Reinfusion of peritoneal fluid elevates the level of plasma D-dimer in patients with early-onset ovarian hyperstimulation syndrome.

Purpose: This study aimed to elucidate the factors that affect the dynamics of blood D-dimer in ovarian hyperstimulation syndrome (OHSS). Methods: We retrospectively reviewed medical records from two hospitals and extracted data obtained during assisted reproductive technology and OHSS treatment. Blood D-dimer levels during hospitalization were plotted against body weight. Other factors possibly related to blood D-dimer levels were also analyzed. Results: The analysis included 10 patients with OHSS admitted between January 2013 and June 2023. In all patients, blood D-dimer levels increased significantly when they convalesced from OHSS and lost weight. None of the patients showed clinical signs of thrombosis, which was confirmed using imaging tests in 8 of 10 patients. Two patients underwent cell-free and concentrated ascites reinfusion therapy (CART), and their blood D-dimer levels increased dramatically after the procedure. Conclusion: Weight change and CART are associated with blood D-dimer dynamics in OHSS. Our results show that elevated blood D-dimer levels in patients with OHSS do not always represent the presence of thrombosis. Reinfusion of pooled D-dimer in ascites may explain the D-dimer surge during the recovery phase or after CART in these patients. Our study provides new perspectives on the clinical implications of D-dimer during OHSS.

The International System for Reporting Serous Fluid Cytopathology: An Institutional Experience on its Implication and Assessment of Risk of Malignancy in Effusion Cytology.

Background: The "international system for reporting serous fluid cytopathology"(TIS) consists of five diagnostic categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). The study was conducted to reclassify effusion cytology samples according to the newly proposed TIS to calculate the risk of malignancy (ROM) for each category and to conduct performance analysis. Materials and Methods: The study was a retrospective observational study conducted at a tertiary care institution in North India. Clinical data of the cases from June 2013 to July 2021 were retrieved and the cases were reviewed by two cytopathologists. All cases were reclassified according to the proposed TIS system into five categories. Results: A total of 2318 patients were included in the study over a time span of 8 years, and 1614 (69.6%) cases of pleural effusion cytology, 612 (26.4%) cases of peritoneal effusion cytology, and 92 (3.9%) cases of pericardial effusion cytology were included. All effusion cytology smears were recategorized as per TIS guidelines into ND, NFM, AUS, SFM, and MAL with 4 (0.17%), 1756 (75.75%), 12 (0.51%), 57 (2.46%), and 489 (21.11%) cases, respectively, and ROM was 25%, 17.9%, 66.7%, 75.4%, and 96.5%, respectively, for the categories. Conclusion: Besides being a simple, easy, and user-friendly system, TIS has the benefit of risk stratification and ROM for each category. The TIS system proposed a tiered scheme, which places the effusion cytology into well-defined categories, and therefore has lesser chances of false-positive and false-negative cases.

Association of serum tumor markers with serous effusion in systemic lupus erythematosus.

The objective of this study was to investigate the relationship between serum tumor markers and serous effusion in systemic lupus erythematosus (SLE) patients, thereby contributing preliminary data on the utility of these tumor markers in diagnosing serous effusion. In this retrospective analysis, clinical data of SLE patients were extracted from electronic medical records. This included the levels of serum tumor markers, including pro-gastrin-releasing peptide, neuron-specific enolase (NSE), cytokeratin-19 fragments (CYFRA 21-1), various carbohydrate antigens (CA 153, CA 125, CA 19-9), along with carcinoembryonic antigen, and alpha-fetoprotein. Positivity of tumor markers was established based on serum levels surpassing the upper threshold of the respective reference ranges. This study included 149 eligible patients with SLE, of whom 38 (25.50%) had serous effusion, and the prevalence of pleural, pericardial, and peritoneal effusions was 11.41%, 14.77%, and 6.71%, respectively. The analysis revealed that patients with serous effusion had higher scores on the SLE Disease Activity Index 2000 (SLEDAI 2000) than those without serous effusion. Notably, this disparity remained significant when the serositis score was excluded from the SLEDAI 2000 calculation. The positivity rate and serum levels of CA 125 were higher in patients with serous effusion and pleural effusion. Patients with pericardial effusion demonstrated an elevated CYFRA 21-1 positivity rate and serum CA 125 and CYFRA 21-1 levels compared to patients without pericardial effusion. CA 125 and NSE were higher both in terms of positivity rate and serum levels for patients with peritoneal effusion. Through receiver operating characteristic curve analysis, a moderate relationship was discerned between the conjoined levels of CYFRA 21-1 and CA 125 and the occurrence of pericardial effusion. Additionally, CA 125, NSE, and their combination revealed the moderate diagnostic ability of peritoneal effusion. In summary, this study observed elevated serum levels of various tumor markers in SLE patients exhibiting serous effusion, which is likely attributable to lupus-induced inflammation. These findings suggest that serum tumor markers can be valuable in diagnosing pericardial and peritoneal effusions.

