Analyzing diagnostic utility of cytospin and cell block techniques in serous effusion cytology

Abstract

Introduction: Fluid cytology plays a pivotal role delineating benign from malignant effusions, tumor staging and diagnosing recurrences. Objectives: To assess the diagnostic utility of cytospin and cell block methods in cytodiagnosis of serous effusions. Material and methods: A total of 240 cases inclusive of 77 pleural and 163 peritoneal effusions were analyzed by cytospin and cell block preparation following conventional smear cytology. Results: Out of 240 cases, 13% were malignant pleural effusion and 14.7% were malignant peritoneal effusion. Cell block diagnosed additional 4% and 2.4% cases of malignant origin in pleural and peritoneal fluid respectively and also aided in ascertain the primary site. Few rare cases such as effusion in synovial sarcoma and squamous cell carcinoma were also diagnosed. Conclusion: Cell block technique aids in cytodiagnosis of malignant effusions but has demerits also, hence both cytospin and cell block should be used as complement.

Diagnostic utility of cytospin in comparison to cell block in peritoneal and pleural fluid cytology

“…the present study, non-neoplastic cases 124 (52.1%) predominates and shows concordance with studies of Mulkalwar et al, and Sidhu et al 2,4 Out of 240 cases, 84 cases (35%) are malignant cases in the present study, but in the study by Mulkalwar et al, out of 170 cases 39 (22.9%) are malignant. 2 In the study of Sidhu et al, out of 240 cases, 34 (14.1%) cases are malignant 4. The present study detected more malignant cases than the study by Mulkalwar et al, and Sidhu et al2,4 Adenocarcinoma is the most common malignancy in fluids in the present study which is in concordance with the studies of Mulkalwar et al, and Irmeen et al2,9 …”

“…Our study is in concordance with the study of Sidhu et al, where cell block diagnosed additional 7 (6.4%) malignant cases in effusions. 4 There is no much statistical differences in non-neoplastic lesions in cytospin and cell block. One case of non-neoplastic lesion in cytospin is diagnosed as suspicious of malignancy in cell block.…”

“…Moreover, cytospin technique is less time consuming, relatively inexpensive, and easy and involves less technical manpower. 4 The drawback is that all cells, including blood cells and debris, are concentrated in a small area, which often tends to obscure any epithelial cells. Aggregation of mesothelial cells into clusters, rosettes, or acinar pattern can also confound the picture in cytospin smears.…”

“…The information provided by body fluid analysis helps the clinician in formulating therapy and prognosis. 4 There are a wide range of cytological techniques available to analyze body fluids, from simple direct smears, cytospin smears to cell block methods. 2,5 The cytospin smear method is designed to concentrate cells, especially in serous effusions with poor cellularity, in which the cells are allowed to be spun at various speeds and times for the formation of a monolayer of cells in a limited area for the best assessment of the Cells.…”

“…The advantages of cell block technique include preservation of tissue architecture and obtaining multiple sections for special stains and immunohistochemistry. 4,6 A good cell block aids in molecular diagnostic studies such as fluorescence in situ hybridization, polymerase chain reaction and cDNA microarray analysis. 7,8…”