammatory and non-inflammatory lesions. Diagnostic problem arises in everyday practice to differentiate reactive atypical mesothelial cells from malignant cells by routine conventional smear method. AIM: To compare the morphological and cytological features of the conventional smear method with those of cytocentrifuge and cell block and also to compare the diagnostic yield of cytocentrifuge and cell block methods with conventional smear in the diagnosis serous effusion. MATERIAL AND METHODS: Ninety eight samples were subjected to diagnostic evaluation. Along with conventional smear, fluids were subjected to cytocentrifuge and cell block technique. Cell blocks were prepared using 10% formalin as a fixative agent. Smears obtained by each of techniques were scored for different parameters. Statistical analysis with Wilcoxon rank sum test was performed and also Index of Qualitative Variation (IQV) was calculated to compare the results obtained by each of the above three methods. RESULTS: Cellularity, diagnostic yield and sensitivity for malignancy was more for Cytocentrifuge and Cell Block technique. CONCLUSION: The cytocentrifuge and cell block method provide high cellularity, better architectural patterns, morphological features and an additional yield of malignant cells, and thereby, increases the sensitivity of the cytodiagnosis when compared to conventional smear method.