Diagnostic efficacy of cell block method in correlation with conventional cytolomorphology in pleural fluid samples

Abstract

Effusion cytology have gained acceptance worldwide in analysing body fluids, and a positive diagnosis renderedon cytomorphologyis often considered as a definitive diagnosis for further work up. However due to the known limitations, diagno stic problems arise in routine practice to differentiate reactive versus atypical mesothelial cells and malignant cells by the routine conventional smear (CS) method, thereby warranting adjunct studies like cell block techniques to enhance its efficacy: To compare and analyse the cytomorphological features of the conventional cytosmears with those of the cell block sections and also to assess the utility and sensitivity of the cell block method in picking up the definitive diagnosis of pleural effusions.: The study was conducted in the cytology section of the Department of Pathology, MGMCRI, SBV, Puducherry. Overall 50 pleural fluid samples were subjected to diagnostic evaluation for over a period of 18 months. Along with the conventional smears, cell blocks were prepared from the remnant fluid using Thromboplastin- pooled plasma method. Histopathology samples were obtained in feasible cases Cellularity yield was low in cytosmears and was enhanced when combined with cell block method especially in non diagnostic /hemorrhagic samples, suspicious cases for malignancy, the efficacy was increased by a margin of 20 % more by the cell block method. Also pattern analysis was possible in Cell block and to categorize primary versus metastatic. The cell block method provides high cellular yield, architectural patterns analysis, morphological features and aids in categorizing primary and metastatic effusions thereby, increases the efficacy of effusion cytology serving as a bridge between cytology and histopathology.