Cytological approach for pleural fluid analysis – One year study

Abstract

Background: Collection of an abnormal quality and quantity of fluid in the pleural cavity is called pleural effusion. Cytological analysis of pleural effusions plays an important role in the diagnosis of various lesions. The objective of the study is to evaluate the utility of pleural effusion cytology as an attempt to diagnose the underlying etiology. Materials and Methods: A prospective study for one year duration from September 2018 - August 2019 was conducted in the Department of Pathology- S N M C and H.S.K hospital and Research Centre, Bagalkot. Pleural fluids received for cytological analysis from all the departments were included in the study. After a thorough physical examination, microscopic evaluation was done. The smears were stained with Giemsa, Papanicolaou stain and Hematoxylin and Eosin Stains. ZN stain was done in suspected cases of tuberculosis. Results: 65 cases of pleural effusion were evaluated out of which67% of patients were males and 33% were females. Out of 65 cases 53.8% showed right sided pleural effusion, 24.6% showed left sided pleural effusion and 21.5% showed bilateral pleural effusion. All the smears were screened for malignancy and resulted in 14% of positive cases. The 86% non-malignant cases were further classified based on the cytology findings; 46.1% lymphocytic predominant, 32.3% neutrophilic predominant, 4.6% reactive mesothelial cell predominant and 1.5% eosinophilic predominant. Conclusion: This study showed that meticulous evaluation of the pleural fluids for their cytological properties will help the clinicians in pointing towards the underlying etiological factor and to choose an appropriate management. Keywords: Pleural effusion, Non-Malignant Effusion, Malignant Effusion, Metastatic Adenocarcinoma, Lymphoma.