CYTO-DIAGNOSIS OF PLEURAL EFFUSIONS: A COMBINED APPROACH TO MORPHOLOGICAL FEATURES IN ROUTINELY STAINED CYTOLOGY SMEARS AND CELL BLOCK TECHNIQUE

2021 ◽  
pp. 3-5
Author(s):  
Lubna Khan ◽  
Mahendra Singh ◽  
Anshul Pratap Singh ◽  
Mohd Faheemuddin
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
North India ◽  
Parietal Pleura ◽  
Cell Block ◽  
Pleural Effusions ◽  
Tertiary Care Centre ◽  
Pathology Department ◽  
Smear Examination

Introduction: Pleural cavity is a potential space between the parietal pleura and visceral pleural. It consists of some amount of uid called pleural uid which is normally less than 25ml. Pleural uid is produced by parietal lining and absorbed by visceral lining. Fluid is produced by plasma ltration through capillary endothelial cells. Aims & Objectives:Acombined approach of cytology and cell block technique in diagnosing the cause of pleural effusion. To evaluate the utility of cell block preparation over the conventional smear in the cytodiagnosis of serous effusions. Material & Methods: The present study was conducted on patients having pleural effusions. The cases and specimens were selected from the outdoor as well as indoor patients admitted in a tertiary care centre of North India and also from those sent directly to Pathology department from other hospitals. The duration of study was from January 2019 to September 2020. The specimens obtained were processed in the biochemistry, cytopathology and histopathology laboratory in the Pathology department of GSVM Medical College, Kanpur. Result And Analysis: Out of 100 cases studied it was found that 83 (83%) cases were of reactive pleural effusion and 17 (17%) cases were of malignant pleural effusions.Out of 17 malignant effusion, 16 (94%) cases were exudative, while 1 (6%) case was transudative.Only 8 cases of adenocarcinoma were diagnosed on smear examination, while 11 cases were diagnosed on cell block examination. 3 cases of poorly differentiated carcinoma were diagnosed on conventional smear and 5 cases on cell block examination.Out of total 17 malignant pleural effusions diagnosed by cell block, only 12 cases were diagnosed by conventional smear examination. Hence diagnostic yield increased by 30% using cell block preparations. Conclusion: Thus it was concluded that routine centrifuge is not satisfactory in reporting uids with scant cellularity. Hence for uids with scant cellularity cell block preparation is a useful method. Also the morphology of the cells were well appreciated by cell block as compared to routine centrifuge, thus aiding in accurate diagnosis. In this study the diagnoses which were missed or incompletely diagnosed on conventional smear were diagnosed by cell block.

Cytopathological spectrum of unusual malignant pleural effusions at a tertiary care centre in north India

Cytopathology ◽  
2007 ◽  
Vol 18 (1) ◽  
pp. 28-32 ◽  
Author(s):  
A. Awasthi ◽  
N. Gupta ◽  
R. Srinivasan ◽  
R. Nijhawan ◽  
A. Rajwanshi
Keyword(s):  
Tertiary Care ◽  
North India ◽  
Care Centre ◽  
Pleural Effusions ◽  
Tertiary Care Centre ◽  
Malignant Pleural Effusions

scholarly journals Computed tomography- guided percutaneous core needle biopsy for diagnosis of intathoracic mass lesions: experience at a tertiary care centre of North India

2019 ◽  
Vol 7 (3) ◽  
pp. 663
Author(s):  
Shivanjali Raghuvanshi ◽  
Shalini Bhalla ◽  
Vanshika Shahi ◽  
Manoj Kumar ◽  
Sumaira Qayoom ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
North India ◽  
Tissue Loss ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Ct Guided ◽  
Core Needle

Background: CT guided core needle biopsy is a less invasive method for initial diagnostic workup in the assessment of intrathoracic masses. This study was conducted to evaluate the diagnostic yield of the procedure as well as to demonstrate the spectrum of various disease in our population.Methods: Present study was conducted in a tertiary care hospital for a study period of two years. Patients with intrathoracic mass were included and CT guided biopsies were performed following a protocol. The CT guided biopsies received were examined for histological diagnosis. Immunohistochemistry was carried out where ever routine histopathology was not sufficient for diagnosis. Relevant immunohistochemical panels were applied for lung, mediastinal and pleural tumours according to the histological differential diagnosis. Detailed demographic and clinical profiles along with radiological findings were noted.Results: Total of 138 cases were taken for CT guided FNAC procedure and 123 (89.1%) cases yielded diagnostic biopsy. Lung was the most commonly involved organ followed by mediastinum. Bronchogenic carcinoma was the most common lesion reported in lung and Non-Hodgkin Lymphoma was the most common mediastinal lesion. Lung collapse was most common radiological feature.Conclusions: CT guided percutaneous biopsy is a valuable diagnostic technique providing for early accurate diagnosis and being minimally invasive procedure. Care should be taken while tissue processing and section cutting of intrathoracic biopsies as the biopsies are small and tissue loss should be prevented so that sufficient material is available for immunohistochemistry.

