Rani S S Sabitha, Vamshidhar Immadi Sudhakar, John Nitin Ashok, John Jyoti
Department of Pathology, ESIC Medical College and Hospital, Sanathnagar, Hyderabad, Telangana, India.
Department of Physiology, All India Institute of Medical Sciences (AIIMS), Bibinagar, Telangana, India.
J Cytol. 2022 Oct-Dec;39(4):169-173. doi: 10.4103/joc.joc_91_21. Epub 2022 Nov 8.
Cytological smear and cell block are commonly used to diagnose pleural fluid effusion. However, there is a paucity of information in the literature where a comparison between a cytological smear and a cell block with corresponding pleural biopsy has been done. This study aimed to evaluate the accuracy of cytological smears, cell blocks, and pleural biopsy for the diagnosis of malignant tumors.
In this cross-sectional study, analysis of successive pleural fluid samples received by the department was done. The sample was divided into equal halves of 5 ml each. One was used for conventional smear and the second was used for the preparation of cell block. The cell block was prepared by centrifuging the specimen of fluid at 2500 rpm for 15 min. A pleural biopsy was obtained by using Cope's pleural biopsy needle.
A total of n = 50 cases were included in the study. A total of n = 8 cases were diagnosed as malignant by cell smear and n = 4 cases were suspicious for malignancy. By cell block, n = 10 cases of malignancy were diagnosed and n = 1 case was suspicious for malignancy. By biopsy, n = 11 cases were diagnosed as malignant and n = 1 case was suspicious for malignancy. Out of the total, n = 2 cases were diagnosed as squamous cell carcinoma by biopsy; one case was diagnosed by cell block; and the other was reported as suspicious for malignancy.
The study shows that cell blocks are complementary to the cell smear technique in over diagnosis and categorization of benign as well as malignant cells. The cell blocks were more useful in the diagnosis of malignancy because of better preserved architectural patterns as seen in corresponding histopathology sections. It, therefore, appears that the cell blocks are a perfect fit to bridge the cytology and histopathology.
细胞学涂片和细胞块常用于诊断胸腔积液。然而，文献中关于细胞学涂片与细胞块以及相应胸膜活检之间比较的信息较少。本研究旨在评估细胞学涂片、细胞块和胸膜活检对恶性肿瘤诊断的准确性。
在这项横断面研究中，对科室接收的连续胸腔积液样本进行了分析。样本被等分为两份，每份5毫升。一份用于常规涂片，另一份用于制备细胞块。通过将液体标本以2500转/分钟的速度离心15分钟来制备细胞块。使用科普氏胸膜活检针获取胸膜活检标本。
本研究共纳入n = 50例病例。细胞涂片诊断为恶性的有n = 8例，可疑恶性的有n = 4例。通过细胞块诊断为恶性的有n = 10例，可疑恶性的有n = 1例。通过活检诊断为恶性的有n = 11例，可疑恶性的有n = 1例。在所有病例中，活检诊断为鳞状细胞癌的有n = 2例；细胞块诊断出1例；另1例报告为可疑恶性。
该研究表明，细胞块在良性和恶性细胞的过度诊断及分类方面是对细胞涂片技术的补充。由于在相应组织病理学切片中可见更好保存的组织结构模式，细胞块在恶性肿瘤诊断中更有用。因此，细胞块似乎非常适合在细胞学和组织病理学之间架起桥梁。