Case Report: Long-term remission of malignant pleural and peritoneal effusion in a case of advanced lung adenocarcinoma treated with combined crizotinib and anlotinib therapy.

Malignant pleural and peritoneal effusion are common clinical manifestations in advanced malignant tumors, associated with a poor prognosis. This article presents a case of advanced lung adenocarcinoma with ROS1 rearrangement, characterized by persistent malignant pleural and peritoneal effusion. The patient received combined therapy of Crizotinib and Anlotinib, resulting in a significant reduction and even disappearance of the malignant effusion. Exploratory use of this treatment approach improved the patient's quality of life and holds potential for extending overall survival. However, given the single case report nature, the efficacy of this regimen in treating advanced ROS1-rearranged lung adenocarcinoma should be considered as a supplementary strategy, warranting further validation through multicenter clinical data.

Pediatric paragonimiasis: a retrospective analysis of cases from a county in south-west China.

Introduction: The clinical manifestations of paragonimiasis are diverse and non-specific, and can easily lead to misdiagnosis. We aimed to analyze the clinical manifestations, laboratory features, treatment, and clinical outcome of children with paragonimiasis in order to improve recognition of this disease and avoid misdiagnosis. Methods: Children diagnosed with paragonimiasis from August 2016 to July 2022 were included in the study. Information on population informatics, medical history, and laboratory features was extracted from case data. The clinical features of paragonimiasis were retrospectively analyzed. Results: A total of 45 children were included in this study. All children had, at least, one risk factor. The clinical features mainly included fever, cough, pleural effusion, peritoneal effusion, and subcutaneous nodules. The main imaging findings were alveolar exudation, peritoneal effusion, pleural thickening, and local nodules. The "tunnel sign" finding on computed tomography (CT)/magnetic resonance imaging (MRI) was helpful in establishing the diagnosis of paragonimiasis. After praziquantel treatment, most of the children improved, and one child with cerebral paragonimiasis experienced sequelae. Conclusion: Most children with paragonimiasis have a good prognosis, but few children can experience sequelae. Avoidance of untreated water and raw food is a simple, feasible, and effective preventive measure.

Efficacy and safety of intraperitoneal bevacizumab combined with hyperthermic intraperitoneal chemotherapy in the treatment of patients with ovarian cancer and peritoneal effusion and the effect on serum lncRNA H19 and VEGF levels.

