Diagnostic utility of cytospin, cell block and immunocytochemistry in pleural effusion cytology

Miachieo, Nounechutuo; Kumar, Madhu; Sagar, Mala; Maurya, Malti Kumari; Kumar, Santosh; Kushwaha, Ramesh Kumar; Goel, Madhu Mati

doi:10.18203/2320-6012.ijrms20203031

Cited by 3 publications

(7 citation statements)

References 10 publications

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“…In the present study, specificity and positive predictive value is 100% which is in concordance with the study of Nounechutuo et al (Table 5). 5 The sensitivity of the present study is 94% and NPV is 96.8%.…”

Section: Discussionmentioning

confidence: 42%

“…Most of the malignant cases are in the 6 th decade. 5 In the present study, 149 patients (62.10%) were female and 91 patients (37.9%) were male, male: female ratio being 1:1.6. According to the study by Mulkalwar et al, females are affected more than males with M: F ratio of 1:1.5. than females.…”

Section: Discussionmentioning

confidence: 43%

“…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. 6 The cell block (CB) technique is one of the oldest method for the evaluation of body cavity fluids, in which small tissue fragments in a fluid specimen are fixed and then processed to form a tissue embedded paraffin block.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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Background: Fluid cytology plays an important role in delineating benign from malignant effusions, tumor staging, and also in diagnosing recurrences. Various methods are used in cytology for the preparation of smears. As the accurate diagnosis of the fluids aids in clinical decisions, the method of preparation of cytology smears, it is very important. Cytospin preparation of smears is one of the methods which provide higher cellular yield with better preservation of cellular morphology and is less time consuming. On the other hand, cell block method gives superior architectural details and provides options for immunocytochemistry. Aims and Objectives: The aim of this study was to assess the diagnostic utility of cytospin in comparison to cell block method in peritoneal and pleural fluid cytology. The study is done to determine the sensitivity, specificity, predictive values, and diagnostic accuracy of cytospin preparations with cell block method which is considered as the gold standard. Materials and Methods: This was a diagnostic test evaluation study done at the Department of Pathology, Government Medical College, Kottayam. The sample size was 240 which included all pleural and peritoneal fluids received in our cytology laboratory during the study period. Cytospin prepared smears of peritoneal and pleural fluids were compared with the tissue sections prepared by cell block method, to evaluate the diagnostic utility of cytospin. Tissue sections prepared from the cell blocks of effusions were considered as the gold standard for comparison. Results: A diagnostic test evaluation of cytospin preparation was done with cell block preparations. The sensitivity of cytopsin preparations in pleural and peritoneal fluid cytology is 94%. The specificity of cytopsin preparations in pleural and peritoneal fluid cytology is 100%. The positive predictive value of cytopsin preparations in pleural and peritoneal fluid cytology is 100% and the negative predictive value of cytopsin preparations in pleural and peritoneal fluid cytology is 96.8%. Hence, accuracy of the test is 97.9%. Conclusion: There is only minimal statistical difference between the results obtained by the cytospin and cell block methods. Cytospin method is less time consuming along with the advantage of higher cellular yield. Hence, the incorporation of cytospin along with the cell block technique is beneficial for augmenting the results of effusion cytology.

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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 43%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…The major location is the lower GI tract, according to CDX2 nuclear expression. Adenocarcinoma is favorably stained for BerEP4 in the membranes [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, IHC helped identify the site of origin in 21 (77.78%) of the 27 (100%) malignant cases in pleural fluids and 16 (76.19%) of the 21 (100%) cases in peritoneal fluids. After applying IHC to the 27 (100%) positive cases on the CB, Miachieo N et al demonstrated in their study that the main site of malignancy was discovered in 19 (70.37%) cases; hence, IHC proved to be useful in identifying the precise site of origin of malignancy in most cases [18].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Cell Block and Immunohistochemistry in Effusion Cytology

