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Journal articles on the topic 'Serous fluids'

Author: Grafiati

Published: 4 June 2021

Last updated: 27 January 2023

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1

Gabali, Ali. "Serous fluids and hematolymphoid disorders." Cytojournal 19 (March 19, 2022): 17. http://dx.doi.org/10.25259/cmas_02_12_2021.

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Diagnosing hematolymphoid neoplasm by evaluating fine-needle aspiration (FNA) cytology sample is controversial and requires experience and clinical skills. This concept becomes more challenging when evaluating hematolymphoid neoplasm in body fluid. Differentiating between low-grade lymphoma and reactive lymphocytes is often difficult by morphology alone as reactive lymphoid cells may acquire activation morphology from being exposed to different cytokines within the body fluid. However, in most cases there are specific features that may aid in differentiating small reactive from non-reactive lymphocytes including the round shape of the nucleus, the absence of visible nucleoli and the presence of fine clumped chromatin. In large cell lymphoma and leukemia cells involvement of body fluid this concept becomes less challenging. Large cell lymphoma and leukemia cells tend to have large size nuclei, less mature chromatin, and visible nucleoli with and without cytoplasmic vacuoles. However, to reach accurate diagnosis and subclassification, the utilizing of flow cytometry, to confirm monoclonality, and other ancillary studies such immunocytochemistry, cytogenetics and molecular studies is needed. This review article will be incorporated finally as one of the chapters in CMAS (CytoJournal Monograph/Atlas Series) #2. It is modified slightly from the chapter by the initial authors in the first edition of Diagnostic Cytopathology of Serous Fluids.

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2

Akash Jain, Mahendra Patil, and Kanetkar S R. "Serous effusions: A clinicopathological study." International Journal of Research in Pharmaceutical Sciences 11, no. 3 (July 8, 2020): 3284–88. http://dx.doi.org/10.26452/ijrps.v11i3.2453.

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This study is a prospective, observational study done for two years, comprising of 267 cases. Their episodes were while tapping pleural cavity, peritoneal cavity and pericardial sac, pleural, ascitic and pericardial fluids were collected. Majority of the samples received were from our hospital (98%) while 2% (5 samples) were obtained from outside. The male cases (55%) outnumbered the females (45%). And, a maximum number of instances in quinquagenarian among males and sexagenarian among females. In peritoneal fluids, females (29/30) outnumbered males. Fifty-nine (22%) samples showed the presence of clot with the majority being in pleural fluid (35/59). Few of the cases of TB showed neutrophilic (10%) or eosinophilic (2.5%) exudate instead of lymphocytic effusion. In contrast, a few cases of liver cirrhosis showed exudative effusion instead of transudative because of bacterial peritonitis. Majority cases were exudates (58.2%) excluding the peritoneal fluids, out of 71 cases of known malignancy. Out of these, 50% of the malignant effusions were nonhemorrhagic. Common microorganisms were gram-negative bacilli and grampositive cocci. There were three unusual cases in this study, viz: Eosinophilic effusion, Parasite (Ascaris) in pleural fluid and an example of a second malignancy. If the effusion is suspected for malignancy, the fluid typing of exudate or transudate may be done. Also, wet mount preparation for abnormal cells may be done before Examination of fixed smears for cancerous cells, as we did not find any transudate fluid positive for malignancy. Diagnostic effusion tapping, followed by immediate processing of fluid in a laboratory may improve cytological outcome. Malignant effusions may not be hemorrhagic in appearance. Rarely effusion may be the first manifestation of malignancy.

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3

Renshaw, Andrew. "Cytopathologic Diagnosis of Serous Fluids." Advances in Anatomic Pathology 15, no. 3 (May 2008): 181. http://dx.doi.org/10.1097/pap.0b013e31817150ad.

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4

Gibson, Kathleen. "Cytopathologic Diagnosis of Serous Fluids." American Journal of Dermatopathology 30, no. 3 (June 2008): 313. http://dx.doi.org/10.1097/dad.0b013e3181705322.

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5

Ren, Shuyue, and William Klump. "Gynecologic Serous Carcinoma: An Immunohistochemical Analysis of Malignant Body Fluid Specimens." Archives of Pathology & Laboratory Medicine 143, no. 6 (April 24, 2018): 677–82. http://dx.doi.org/10.5858/arpa.2017-0260-oa.

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Context.— Evaluation of fluid specimens involved by serous carcinoma might potentially include PAX8, GATA3, Uroplakin II, SOX2, and SALL4 antibodies. Those markers are commonly employed for diagnosing carcinomas of various types, including urothelial malignancies and germ cell tumors. There have been no comprehensive immunohistochemical studies, to our knowledge, for those markers on fluid specimens involved by serous carcinoma. Objective.— To evaluate immunohistochemical markers PAX8, GATA3, SOX2, uroplakin II, and SALL4 in the diagnosis of high-grade serous carcinoma in fluid specimens. Design.— We examined 113 fluids (96 ascites specimens and 17 pleural fluid specimens) that were positive for carcinoma. Most (94 cases; 83.2%) consisted of high-grade serous carcinoma of Müllerian origin. Nineteen cases of non–high-grade serous carcinoma (including one case of low-grade serous carcinoma) of gynecologic origin were also included as anecdotal data. Results.— In 113 fluid specimens with positive results for carcinoma, including nonserous types, 99 (87.6%) had positive results for PAX8, 19 (16.8%) for GATA3; 19 (16.8%) for SOX2, 23 (20.4%) for uroplakin II, and 8 (7.1%) for SALL4. Of 94 fluids (83.2%) involved with high-grade serous carcinoma, 84 (89.4%) had positive results for PAX8, 18 (19.1%) for GATA3, 17 (18.1%) for SOX2, 22 (23.4%) for uroplakin II, and 8 (8.5%) for SALL4. Some of these specimens showed reactivity for more than one immunohistochemical marker. Conclusions.— Most fluids involving high-grade serous carcinoma showed positive results for PAX8, and some cases expressed GATA3, SOX2, uroplakin II, and SALL4. Serous carcinoma in fluids may be positive for immunohistochemical markers not thought of traditionally as associated with gynecologic malignancy, an important consideration in avoiding misdiagnosis.

