Title: Cytomorphological Evaluations of Malignant effusion in tertiary care center in central India- A hospital based study
Authors: Dr Jai Bharat Singh, Dr Anand Bhadkariya, Dr Vijay Chaudhary, Dr Dimple A Bhadkariya, Dr Arjun Singh
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.42
Abstract
Introduction: Fluid can build up in the abdomen or chest, putting pressure on the internal organs. Examinations of the effusion fluid are very easy and relatively non-invasive technique for diagnosis. It has provided much information to helpful to patients diagnostically as well as therapeutically. The morphological examinations of the cells are helpful to diagnose as primary and secondary sites of malignancy that means its help prognostic evaluations of the diseases.
Material and Method: This prospective study was conducted in the Department of Pathology in Ruxmaniben Deepchand Gardi Medical College, Ujjain. Eighty-eight cases were included in this study.
Result: We studied 88 effusion fluids in which 37 (42.04%) effusions were inflammatory with predominance of inflammatory cells to reactive mesothelial cells, followed by 20 (39.5%) fluids showing malignant metastatic deposits. Grossly out of 88 effusions, 57 (64.0%) fluids were straw colored while rest 31/88 (35.9%) were reddish. Twenty-five malignant effusions were reddish appearance, while only six malignant effusions (19.3%) were of straw-colored. Inflammatory fluids showed lymphocyte as the predominant cells.
Discussion: In present study cytological evaluation and routine staining of 88 cases with serous effusion was performed. On microscopy, apart from frankly malignant and other cases classified as inflammatory, or reactive effusion few cases were having variable number of cells with relatively large and rather hyperchromatic nuclei These cells were isolated or occurred in small clusters and could best be defined as suspicious. On white cell count, 68.1% effusion had white cell counts less than 1000 cells/mm3 and most of these effusions were either inflammatory or suspicious for malignancy. We found white cell count > 1000/mm3 in 51.61% (16 /31) of all malignant, effusion and 31.8% (10/31) of malignant effusion were with cell count less than 1000 cells/ mm3.
Keywords: Effusion, Malignancy, Cytology, Cell morphology.
References
- "NCI Dictionary of Cancer Terms". NCI. 2011-02-02. Retrieved 21 December 2018
- Cheson BD. Clinical utility of body fl uid analysis. Clin Lab Med 1985;5:195-208.
- Frist B, Kahan AV, Koss LG. Comparison of the diagnostic values of biopsies of the pleura and cytologic evaluation of pleural fl uids. Am J Clin Pathol 1979;72:48-51.
- Sherwani R, Akhtar K, Naqvi AH, Akhtar S, Abrari A, Bhargava R. Diagnostic and prognostic signifi cance of cytology in effusions. J Cytol 2005;22:73-7.
- Khushwah R,Shashikala P, Hiremath S, Basavaraj FG; Cell in pleural fluid and their value in differential diagnosis. Journal of cytology : Volume 25:Issue 4;2008.
- Alusi FA, pleural effusion in Iraq. A prospective study of 100 cases Thorax 1986; 41:29223.
- Leila Antonangelo et al clinical and laboratory parameters in the differential diagnosis of pleural effusion secondry to tuberculosis or cancer. CLINICS 2007; 62(5):585-90.
- Smith G P, Kjeldsberg LR. Cerebrospinal, synovial and serous boddy fluids. In: John Bernard Henry, editior. Clinical diagnosis and management by laboratory method, 19thrd. W.B. Saunders Company; 1996;pp 457-482.
- Getachew A, Tesfahunegn Z. Is fine needle aspiration cytology a useful tool for the diagnosis of tuberculous lymphadenitis. East Afr Med J. 1999 May;76 (5):2603. [ PMID:10750505 Abstract]
- Lai RS, Chen CC, Lee PC, Lu JY. Evaluation of cytokeratin 19 fragment (CYFRA 21-1) as a tumor marker in malignant pleural effusion. Jpn J Clin Oncol. 1999 Sep;29(9):421-4.[ PubMed -10563194 Abstract].
- Margaritescu Cl, Mogoanta , Manescu P, Cristiana S, Pirici D,Streba L, Mercut D. The immunohistochemical profile of the adenocarcinoma of upper gastric pole. Romanian Journal of Morphology and Embryology 2007, 48(3):215–235.
- Kaufmann o,Fietze E,Mengs J,Dietel M.Value of p63 and cytokeratin 5/6immunohistochemical markers for the differential diagnosis of poorly differentiated and undifferentiated carcinomas. Anatomic pathology 2001
- Dines DE, Pierre RV, Franzel SI. The value of cells in pleural fluid in differential diagnosis. Mayo clin proc 1975; 50:571-572.
- Prasoon D. Acid-fast bacilli in fine needle aspiration smears from tuberculous lymph nodes. Where to look for them. Acta Cytol. 2000 May-Jun;44(3):297-300.[ PMID:10833981 Abstract]