Peritoneal effusion is a common event in ovarian cancer (OC) patients. LncRNA H19 and vascular endothelial growth factor (VEGF) are implicated in cancer progression. The study evaluated the curative effect and safety of bevacizumab combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in OC patients with peritoneal effusion and the effect on serum lncRNA H19/VEGF levels. Totally 248 OC patients with peritoneal effusion were treated with intraperitoneal bevacizumab + HIPEC (observation group) or abdominal paracentesis without HIPEC (control group). The clinical efficacy, quality of life, and adverse reactions were evaluated after two treatment cycles. The serum lncRNA H19 and VEGF levels pre-/post-treatment were determined by RT-qPCR and ELISA. The observation group exhibited better clinical efficacy than the control group, evidenced by a higher partial response rate, response rate, and disease control rate. The observation group exhibited reduced physical/cognitive/role/social/emotional function scores and total adverse reactions. LncRNA H19/VEGF levels showed no significant difference between the two groups before treatment but were significantly downregulated in the observation group after treatment. Summarily, intraperitoneal bevacizumab + HIPEC has significant efficacy in treating peritoneal effusion, improves the quality of life, and reduces serum lncRNA H19 and VEGF levels in OC patients, with fewer adverse reactions and higher safety.Impact statementWhat is already known on this subject? The utilization of hyperthermic intraperitoneal chemotherapy (HIPEC) as an emerging treatment option for abdominal malignancies has garnered the attention of numerous researchers over the years, which has significant clinical effects on peritoneal effusion in ovarian cancer and can control patients' conditions and improve their signs and symptoms to a certain extent.What do the results of this study add? In this paper, we investigated the efficacy and safety of intraperitoneal bevacizumab combined with hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal effusion in ovarian cancer. Meanwhile, we compared serum lncRNA H19 and VEGF levels before and after treatment.What are the implications of these findings for clinical practice and/or further research? Our findings may provide a clinically worthy method for the treatment of peritoneal effusion in ovarian cancer. The treatment method reduces serum lncRNA H19 and VEGF levels in patients, which provides a theoretical basis for further research.

Cytohistologic immunohistochemical correlation of epithelial tubo-ovarian neoplasms: Can cell blocks substitute for tissue?

BACKGROUND: Cytologic specimens often represent the initial diagnostic material for tubo-ovarian neoplasms resulting from therapeutic paracentesis for patients presenting with high-volume ascites. However, subtyping and immunohistochemical (IHC) characterization, which have implications in preoperative management and downstream ancillary testing, are not routinely performed in many institutions. This study aims to perform cytohistologic correlation of commonly used IHC stains to establish their reliability in peritoneal fluids/washing specimens. METHODS: A retrospective search of the laboratory information systems was performed to identify peritoneal fluid/washing specimens involved by borderline or malignant epithelial tubo-ovarian neoplasms and concurrent/subsequent surgical resection specimens. Cell blocks and tissue were stained for PAX8, WT-1, p53, p16, Napsin-A, estrogen receptor, and progesterone receptor, and staining between cytological and surgical specimens was compared. RESULTS: A total of 56 case pairs were included, with the following final diagnoses on histological examination: 37 high-grade serous carcinomas, eight clear cell carcinomas, one endometrioid adenocarcinoma, two low-grade serous carcinomas, and eight serous borderline tumors. There was perfect cytohistologic correlation for PAX8 (Lin's concordance correlation coefficient [LINCCC] = 1.00) and WT-1 (LINCCC = 1.00), substantial/good correlation for p53 (LINCCC = 0.96), p16 (LINCCC = 0.93), napsin-A (LINCCC = 0.91) and ER (LINCCC = 0.77), and moderate correlation for PR (LINCCC = 0.54). CONCLUSIONS: Immunohistochemical correlation between peritoneal fluid and surgical resection specimens for tubo-ovarian neoplasms is high. Common subtypes of tubo-ovarian carcinomas can be reliably distinguished on fluids using IHC.

Yellow nail syndrome accompanied by minimal-change nephrotic syndrome: A case report.

BACKGROUND: In most cases of yellow nail syndrome (YNS), the classic triad of yellow nails, lymphedema and respiratory manifestations rarely manifest simultaneously. Therefore, diagnosis is delayed or frequently missed. CASE SUMMARY: We report a 62-year-old YNS patient presenting with bilateral pleural, pericardial and peritoneal effusions who, 2 mo later, developed minimal-change nephrotic syndrome. After treatment with vitamin E, clarithromycin and prednisone for 3 mo, effusions in the chest, pericardium and abdominal cavity decreased while urine protein levels returned to within normal ranges. CONCLUSION: Clinicians should consider the possibility of YNS for patients presenting with multiple serous effusions and nephrotic syndromes.

Peritoneal effusion as unusual complication post COVID 19 infection.

