Ascites refers to collection of excess fluid in the peritoneal cavity. Ascitic fluid was obtained from 75 patients of either sex. How valuable is ascitic cytology in the detection and. Audit how valuable is ascitic cytology in the detection. How valuable is ascitic cytology in the detection and management of. Third, ascitic fluid cytology may not be contributory, a frozen section may reveal the presence of malignant stromal tumour which needs further categorization and hence the importance of. A report of a case with cytologic and histologic findings. Audit how valuable is ascitic cytology in the detection and management of malignancy. Slide preparations for the cytology of pleural fluid or. Utility of ascitic fluid adenosine deaminase levels in the. The 5year survival rate was similar between the groups 62% positive cytology, 68% adnexal or serosal disease, but in a multivariable analysis, cytology was an independent predictor of recurrence and poorer survival. The value of a cell count and bacterial culture of the ascitic fluid is not disputed, but the role of biochemical testing is less clear.
Analysis of ascetic fluid for cytological and biochemical findingsx. A specific diagnosis of highgrade serous ovarian carcinoma is required prior to institution of neoadjuvant chemotherapy. Morphologic and immunocytochemical features of highgrade. Microscopic examined was carried out by surepath liquid based cytology, conventional fixed sediment smears, and cell blocks. Ascitic fluid analysis ascites is a condition that is characterized by the accumulation of fluid in the abdominal region. The correlation between cytological examination of ascitic. One technique is similar to that used to make a blood smear. Peritoneal cytology of ascitic fluid is highly specific but has relatively low sensitivity, particularly in the case of endometrioid ovarian carcinoma. Analysis of diagnostic value of cytological smear method. Ascitic fluid cytology in a previously healthy woman. Ascites in ovarian carcinoma reliability and limitations of. Ascitic fluid analysis the appearance of ascitic fluid can provide useful clues. Ascitic fluid cytology has a low negative predictive value. Ascites is abnormal excessive accumulation of fluid in peritoneal cavity it is the most common of the 3 major complications of cirrhosis ascites, hepatic encephalopathy and bleeding.
Patients with positive cytology alone n 37 were compared with patients with adnexal or serosal involvement n 20. The value of glycoprotein determination and cytology in the study of ascitic fluid. From january 1999 to may 2001, all ascitic fluid samples sent for cytology were identified. Normally only thin layer of fluid, effusion is pathologic. Centrifugation a sedimentation fill the samples into the centrifugation tubes and centrifuge them for 10 minutes at 490 x g. Ascitic fluid cytology is expensive and is only revealing in the setting of peritoneal carcinomatosis, typically in patients with a history of breast, colon, gastric or pancreatic carcinoma. Review the diagnostic workup in patients with ascites. In 1882 quincke was credited for detailed descriptions of ovarian and lung cancer cells in serous effusions. At least 50 ml of fresh warm ascitic fluid needs to be immediately processed for optimal yield, with a. Unfortunately, the cause of ascites formation in the remaining 30 to 50% of patients who have cancer and ascites is. Gk, askos, bag a watery fluid containing albumin, glucose, and electrolytes that accumulates in the peritoneal cavity in association with certain diseases, such as liver. Fluid was obtained by aspiration of ascitic fluid 74 patients or by peritoneal washings at the time of laparotomy 20 patients. Each subgroup had a distinctive ascitic fluid analysis. Ascites is the accumulation of ascitic fluid in the peritoneal cavity.
Tuberculous peritonitis is difficult to diagnose due to its varying clinical features, in addition to the low yield on bacterial culture or polymerase chain reaction using ascitic fluid samples. R o s karoo,tdrlloyd, g garcea, h d redway,gsrrobertson postgrad med j 2003. Pdf ascites is a common clinical finding with a wide range of causes. West indian medical journal university of the west indies.
All the 150 fluid specimens were subjected to the cs and the cb techniques. Although the underlying cause of the ascites is often thought to be clinically obvious, it is important to establish a definitive diagnosis. There have been very few case reports of primary and metastatic flhcc diagnosed by fna cytology in the previous literature. Ascitic fluid definition of ascitic fluid by medical. Peritoneal fluid cytology in patients with ovarian cancer. Metastatic fibrolamellar hepatocellular carcinoma in ascitic fluid.