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Jhala, Nirag, Darshana Jhala, and Vinod B. Shidham. "Serous fluid: Reactive conditions." Cytojournal 19 (March 19, 2022): 14. http://dx.doi.org/10.25259/cmas_02_06_2021.

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This chapter highlights the steps that would help to analyze any fluid. It highlights importance of knowing gross analysis of fluid along with biochemical information. These parameters along with clinical information are very important in arriving at a differential diagnosis. Morphologic appearances in the fluid can often become challenging and occasionally reactive conditions can reveal changes that may mimic malignancies. This chapter provides not only a framework of approach to assessment of fluid cytology but also shows how to distinguish some of the challenging reactive conditions from the diagnosis of carcinoma. The chapter also utilizes two cases to demonstrate approach to reactive conditions. This review article will be incorporated finally as one of the chapters in CMAS (CytoJournal Monograph/Atlas Series) #2. It is modified slightly from the chapter by the initial authors in the first edition of Cytopathologic Diagnosis of Serous Fluids.

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7

Shidham, Vinod B., and Lester J. Layfield. "Approach to Diagnostic Cytopathology of Serous Effusions." Cytojournal 18 (December 6, 2021): 32. http://dx.doi.org/10.25259/cmas_02_03_2021.

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Collection of most serous fluids from various effusions is a relatively simple procedure. Because of this, serous fluids are commonly submitted for pathologic examination including cytopathologic evaluation by various clinical institutions. As a consequence, even a general pathology laboratory which may not have expertise with highly trained cytopathologist would be confronted with serous fluids for cytologic evaluation. However, cytopathologic evaluation of serous fluids is complex as compared to evaluation of fine needle aspiration cytology. This signifies the fact that all pathologists, irrespective of subspeciality cytopathology training and level of subspeciality expertise, should be conversant with the diagnostic challenges and pitfalls of effusion fluid cytology. Although, majority of effusions are due to reactive and non-neoplastic etiologies, cancer is one of the causes of an effusion as a manifestation of advanced cancer. Detecting neoplastic cells in effusion specimens in most of clinical settings is related to the advanced status of the disease, which usually is equivalent to incurable stage. Thus, interpretation of cytopathology as positive for cancer cell is highly critical in planning the trajectory of the clinical management with an obvious negative impact of false positive interpretation. Apart from cancer, effusions may be secondary to hemodynamic pathologies such as heart failure, hypoalbuminemia, cirrhosis etc. in addition to the different inflammatory conditions including parasitic infestations, bacterial, fungal, or viral infections, and other non-neoplastic etiologies including collagen diseases. Due to the cytomorphologic overlap of reactive mesothelial cells with malignant cells, general cytologic criteria for diagnosis of malignancy in single cells cannot be applied in most of the effusion specimens. This challenge is further amplified because of surface tension related phenomenon which ‘round up’ the cells after exfoliation in serous fluids. As a result, the native shapes of cancer cells cannot be a guiding feature. Thus the cytomorphologic features of cancer cells in serous fluids may not be same as seen in routine cytopathology of exfoliative, brushing, and fine-needle aspiration specimens. The cancer cells may continue to proliferate after exfoliation in the nutrient rich effusion fluids and may form proliferation spheres. It is crucial to consider these factors when interpreting effusion cytology. Amongst malignant effusions, adenocarcinomas are the most common cause of metastatic cancers, but almost any type of malignancy including melanomas, hematopoietic neoplasms, sarcomas, and mesotheliomas may involve serous cavities. The interpreter must be aware of the wide range of the cytomorphologic appearances of reactive mesothelial cells in effusion fluids. It is essential to understand these and other nuances related to effusion fluid cytology. Understanding potential pitfalls during various stages from processing to application of ancillary studies would increase the diagnostic accuracy and minimize atypical interpretations and false positivity.

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Saad, Mohammed, and Liron Pantanowitz. "Cytomorphology of Metastatic Melanoma in Serous Fluids." Journal of the American Society of Cytopathology 11, no. 6 (November 2022): S22. http://dx.doi.org/10.1016/j.jasc.2022.07.041.

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9

Riches, Pamela. "Body fluids: Laboratory examination of amniotic, cerebrospinal, serous and synovial fluids." Clinica Chimica Acta 167, no. 1 (July 1987): 119–20. http://dx.doi.org/10.1016/0009-8981(87)90096-9.

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10

Riches, Pamela. "Body fluids: Laboratory examination of amniotic, cerebrospinal, serous and synovial fluids." Clinica Chimica Acta 166, no. 1 (June 1987): 117–18. http://dx.doi.org/10.1016/0009-8981(87)90209-9.

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11

Heagley, Dawn, Jon P. Gates, Caitlin Schein, Larry Kluskens, Vijaya Reddy, and Paolo Gattuso. "Serous Fluids Involved by Hepatocellular Carcinoma: A Review." American Journal of Clinical Pathology 138, suppl 2 (November 1, 2012): A266. http://dx.doi.org/10.1093/ajcp/138.suppl2.59.

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12

Gabriel, Charlotte, Ruth Achten, and Maria Drijkoningen. "Use of Liquid-Based Cytology in Serous Fluids." Acta Cytologica 48, no. 6 (2004): 825–35. http://dx.doi.org/10.1159/000326453.

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13

Siddiqui, Momin T. "Serous cavity fluids: Momentum, molecules, markers… and more!" Cancer Cytopathology 128, no. 6 (March 12, 2020): 381–83. http://dx.doi.org/10.1002/cncy.22255.

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14

Weir, Michele M., and Debra A. Bell. "Cytologic identification of serous neoplasms in peritoneal fluids." Cancer 93, no. 5 (October 15, 2001): 309–18. http://dx.doi.org/10.1002/cncr.9045.

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15

Rabczynski, Jerzy, Julia K. Bar, Anna Noworolska, Mieczyslaw Cislo, Roman Richer, and Antonina Harlozinska. "Morphologic Heterogeneity of Cell Populations Isolated by Density Gradient Centrifugation from Serous Fluids of Ovarian Tumors." Tumori Journal 73, no. 6 (December 1987): 539–45. http://dx.doi.org/10.1177/030089168707300601.

