Diagnostic role of cell block method in serous effusions: A comparative study with conventional smear cytology

Abstract

Background and Objectives: Cytological examination of body cavity effusions is important in diagnosing neoplastic and non-neoplastic conditions. Study of conventional smear of effusions is a rapid method of analyzing the part of fluid. However, the residual material may be evaluated by cell block preparation. Hence, the present study is undertaken to assess diagnostic efficacy of cell block preparation (CB) by combined approach of conventional smear (CS) cytology and cell block preparation in serous effusion. Methods: Serous fluid samples were analyzed from January 2012 to December 2014. Conventional smears and cell block sections were prepared as per the standard procedure and were interpreted separately noting the cellularity, obscuring background, cellular architecture and cytomorphological details. Statistical significance was determined by Chi-square test. Diagnostic accuracy, sensitivity and specificity of conventional smear cytology and cellblock study was calculated. Results: A total of 110 samples were analysed, of which pleural, peritoneal and pericardial fluids were 49%, 46% and 5% respectively. By conventional smear cytology benign, suspicious and malignant cases were 76%, 14.5% and 9.5% respectively. By cell block study benign and malignant cases were 75.5% and 24.5% respectively. Additional 15.5% of cases were diagnosed as malignant by cell block study. Conclusion: Cellular yield, architectural pattern and morphological features were better appreciated in cell block preparation than in conventional smear cytology which increased sensitivity of diagnosis. Hence cell block serves as useful adjuvant to conventional smears. Key words: Serous effusions, Conventional Smear, Cell block