The Changes in the Diagnosis Following the Use of Cell Block and Immunostains Techniques in Serous Fluid with Atypia of Undetermined Significance (AUS)
The Changes in the Diagnosis of Serous Fluid with Atypia of Undetermined Significance (AUS) ปีที่
Keywords:
cytology, pathology, peritoneal fluid, pericardial fluid, pleural fluidAbstract
The cytological examination of serous fluid currently follows the guidelines of The International System for Serous Fluid Cytopathology, which categorizes diagnoses into five groups. Group III, Atypia of undetermined significance, still carries a high risk of malignancy, up to 66%. Repeat cytological examination or tissue biopsy may be conducted to obtain a clearer diagnosis. However, contemporary techniques such as cell block with immunostains have emerged to reduce the need of repeating invasive procedures in this patient group. This was a retrospective cross-sectional design examining serous fluid specimens from the pericardial, pleural, and peritoneal cavity diagnosed as Atypia of undetermined significance through conventional cytology. This study, conducted at the Department of Anatomical Pathology, Buddhachinaraj Phitsanulok Hospital, involving 128 specimens. Its objective was to assess diagnostic changes following the implementation of cell block with immunostains and to analyze the data using binary logistic regression. The results revealed a significant alteration in diagnoses after employing cell block with immunostains, with an increase of 46.9% in cases categorized as suspicious for malignancy and malignant (p < 0.001, 95%CI 33.5, 60.2). In conclusion, serous fluid diagnosed as Atypia of undetermined significance should undergo a cell block, along with immunostains in each case. This is recommended due to significant diagnostic changes, both clinical and statistically
References
Chandra A, editor. The International System for Serous Fluid Cytopathology. Cham, Switzerland: Springer International Publishing; 2020.
Udasimath S, Surekha UA, Mahesh HK, Yelikar BR. Diagnostic utility of the cell block method versus the conventional smear study in pleural fluid cytology. J Cytol 2012;29(1):11-5.
Rodriguez EF, Jones R, Gabrielson M, Santos D, Pastorello RG, Maleki Z. Application of the International System for Reporting Serous Fluid Cytopathology (ISRSFC) on reporting pericardial effusion cytology. Acta Cytol 2020;64(5):477-85.
Matreja SS, Malukani K, Nandedkar SS, Varma AV, Saxena A, Ajmera A. Comparison of efficacy of cell block versus conventional smear study in exudative fluids. Niger Postgrad Med J 2017;24(4):245-9.
Dey S, Nag D, Nandi A, Bandyopadhyay R. Utility of cell block to detect malignancy in fluid cytology: Adjunct or necessity? J Cancer Res Ther 2017;13(3):425-9.
Guldaval F, Anar C, Polat G, Gayaf M, Yavuz MY, Korkmaz A, et al. Contribution of cell block obtained by thoracentesis in the diagnosis of malignant pleural effusion. J Cytol 2019;36(4):205-8.
Rekhi B, Karmarkar S, Gupta C, Deodhar KK, Menon S, Pathuthara S, et al. Evaluation of cell blocks from effusion specimens in Gynecologic Oncopathology: An experience of 220 cases, diagnosed at a Tertiary Cancer Referral Center. Indian J Pathol Microbiol 2020;63(3):427-34.
Chandan RH, Pawar S, Reddy P. Analysis of diagnostic value of cytological smear method versus cell block method in body fluids with clinical and biochemical correlation: Study of 150 cases. Trop J Pathol Microbiol 2021;7(1):9-16.
Datta P, Saha R, Chakraborty J. A comparative study of conventional cytology and cell block method with immunohistochemistry in the diagnosis of serous effusions. Trop J Pathol Microbiol 2020;6(2):146-54.
Goswami FJ, Srilakshmi HP, Gidwani RK, Patel R, Shah NV, Shringarpure K. The diagnostic utility of cell block preparation with conventional cytological smears: A cross sectional study. Ann Pathol Lab Med 2019;6(1):A18-23.
Jyotsna SVG, Deepak A, Subhash B. Analysis of cell block vs conventional smear in fluid cytology. J Evid Based Med Healthc 2015;2(39):6464-71.
Khurram N, Yousaf I, Yusuf NW. Utility of cell block in diagnosis of serous effusions in comparison with conventional cytological smears. Biomedica 2020;36(1):53-8.
Shivakumarswamy U, Arakeri SU, Karigowdar MH, Yelikar BR. Diagnostic utility of the cell block method versus the conventional smear study in pleural fluid cytology. J Cytol 2012;29(1):11-5.
Thapar M, Mishra RK, Sharma A, Goyal V, Goyal V. Critical analysis of cell block versus smear examination in effusions. J Cytol 2009;26(2):60-4.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Buddhchinaraj Phisanulok Hospital
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