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The cells of tumor fluid from patients with malignant and benign serous ovarian neoplasms were fractionated using Ficoll-Uropoline density gradient centrifugation. Density distribution and morphologic characteristics of cell fractions were analyzed. It was found that serous ovarian adenocarcinomas contained three to four types of morphologically malignant cells focused in low density layers. Borderline ovarian neoplasms showed the presence of one subpopulation of cells with some features of malignancy and cells with some atypical but non-malignant features. The fluids of serous cysts contained mainly normal epithelial cells representing different stages of morphological maturity and were focused in denser layers. The results allowed us to catalogue ovarian tumor cell subpopulations present in each density fraction of individual patients and confirmed that ovarian tumors could be diagnosed by morphologic identification of cells from tumor fluids.

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A., Zahida O., Krishnaraj Upadhyaya, Mohammad Niaz, and Shreesha Khandige. "Approach for reporting serous effusion fluid in pleural, peritoneal and pericardial cavity and immunohistochemistry." International Journal of Research in Medical Sciences 8, no. 4 (March 26, 2020): 1485. http://dx.doi.org/10.18203/2320-6012.ijrms20201347.

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Background: The aim of this study is to make a detailed cytological study of effusion fluids and compare with cell block study of the representative cases and IHC studies were done.Methods: Prospective study of 216 cases effusion fluids from in and around hospitals, Mangalore. This study conducted over a period of 18 months from October-2014 to April-2016. This study scrutinized and approved by Institutional Ethics Committee. The samples were processed by conventional cytology using Papanicolaou-stain and Cell Block (CB) method using 10% Alcohol-formalin fixative and stained with H and E. The cellularity, architectural patterns, morphological details were studied both smears. Ancillary immunohistochemical staining with calretinin and EMA are done.Results: A total of 216 cases of effusion fluids with cell block study were included, age range of 13 years to 93 years. Pleural fluid comprised of 55.09%, peritoneal fluid of 43.51% and pericardial fluid of 1.38%. 71% were clinically diagnosed as non-neoplastic and 29% were neoplastic condition. In CS study, 84.5% cases were benign/reactive effusion and 8.5% were positive for malignancy. In CB study, 84.5% were benign/reactive effusion and 10.2% were positive for malignancy. In comparison authors found an increase in diagnostic efficacy by 18%. IHC EMA for adenocarcinoma cells has sensitivity of 100% and calretinin for reactive mesothelial cells has specificity of 100%.Conclusions: Authors concluded that cell block technique when used as an adjuvant to routine smear examination in effusion fluids has increased the diagnostic yield and better preservation of architectural pattern. IHC is helpful in differentiating between reactive mesothelial and adenocarcinoma cells.

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Milevoj Kopcinovic, Lara, Jelena Culej, Anja Jokic, Marija Bozovic, and Irena Kocijan. "Laboratory testing of extravascular body fluids." Biochemia medica 30, no. 1 (February 15, 2020): 31–59. http://dx.doi.org/10.11613/bm.2020.010502.

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Extravascular body fluids (EBF) analysis can provide useful information in the differential diagnosis of conditions that caused their accumulation. Their unique nature and particular requirements accompanying EBF analysis need to be recognized in order to minimize possible negative implications on patient safety. This recommendation was prepared by the members of the Working group for extravascular body fluid samples (WG EBFS). It is designed to address the total testing process and clinical significance of tests used in EBF analysis. The recommendation begins with a chapter addressing validation of methods used in EBF analysis, and continues with specific recommendations for serous fluids analysis. It is organized in sections referring to the preanalytical, analytical and postanalytical phase with specific recommendations presented in boxes. Its main goal is to assist in the attainment of national harmonization of serous fluid analysis and ultimately improve patient safety and healthcare outcomes. This recommendation is intended to all laboratory professionals performing EBF analysis and healthcare professionals involved in EBF collection and processing. Cytological and microbiological evaluations of EBF are beyond the scope of this document.

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Sukumaran, Renu, Nileena Nayak, Rekha A. Nair, Jayasree Kattoor, Priya Mary Jacob, Geetha Narayanan, and Priyakumari Thankamony. "Hematolymphoid Neoplasms in Serous Effusions: Morphological Spectrum, Distribution, and Role of Ancillary Techniques—A Retrospective Analysis of 75 cases." Indian Journal of Medical and Paediatric Oncology 42, no. 05 (October 2021): 451–56. http://dx.doi.org/10.1055/s-0041-1731844.

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Abstract Introduction Involvement of body fluids can occur at the time of diagnosis or during the disease course of hematolymphoid neoplasms. Cytodiagnosis of malignant effusion is important in effective clinical management. Objectives (1) The aims of the study were to determine the frequency of distribution of various hematolymphoid neoplasms involving body fluids, (2) to study the morphology of hematolymphoid neoplasms in fluids, and (3) to assess the role of ancillary techniques in the diagnosis. Materials and Methods In this retrospective study, all cases of hematolymphoid neoplasms involving body fluids diagnosed from January 2016 to December 2018 were evaluated. Results During the 3-year period, there were 75 cases of hematological malignancies involving body fluids. These included 48 male patients and 27 female patients. Pleural fluid was involved in majority of cases (56 cases; 74.67%), followed by ascitic fluid (17 cases; 22.67%), and pericardial fluid (2 cases; 2.67%). High cellularity, monotonous population of cells, high nuclear-cytoplasmic (N/C) ratio, indentation/irregularity of nuclear membrane, immature chromatin/irregular clumping of chromatin, increased mitosis, and karyorrhexis were the key features which helped to differentiate between reactive and neoplastic processes. There were 35 cases of B-cell neoplasms, 33 cases of T-cell neoplasms, and seven cases of myeloid neoplasms involving body cavity fluids. T-lymphoblastic lymphoma was the most common subtype (29 cases; 38.7%), followed by diffuse large B-cell lymphoma (DLBCL) (12 cases; 16%). In 53 cases, effusion was present in the initial presentation itself. Initial diagnosis was made in effusion cytology in 25 cases (33.33% of the total), with the help of flow cytometry in 20 cases, and immunohistochemistry (IHC) in cell blocks in five cases. Conclusion Diagnosis of hematolymphoid neoplasms in body fluids based on correlation with clinical details, critical evaluation of cytology findings, and comparison with previous diagnosis along with the judicious use of ancillary techniques helps in deciding an early treatment plan.

