Patterns of argyrophilic nucleolar organiser regions in pleural and peritoneal effusions.

OBJECTIVE

To evaluate AgNOR size and dispersion as alternate methods to AgNOR counts in order to differentiate malignant from non-malignant effusions.

DESIGN

Comparative study.

PLACE AND DURATION OF STUDY

Department of Pathology, Postgraduate Medical Institute, Lahore, from January 2003 to June 2004.

MATERIALS AND METHODS

A total of 240 samples of pleural and peritoneal effusions were centrifuged, deposits smeared on slides and stained with H and E and AgNOR stain. The diagnosis of malignancy or otherwise was made on H and E staining. AgNOR counts, variation in size and dispersion of AgNOR dots in smears were graded and compared in malignant and non-malignant effusions.

RESULTS

Mean AgNOR counts of 11.47+/-3.60 and 11.04+/-3.89 in malignant pleural and peritoneal effusions, respectively, were significantly (p<0.0001) greater as compared with counts of 3.36+/-0.69 and 3.35+/-0.66 in non-malignant effusions. AgNOR size and dispersion were of higher grade in significantly greater proportion of malignant as compared with non-malignant effusions (p<0.0001).

CONCLUSION

Typing of AgNOR size and dispersion was found to be an easy and reproducible alternative to traditional AgNOR counts for differentiating malignant from non-malignant effusions. These parameters should be correlated with already established but expensive techniques of AgNOR area and size imaging by electron microscopy and flow cytometry, as an economical alternative.