Cytodiagnosis of malignant effusion and determination of primary site

Khan, Nausheen S; Sherwani, RK; Afroz, Nishat; Kapoor, Sunil

doi:10.4103/0970-9371.238647

Cited by 14 publications

(3 citation statements)

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“…Both effusion and FNAC cases showed higher incidence in the same age groups. These findings were similar to study done by Bansode et al 3 [5][6][7] Greater frequency of effusion in females (34.3% vs 13.2%) and conversely greater number of fine needle aspirates from males (36% vs 16%) was recorded.…”

Section: Discussionsupporting

confidence: 92%

The diagnostic utility of cell block as an adjunct to routine cytology

Pathak,

Rhutso,

Ahmed

2024

ACHR

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Despite the diagnostic utility of cell block in FNAC and fluid cytology, known for better cellular yield and improved diagnostic accuracy, the technique remains to be underutilized for diagnosing neoplastic lesions.In this paper, a hospital based prospective study of 195 samples was conducted on cytological samples with the aim (a) to evaluate the diagnostic utility of cell block as an adjunct to routine cytological evaluation of aspiration and effusion fluid specimens, (b) To correlate the findings of routine cytology, cell block and routine histopathological examination wherever possible and (c) to explore the possibility of using ancillary techniques such as immunohistochemistry on cell blocks. The study revealed, most of the patients were between 51- 60 years with female preponderance. Among 195 samples, 79 (40.5%) were peritoneal fluids and 85 (43.5%) were lymph node. The diagnosis on conventional smear and cell block showed 71 (36.5%) cases and 68 (35%) cases were negative for malignancy respectively. 6 (3%) cases and 4 (2%) cases were suspicious for malignancy respectively. 118 (60.5%) cases and 123 (63%) cases were positive for malignancy respectively. Amongst the peritoneal effusion the most common primary site was ovary whereas majority of the primary site was unknown in lymph node FNAC. Peritoneal effusion showed 8 additional cases as positive for malignancy in CB preparation which were negative or suspicious for malignancy on CS. In FNAC, two additional positive case was found in CB preparation of lymph node. A Kappa value of 89.5 % for statistical correlation between Conventional smear and cell block preparation was calculated. The use of Cell block technique increases the detection of malignancy when used as an adjunct to conventional smears. Cell block technique is simple, inexpensive and reliable adjuvant to smears and it is recommended for routine cytological diagnosis and for application of immunomarkers and molecular studies.

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Section: Discussionsupporting

confidence: 92%

The diagnostic utility of cell block as an adjunct to routine cytology

Pathak,

Rhutso,

Ahmed

2024

ACHR

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“…[ 13 ] The large conglomerate clusters, known as “proliferation spheres” or “cannon balls,” may be hollow or solid (without or with stromal cores [papillary]) or a combination (including tubulo-papillary). [ 13 , 14 ] Hollow proliferation spheres have well-defined internal spaces (glandular-/tubular-/ductal-like or acinar-like) or ill-defined internal spaces (vague glandular-like). [ 14 , 15 ] Non-cohesive, singly scattered atypical cells or loose clusters would point towards lymphomas or melanomas.…”

Section: Methodsmentioning

confidence: 99%

“…[ 13 , 14 ] Hollow proliferation spheres have well-defined internal spaces (glandular-/tubular-/ductal-like or acinar-like) or ill-defined internal spaces (vague glandular-like). [ 14 , 15 ] Non-cohesive, singly scattered atypical cells or loose clusters would point towards lymphomas or melanomas. If the atypical cells distinctively comprised a second population of cells besides the reactive mesothelial cell population, it was considered metastasis.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic analysis of pleural fluid cell blocks using relevant immunohistochemical markers in clinically suspicious cases of malignancy

Mathew,

Rajan,

Kunju

2024

Cytojournal

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Objective: Thoracocentesis is a less invasive and expensive procedure than pleural biopsy, enabling sample collection for cytological evaluation. Cell blocks prepared from these samples provide histopathological diagnoses; further, immunohistochemistry (IHC) can be performed for subtyping malignancies, guiding the clinician in choosing the appropriate treatment modality for the patient. We aimed to determine the various histological subtypes of malignancies using cell block IHC and compare the cell block and conventional cytology methods for diagnosing malignant pleural effusion. Material and Methods: All pleural fluid samples from the clinically suspicious cases of malignancy collected at the Department of Pathology, Government Medical College Kottayam, India, during 18 months, except duplicate and inadequate samples, were included in this prospective observational study. IHC was performed on cell blocks that were positive for malignancy. Results: This study analyzed 630 samples, of which 121 cell blocks demonstrated the presence of malignancy. Overall, 80%, 13%, and 7% of cases were negative, suspicious, and positive for malignancy based on conventional cytology, and 81%, 0%, and 19% were negative, suspicious, and positive for malignancy based on cell blocks, respectively. Among all malignancies, adenocarcinomas from the lung (56%) were the most common, followed by adenocarcinomas from the breast (6%), squamous cell carcinomas (5%), and adenocarcinomas from the ovary (3%). Cell blocks helped detect more malignancies (19%) than conventional cytology (7%), despite a moderate agreement between both methods. Conclusion: Adenocarcinomas were the most common cause of malignant pleural effusions, and the most frequent site of origin was the lungs. Cell blocks helped diagnose more malignancies than conventional cytology.

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Evaluation of pleural ?uid cytology for the diagnosis of pleural effusion: A retrospective study

Patel,

Contractor,

Dayal

et al. 2024

ACHR

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Cytological examination of pleural ﬂuid has good speciﬁcity for the diagnosis of malignant pleural effusion (MPE). (1). To study the incidence of non-neoplastic and neoplastic effusions; (2). To study most common cause of neoplastic effusions.This study is an Observational retrospective study that was conducted from April 2021 to October 2022 (1.5 years). This study was conducted in the Cytology section, Pathology Department, of a tertiary care centre, Gujarat, India. A total of 248 pleural fluid samples were studied among them 186 were benign effusions, 48 were malignant effusions, 10 cases were unsatisfactory for evaluation and 4 cases were suspicious for malignancy.A descriptive study was performed to know the incidence of benign and malignant effusion in the pleural fluid sample. Pneumonia was the most common clinical diagnosis followed by tuberculosis and malignancy. Lung was the most common primary site for pleural effusion. In females, ovarian carcinoma was the primary aetiology followed by breast carcinoma. Cytodiagnosis of pleural fluid represents the cell population from a much larger representative area than obtained from the needle biopsy.

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Cytodiagnosis of malignant effusion and determination of primary site

Cited by 14 publications

References 0 publications

The diagnostic utility of cell block as an adjunct to routine cytology

The diagnostic utility of cell block as an adjunct to routine cytology

Diagnostic analysis of pleural fluid cell blocks using relevant immunohistochemical markers in clinically suspicious cases of malignancy

Evaluation of pleural ?uid cytology for the diagnosis of pleural effusion: A retrospective study

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