Introduction: COVID 19 is a new virus appeared in the late of 2019, and spread widely through the world, causing respiratory symptoms and sometimes could cause digestive manifestations. Case presentation: We reported a case of a 72 years old women presented with a complaint of dry cough, dyspnea and swollen abdomen, which she diagnosed with COVID19 and her medical history showed type 2 diabetes mellitus and acute kidney injury one month prior to her presentation. CT-abdomen showed Ascites and slightly hepatomegaly then we performed prednisolone antibiotics medication. After a week the Ascites decreased and her condition was good and stable. Discussion: Few similar cases have been reported in the literature as case reports, but our article reports the first case report from Syria, which may increase the clinical awareness towards rare complications of COVID19 infection among Syrian clinical doctors, especially pulmonologists. Conclusion: The peritoneal effusion consider as s rare digestive manifestation of COVID19 that Clinical doctors should take aware off.

Giant Hepatic Hemolymphangioma With Peritoneal Effusion in Children: A Case Report and Literature Review.

Hemolymphangioma is a congenital malformation of blood vessels and lymphatic vessels, commonly found in the head, neck, and subcutaneous, rarely in the viscera and extremely rarely in the liver. In this case, a 6-year-old boy was found to have abdominal distension for more than 2 months with no other obvious symptoms. Physical examination revealed a large abdominal mass that was hard and not mobile. Laboratory tests found no obvious abnormity. Preoperative ultrasound and CT showed a huge cystic and solid-cystic tumor in the abdomen with close relationship to the right lower margin of the liver and fluid accumulation in the abdominopelvic cavity. The preliminary diagnoses were a malignant tumor of embryonic origin and undifferentiated sarcoma. Liver tumor resection was performed in our hospital, and the postoperative pathology was diagnosed as hepatic hemolymphangioma. The patient recovered well after surgery. It is easy to diagnose a large abdominal mass in a child as a malignant tumor of the liver and delay the treatment-no obvious symptoms, no obvious abnormalities in laboratory tests, and imaging shows a multiocular cystic lesion with clear borders and no invasion of blood vessels, indicating that the possibility of this disease should be considered. The tumor has an abnormal rich blood supply, and preoperative imaging evaluation clearly shows the vascular pathway and blood supply status to help optimize the surgical plan.

Application of the International System for Reporting Serous Fluid Cytopathology with Cytohistological Correlation and Risk of Malignancy Assessment.

The International System for Reporting Serous Fluid Cytopathology (TIS) classifies serous effusions into five categories: non-diagnostic (ND), negative for malignancy (NFM), atypia of unknown significance (AUS), suspicious for malignancy (SFM) and malignant (MAL). The main objectives of this classification comprise the establishment of a universal code of communication between cytopathologists and clinicians and histopathologists, as well as between different laboratories worldwide, paving the way for the setting of clinical management guidelines based on the risk of malignancy assessment for each diagnostic category. We retrieved the total number of pleural and peritoneal effusion cases of our department for the three-year time period between 2018 and 2020, yielding a total of 528 and 500 cases, respectively. We then proceeded to reclassify each specimen according to TIS guidelines and calculate the risk of malignancy (ROM) for each category by searching each patients' histology records, medical history and clinical follow-up. For pleural effusions, 3 (0.57%) cases were classified as ND, 430 (81.44%) cases as NFM, 15 (2.84%) as AUS, 15 (2.84%) as SFM and 65 (12.31%) as MAL. ROM amounted to 0%, 5.3%, 33.33%, 93.33% and 100% for each category, respectively. As far as peritoneal effusions are concerned, 6 (1.2%) were categorized as ND with ROM estimated at 16.66%, 347 (69.4%) as NFM (ROM = 9%), 13 (2.6%) as AUS (ROM = 38.46%), 12 (2.4%) as SFM (ROM = 83.33%) and 122 (24.4%) as MAL (ROM = 100%). Our results underline the utility of the current classification, both as a means of communication between doctors of different specialties and as general guidelines for the further clinical management of patients.

Recurrent abdominal pain, peritoneal effusion, and eosinophilia in a boy aged 17 years. / 17å²ç”·ç«¥åå¤è ¹ç—›ã€è ¹è ”ç§¯æ¶²ä¼´å—œé ¸æ€§ç²’ç»†èƒžå¢žå¤š.

A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis.

Bacterial Pathogens, Drug-Resistance Profile and Its Associated Factors from Patients with Suspected Peritonitis in Southern Ethiopia.

