Diagnostic Utility of Various Techniques in Body Fluid Cytology- A Comparison Between Ordinary Centrifuge, Cytocentrifuge and Cell Block Techniques

Abstract

BACKGROUND Cytological examination of serous effusions has been done for nearly a century and it has helped in staging and prognosis of the malignant tumours and also gave information regarding various inflammatory lesions of serous membranes. MATERIALS AND METHODSThis study was a Descriptive study. The body effusions include peritoneal, pleural and pericardial fluids received in cytology section of Department of Pathology, Gandhi Medical College, Bhopal from 1st January 2017 to 31st May 2017. Conventional smears and Cytocentrifuge smears were prepared from each sample. Remaining fluid was processed histopathologically for preparation of cell block. RESULTSOut of total 85 effusion fluids, 42 cases were suspected/ diagnosed for malignancy with body effusions. Out of 42 cases, ordinary centrifuge detected 10 (23.8%) samples as positive for malignancy and cell block has detected 36 (85.7%) cases positive for malignant cells, whereas cytocentrifuge has detected 30 (71.4%) cases positive for malignancy and 6 (14.3%) cases suspicious for presence of malignant cells. CONCLUSIONIn our study, we have concluded that cell block and cytocentrifuge techniques are superior in detecting malignant cells in effusion fluids compared to ordinary centrifuge. Cell block also gives advantage of performing ancillary techniques for further study. It has helped for staging and prognosis of the malignant tumours and also gave information regarding various inflammatory lesions of serous membranes. (2) A positive diagnosis, especially for malignant cells, is always taken as definitive diagnosis and assists the clinicians in deciding the further course of action and treatment of the patient. It is a relatively simple and non-invasive technique, which helps in coming to a conclusion about aetiology of effusion as inflammatory, benign or malignant. (3) Most of the laboratories perform direct smear prepared from centrifuged deposits of effusion. At times, lack of morphological details of the representative cells contribute 'Financial or Other Competing Interest': None. Submission 08-02-2018, Peer Review 20-02-2018, Acceptance 23-02-2018, Published 05-03-2018. Corresponding Author: Dr. Puneet Tandon, E1/179, Arera Colony, Bhopal-462016, Madhya Pradesh. E-mail: drpuneettandon@yahoo.co.in DOI: 10.14260/jemds/2018 to considerable difficulties in making diagnosis on conventional smears. (4) Except in a few institutes, there is no standard technique for processing these fluids that is reliable and cost effective. The technique still widely used in most cytology laboratory of India is the centrifugation and sedimentation smear preparation technique. With use of ordinary centrifuge alone, collecting cells in scantily cellular samples is quite difficult resulting in more of unsatisfactory smears. Thus resulting in effusion being reported as negative or atypical without definitive diagnosis and false negative diagnosis. (5) The aims and objective of our study was to compare morphological features of the conventional smear method with t...