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Gabali, Ali. "Flow cytometry, molecular analysis, and other special techniques (in Serous Fluid Cytopathology)." Cytojournal 19 (March 19, 2022): 18. http://dx.doi.org/10.25259/cmas_02_13_2021.

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Morphological and architectural pattern evaluations play a major role in the rpretation of hematopoietic neoplasms. However, confirmation of diagnosis, classification, prognosis, and risk stratification are highly dependent on the utilization of multiple ancillary studies. The importance of these ancillary studies increases in evaluating serous fluid samples, as these samples lack architecture and patterns. Likewise, the morphology can be disturbed by sample preparation. The most common ancillary studies utilized are flow cytometry, immunohistochemistry for immunophenotyping, Fluorescent In Situ Hybridization (FISH), cytogenetics for structural and gene rearrangements, and molecular studies for mutational analysis. Among them, flow cytometry analysis is the handiest test to perform with high diagnostic yield on serous fluid specimens. In this article we will discuss the use, caveat, and role of the most common ancillary studies on serous fluid specimen evaluation. This review article will be incorporated finally as one of the chapters in CMAS (CytoJournal Monograph/Atlas Series) #2. It is modified slightly from the chapter by the initial authors (Choladda Vejabhuti, MD and Chung-Che (Jeff) Chang, MD, PhD) in the first edition of Diagnostic Cytopathology of Serous Fluids.

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Chandra, Ashish, Barbara Crothers, Daniel Kurtycz, and Fernando Schmitt. "Announcement: The International System for Reporting Serous Fluid Cytopathology." Acta Cytologica 63, no. 5 (2019): 349–51. http://dx.doi.org/10.1159/000501536.

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Serous fluids are a common but important specimen type in a cytopathology laboratory. There is as yet no agreed standardized terminology to allow uniformity in reporting on these specimens. Given that serous fluids are a rich source of cytopathological as well as molecular information on a range of benign and often advanced malignant conditions, a unified approach to handling and reporting these specimens covering the pre-analytical, analytical and postanalytical stages seems timely. Representatives of the international cytology community have come together once again to develop an algorithmic diagnostic and management approach to the reporting of these samples.

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Saxena, Arti, Vijay Kumar, and JB Shukla. "Four Layer Cylindrical Model of Mucus Transport in the Lung: Effect of Prolonged Cough." Bangladesh Journal of Medical Science 19, no. 1 (November 3, 2019): 53–63. http://dx.doi.org/10.3329/bjms.v19i1.43873.

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Background: In this paper, a four layer model of the simultaneous and coaxial flow of moist air, mucus, mixture of mucin and periciliary liquid and serous fluid (assumed to be incompressible and Newtonian fluids) in a circular tube under time dependent pressure gradient representing prolonged cough is analyzed to study the mucus transport in an airway in the presence of prolonged cough. It is assumed that air and mucus flow under quasi steady state turbulent conditions while the mixture of mucin and periciliary liquid and serous layer surrounding mixture layer flows under unsteady laminar condition in presence of immotile cilia carpet. Result: It is shown that the mucus transport increases as the viscosity of serous fluid decreases. Also the mixture and serous fluid flow rates increase as the viscosity of serous fluid decreases. It is also observed that the effect of resistance to flow by serous fluid in the cilia bed is to decrease flow rates. The flow rates of mucus and mixture of mucin and periciliary fluid increase as the viscosity of mixture decreases also air and mixture of mucus and periciliary fluid flow rates increase as the thickness of mixture increases. Conclusion: As the thickness of mucus increases its flow rate increases on the other hand the mixture flow rate, mucus and serous fluid flow rate decreases with the increase of the mixture thickness. Bangladesh Journal of Medical Science Vol.19(1) 2020 p.53-63

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Satpathi, Dipak Kumar, Kota Venkata Ratnam, and Adepalli Ramu. "Model for mucus transport in the airways due to air motion — Effect of slipperiness." International Journal of Biomathematics 09, no. 05 (June 13, 2016): 1650074. http://dx.doi.org/10.1142/s1793524516500741.

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In this paper, a circular three-layer flow model is proposed to study mucus transport in the airways due to air motion caused by mild forced expiration or mild coughing. Mucus is represented by four-parameter viscoelastic fluid, a combination of Maxwell and Voigt elements, whereas air and serous fluid are taken as Newtonian fluids (incompressible). The pressure gradient generated in the fluid layers is assumed to be given by a time-dependent function representing mild forced expiration or mild cough in the airways causing laminar flow. The effect of slip velocity at the mucus–serous interface caused by the presence of surfactant and at the top surface caused by immotile cilia are also taken into account. The roles of rheological properties of mucus on its transport are studied. The effect of serous fluid and its viscosity on mucus transport is also considered.

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Saleh, Husain A., Paula Bober, and Pamela Tabaczka. "Improved Detection of Adenocarcinoma of Serous Fluids with p53 Immunocytochemistry." Acta Cytologica 42, no. 6 (1998): 1330–35. http://dx.doi.org/10.1159/000332163.

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24

Shidham, Vinod B., and Lester J. Layfield. "Introduction to the second edition of ‘Diagnostic Cytopathology of Serous Fluids’ as CytoJournal Monograph (CMAS) in Open Access." Cytojournal 18 (December 6, 2021): 30. http://dx.doi.org/10.25259/cmas_02_01_2021.

