Abstract

Background: The cytological examination of pleural fluid is a simple, inexpensive and non-invasive method which helps in rapid diagnosis. A positive diagnosis is often considered as definite criteria for even an explorative surgery. It helps not only in the diagnosis but also in the staging and prognosis of malignancy. However it is difficult for even an experienced pathologist to reliably distinguish benign and malignant effusions.

Objective: To analyse the interobserver agreement in pap stained smear and cell block preparation in pleural fluid cytology.

Methods:

Study Design: Cross Sectional Study –Interobserver Agreement.                                                                                                    

Sampling Procedure:  Continuous sampling.

Study Population: Study sample include first 100 pleural fluid samples received in department of pathology, Govt. medical college, Kottayam during the study period.

Study Procedure: Cytological smear and cell block were interpreted by two different pathologists each.

Analysis: Interobserver agreement in cytological smear and cell block, each were interpreted with kappa value.

Results and Discussion: The mean age of the present study population is 57 years .Minimum age is 7 years and maximum is 85 years. Majority belong to the age group 51-60 years (23%). Cytological smear shows substantial agreement with kappa value of 0.642 and cell block preparation also shows substantial agreement with kappa value of 0.783.

Conclusion: Both cytological smear and cell block preparation shows substantial agreement with cell block preparation being superior than cytological smear for diagnosis with a higher interobsever agreement.

Keywords: Cytological smear, cell block, interobsever agreement.