Batool¹,

Sadaf²,

Chughtai³

et al. 2023

Cureus

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IntroductionAlthough the cytology of effusion fluids is considered a routine laboratory test, it has recently emerged as an essential tool in determining the primary site of origin of carcinoma of unknown primary. The sensitivity for diagnosing malignancy has enhanced with the inclusion of cytospin, cell block (CB), and immunohistochemistry (IHC) to effusion fluid cytology due to the improvement in morphological preservation and good cellular yield. The purpose of this study was to assess the diagnostic yield, sensitivity, specificity, positive predictive value, and negative predictive value of IHC and CB in effusion cytology. MethodologyAn institution-based cross-sectional study was conducted over a period of six months on 150 cases of effusion fluids submitted for diagnostic purposes. After the preparation of cytospin, the residual amount of centrifuged deposit was mixed with CytoLyt solution, thrombin, and plasma, and CBs were prepared. IHC was applied to the CB. Calretinin was used for mesothelial cells, and BerEP4, TTF-1, ER, WT-1, and CD-X2 were used for the confirmation and origin of malignant cells. ResultsThe mean age of the patients was 51.75 ± 16.63 years. The male-to-female ratio was 1:1.24. Out of 150 cases, 78 were pleural effusions, 68 were peritoneal effusions, and four were pericardial effusions. Out of 150 cases, based on cytological examination alone, 66 (44%) were classified as benign, 27 (18%) as malignant, and 57 (38%) were suspicious for malignancy. When cytology was combined with CB and IHC, the diagnostic yield was increased to benign 95 (63.33%), malignant 48 (32%), and suspicious for malignancy 7 (4.67%). The most common cause of malignant pleural effusion was breast carcinoma in females and lung carcinoma in males. The most common primary tumor in malignant peritoneal effusion was ovarian carcinoma in females and colonic adenocarcinoma in males. The sensitivity and specificity of combined cytology with cell block and IHC were 92.31% and 98.95%, respectively. This combination produced significantly better results (pvalue = 0.001) for detecting malignancy and reduced suspicious cases from 38% to 4%. ConclusionCB, in combination with IHC, increases the diagnostic yield and aids in detecting malignancy at an unknown primary site in effusion fluids. Both of these techniques can thus enhance the sensitivity and specificity of the diagnosis of effusion cytology. Hence, CB and IHC have advanced utility over cytological smears in effusion fluid cytological diagnosis.

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Diagnostic Utility of Pleural Fluid Cytology versus Cell Block Technique: A Comparative Study

Acharya

2023

J. Nepalgunj Med. College

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Introduction: Categorization between benign and malignant pleural effusions most often create diagnostic dilemma. Categorization often requires clinical findings and morphological evaluation. Diagnostic possibility is increased if cell blocks are performed in addition to conventional cytology smears. This will help the clinicians in both treating the patient and determining the outcome of the disease process. Aims: The aim of this study was to compare the smears cytology with cell blocks sections in pleural effusions. Methods: This hospital-based cross sectional analytical study was carried out in Department of Pathology in Nepalgunj Medical College, Nepalgunj for one year. Results: The four criteria scored for each technique were amount of background blood, yield of diagnostic cellular material, degree of cellular degeneration as well as cellular trauma and architectural preservation. More amount of diagnostic material present and appropriate retention of architecture was more in cell block sections compared with smears cytology; whereas cellular degeneration as well as cellular trauma and background blood was less appreciated in cell block sections which scored more than the smears cytology. Conclusion: Cell block method especially in clinically, radiologically and cytologically suspected malignant cases should be routinely processed for cell block method.

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Diagnostic utility of cytospin, cell block and immunocytochemistry in pleural effusion cytology

Cited by 3 publications

References 10 publications

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

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

Diagnostic Accuracy of Cell Block and Immunohistochemistry in Effusion Cytology

Diagnostic Utility of Pleural Fluid Cytology versus Cell Block Technique: A Comparative Study

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