BACKGROUND: Ascitic fluid plays a critical role in the microbiological diagnosis of peritonitis. Drug-resistant bacterial infection of the peritoneal cavity is becoming a public health threat. However, data on bacterial profile and antimicrobial-resistant pattern of isolates from the ascitic fluid are scarce. Thus, this study was aimed to assess drug-resistant bacteriological profiles and factors associated with peritonitis in southern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted from March 2019 to December 2019. A semi-structured questionnaire was used to collect socio-demographic and clinical data. A total of 147 ascitic fluid samples were aseptically collected and inoculated onto blood agar, MacConkey agar, and chocolate agar. The inoculated culture media were incubated aerobically and micro-aerobically at 37°C for 48 hrs. Bacterial identification was done by standard protocols and the antimicrobial susceptibility testing by Kirby Bauer's disk diffusion method. Logistic regression was used to identify the associated factors with bacterial peritonitis. RESULTS: Of the total study participants, the overall magnitude of bacterial peritonitis was 19.05% with a total of 30 bacterial isolates. Majority of the isolates were Gram negative bacteria with predominant species E. coli 36.67% followed by Gram positive S. aureus 13.33%. The multidrug resistant isolates accounts about 43.3% while a quarter of isolated S. aureus were methicillin resistant. The bacterial peritonitis was associated with recent history of surgery [AOR = 8.724, 95% CI: (2.688-28.314)], hospitalization more than seven days [AOR = 8.990, 95% CI: (2.755-29.342)], cirrhosis [AOR = 2.751, 95% CI: (1.109-6.822)] and alcoholism [AOR = 5.802, 95% CI: (1.948-17.285)]. CONCLUSION: Nearly half of the isolated bacteria were observed to be MDR, and this may alarm all healthcare workers and policymakers. Thus, continuous surveillance of antimicrobial resistance patterns along with associated factors is essential for regular monitoring of transmission of drug-resistant bacteria and the emergence of antibiotic resistance.

The predominance and diagnostic value of neutrophils in differentiating transudates and exudates in dogs.

BACKGROUND: There is disagreement in the literature about the proportion of neutrophils expected in canine transudates. A cutoff of <30% neutrophils has been recommended for distinguishing transudates from exudates, but its validity has not been established. OBJECTIVE: The aim of this study was to evaluate differential cell counts in canine effusions and analyze the percentage and number of neutrophils in transudates and exudates. METHODS: Effusion data were obtained retrospectively from 263 dogs with pleural or peritoneal effusion. Low-protein transudates, high-protein transudates, and exudates were classified using the total protein (TP) concentration and total nucleated cell count (TNCC). Differential percentages and absolute neutrophil counts were compared by the effusion type and underlying etiology. RESULTS: Low-protein transudates (n = 63), high-protein transudates (n = 84), and exudates (n = 77) had a median (range) of 35% (0%-100%), 59% (0%-100%), and 90% (50%-98%) neutrophils (P < .0001). All effusions with <50% neutrophils were transudates, but 53% of transudates had ≥50% neutrophils, and 69% had ≥30%. Median neutrophil counts were 62/µL (0-892/µL), 538/µL (0-4550/µL), and 45 590/µL (5400-496 800/µL) in low-protein transudates, high-protein transudates, and exudates, respectively (P < .0001). Neutrophil counts correlated with TNCC (r2  = 0.99), such that using neutrophil cutoffs did not affect effusion classifications in most cases. Neutrophil percentages and counts were higher in effusions from dogs with uroabdomen and sepsis (P < .01); neutrophil counts were lower in dogs with hepatic insufficiency (P < .0001). Uroabdomen usually caused low-protein, high-neutrophil exudates. CONCLUSIONS: Although effusions with <50% neutrophils are transudates, most transudates and exudates have ≥50% neutrophils, limiting the diagnostic usefulness of % neutrophils for classifying effusions. Absolute neutrophil cutoffs did not notably improve effusion classification but could warrant future studies.

Feasibility study evaluating a veterinary point-of-care urine culture system for diagnosing septic peritonitis.

