Diagnostic accuracy in cytological evaluation of body fluids: A retrospective study

Background: Cytological examination of serous effusions is of paramount importance in differentiating malignant from non-malignant effusions as it is simple, rapid, less invasive, cost-effective method. It plays a significant role in early detection, staging, treatment and prognosis of patient. Materials & Methods: An observational study was performed over a time period from January 2021 to May 2024. A total of 1,321 cases including pleural, peritoneal, synovial and cerebrospinal fluid were analyzed. Samples were centrifuged for ten minutes at 3000 rpm and smears prepared from deposit were stained by Haematoxylin & Eosin (H&E), Papanicolaou (PAP) and May-Grunwald-Giemsa (MGG) stains. Cytospin technique was also used for some samples. Results: Out of 1,321 cases, 780 were peritoneal effusions, 460 were pleural, 43 were cerebrospinal fluids and 38 were synovial fluids. The age range was newborns to 92 years. The maximum numbers of cases were in the age group of 51-60 years. Male preponderance was observed with male: female ratio of 1.31: 1. A total of 231 out of 1,321 cases (17.48%) were of transudative nature and 1,091 (82.49%) were exudative. Most common malignancy encountered was adenocarcinoma. Majority of the primary malignancy in pleural fluid and peritoneal fluid belonged to adenocarcinoma of lung and ovary respectively. Conclusion: Effusion cytology is simple, rapid, and cost-effective modality which helps clinicians and pathologists to reach accurate diagnosis for better patient management. Although it has its own limitations but it can be overcome by techniques like cell block, immunohistochemistry, biochemical and microbiological studies.