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Serous fluids are excessive accumulation of fluids in a serous cavity as effusion. However, traditionally this area also covers cytopathologic evaluation of washings of these cavities including pelvic/peritoneal washing. This is the introductory review article in series on this topic with the application of simplified algorithmic approaches. The series would be compiled finally as a book after minor modifications of individual review articles to accommodate the book layout on the topic as second edition of ‘Diagnostic Cytopathology of Serous Fluids’ book. The approach is primarily directed towards detection of neoplastic cells based on morphology alone or with the help of various ancillary tests, including commonly applied immunocytochemistry to be interpreted as second foreign population with application of SCIP (subtractive coordinate immunoreactivity pattern) approach in effusion fluid tapings. As the role of molecular pathology tests is increasing, this component as ancillary testing will also be covered as applicable. Because a picture and sketches are worth a thousand words, illustrations and figures are included generously even at the risk of moderate repetition. The clinically important serous cavities include peritoneal cavity, pericardial cavity, and two pleural cavities. The primary topic of this series is specimens from these cavities as effusion fluids and washings including cytopathologic evaluation of peritoneal/pelvic washing. It is expected that some readers may not read the entire series or the final book from beginning to end, but refer to the individual review articles and chapters sporadically during their clinical practice. Considering this practical limitation, some brief repetition may be observed throughout the book. Some of the important themes will be highlighted as italicized and bolded text for quick reference. Dedicated articles/chapters are assigned for technical and other reference material as appendices. Tables, algorithms, sketches, and combination of pictures are included generously for quick reference. Most of the illustrations are attempted to be labeled appropriately with arrows and other indicators to avoid equivocation, especially for beginners in the field. This introductory review article describes general details under the following three broad headings: Histology and general cytology of serous cavity lining Effusion (general considerations) Ancillary techniques in brief.

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Shidham, Vinod B. "Metastatic Carcinoma in Effusions." Cytojournal 19 (January 31, 2022): 4. http://dx.doi.org/10.25259/cmas_02_09_2021.

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Serous cavity may be involved by any neoplasm, including very rare examples of involvement by central nervous system tumors leading to a malignant effusion. The serous cavity lining is rich in lymphatics with lymphatic lacunae opening directly through narrow gaps (stoma) in the lining. Carcinomas mainly metastasize to serosa via the lymphatic vessels, which may be blocked leading to effusion. Primary carcinomas of organs such as lung, intestines, liver, ovary, etc., lined by serosal membranes may spread by direct extension, resulting in malignant effusions. As standard of practice, unless specified, cytopathologic examination of serous effusions implies detection of malignant cells. As compared to a surgical biopsy from a small focal area of an extensive serosal surface, effusion fluid from respective cavity exfoliates the cells from the entire serosal surface with minimal chance of sampling artifact. Because of this, effusion fluid cytology generally provides a higher diagnostic yield as compared to biopsy of the serous lining, as demonstrated by some studies. However, various challenges related to effusion fluid cytology makes the interpretation of effusion fluid cytology a field with potential misinterpretations, especially for those without proper experience or training. Developing and following a methodical approach is important for appropriate cytologic examination of effusion fluids. Proper approach may achieve definitive interpretation even without ancillary tests. However, lack of appropriate approach and processing may introduce a significant variation in interpretation due to combination of well-recognized diagnostic pitfalls, which may lead to lower reproducibility and even serious misinterpretations. Current review discusses in brief appropriate approach to processing and evaluating effusion fluid cytology for metastatic carcinoma. At general level, this is comparable to that of other specimens; however, it is critical to modify with reference to the limitations associated with effusion cytology.

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Kashimura, Masamichi, Keita Matsukuma, Toshiharu Kamura, Toshitaka Matsuyama, and Naoki Tsukamoto. "Cytologic findings in peritoneal fluids from patients with ovarian serous adenocarcinoma." Diagnostic Cytopathology 2, no. 1 (January 1986): 13–16. http://dx.doi.org/10.1002/dc.2840020104.

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Laurini, Javier A., Alejandro Garcia, Boris Elsner, Marta Bellotti, and Carla Rescia. "Relation between natural killer cells and neoplastic cells in serous fluids." Diagnostic Cytopathology 22, no. 6 (June 2000): 347–50. http://dx.doi.org/10.1002/(sici)1097-0339(200006)22:6<347::aid-dc4>3.0.co;2-t.

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Tyan, Yu-Chang, and Pao-Chi Liao. "Proteomics analysis of serous fluids and effusions: Pleural, pericardial, and peritoneal." PROTEOMICS – CLINICAL APPLICATIONS 1, no. 8 (August 2007): 834–44. http://dx.doi.org/10.1002/prca.200700036.

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Smetanina, S. V., E. Y. U. Uskova, A. A. Khusiyanova, M. B. Danyaeva, S. B. Korol’kova, E. N. Slavnova, and N. N. Voronova. "Cellular composition research of serous pleural effusion fluids. Conceptual issues of preanalytics." Russian Clinical Laboratory Diagnostics 66, no. 2 (March 13, 2021): 95–98. http://dx.doi.org/10.51620/0869-2084-2021-66-2-95-98.

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The purpose of this work was to show the effectiveness of the cytological method on a small number of observations, excluding all possible errors of the preanalytical stage. The paper presents several simple and easily reproducible algorithms for the cytological study of serous pleural effusions with small cellular content. On the example of 20 observations of the study of the cellular composition of serous exudates, a direct dependence of the research results on the preanalytical stage is shown. A complete study of effusion fluids in compliance with all stages of preanalytics and the use of modern methods of cytological diagnostics makes it possible to nullify the options for false-negative.

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Chandan, Dr Rajesh h., Dr Sumana Pawar, and Dr Purushotham Redd. "Analysis of diagnostic value of cytological smear method versus cell block method in body fluids with clinical and biochemical correlation: study of 150 cases." Tropical Journal of Pathology and Microbiology 7, no. 1 (February 20, 2021): 9–16. http://dx.doi.org/10.17511/jopm.2021.i01.02.

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Background: Aspiration of serous cavities is a simple and relatively non-invasive technique toachieve diagnosis. Cytological evaluation of body cavity fluid is diagnostically challenging. Especiallyin malignant effusions, helps in staging, prognosis and management of the patients. Aims: Toassess the utility and sensitivity of cell block method over conventional smear technique incytodiagnosis of the serous effusions. And to assess the utility and sensitivity of cytologicalevaluation of body fluids with biochemical and clinical correlation. Methods: A total of 150 fluidspecimens were examined for conventional cytological smear (CS) and cell block method (CB). Outof 150 fluids, 96 were pleural fluid, 48 were ascitic fluid, 04 fluid from pouch of Douglas and 01 wasfrom synovial fluid. Results: In this study, the utility of the CB method in the cytodiagnosis ofmalignant effusions was found to be highly significant as compared to the CS method. The additionalyield of malignancy was 12% more as was obtained by the CB method. Conclusion: For the finalcytodiagnosis of body fluid, there is statistically significant difference between the two techniques. Inother words, CB is superior to CS method. It gives more information about the architecturalarrangement and the likely source of primary. More important is that diagnostic material in cellblocks is available for special studies for Immunohistochemistry which can further supplement ourknowledge about the primary source of metastasis.

