Interpretation of serous effusion cytopathology 75 Int J Res Med. 2014; 3(1);75-78 e ISSN:2320-2742 p ISSN: 2320-2734 Interpretation of serous effusion cytopathology in a medical college Nilay Shah 1 , Sunita Shah 2 , F.R. Shah 3 , Sanjay Chauhan 4* , Piyush Solanki 5 1 Consultat Pathologist, Green Cross Laboratory, Paldi, Ahmedabad, Gujarat 2 Consultat Pathologist, Green Cross, Laboratory, Maninagar, Ahmedabad, Gujarat 3 Associate Professor, Department of Pathology, N.H.L.M.M.C. Ahmedabad 3 Assistant Professor, Department of Pathology, GMERS Medical College, Sola, Ahmedabad, Gujarat 4 Assistant Professor, Department of Pathology, GMERS Medical College, Gandhinagar, Gujarat INTRODUCTION A serous effusions are accumulation of fluid in excess of the normal in serous cavities. There are three serous cavities in our body and effusions are designated according to their location as a) pleural,b) peritoneal or c) pericardial 1,3 . Disturbances of the mechanism that normally maintains this dynamic flow may result in accumulation of excess fluid, i.e. serous effusion. Two types of effusions are recognized, transudates and exudates. Transudates is generally thin and watery fluid contains few cells and low protein. Exudates is fluids rich in cells, proteins and other cellular substances. Other types of effusions are chylous and pseudochylous effusions 4 . Cytologic examination of serous fluids is the most common procedure of examination. It is low cost, rapid and safe investigation and of paramount importance not only for the diagnosis of cancer but also for the staging and prognosis of the patient. Apart from finding the cancer cells, cytologic examination of the pleural, peritoneal and pericardial fluids may so *Corresponding Author Dr. Sanjay Chauhan 73, Narnarayan society Opp. D-mart, L.B.S. Road Thakkarnagar Ahmedabad 382350 Email: drsanjaychauhan@gmail.com reveal information regarding systemic pathology, various inflammatory conditions of the serous membranes, like bacterial, viral, fungal infections and parasitic infestations 5 . The responsibility of the pathologist is two-folds: (a) to identify cancer cells accurately and (b) to identify the tumor type and, if possible, the site of primary origin. Although the tumors often shed abundant malignant cells, singly and in clusters, the interpretation of malignancy is much more difficult in body fluid than in any other cytologic media because of the exuberant proliferation of cells within the fluids 6 . Adenocarcinomas, which are the most common tumors producing effusions, are often relatively easy to diagnose. The most common type of tumor to produce metastasis in the serous cavities is the broad group of adenocarcinomas, most often from breast, lung, ovary and GIT 7,8,9,10,11 . However, there are occasions when the cytopathologist encounters some unusual malignancies in the fluids. The diagnosis in such cases requires a constellation of cytomorphological criteria and correlation with the clinical history of the patient. The present study was undertaken to analyze the spectrum of usual and uncommon malignancies presenting as effusions in our setup and also to determine the subtle cytomorphological features that might aid their ORIGINAL ARTICLE ABSTRACT BACKGROUND: Differentiation between benign and malignant serous effusions always poses a great diagnostic dilemma. Differentiation often requires clinical findings, morphological evaluation and sometimes immunocyto chemistry. This will help the clinicians in both treating the patient and determining the outcome of the disease process. MATERIALS AND METHODS: The material for the study was collected from the in patients being admitted at N.H.L. Medical College, V.S. Hospital, Ahmedabad from April 2011 to October 2012. Data was collected in the pretested proforma. RESULTS: Total 200 body serous cavity fluid samples were received, out of which 96(48%) were pleural fluids and 94 (47%) were peritoneal fluids and 10 (5%) cases were pericardial fluid. Out of 200 cases maximum number of cases are of non malignant lesions accounting 175 (87.5%) cases and malignant effusion accounting 25 (12.5%) cases. Among 175 cases of non malignant effusion, cases of peritoneal effusion were 86 ( 49.14%) which were slightly higher than cases of pleural fluid which were 81 (46.28% ) .Out of 25 cases of malignant effusion, maximum number of cases was of pleural fluid effusion accounting 15 (60%) followed by peritoneal fluid 8 (32%) cases and 2 (8%)cases of pericardial fluid. CONCLUSION: Cytologic examination of serous fluids is the most effective procedure to differentiate between benign and malignant effusion and also to know primary site of lesion. However, in uncommon malignancies presenting as effusions, a detailed clinical history and ancillary investigations are often required to make a correct diagnosis. Keywords: Effusion, fluid, cytology, pleural, peritoneal, pericardial, ascites