Efficacy of Cell Block Technique in the Cytodiagnosis of Malignant Serous Effusions.

Abstract

Background: The investigation of serous effusions has an important place in cytopathology because it has diagnostic and prognostic value. The proper identification of the primary tumor with staging and grading has therapeutic and prognostic implications. In the current study, we evaluated the efficacy of two techniques for the diagnosis of malignant serous effusions. Methods: Fresh samples of pleural, peritoneal, and pericardial fluids were evaluated for the present study. Ten milliliters of fluid were divided into two equal parts of 5 mL each, of which one was kept for conventional cytology and the other was used for the preparation of cell block. Results: The evaluation of cell smear and cell block techniques showed predominantly moderate cellularity. Both in pleural and peritoneal fluids, cellularity was higher when using the cell block method as compared to the conventional smear method. Architectural patterns, including sheets, cell balls, papillae, glands, and three-dimensional clusters, were better appreciated in cell block than conventional smears. By using the cell block method, five additional cases were detected as malignant, which meant 6.66% more diagnostic yield for malignancy as compared to the cell smear technique. Conclusion: This study revealed the importance of cell block preparation for supplementation of conventional smear technique. The same fluid extracted for the preparation of smear could be utilized to concurrently prepare cell blocks. The cell block technique provides additional diagnostic features and can help in further investigation by IHC studies for tumor staging and grading.