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Rajeswaran, Priyadarshini Kumaraswamy, Vidhyalakshmi Srinivasan, Swaathi Shri Venkatasubramanian Mahesh, and Arsha Usha Ashok. "A Retrospective Analysis of the Application of the Newly Proposed International System for Reporting Serous Fluid Cytopathology on Serous Effusion Specimens: An Institutional Experience." Acta Cytologica 67, no. 1 (December 7, 2022): 70–79. http://dx.doi.org/10.1159/000527398.

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<b><i>Introduction:</i></b> The International Academy of Cytology and the American Society of Cytopathology recently proposed the International System for Reporting Serous Fluid Cytology (ISRSFC) to standardize serous fluid cytopathology reporting and guide further clinical management. The current study aimed to assess the feasibility of utilizing ISRSFC reporting categories for serous fluids, estimate the risk of malignancy (ROM) of each category, and scrutinize if the management protocols followed in our institution are as per the ISRFSFC recommendations. <b><i>Methods:</i></b> All pleural, peritoneal, and pericardial effusions submitted for evaluation at our institute between January 2021 and December 2021 were retrieved. All these cases were reviewed and re-categorized into one of the five categories proposed by the ISRSFC: non-diagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspicious for malignancy (SFM), and malignant (MAL), and ROM was calculated for each category. <b><i>Results:</i></b> The present study examined 596 serous effusions, of which 229 were pleural effusions, 358 were peritoneal effusions, and the remaining nine were pericardial effusions. Among 596 cases, 395 cases had a radiological or histological follow-up. The serous effusion samples were re-categorized as 61 (10.2%) ND, 449 (75.3%) NFM, 47 (7.8%) AUS, 17 (2.9%) SFM, and 22 (3.8%) MAL, and ROM for each above category were 10%, 4.4%, 19%, 83.3%, and 100%, respectively. <b><i>Conclusion:</i></b> Categorizing serous effusion cytology samples per the ISRSFC diagnostic categories reduces reporting variability. The ISRSFC provides a standardized format to predict the ROM and thus improves the quality of clinical care.

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Pantanowitz, Liron, and Mamatha Chivukula. "Serous fluid: Metastatic sarcomas, melanoma, and other non-epithelial neoplasms." Cytojournal 19 (March 19, 2022): 15. http://dx.doi.org/10.25259/cmas_02_10_2021.

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While most tumors metastatic to the serous membranes are of epithelial origin, cytologists should be aware that non-epithelial neoplasms can also cause malignant effusions including sarcomas, melanomas, germ cell tumors, and, more rarely, brain tumors. The differential diagnosis of a malignant effusion is accordingly broad, especially for the small round blue cell tumors that includes not only mesenchymal tumors, but also non-mesenchymal tumors, such as neuroblastoma and Wilms tumor. Diagnosing non-epithelial malignancies in effusion specimens based entirely upon their cytomorphologic features is difficult because these neoplasms often exhibit considerable morphological overlap and their cytomorphology can differ from the original tumor. As malignant cells have a tendency to round up in body fluids these non-epithelial neoplasms can therefore mimic reactive mesothelial cells and metastatic adenocarcinoma. The use of ancillary studies including immunostaining, FISH, and molecular studies is thus often critical to reach a definitive diagnosis. This review article will be incorporated finally as one of the chapters in CMAS (CytoJournal Monograph/Atlas Series) #2. It is modified slightly from the chapter by the initial authors in the first edition of Diagnostic Cytopathology of Serous Fluids.

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Riittinen, Leena. "Serous Ovarian Cyst Fluids Contain High Levels of Endometrial Placental Protein 14." Tumor Biology 13, no. 3 (1992): 175–79. http://dx.doi.org/10.1159/000217762.

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Afify, Alaa M., Basim M. Al-Khafaji, Augusto F. G. Paulino, and Rosa M. Davila. "Diagnostic Use of Muscle Markers in the Cytologic Evaluation of Serous Fluids." Applied Immunohistochemistry & Molecular Morphology 10, no. 2 (June 2002): 178–82. http://dx.doi.org/10.1097/00129039-200206000-00014.

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Ramos, R., N. Del Amo, I. PeÑa, M. J. Ruiz, M. F. Calafell, M. B. Alvarez, F. Cava, and R. Guillen. "Evaluation of BD Vacutainer® urinalysis tubes for serous fluids cell counts." Clinica Chimica Acta 493 (June 2019): S673. http://dx.doi.org/10.1016/j.cca.2019.03.1494.

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Zaharopoulos, Paul, Julie W. Wen, and Jick Wong. "Membranous Lamellar Cytoplasmic Inclusions in Histiocytes and Mesothelial Cells of Serous Fluids." Acta Cytologica 42, no. 3 (1998): 607–13. http://dx.doi.org/10.1159/000331815.

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Rosendale, Brian E., and David Dusenbery. "Cytology of hepatocellular carcinoma in serous fluids: A report of three cases." Diagnostic Cytopathology 15, no. 2 (August 1996): 127–31. http://dx.doi.org/10.1002/(sici)1097-0339(199608)15:2<127::aid-dc9>3.0.co;2-f.

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Darraj, Eyad, Mouhannad Fakoury, and Yusur Abdulghafoor. "Sensitivity and specificity of tympanometry in diagnosis of serous otisis media (SOM)." Journal of Otolaryngology-ENT Research 12, no. 2 (2020): 60–63. http://dx.doi.org/10.15406/joentr.2020.12.00457.

