Academic literature on the topic 'Cytology; AgNOR count and Effusions'

We compared the performance of clinicopathologic and molecular tests used in the antemortem diagnosis of feline infectious peritonitis (FIP). From 16 FIP and 14 non-FIP cats, we evaluated retrospectively the sensitivity, specificity, and likelihood ratios (LRs) of serum protein electrophoresis, α1-acid glycoprotein (AGP) on peripheral blood, screening reverse-transcription nested PCR (RT-nPCR) on the 3’–untranslated region (3’-UTR), and spike (S) gene sequencing on peripheral blood, body cavity effusions, and tissue, as well as body cavity cytology and delta total nucleated cell count (ΔTNC). Any of these tests on blood, and especially the molecular tests, may support or confirm a clinical diagnosis of FIP. A negative result does not exclude the disease except for AGP. Cytology, 3’-UTR PCR, and ΔTNC may confirm a clinical diagnosis on effusions; cytology or 3’-UTR PCR may exclude FIP. Conversely, S gene sequencing is not recommended based on the LRs. On tissues, S gene sequencing is preferable when histology is highly consistent with FIP, and 3’-UTR PCR when FIP is unlikely. Combining one test with high LR+ with one with low LR− (e.g., molecular tests and AGP on blood, ΔTNC and cytology in effusions) may improve the diagnostic power of the most used laboratory tests.

Background: Exudative pleural effusions are a common diagnostic problem in clinical practice, as the list of causes is quite exhaustive, although sometimes they can be inferred from the clinical picture. In the West the most common cause is Para pneumonic effusions followed by malignancy, while in India it is tubercular effusion followed by malignant effusion. Despite the availability of various tests, there is a need for defining the best diagnostic and cost-effective approach to quickly diagnose and treat exudative pleural effusions. The objectives are to conduct a clinical and etiological study of exudative pleural effusion, to evaluate biochemical profile, cytological profile and radiological profiles of exudative pleural effusion.Methods: Prospective study of 100 patients with exudative pleural effusions. The demographic data was expressed as mean±standard deviation. Comparison between groups was done by Chi-Square test and Fischer exact test for categorical variables and Kruskar-Wallis and Mann-Whitney tests for continuous variables.Results: There were 67 males and 33 females. The mean age was 41.6±15.74. The majority were tubercular in origin (67%),13%,8%,3%and 6% were malignant effusions, Synpneumonic effusion, pancreatic effusions and empyema respectively. Diagnosis was not established in 3% of effusions. Massive effusions were seen in 53.8% of malignant effusions and 33.3% of empyemas. Most effusions had a total cell count between 1000 to 5000 cells /mm3.Lymphocyte predominant effusions were seen in 84.6% and 89.6% of malignant and tubercular effusions. 61.5% of malignant effusions had a positive cytology. Tubercular effusion had a pleural fluid ADA more than 40 IU/L. 92.3% of malignant effusion had pleural fluid ADA less than 30IU.Conclusions: Pleural effusion is a commonly encountered in medical practice and in our country, the commonest cause is tuberculosis, as is evidenced from the present study. The initial step in evaluating case of pleural effusion is to establish the cause of pleural effusion which is done by a detailed history, clinical examination and investigations like a chest radiology and pleural fluid analysis. Even in the advanced diagnostic approaches, still detailed clinical history and examination of the patient of the patient is important to make a clinical diagnosis. All suspected cases of pleural effusion should undergo Sonography of the thorax along with routine chest x-ray. Fluid cytology should be done to confirm tuberculosis or to rule out malignancy, which guides the physician for further evaluation of the patient if required.

The cell count differential of pleural fluid sample is of great importance for estimation of the nature of pleural effusion. In the present article, we compared the efficiencies of routine cytology method with light microscopy, cytological examination with centrifuge Cytospin-4 and immunocytochemical methods. We have studied cytological samples from 1597 patients, with pleural effusion. Effusions associated with malignancies were reported in 22.7 % of patients including carcinomatosis (74.6 %), primary tumors of pleura (21.5 %), effusions associated with non epithelial malignancies (3.9 %). Benign pleural effusions were reactive (63.6 %), tuberculotic (13.5 %), "cholesterol pleurisy" and chylothorax (0.2 %). Carcinomatous pleuritis was found in patients with lung carcinoma (55.4 %), breast cancer (21.8 %) and ovary cancer (12.2 %). Specific malignant features (direct and indirect) were noted in pleural fluid on breast cancer, carcinomas of ovary, stomach, kidney, small cell lung carcinoma and squamous cell lung carcinoma. These features are hardly detected in patients with malignancies of intestines, prostate and endometria because these types of tumours are rarely metastatic to pleura. We were failed to define particular features of lung adenocarcinoma. The centrifuge Cytospin-4 was used in the most difficult cases (13.5 %) providing minimal number of presumable diagnosis. Primary tumours of pleura are the most difficult for detection. Immunocytochemical analysis found monoclonal mesothelial cell of НВЕМ 1 clone, cytokeratin, vimentin to be positive and carcinoembry onic antigen, Ber-EP4, CD-15 to be negative in the studied tumors.