Cytological Analysis of Body Fluids in A Tertiary Care Hospital of Jammu Region: A One-year Retrospective Observational Study

Abstract

Introduction: Exfoliative cytology of body fluids involves the analysis of cells present in fluids such as cerebrospinal fluid, pleural fluid, peritoneal fluid, pericardial fluid and synovial fluid. The cytological interpretation of individual cells exfoliated into these fluids provides an insight into the diagnosis, prognosis and therapeutic aspects of various pathological conditions. It also helps in staging of malignancies. Objective: To evaluate the significance of fluid cytology for various pathological conditions, including malignancies. Materials and Methods: This observational retrospective study was carried out for a period of one year from 31st May 2023 to 1st June 2024. A total of 392 cases of peritoneal, pleural, cerebrospinal, synovial, and pericardial fluids received during the study period in the cytology section of Department of Pathology, Government Medical College and Hospital, Jammu, J&K, India were included in this study. Gross and clinical findings were noted from the requisition forms. The fluids were centrifuged at 2000 rpm for 5 minutes and the sediment was used to prepare smears that were stained by May-Grunwald-Giemsa (MGG) stain and Papanicolaou (Pap) stain. Results: A total of 392 cases of serous effusions were studied. The most common fluid was peritoneal fluid, 230 (58.67%) cases, followed by pleural fluid, 145 (36.99%) cases, CSF, 15 (3.83%) and least common were pericardial fluid and synovial fluid, 1 (0.26%) case each. The age ranged from 4 years to 98 years. Most cases, 85 (21.68%) belonged to 51-60 years age group. Female preponderance was observed with M: F ratio of 1:1.23. 43 (10.97%) of the total effusions were malignant, out of which 23 were malignant peritoneal effusions. 23 (5.87%) cases were suspicious of malignancy of which 13 (56.52%) cases were peritoneal fluids. Carcinoma ovary was the most common primary site causing malignant peritoneal effusion. Conclusions: Exfoliative cytology is a valuable tool in evaluation of body cavity fluids. It is relatively painless, simple, cost effective, rapid technique that yields quick and reliable results. Some cases may present major interpretative challenges to the pathologist like presence of reactive mesothelial cells which at times poses difficulty in diagnosis, being close mimicker of malignancy. It is especially helpful in evaluation and staging of malignancy.