RESUMO
Background: Body cavity fluids are evaluated by cell block (CB) technique. In conventional cytological smears (CS), appropriate identification of the cells as either reactive mesothelial cells or malignant cells is a diagnostic problem. In CB method, there is increase in cellularity, so it gives more morphological details of cells and improving the sensitivity of diagnosis. Sections obtained by CB method are also can be stored for future study like immunohistochemistry (IHC). Aims and Objectives: The aim of the study was to determine the diagnostic efficacy of CB technique over conventional CS and to study of IHC in CB of malignant pleural effusion. Materials and Methods: This will be institution-based, cross-sectional, and observational study. The pleural fluid (except blood and pus) obtained by thoracocentesis from both male and female patient (>18 years of age) 100 cases was included in the study. Pleural fluid mixed with blood/pus, fluid from cystic lesion, and inadequate sample (<15 ml vol.) were excluded in the study. Results: Association between architectural pattern in CB versus architectural pattern in cytology smear showed statistically significant value Chi-square: 201.7417, P < 0.0001. Conclusion: We may conclude that CB technique is better than conventional cytology smear technique especially in case of malignant pleural effusion. It increases true positive cases and decreases false negative cases. It also increases cellularity, maintain architectural pattern, and cellular morphology.
RESUMO
Background: Anterior mediastinal tumors comprise only 3% of all chest tumours. They are often of diagnostic challenge to both clinicians and histopathologists owing to their wide variety of clinical presentations and diversity in histomorphological appearance respectively. Hence, there is a need for elaborated studies to make the pathologists and clinicians aware of their diversity. Aim and Objectives: The present study was aimed to evaluate the diverse spectrum of clinical presentations and histomorphological appearances of anterior mediastinal lesions. In addition, cytological and radiological interpretations were correlated with histological diagnosis to assess their comparative role in diagnosis. Materials and Methods: It was a descriptive observational cross-sectional study. Patients diagnosed with anterior mediastinal mass on chest computed tomography (CT) scan were included in this study. Demographic details including clinical presentations and radiological interpretations were recorded. Patients underwent both CT guided Fine needle aspiration cytology (FNAC) and needle core/excisional biopsy. Histological diagnosis was correlated with radiological and cytological interpretations. Results: Of 659 patients presented with chest tumours, 19 were detected as having anterior mediastinal mass on chest CT scan indicating the prevalence of 2.88%. The most common presenting symptom was respiratory distress (73.68%), followed by chest pain (36.84%), superior vena cava syndrome (26.32%) and Myasthenic features (5.26%). About 50% of malignant tumours occurred at the 2nd decade of life. Thymic epithelial neoplasms comprise the major tumour type in this study (52.63%) followed by germ cell tumors (15.79%) and lymphomas (10.53%). Cytology was found to be more effective compared to radiology in diagnosis. Conclusion: Anterior mediastinal tumors are extremely heterogeneous in clinical presentation and histomorphological appearance. CT-guided FNAC can play an important role in their diagnosis along with radiology and histology.