Cytological Study of Pleural Effusions and its Utility in Clinical Approach

Abstract

IntroductionPleural fluid cytology is a simple and a minimally invasive technique as the preliminary step for the diagnostic evaluation of pleural effusions, assisting the clinician in establishing the differential diagnosis. It may lead to final diagnosis and provide useful information for treatment. The diagnostic yield of the cytological analysis may be attributable to the cell population present in the sediment that is representative of a much larger surface area than the pleural biopsy [1,2] . It is very useful in the very first initial work up for the management of the case of pleural effusion. It may also provide crucial clues for the identification of both non-malignant pleural and transudative effusions. Sensitivity will be higher if the clinical, radiological and laboratory results are collaborated. This study was carried out to determine the diagnostic utility of pleural fluid cytology. Materials and MethodsThe study was conducted in the Department of PathologyCytology section of Govt. Medical College and Sir T Hospital, Bhavnagar (Gujarat). It's a retrospective study of cytology impression of pleural fluids for one year duration from January 2015 to December 2015. Pleural fluids which received for cytological analysis from the various departments of our institute with the proper complete history and clinical brief are included in the study. These fluid samples were examined for physical properties like the volume, color, appearance, turbidity, presence of clot coagulum. Fluids samples are then centrifuged at 2000 rpm for five minutes. Smears made from the sediment part of centrifuged fluid and stained with Giemsa, Hematoxylineosin and Papanicolaou stains. Smears were examined for the differential cell count and reported descriptively, final impression given as malignant or non-malignant pleural effusion. Malignant pleural effusions were further classified according to its morphometrics. Study results then analyzed with the help of tables and charts and discussed for its incidence rate. ResultIn our study during the year 2015 total 295 cases of pleural fluids were examined for cytology. Out of 295 pleural fluids specimens 84 samples were of females and remaining 211 were of males, so here male is to female ratio of pleural fluid specimens was 2.5:1CHART-1. The pulmonary department had sent pleural fluid examination mostly among the all other departments. Pleural effusions

Analysis of Pleural fluid cytology: A one year study in tertiary care centre

“…We had total of 120 cases in our study. Male comprised the majority with male to female ratio of 1.5:1, which is in concordance with studies conducted by Gojiya P, 5 Rasik Hathila et al, 6 Priyanka Kiyawat et al 7 and Ishan Arora et al 8 Fig. 5: Centrifuged smear shows predominance of neutrophils -Acute Inflammation.…”