FIXATIVE CHOICE MATTERS: A COMPARATIVE STUDY OF DIFFERENT TYPES OF FIXATIVES IN SEROUS EFFUSION CYTOLOGY
Main Article Content
Keywords
Ethanol, Carnoy’s, Formalin
Abstract
- Objectives: This study aimed to evaluate and compare the efficacy of Carnoy’s, Formalin and Ethanol fixatives in preserving cellular morphology and providing background clarity in serous effusion cytology. The goal of this study is to determine the most effective fixative for optimal nuclear and cytoplasmic preservation and diagnostic quality.
- Materials & Methods: Out of 50 effusion samples, including Pleural (48%), Ascitic (36%), Synovial (12%) and Pericardial (4%) fluids. Samples were centrifuged and smears were prepared using Carnoy’s, Formalin and Ethanol fixatives. Papanicolaou (PAP ) stained slides were assessed for nuclear and cytoplasmic details, background staining and cellular arrangement.
- Statistical Analysis : The data was tabulated in an MS Excel worksheet and basic statistical analysis such as calculating the mean and percentage was performed.
- Results: Among all three fixatives, Carnoy’s fixative demonstrated the best preservation of cellular morphology. For nuclear details, 74% of smears showed excellent features with Carnoy’s, 34% of Ethanol and 0% of Formalin. Cytoplasmic features were also best preserved with Carnoy’s, 80% showed excellent results. Formalin showed the highest incidence (30%) of residual bakground staining. Cells were predominantly arranged in singles or in sheets, while 3D clusters were rare (2%).
- Conclusion: Carnoy’s fixative proved to be superior in preserving both nuclear and cytoplasmic details with best background clarity making it most effective among the fixatives that are been used in this study. Ethanol was moderately effective, while formalin showed poor cellular preservation and background staining. Hence, Carnoy’s is recommended for cytological evaluation of body fluid samples.
References
1. Husain AN. Robbins and Cotran Pathologic basis of disease. 8th ed. Philadelphia: Elsevier; 2010. The Lung. In: Kumar V, Abbas AK, Fausto N, Aster JC; pp. 677–737. [Google Scholar]
2. Al-Abbadi MA. Basics of cytology. Avicenna J Med. 2011 Jul;1(1):18-28. doi: 10.4103/2231-0770.83719. PMID: 23210005; PMCID: PMC3507055.
3. Agarwal PK. Cytologic examination of hemorrhagic fluid by capillary centrifugation: A new technique. Acta Cytol. 2009;53:527–32. doi: 10.1159/000325380. [DOI] [PubMed] [Google Scholar]
4. Sattenspiel E. Cytological diagnosis of cancer in transudates and exudates: A comparison of the papanicolaou method and the paraffin block technique. Surg Gynaecol Obstet. 1949;89:478–84. [PubMed] [Google Scholar]
5. Bancroft, J.O, A. Stevens. Theory and Practice of Histological Techniques. 2nd ed. Edinburgh: Churchill Livingstone:1982. P. 466
6. Bales CE. Diagnostic cytology and its Histopathologic bases. 5th ed. Philadelphia: JB Lippincott Company; 2006. Laboratory techniques. In: Koss LG; pp. 1569–634.
7. Sulochana Sonti etal. Effectiveness of different fixatives in body fluid analysis. Saudi J Pathol Microbiol, Sep. 2019; 4(9): 682-688.
8. Preeti, Mittal S, Alka. Haemorrhagic effusions: Comparison of methods for better cytological assessment. Asian Journal of Critical care. 2011;7:19-22. 10.
9. Shabnam M, Sharma S, Upreti S, Bansal R, Saluja M, Khare A, Tripathi M, Khanna S. Comparative study of processing of haemorrhagic body fluids by using different techniques. J Clin Diagn Res. 2013 Oct;7(10):2186-8. doi: 10.7860/JCDR/2013/5589.3466. Epub 2013 Oct 5. PMID: 24298471; PMCID: PMC3843426.
10. Shidham VB. Collection and processing of effusion fluids for cytopathologic evaluation. Cytojournal. 2022 Jan 31;19:5. doi: 10.25259/CMAS_02_14_2021. PMID: 35541031; PMCID: PMC9079316.
11. Gill GW. Cytopreparation: Principles & practice, Rosenthal D, editor. London: Springer, 2013.
2. Al-Abbadi MA. Basics of cytology. Avicenna J Med. 2011 Jul;1(1):18-28. doi: 10.4103/2231-0770.83719. PMID: 23210005; PMCID: PMC3507055.
3. Agarwal PK. Cytologic examination of hemorrhagic fluid by capillary centrifugation: A new technique. Acta Cytol. 2009;53:527–32. doi: 10.1159/000325380. [DOI] [PubMed] [Google Scholar]
4. Sattenspiel E. Cytological diagnosis of cancer in transudates and exudates: A comparison of the papanicolaou method and the paraffin block technique. Surg Gynaecol Obstet. 1949;89:478–84. [PubMed] [Google Scholar]
5. Bancroft, J.O, A. Stevens. Theory and Practice of Histological Techniques. 2nd ed. Edinburgh: Churchill Livingstone:1982. P. 466
6. Bales CE. Diagnostic cytology and its Histopathologic bases. 5th ed. Philadelphia: JB Lippincott Company; 2006. Laboratory techniques. In: Koss LG; pp. 1569–634.
7. Sulochana Sonti etal. Effectiveness of different fixatives in body fluid analysis. Saudi J Pathol Microbiol, Sep. 2019; 4(9): 682-688.
8. Preeti, Mittal S, Alka. Haemorrhagic effusions: Comparison of methods for better cytological assessment. Asian Journal of Critical care. 2011;7:19-22. 10.
9. Shabnam M, Sharma S, Upreti S, Bansal R, Saluja M, Khare A, Tripathi M, Khanna S. Comparative study of processing of haemorrhagic body fluids by using different techniques. J Clin Diagn Res. 2013 Oct;7(10):2186-8. doi: 10.7860/JCDR/2013/5589.3466. Epub 2013 Oct 5. PMID: 24298471; PMCID: PMC3843426.
10. Shidham VB. Collection and processing of effusion fluids for cytopathologic evaluation. Cytojournal. 2022 Jan 31;19:5. doi: 10.25259/CMAS_02_14_2021. PMID: 35541031; PMCID: PMC9079316.
11. Gill GW. Cytopreparation: Principles & practice, Rosenthal D, editor. London: Springer, 2013.
Article Sidebar
Published
Sep 30, 2026
Article Details
How to Cite
Dr. Kavithamani K. (2026). FIXATIVE CHOICE MATTERS: A COMPARATIVE STUDY OF DIFFERENT TYPES OF FIXATIVES IN SEROUS EFFUSION CYTOLOGY. Journal of Population Therapeutics and Clinical Pharmacology, 32(11), 1056-1060. https://doi.org/10.53555/gwqw7n26
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biography
Dr. Kavithamani K
Assistant Professor, Pathology, College/University Name: Mahatma Gandhi Medical college & Research Institute, SBV University, Puducherry, Email: [email protected]
How to Cite
Dr. Kavithamani K. (2026). FIXATIVE CHOICE MATTERS: A COMPARATIVE STUDY OF DIFFERENT TYPES OF FIXATIVES IN SEROUS EFFUSION CYTOLOGY. Journal of Population Therapeutics and Clinical Pharmacology, 32(11), 1056-1060. https://doi.org/10.53555/gwqw7n26
