COMPARATIVE STUDY OF CELL - BLOCKS & ROUTINE CYTOLOGICAL SMEARS OF PLEURAL & PERITONEAL FLUIDS IN SUSPECTED CASES OF MALIGNANCY

Cell-block preparations made from sedimented cells can be useful adjunct to the routine cytological methods used for pleural and peritoneal fluids. There are only few studies evaluating its diagnostic efficacy and additional benefits when used with routine cytology. This study was conducted to compare the diagnostic efficacy parameters of cell-blocks and routine cytological smears of pleural and peritoneal fluids in suspected cases of malignancy. A one year study was done in a Gov. Medical College on pleural and peritoneal fluids in cases of suspected malignancy. Total number of cases studied was 148. Cytology smears were stained with Papanicolaou stain and cell-block preparations of centrifuged deposits were processed cut at 5 micrometers and the sections stained by Hematoxylin and Eosin in every case. Additional stains and immunohistochemistry were done in the cell- block slides as required. Diagnosis of malignancy by any tissue based method within a period of three months of follow up was taken as the gold standard for analysis. Sensitivity of cell-blocks (0.6714%; 95% CI 0.5476-0.7762) was nearly double that of routine cytology (0.3230; 95% CI 0.2154-0.4517). Both methods had very high specificity. Cell- blocks proved to be superior to smears in pattern recognition and are advantageous when there’s need for immunohistochemistry. Use of cell-blocks as an adjunct to routine cytology smears of body fluids can increase the sensitivity to a considerable extent. It is of further use in pin-pointing a diagnosis by pattern recognition or immunohistochemistry.