COMPARISON OF EFFICACY OF CELL BLOCK VERSUS CONVENTIONAL SMEAR STUDY IN EXUDATIVE FLUIDS - AND ITS ROLE IN DIAGNOSTIC CYTOLOGY

Abstract

Cell blocks prepared from residual tissue fluids can be useful adjuncts to smears for establishing a more definitive cytopathologic diagnosis. They can be particularly useful for categorization of tumors that otherwise may not be possible from smears themselves  .CB technique increases the diagnostic accuracy due to increased cellularity, preservation of tissue architecture and feasibility of performing ancillary techniques  like immunohistochemistry (IHC). 

Aims and Objectives: To  compare the cytological features of pleural and peritoneal exudative fluids by conventional smear (CS) method and cell block (CB) method  and  to assess the utility of a combined approach for cytodiagnosis of these effusions.

Materials and Methods: The study was done on all exudative fluid samples received in the Pathology lab for cytological examination .All fluids were divided into two equal parts: one part was subjected to CS technique, while the other part was subjected to Plasma thromboplastin CB technique and the sections stained by Hematoxylin and Eosin. IHC was performed whenever required.

Results: 128 pleural and peritoneal fluid samples were processed. 07(5.4 %) cases were positive for malignancy on conventional smear, whereas on CB 18 (14 %) cases were diagnosed as malignancy. The additional yield of malignancy was 9 % more by the CB method.

Conclusions Our study showed that the CB method yielded better results in diagnosis of malignancy. Therefore, this technique could be considered as a useful adjuvant in evaluating fluid cytology and final cytodiagnosis, along with the routine CS method.