Cyto-Diagnosis of Ascitic Fluid in Ovarian Tumor: A Combined Approach in Routinely Stained Cytology Smears and Modified Cell Block Technique with Histopathological Correlation

Abstract

Background:The importance of cytological examination of ascitic fluid is widely recognized and well documented. It helps for staging and prognosis of the disease in malignancy and also gives information about inflammatory lesions. Problem in diagnosis arise in every day practice for the differentiation of reactive mesothelial cells and malignant cells by conventional smears (CS)  method. Cell block (CB) method provides better architectural patterns, morphological features and helps to differentiate reactive mesothelial cells and malignant cells and thereby increases the efficacy of cytodiagnosis.

Objectives - To compare the accuracy of either conventional smear or cell block technique of ascitic fluid or combination of each in relation to histologic type for the diagnosis of ovarian tumors.

Methods –  Asciticfluid  will be subjected for cytological evaluation by CS and CB techniques. Gross examination of ascitic fluid will be done for cell count and cell type.

Conventional Smear Technique: About half of ascitic fluid sample received will be centrifuged at 2500 rpm for 15 minutes and a minimum of 2 smears were prepared from the sediment and stained with routine hematoxylin and eosin stain, Leishman stain and Papanicolaou stain.

Cellblock technique: Remaining fluid will be immediately fixed in 10% alcohol-formalin in 1:1 proportion for 1 hour and centrifuged at 2500 rpm for 15 minutes. 3 ml of 10% alcohol-formalin will be added and kept for 24 hours. Cell button will be processed to prepare H and E stained sections. Special stains will be done wherever required.

Results -The observations will be made pertaining to the objectives and will be tabulated. These observations will be subjected to statistical tests for its significance and conclusions.

Conclusion - Conclusion will be drawn from the results obtained from the study.