A Cytological Study to Differentiate Between Reactive Mesothelial Cells and Malignant Cells in Effusions
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
The excessive accumulation of fluid in the body cavities is called as effusion. Since the effusion fluids can be the face of the underlying pathology mostly due to Infections and malignancies the cytological evaluation of these serous effusions is performed mainly to establish the presence or absence of malignancy. Cytological differentiation of reactive mesothelial cells from malignant cells is often difficult by conventional cytology and hence Immunocytochemistry (IHC) is more sensitive and specific than other methods including the ease of availability. The aim of the present study is to analyze the samples of body fluids with a stress on differentiating between reactive mesothelial cells and the malignant cells. Materials& methods: Fluid samples that were received at the hospital cytology section of GSL General Hospital during the period from October 2013 to September 2015. Cytological smears and cell blocks were prepared and evaluated by cytomorphology in all the cases, cytochemistry and immunohistochemistry (IHC) was done to identify cells as per the merit of the case using at least two IHC markers. It was proposed to study a minimum of 100 samples. Results: A total number of 335 samples of effusions were received out of which, 235 were opined as inflammatory effusions, 40 cases were opined as malignant effusion and 35 cases showed reactive mesothelial cells. A peer study was conducted by 3 different observers and the suspicious cases were subjected to IHC with Calretinin and EMA so as to determine the nature of these suspicious cells whether they are of mesothelial lineage or of epithelial in nature. Conclusion: This study has given an insight as to the morphological variations that a reactive mesothelial cell can show nearly bordering on to malignancy and that the fact has to be kept in mind while reporting effusion cytology. Calretinin unfortunately gave negative staining in all the cases that were opined as reactive mesothelial cells in spite of the reagent gave an excellent staining in control. The reason for this uniform negativity is unfathomable and requires further evaluation. Where as EMA yielded reliable results.
Authors and Affiliations
T. Bharath 1T, Satya Prakash Venkatachalam2
Keywords
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- EP ID EP365862
- DOI 10.9790/0853-1702165963
- Views 69
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