CYTOLOGICAL DIAGNOSIS OF SEROUS EFFUSION BY COMPARATIVE APPROACH OF ROUTINE STAINING AND MODIFIED CELL BLOCK TECHNIQUE

BACKGROUND Cytological serous effusions many times poses a diagnostic dilemma between benign and malignant effusions. Study of Conventional Smears (CS) is a routine practise in diagnosis of body fluids. Hence, the present study is undertaken to assess the diagnostic efficacy of Cell Block (CB) preparation by combined approach of conventional smears and cell block preparation. MATERIALS AND METHODS This study was conducted in cytology section of Department of Pathology for a period of 18 months. Two conventional smears were prepared and stained for Haematoxylin and Eosin and Wright’s stain. Cell blocks using 10% alcohol-formalin as fixative agent were prepared and paraffin sections were stained with Haematoxylin and Eosin stain. Both CS and CB were interpreted separately noting cellularity, cellular architecture and cytomorphological details. Statistical analysis for sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and diagnostic accuracy was calculated for combined CS and CB preparation. RESULTS A total of 300 body fluids were studied of which 41.6% were pleural fluid and 58.4% were peritoneal fluid. Only, 7.7% of case of malignant effusions from both pleural and peritoneal fluid cytology was encountered. An additional 0.67% of cases were diagnosed as malignant effusions by cell block preparation, which otherwise would have been missed with only CS preparation. CONCLUSION The cell block preparation is simple, rapid and inexpensive technique for serous effusions. The cell block preparation provides better architectural and morphological details when compared to conventional smear preparation, thereby increases sensitivity of cytodiagnosis. Hence, cell block preparation is an useful adjuvant to conventional smear