Sherwani R, Akhtar K, Naqvi AH, Akhtar S, Abrari A, Bhargava R

This study was under taken to diagnose cases of serous effusions and to differentiate between benign and malignant effusions by cytological examination. The clinicopathological study was carried out in 209 patients presenting with effusion. After a detailed clinical history and a thorough physical examination, physical, chemical and cytological examination of fluid was carried out. Smears made from cytocentrifuged fluids were stained with Haematoxylin & Eosin and Papanicolaou stains. About 35% of cases were found in age group of 51-60 years. Peritoneal effusion made up 61.7% of cases followed by 35.9% of pleural effusion. 95.2% were exudative effusions and 4.8% transudative. Malignant cells were seen in 42.6% of cases while 57.4% cases were of benign etiology. Lung was the commonest site metastasizing (31.5%), followed by ovaries (29.2%), gastrointestinal tract (19.1%), prostate and kidneys (2.2% each). The diagnostic accuracy increased by a substantial 11.2% on subsequent examination of effusions. Most common clinical presentation was ascitis in 60.7% of cases, followed by weakness (49.3%), dyspnoea (31.7%), mass (28.2%), fever (20.5%) and lymphadenopathy (17.2%). The cytologic study of fluids represents the cell population in the sediment is from a much larger representative surface area than that obtained by needle biopsy. Cytology has a greater opportunity than needle biopsy technique, to retrieve malignant cells in the presence of scanty malignant deposits on the mesothelium.

Key words: Cytopathology, effusion