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Background: Serous Otitis media (SOM) is one of the most commonly encountered pathologies in children population. Fluids collection often leads to hearing loss with subsequent speech and language delay. So early diagnosis and management are of paramount importance to prevent these sequela. Effective management is often surgical: myringotomy and fluid aspiration. Myringotomy is not only therapeutic procedure, it is also the gold standard diagnostic method. It has been noticed that many ENT Surgeons in Gulf region depend on Tympanometry only for SOM diagnosis and ignore a complete clinical approach (history, physical examination including pneumatic endoscopy), this has ended up to a considerable unnecessary surgeries with high false positive diagnosis. The aim of this study is to evaluate the sensitivity and specificity of Tympanometry in diagnosis of SOM in a local study, and to draw the attention of ENT Surgeons in this part of the world not to rush to book patients for myringotomy based on Tympanometry results only. Methods: This cross-sectional study involved patients aged ≤12 yo, whom underwent myringotomy for SOM management during the period: from June 2018 to March 2019 at the ENT - department Dubai Hospital. The evaluation included the presenting complaint, physical examination, preoperative tympanometry result and intraoperative findings. Typ B tympanometry was considered (positive) for the diagnosis of SOM, while other graph types were deemed (negative). Gold standard SOM diagnosis was the intraoperative existence of fluid (positive), and subsequently absence of fluids was (negative) Intraoperative findings were matched with the preoperative tympanometry results, proper statistical schedules were performed and tympanometry sensitivity and specificity were calculated. Results: The study included 139 patients: 90 patients are male (64.7%) and 49 are female (35.3%) with mean age of 5.2 year (SD=2.1). The most common complaint was hearing loss in 77 patient (55.4%). Type B tympanometry found in 113 patients (82.5%) and fluid was found in 111 patients (79.9%). The sensitivity and specificity of Type B tympanometry: 88.2% and 80.7% respectively. Statistical tests found significant findings with P value < 0.05. Conclusions: SOM is common in age group 3-7years. History of hearing loss along with dull tympanic membrane and type B tympanometry strongly suggest SOM. However, in our study we found out that Type B graph highly suggests SOM, while the absence of this graph not necessarily rule out fluid collections. So Physicians should be aware while interpreting tympanometry graphs and evaluate these results in the context of patients’ history and examination. In order to enhance SOM diagnosis, we suggest combining Pneumatic otoscopy findings with Tympanometry graphs. This could be a future research topic: the addition value of Pneumatic otoscopy to Tympanometry graphs in the diagnosis of SOM.

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Kimura, Takeshi, Takashi Araki, Yuki Komuku, Hisashi Iwami, and Fumi Gomi. "Central Serous Chorioretinopathy and Blood Serotonin Concentrations." Journal of Clinical Medicine 10, no. 4 (February 3, 2021): 558. http://dx.doi.org/10.3390/jcm10040558.

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Background: To investigate blood serotonin (5-hydroxytryptamine (5-HT)) concentrations and their relationships with selected characteristics in patients with central serous chorioretinopathy (CSC). Methods: This was a prospective study including 93 patients with active CSC. Blood concentrations of 5-HT, adrenocorticotropic hormone, and cortisol were measured in patients with CSC. Selected patient characteristics, including disease history (acute or chronic), medication use, smoking history, mood status, best-corrected visual acuity (BCVA), subfoveal choroidal thickness (SCT), findings on fluorescein and indocyanine green angiography, and anatomical changes were evaluated during follow-up. Results: Eleven of the 93 patients had low 5-HT concentrations (<57 ng/mL) (12%, eight men and three women; mean age 55 years); we identified no significant relationship with acute/chronic disease status. The patients with low 5-HT were significantly more likely to have five or more fluorescein leakage sites (p = 0.0275), recurrence of subretinal fluids (p < 0.0001), and failure to achieve significant improvement in BCVA during follow-up (p = 0.862) than patients with 5-HT within the normal range. Conclusions: Blood serotonin concentrations may influence the pathophysiology and prognosis of CSC.

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Jhala, Nirag, Aileen Arriola, and Liron Pantanowitz. "Serous cavity metastasis: Evaluation of unknown primary." Cytojournal 19 (March 19, 2022): 16. http://dx.doi.org/10.25259/cmas_02_11_2021.

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Malignant effusions can occur in patients with neoplasia. Once a metastatic diagnosis is confirmed, the primary site of origin of malignancy needs to be ascertained. This task can be challenging without a prior history of malignancy. In some patients their effusion may be the initial presentation of an underlying malignancy. Metastases usually present with a dual population of mesothelial and malignant cells. Combining cytomorphologic examination with ancillary testing such as immunocytochemistry can help identify the origin of the foreign malignant cell population. Helpful architectural clues include a single cell pattern, solid cell ball pattern, single file arrangement, papillary formation, psammoma bodies and background mucin. Useful cellular features include the presence of signet ring cells, small cells, pleomorphic and multinucleated giant cells, squamous cells, spindle cells and pigmentation. Rarely, despite an extensive work-up the primary site of origin for a malignant effusion may remain unresolved. This review article will be incorporated finally as one of the chapters in CMAS (CytoJournal Monograph/Atlas Series) #2. It is modified slightly from the chapter by the initial authors in the first edition of Cytopathologic Diagnosis of Serous Fluids.

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Milevoj Kopcinovic, Lara, Marija Brcic, Jelena Culej, Marijana Miler, Nora Nikolac Gabaj, Marija Bozovic, Adriana Unic, and Alen Vrtaric. "Long-term stability of clinically relevant chemistry analytes in pleural and peritoneal fluid." Biochemia medica 30, no. 2 (June 14, 2020): 234–41. http://dx.doi.org/10.11613/bm.2020.020701.

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Introduction: Our aim was to investigate the stability of clinically relevant analytes in pleural and peritoneal fluids stored in variable time periods and variable storage temperatures prior to analysis. Materials and methods: Baseline total proteins (TP), albumin (ALB), lactate dehydrogenase (LD), cholesterol (CHOL), triglycerides (TRIG), creatinine (CREA), urea, glucose and amylase (AMY) were measured using standard methods in residual samples from 29 pleural and 12 peritoneal fluids referred to our laboratory. Aliquots were stored for 6 hours at room temperature (RT); 3, 7, 14 and 30 days at - 20°C. At the end of each storage period, all analytes were re-measured. Deviations were calculated and compared to stability limits (SL). Results: Pleural fluid TP and CHOL did not differ in the observed storage periods (P = 0.265 and P = 0.170, respectively). Statistically significant differences were found for ALB, LD, TRIG, CREA, urea, glucose and AMY. Peritoneal fluid TP, ALB, TRIG, urea and AMY were not statistically different after storage, contrary to LD, CHOL, CREA and glucose. Deviations for TP, ALB, CHOL, TRIG, CREA, urea and AMY in all storage periods tested for both serous fluids were within the SL. Deviations exceeding SL were observed for LD and glucose when stored for 3 and 7 days at - 20°C, respectively. Conclusions: TP, ALB, CHOL, TRIG, CREA, urea and AMY are stable in serous samples stored up to 6 hours at RT and/or 30 days at - 20°C. Glucose is stable up to 6 hours at RT and 3 days at - 20°C. The stability of LD in is limited to 6 hours at RT.

