Cytological evaluation of peritoneal fluid with special reference to malignancy

Abstract

Aspiration of serous cavities is a simple and relatively non invasive technique to achieve a diagnosis. Cytological examination of serous fluid is of paramount importance , it revelas information about inflammatory conditions of serous membrane,infection by bacteria, fungi,virus,finding of cancer cells and also supply evidence of fistulous connection with a serous cavity. Cytological examination not only helps for the diagnosis of cancer but also for staging and prognosis of disease.It is a complete diagnostic modality which aims at pointing out the etiology of effusion as well as prognosis of disease. Methods A total of 160 peritoneal effusion samples received for cytopathological examination over a 1 year period were analyzed. Cytomorphological features of neoplastic effusions were studied. Special stains and immunocytochemistry (ICC) were performed to aid the diagnosis in difficult cases. Result The peritoneal effusion samples comprised of 160 cases out of which adenocarcinoma was found to be the cause of metastatic malignant effusion.Reactive mesothelial cells were the most challenging to differentiate from malignant effusion cytology. Immunohistochemical staining was useful to arrive at a definitive diagnosis in difficult cases. Conclusion Cytology is a useful tool to detect malignant effusions. Immunohistochemical staining must be performed in difficult cases to differentiate metastatic epithelial cells from reactive mesothelial cells,which is a benign condition.