Authors :
Ujyara Maryam Lone; Zubaria Rafique; Saira Javeed; Saima Batool; Safana Sadaf; Aribah Atiq
Volume/Issue :
Volume 9 - 2024, Issue 7 - July
Google Scholar :
https://tinyurl.com/ctkjbfa3
Scribd :
https://tinyurl.com/yc646etz
DOI :
https://doi.org/10.38124/ijisrt/IJISRT24JUL1169
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Aim of Study
Effusion cytology is a test used to determine the
etiology of a disease. Pleural, ascitic, pericardial, synovial,
and cerebrospinal fluid are commonly analyzed samples.
When a malignancy is detected in effusions, the place of
origin cannot be determined merely by cytologic
appearance. In the era of advanced technology,
cytomorphology alone is insufficient, and hence,
immunocytochemistry is the most widely used modality in
cytology effusion. Application of judicious immunopanel
can help determine origin of metastatic tumor, hence
aiding the clinician in initiation of treatment and prompt
management of wider spread disease.
Material and Methods
It was a single center study carried out at Chugtais
Institute of pathology for a period of one year. All
malignant pleural and peritoneal effusions from both
genders were included in the study. Concomitant naturally
formed clots were fixed in 10% neutral buffered formalin
and processed as cell blocks. Cell blocks were prepared
using the complex streptavadin-biotin peroxidase
technique. Immunohistochemistry was applied to 104
cases with external positive controls. CK7, CK20, Wt1,
GATA3, Napsin A, CDX2, LCA, PAX8 & TTF1 were
applied to determine primary site of origin.
Results
Most common cause of malignant peritoneal effusion
was due to ovarian malignancies in females and
adenocarcinoma in males while, in case of pleural effusion,
it was breast carcinoma in females and lung carcinoma in
males.
Conclusion
Cellblock combined with a judicious
immunohistochemical panel according to gender and most
common metastatic tumors can be an accurate and
affordable method to determine the primary site of cancer.
Our study results signifies the necessity of utilizing a panel
of markers to prevent misidentification of the primary
sites of metastatic carcinoma in effusions.)
Keywords :
Component Cell Block, Immohistochemistry, Effusion Cytology, Primary Site.
References :
- Wadha B, Mohan A, Agarwal AK, Varshney A, Kumar R, Garg V, Sharma P. A study of malignant serous effusions in a tertiary teaching hospital in western Uttar Pradesh. IJPO. 2016 Apr;3(2):276-80.
- Koss LG, Melamed MR, editors. Koss' diagnostic cytology and its histopathologic bases. Lippincott Williams & Wilkins; 2006.
- Kumar SH, Sudhamani S, Shetty D, Rao R. Clinicopathological study of 117 body fluids: comparison of conventional smear and cell block technique. Current Health Sciences Journal. 2020 Oct;46(4):336.
- Takano GH, Amorim RF, Ferreira VM, de Souza Vianna LM, de Castro TM, de Vasconcelos Carneiro M, de Araújo Oliveira Í, Motoyama AB, Carneiro FP. The initial panel of immunocytochemical markers for identification of primary carcinoma site for effusions and peritoneal washings from women. International Journal of Clinical and Experimental Pathology. 2022;15(4):191.
- Dey S, Nag D, Nandi A, Bandyopadhyay R. Utility of the cell block to detect malignancy in fluid cytology: Adjunct or necessity? Journal of cancer research and therapeutics. 2017 Jul 1;13(3):425-9.
- Porcel JM, Gasol A, Bielsa S, Civit C, Light RW, Salud A. Clinical features and survival of lung cancer patients with pleural effusions. Respirology. 2015 May;20(4):654-9.
- Yang Y, Du J, Wang YS, Kang HY, Zhai K, Shi HZ. Prognostic impact of pleural effusion in patients with malignancy: A systematic review and meta‐analysis. Clinical and Translational Science. 2022 Jun;15(6):1340-54.
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- Carneiro FP, Muniz-Junqueira MI, Pittella-Silva F, Carneiro MD, Takano GH, Vianna LM, De Andrade LB, De Castro TM, Peres I, Dos Santos Borges TK, Ferreira VM. A panel of markers for identification of malignant and non-malignant cells in culture from effusions. Oncology reports. 2017 Dec 1;38(6):3538-44.
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- Dermawan JK, Policarpio-Nicolas ML. Malignancies in pleural, peritoneal, and pericardial effusions: a 17-year single-institution review from 30 085 specimens. Archives of pathology & laboratory medicine. 2020 Sep 1;144(9):1086-91.
- Hsu C. Cytologic detection of malignancy in pleural effusion: a review of 5,255 samples from 3,811 patients. Diagnostic cytopathology. 1987 Mar;3(1):8-12.
- DiBonito L, Falconieri G, Colautti I, Bonifacio D, Dudine S. The positive pleural effusion. A retrospective study of cytopathologic diagnoses with autopsy confirmation. Acta cytologica. 1992 May 1;36(3):329-32.
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- Koss LG: Diagnostic cytology and its histopathological basis. Lippincott 2005 pp 920-948.
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Aim of Study
Effusion cytology is a test used to determine the
etiology of a disease. Pleural, ascitic, pericardial, synovial,
and cerebrospinal fluid are commonly analyzed samples.
When a malignancy is detected in effusions, the place of
origin cannot be determined merely by cytologic
appearance. In the era of advanced technology,
cytomorphology alone is insufficient, and hence,
immunocytochemistry is the most widely used modality in
cytology effusion. Application of judicious immunopanel
can help determine origin of metastatic tumor, hence
aiding the clinician in initiation of treatment and prompt
management of wider spread disease.
Material and Methods
It was a single center study carried out at Chugtais
Institute of pathology for a period of one year. All
malignant pleural and peritoneal effusions from both
genders were included in the study. Concomitant naturally
formed clots were fixed in 10% neutral buffered formalin
and processed as cell blocks. Cell blocks were prepared
using the complex streptavadin-biotin peroxidase
technique. Immunohistochemistry was applied to 104
cases with external positive controls. CK7, CK20, Wt1,
GATA3, Napsin A, CDX2, LCA, PAX8 & TTF1 were
applied to determine primary site of origin.
Results
Most common cause of malignant peritoneal effusion
was due to ovarian malignancies in females and
adenocarcinoma in males while, in case of pleural effusion,
it was breast carcinoma in females and lung carcinoma in
males.
Conclusion
Cellblock combined with a judicious
immunohistochemical panel according to gender and most
common metastatic tumors can be an accurate and
affordable method to determine the primary site of cancer.
Our study results signifies the necessity of utilizing a panel
of markers to prevent misidentification of the primary
sites of metastatic carcinoma in effusions.)
Keywords :
Component Cell Block, Immohistochemistry, Effusion Cytology, Primary Site.