OBJECTIVE: To evaluate the use of a veterinary point-of-care urine culture system (POCUCS) for the diagnosis of septic peritonitis. DESIGN: Prospective feasibility study performed between August 2017 and April 2018. SETTING: Private referral hospital. ANIMALS: Twenty samples of naturally occurring canine peritoneal effusion collected via aseptic abdominocentesis. PROCEDURES: Point-of-care urine culture systems were inoculated and incubated according to manufacturer's instructions. The presence of bacterial growth, estimation of colony-forming units/mL of bacteria, and organism identification were recorded. Bacterial growth and organism identification on POCUCS were compared to an aerobic culture performed at a commercial microbiology laboratory. Serial dilution and subsequent culture on a POCUCS of a confirmed Escherichia coli infected peritoneal effusion and negative control sample were performed to determine the lowest concentration of bacteria detectable. RESULTS: There were 10 septic and 10 aseptic samples of peritoneal effusion confirmed by aerobic laboratory culture. Of the 10 culture-positive samples, 8 were culture-positive on the POCUCS. The sensitivity and specificity of the POCUCS for the detection of bacteria in peritoneal effusion were 80.0% and 100%, respectively. The POCUCS lowest limit of detectable bacteria in peritoneal effusion was 1000 CFUs/mL. CONCLUSIONS: The POCUCS evaluated in this study was less sensitive and less rapid for diagnosing septic peritonitis than blood glucose to peritoneal effusion glucose ratio and plasma lactate to peritoneal effusion glucose ratio. This POCUCS is not recommended as a tool for diagnosing septic peritonitis.

Fluid Analysis in the Equine Patient: Cerebrospinal, Synovial, and Peritoneal Fluids.

Fluid analysis is an important part of the diagnostic work-up of equine patients presenting with disorders of the nervous system, musculoskeletal system, and abdominal cavity. Proper specimen handling and processing are paramount for complete and accurate interpretation of fluid samples. Normal cerebrospinal fluid is a low-cellularity, low-protein fluid requiring specific sample handling to ensure accurate results. Joint and abdominal fluid analyses are completed in practice or submitted for analysis to a reference laboratory. This article discusses fluid sample handling and processing considerations for the equine practitioner and reviews cytologic evaluation of normal and abnormal cerebrospinal, synovial, and peritoneal fluid samples.

Cytohistological correlation in serous effusions using the newly proposed International System for Reporting Serous Fluid Cytopathology: Experience of an oncological center.

BACKGROUND: Cytological analysis is part of the initial etiological evaluation of serous effusions. The newly proposed International System for Reporting Serous Fluid Cytopathology (ISRSFC) aims to standardize reporting. METHODS: All pleural and peritoneal effusion samples admitted for cytological analysis at our institution between 2012 and 2016, and pericardial effusion samples admitted between 2008 and 2018, were reviewed and reclassified according to the ISRSFC. Risk of malignancy (ROM) and performance parameters were calculated. RESULTS: 1496 pleural effusion samples were reclassified: 12(0.8%) non-diagnostic (ND), 944(63.1%) negative for malignancy (NFM), 9(0.6%) atypia of undetermined significance (AUS), 54(3.6%) suspicious of malignancy (SFM) and 477(31.9%) malignant (M). 64 pericardial effusion samples were reclassified: 23(35.9%) NFM, 1(1.6%) AUS, 4(6.3%) SFM and 36(56.2%) M. 763 peritoneal effusion samples were reclassified: 5(0.7%) ND, 457(59.9%) NFM, 12(1.6%) AUS, 37(4.8%) SFM and 252(33%) M. The ROM was, respectively, for each of the aforementioned categories, 57.1%, 23.9%, 50%, 76.2%, 100% in pleural effusions, 100%, 26.3%, 62.5%, 91.7%, 100% in peritoneal effusions and 0% for NFM, 0% for AUS and 100% for M in pericardial effusions. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were, respectively, 61.6%, 100%, 100%, 73.3%, 81.3% for pleural, 100%, 100%, 100%, 100%, 100% for pericardial and 61.2%, 100%, 100%, 70%, 79.7% for peritoneal effusion samples. CONCLUSION: Serous effusion cytology has a high specificity and positive predictive value and a modest sensitivity and negative predictive value, supporting its role in confirming the diagnosis of malignancy. The ISRSFC will increase standardization and reproducibility in reporting, leading to improved clinical decision-making.