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Objective: Thoracocentesis is a less invasive and expensive procedure than pleural biopsy, enabling sample collection for cytological evaluation. Cell blocks prepared from these samples provide histopathological diagnoses; further, immunohistochemistry (IHC) can be performed for subtyping malignancies, guiding the clinician in choosing the appropriate treatment modality for the patient. We aimed to determine the various histological subtypes of malignancies using cell block IHC and compare the cell block and conventional cytology methods for diagnosing malignant pleural effusion. Material and Methods: All pleural fluid samples from the clinically suspicious cases of malignancy collected at the Department of Pathology, Government Medical College Kottayam, India, during 18 months, except duplicate and inadequate samples, were included in this prospective observational study. IHC was performed on cell blocks that were positive for malignancy. Results: This study analyzed 630 samples, of which 121 cell blocks demonstrated the presence of malignancy. Overall, 80%, 13%, and 7% of cases were negative, suspicious, and positive for malignancy based on conventional cytology, and 81%, 0%, and 19% were negative, suspicious, and positive for malignancy based on cell blocks, respectively. Among all malignancies, adenocarcinomas from the lung (56%) were the most common, followed by adenocarcinomas from the breast (6%), squamous cell carcinomas (5%), and adenocarcinomas from the ovary (3%). Cell blocks helped detect more malignancies (19%) than conventional cytology (7%), despite a moderate agreement between both methods. Conclusion: Adenocarcinomas were the most common cause of malignant pleural effusions, and the most frequent site of origin was the lungs. Cell blocks helped diagnose more malignancies than conventional cytology. [ABSTRACT FROM AUTHOR]

Background: The cytological analysis of body fluids is the preliminary investigation performed for the diagnostic evaluation of body fluids, helping the physician make the diagnosis and plan proper treatment. The International System for Reporting Serous Fluid Cytology (ISFRSFC) was created using best international practises, current literature and expert consensus to make a uniform reporting system for serous fluids. Aims: The present study was conducted with the aim of recategorising the effusion fluids as per the guidelines prescribed by ISRFRC, knowing the distribution of cases into various categories and assessing their feasibility in day-to-day reporting. Patients and Methods: This study was performed on serous fluids (ascitic, pleural, peritoneal and pericardial) received over a period of 5 years, from January 2017 to April 2022, in the cytology unit of the Department of Pathology, ABVIMS, Dr. Ram Manohar Lohia Hospital, New Delhi. Wherever possible, clinicoradiological and histopathological data were obtained and correlated with cytological findings. Serous fluids were categorised into reporting formats as prescribed by ISRFRC and its feasibility was assessed in day-to-day reporting. Results: A total of 1115 cases of serous effusion fluid were examined. The male‑to‑female ratio was 1:1.12. Pleural fluid constituted the majority of the sample (436, 39.10%). Overall, 56 (5.02%) cases were non‑diagnostic (ND), 1013 (90.85%) cases were negative for malignancy, 8 (0.72%) were atypia of undetermined significance, 11 (0.99%) were suspicious of malignancy and 27 (2.42%) were malignant (MAL). Conclusion: The current study emphasises the significance of cytological analysis of serous fluid as a comprehensive diagnostic investigation that also aids in determining the cause and monitoring the disease process. With the introduction of ISFRSFC, serous fluid reporting is now uniform and more comprehensive, both for cytopathologists and clinicians. [ABSTRACT FROM AUTHOR]

Background&Method: This study was conducted with an aim toassess the usefulness of pleural fluid LDH, PROTEIN, CHOLESTEROL, BILIRUBIN and CELLS in diagnosis and differentiating transudative and exudative pleural effusion patient.All patients between >18 years of age admitted in Chest ward of Index Medical College, Indore with diagnosis of a PLEURAL EFFUSION. Study was be conducted on 60 patients from the Department of TB and CHEST at Index Medical College, Hospital & Research centre Indore and all the tests was be perform with due permission from the Institutional Ethical Committee and informed consent from the subjects or their legal relatives. Subjects were included on the basis of their diagnosis of PLEURAL EFFUSION as per Extended Lights criteria. Result:According to Lights Criteria the mean pleural sugar is 86.29±48.88 in exudates and 116±42.76 in transudate, although it was not statistically significant. The mean protein value is 4.73±1.11 in exudates and 2±0.81 in transudate and this difference between the mean protein values was statistically significant. Mean pleural LDH is 896±867 in exudates and 189±60 in transudate, although this difference between the mean values was not statistically significant. The mean cholesterol value is 78.14±38.20 in exudates and 31.75±21.54 in transudate and this difference between the mean protein values was statistically significant. The mean ADA value is 56.96±28.58 in exudates and 19.75±13.52 in transudate and this difference between the mean protein values was statistically significant. Conclusion:In pulmonary medicine, pleural effusion diagnosis is still a developing field. With the increased prevalence of pleural disease, multidisciplinary initiatives to improve diagnosis accuracy while remaining cost-effective are required. Pleural fluid cholesterol criteria (cholesterol >60 mg/dl – exudate; cholesterol <60 mg/dl – transudate) are shown to be an effective tool for separating pleural effusions in this investigation. As a result, it is suggested that using pleural fluid cholesterol to distinguish exudate from transudate is preferable to using Light's criteria, with the added benefit of not having to collect a blood sample at the same time, especially in countries like India where financial and technical constraints are severe. [ABSTRACT FROM AUTHOR]