Usefulness of ascites cytology for the evaluation of. The objectives of this study were to examine the validity of ascitic fluid cytology in the detection of pathological findings, to examine the percentage of false positive and false negative. Cytlogical examinations of serous effusions have been well accepted and a positive diagnosis often considered as. Pleural fluid cytology was submitted for cytological evaluation. Diagnostic ascitic aspiration also known as an ascitic tap is a frequently performed procedure, used to obtain a sample of fluid from the peritoneal cavity. Ascitic cytology is often requested in the early stages of ascitic assessment. Chylous ascites appears milky and suggests impaired lymphatic drainage. Since that time reports on effusion cytology have started to appear in the. A tumor originating from the right adnexa in the pelvis, and involving the rectum, was found in surgery. An ascitic fluid analysis is a test that is conducted on the peritoneal fluid during a case of ascites. Abdominal paracentesis is a bedside procedure where the ascitic fluid is collected by insertion of needle into the peritoneal cavity.
A simplified description of ascitic fluid analysis. The findings were correlated with the type, grade, and stage of the tumor. The peritoneum is a tough semipermeable membrane lining abdominal and visceral cavities. Ascites fluid cytology an overview sciencedirect topics. Ascites cytology monitors the efficacy of chemotherapy in ovarian carcinosarcoma. Peritoneal carcinomatosis accounts for twothirds of patients with malignancyrelated ascites and nearly all of these have positive cytology, due to the shedding of viable malignant cells. It is recommended that the initial assessment should concentrate on history. This is a symptom of a bigger disease, which could be heart. Ascites means presence of excess fluid in the peritoneal cavity, normally upto 50 ml of fluid. It was then observed that out of total 150 specimens studied, 7953% were of pleural fluid, 6946% were of ascitic fluid and. Common studies conducted on ascitic fluid include cell count and differential, albumin, protein, cytology, and cultures. Metastatic fibrolamellar hepatocellular carcinoma in. Often, it occurs due to improper functioning of liver that leads to abnormal accumulation of fluid in the space present between the lining of the organs and the abdomen. Pathology reports of the patients whose saag was calculated by taking the difference between serum albumin values and simultaneously taken ascitic fluid albumin and whose ascitic fluid cytology.
Vijay kumar bodal, preeti banasal, manjit singh bal, anil kumar suri, ranjeev bhagat, navneet kaur, mohanveer kaur and anikita goel. Pdf the cytology of the cirrhotic and malignant ascitic. Slide preparations for the cytology of pleural fluid and ascitic fluid 4. Ascitic fluid samples are frequently sent to the laboratory for analysis. Pdf study of ascitic fluid by liquid based cytology and. Fluids that were positive for malignant cells were associated with serous and. Analysis of ascetic fluid for cytological and biochemical. Top tips for ascitic tap paracentesis always send the most fluid to cytology, especially if malignancy is suspected. Although the test for acidfast bacilli in the peritoneal fluid is highly. In healthy individuals the pleural, peritoneal and pericardial cavities are lined by a single layer of mesothelial cells and contain a small amount of serous fluid. The 5year survival rate was similar between the groups 62% positive cytology. Many diseases can cause ascites, but the most common is portal hypertension, which is usually due to cirrhosis. Ascitic fluid analysis ascites interpretation geeky medics. The more fluid sent, the higher the diagnostic yield.
It is recommended that the initial assessment should concentrate on. It is a key investigation in the assessment of new. Pdf analysis of ascitic fluid for cytological and biochemical. Ascitic fluid cytology of adenosarcoma of the ovary. These studies can be used to evaluate the patient for both infectious. In these patients, ascitic fluid cytology and fineneedle aspiration of adnexal mass are. A 57 year old man presented with chronic neutrophilia of unknown etiology together with chest pain and bilateral pleural effusions. Prevalence of metastatic cancers in peritoneal fluid. Peritoneal fluid analysis litfl ccc investigations. The fresh fluid was sent to the cytology laboratory where filter preparations. The cytology of the cirrhotic and malignant ascitic fluid. Too much hope is placed on ascitic cytology to provide the diagnosis at the expense of other investigations. Ascites fluid cytology could be a useful tool to detect the peritoneal spread of ovarian carcinosarcoma.
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