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Jain, Pragya Virendrakumar, and Laila Nomani. "Metastatic Neuroendocrine Tumors in Serous Fluids: A 10-year Retrospective Single Institute Analysis." Journal of the American Society of Cytopathology 10, no. 5 (September 2021): S17. http://dx.doi.org/10.1016/j.jasc.2021.07.017.

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Hafez, Nesreen H., and HebatAllah M. Shaaban. "SurePath liquid-based cytology versus conventional smears for interpretation of serous effusion fluids." Egyptian Journal of Pathology 38, no. 1 (July 2018): 154–61. http://dx.doi.org/10.1097/01.xej.0000542239.29506.40.

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Afify, Alaa, Heidi Zhou, Lydia Howell, and Augusto F. G. Paulino. "Diagnostic Utility of GLUT-1 Expression in the Cytologic Evaluation of Serous Fluids." Acta Cytologica 49, no. 6 (2005): 621–26. http://dx.doi.org/10.1159/000326249.

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Katz, Ruth L. "Second edition of Cytopathologic Diagnosis of Serous Fluids (CMAS #2): Shidham and Layfield." Cytojournal 19 (December 22, 2022): 60. http://dx.doi.org/10.25259/cmas_02_00_2022.

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Goubard, A., M. Marzouk, F. Canoui-Poitrine, S. Launay, A. Le Thuaut, and P. Legrand. "Performance of the Iris iQ®200 Elite analyser in the cell counting of serous effusion fluids and cerebrospinal drainage fluids." Journal of Clinical Pathology 64, no. 12 (August 11, 2011): 1123–27. http://dx.doi.org/10.1136/jcp.2010.084285.

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AimsEvaluation of the Iris iQ®200 Elite analyser, initially designed for urinary cell counting, for the analysis of biological fluids (serous effusion fluids and cerebrospinal drainage fluids) and comparison of its performance with that of the manual microscopic method.MethodsRoutine samples (ascite fluids, pleural fluids and cerebrospinal fluids) were evaluated in terms of red blood cells and nucleated elements using the iQ®200 analyser and the manual method. The authors compared the reliability, repeatability and speed of the two techniques. In addition, the authors assessed the contribution of two different sample dilution processes to the improvement of iQ®200 analyser cytological results.ResultsVery good agreements were found between the two methods and between the two sample dilution processes. Regarding the repeatability, the coefficients of variation obtained with the iQ200 were slightly higher than those obtained by the manual method. Besides, the difference in the speed of the two methods was not significantly different for series with <10 samples.ConclusionsThe Iris iQ®200 Elite analyser has allowed us to obtain reliable results, equivalent to that of the manual method, for cell enumeration in biological fluids. Although the speed of this instrument needs to be improved for larger series of samples, it enables standardised and objective cytological results to be obtained and represents an alternative to the usual manual microscopic method. Moreover, automation of such analyses permits saving of technician time.

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Spicer, S. S., M. A. Spivey, M. Ito, and B. A. Schulte. "Some ascites monoclonal antibody preparations contain contaminants that bind to selected Golgi zones or mast cells." Journal of Histochemistry & Cytochemistry 42, no. 2 (February 1994): 213–21. http://dx.doi.org/10.1177/42.2.7507139.

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A small proportion of mouse ascites fluid induced by hybridomas producing monoclonal antibodies or myelomas secreting immunoglobulin yielded staining that was confined to the Golgi zone of certain epithelial cell types in rats and gerbils but not in mice. In addition, a commercial IgG fraction from mouse plasma similarly labeled the Golgi area, unlike IgG from mouse serum from another source. Culture supernatant from one hybridoma line contrasted with ascites fluid produced by the same hybridoma in failing to stain the Golgi region. The capacity of a fluid to react with the Golgi cisternae bore no relationship to the class of immunoglobulin secreted by the hybridoma or myeloma. Absorption of an ascites fluid with blood group A1 human erythrocytes eliminated its affinity for Golgi cisternae. Adsorption with blood group A2 or B or two type O cells used for screening for blood group antibodies had no effect on Golgi zone labeling by this ascites fluid. The positive cells included most serous secretory cells in rats, serous cells of sublingual and tracheal glands, and some endometrial and oviduct-lining cells in gerbils, and columnar lining cells of small intestine and cecum and all or part of the lining cells in some prostate lobes in both genera. Some of the tested ascites fluids stained mast cells. The agent accounting for mast cell labeling differed, however, from that reacting with Golgi cisternae in its distribution among the mouse ascites fluids examined, lack of relationship to the ABO blood group system, occurrence additionally in normal rat serum, and capacity to stain cells in mice as well as rats and gerbils.

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Shidham, Vinod B., Shikha Bose, Zubair Baloch, and Lester J. Layfield. "Second CMAS (CytoJournal Monograph/Atlas Series) titled “Cytopathologic Diagnosis of Serous Fluids” (second edition)." Cytojournal 19 (March 21, 2022): 19. http://dx.doi.org/10.25259/cmas_02_00_2021.

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Yan, Mingfei, Claire Michael, and Aparna Harbhajanka. "Cytologic Presentation and Clinicopathologic Correlation of Malignant Mixed Mullerian Tumor Diagnosed in Serous Fluids." Journal of the American Society of Cytopathology 9, no. 6 (November 2020): S10. http://dx.doi.org/10.1016/j.jasc.2020.07.021.

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Afify, Alaa M., and Basim M. Al-Khafaji. "Diagnostic Utility of Thyroid Transcription Factor–1 Expression in Adenocarcinomas Presenting in Serous Fluids." Acta Cytologica 46, no. 4 (2002): 675–78. http://dx.doi.org/10.1159/000326974.

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