Cytology- A useful diagnostic tool in ascites, 2 years study

Abstract

Background: Identification of malignant cells in any body fluid always is a challenging task for cytopathologist. Detailed clinical history, morphological evaluation and sometimes modern techniques like cytochemistry and immunohistochemistry can help us whenever required. Ascites is a common clinical finding with a wide range of etiology. Ascites is defined as collection of excessive fluid in the peritoneal cavity. The present study aims to note down various pathological findings in Transudative and Exudative ascites. This will help the clinician, surgeon and oncologist in treating the patient and it is the determining factor for treating patient.

Materials and Methods: It is an observational, prospective study. 120 cases of ascitic fluid cytology were collected from the patients admitted in a tertiary care hospital which is situated in Ahmedabad over a period of 2 years. Detailed examination – physical, biochemical and microbiological (wherever indicated) was done along with cytology examination of ascitic fluid.

Result:We studied 120 cases of ascitic fluid cytology. Most common causes of ascitic fluid effusion after examining 120 cases were liver cirrhosis followed by tuberculosis, inflammatory, malignant, acute bacterial infection, cardiac and renal causes. Among malignant effusion GIT and ovary were most common primary site of malignancy and commonest malignancy was adenocarcinoma.

Conclusion: Definite diagnosis of ascitic fluid effusion can be done in most of the cases by doing cytology and detailed examination like physical, biochemical and microbiological examination of that fluid. However in some cases newer techniques like cytochemistry and immunohistochemistry may require for confirmation. Cytology is first line of investigation along with other radiological investigation to rule out neoplastic lesions. It is also useful in identification of non neoplastic lesions like tuberculosis, Cirrhosis of liver, Nephrotic Syndrome, congestive cardiac failure, Anaemia-Hypoproteinemia & Spontaneous bacterial peritonitis. It helps clinician in management of patients.