scholarly journals Study of Diagnostic Importance of Adenosine Deaminase (ADA) Level in Pleural Effusions

2015 ◽  
Vol 2 (2) ◽  
pp. 104 ◽  
Author(s):  
Sachin Kate ◽  
B. K. Mutha ◽  
Gauri Kulkarni ◽  
Chetan Mahajan ◽  
Sushma Dugad
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Tertiary Care ◽  
High Sensitivity ◽  
Pleural Effusions ◽  
Tertiary Care Centre ◽  
Adenosine Deaminase Activity

<strong>Introduction</strong>: Pleural effusion is the abnormal accumulation of fluid in the pleural space. TB is the most common cause of pleural effusion worldwide (30-60%). The pleural fluid activity of adenosine deaminase (ADA) is one of the best, providing reliable basis for a treatment decision, particularly in excluding the diagnosis of tuberculosis, due to its high sensitivity.<strong> Aims and Objectives</strong>: To assess the importance of adenosine deaminase(ADA) level in the diagnosis of pleural effusion. To assess Adenosine Deaminase Activity (ADA) in tuberculosis pleural effusion and assess the sensitivity and specificity of ADA levels. <strong>Materials and Methods</strong>: This study was performed at the Department of Pulmonary Medicine at tertiary care centre. The study comprised of 75 patients of pleural effusion having Age &gt; 14 years, Clinical and Radiological evidence of Pleural Effusions&amp;Patients willing for ADA examination. Patients having Age &gt; 65 years, minimal nontappable effusion, not giving consent for ADA examination patient were excluded from the study. Detailed history, thorough physical examination, radiological findings, haematological and biochemical findings were recorded in the proforma. Pleural aspiration was performed on all patients. Macroscopic findings, cytological, microbiological and biochemical analysis of pleural fluid were performed in all patients including ADA level. PCR for Mycobacterium tuberculosis was also assessed in pleural fluid. Pleural fluid Adenosine deaminase level was measured by Giusti and Galanti method. <strong>Result</strong>: In our study out of 45 patients with tuberculosis pleural effusion ADA was more than 40IU/L in 42 (93.33%) and less than40IU/L in 3 (6.66 %). Our study showed a mean ADA of 107.7 IU/L Using a cut off of greater 40IU/L we got a sensitivity and specificity of 93.3% and 90% respectively and Positive predictive value 93.3% and Negative predictive value 90%. <strong>Conclusion</strong>: Pleural fluid ADA activity has been shown to be a valuable biochemical marker that has a high sensitivity and specificity for TB diagnosis.

Emerging Antimicrobial Resistance Among Methicillin Resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Centre in North India

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 48-49
Author(s):  
Javaid Ahmad Bhat ◽  
Shariq Rashid Masoodi
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
Resistance Mechanisms ◽  
North India ◽  
Global Public Health ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Effective Prevention ◽  
Mupirocin Resistance

Apropos to the article by Dr Bali, titled “Mupirocin resistance in clinical isolates of methicillin-sensitive and resistant Staphylococcus aureus in a tertiary care centre of North India” (1), the authors have raised important issue of emerging antimicrobial resistance (AMR). Antimicrobial resistance is an increasingly serious threat to global public health that requires action across all government sectors and society. As per WHO, AMR lurks the effective prevention and management of an ever-increasing spectrum of infections caused by bacteria, parasites, fungi and viruses. Novel resistance mechanisms are emerging and spreading globally, threatening the man’s ability to treat common infectious diseases.

scholarly journals Acute myeloid leukemia with leukemic pleural effusion and high levels of pleural adenosine deaminase: A case report and review of literature

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 387-396
Author(s):  
Sing-Ting Wang ◽  
Chieh-Lung Chen ◽  
Shih-Hsin Liang ◽  
Shih-Peng Yeh ◽  
Wen-Chien Cheng
Keyword(s):  
Acute Myeloid Leukemia ◽  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Myeloid Leukemia ◽  
Diagnostic Yield ◽  
Leukemic Cells ◽  
Pleural Effusions ◽  
Diagnostic Dilemma ◽  
True Incidence ◽  
Acute Myeloid

Abstract Pleural effusions are rarely observed in association with acute myeloid leukemia (AML), and their true incidence remains unknown. Given the low diagnostic yield from cytopathologic analysis of malignant pleural effusions and the fact that patients with leukemia are often thrombocytopenic and unable to tolerate invasive procedures, the incidence of leukemic effusions may be underestimated. Here, we report a rare case of pleural effusion in a patient with newly diagnosed AML. Initial analysis revealed an exudative, lymphocyte-predominant effusion. High levels of adenosine deaminase (ADA) were detected in pleural fluid, consistent with a diagnosis of tuberculosis. However, the analysis of pleural cytology revealed leukemic cells, permitting the diagnosis of leukemic effusion to be made. The patient underwent induction chemotherapy and pleural effusion resolved without recurrence. This case emphasizes the diagnostic dilemma presented by high levels of ADA in a leukemic pleural effusion, as this association has not been previously considered in the literature.

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