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ABSTRACT
Background
The accurate identification of cells as either malignant or reactive mesothelial cells is a diagnostic problem in conventional cytological smears. Distinguishing benign from malignant cellular changes may require meticulous screening, careful scrutiny of cellular features and an understanding of the range of reactive changes. Cell block preparation increases the sensitivity of detecting malignancies and also has the ability to reduce false positive interpretations. The aim of the study was to determine the diagnostic accuracy of cell block technique by comparing with conventional cytological smears for cytopathological diagnosis of serous effusion.
Method
This study was used as quantitative descriptive and prospective study aimed at assessing the accuracy and sensitivity of the cell block method compared to conventional method of serous fluid cytology sent to National Health Laboratory Service Dr. George Mukhari Tertiary Laboratory.
Result
A total of 50 cases formed the study cohort which consisted of male predominance with average age of 54 years. Serous effusions were received in the laboratory for assessment. Of these cases, 68% were from the pleural fluid, while 32% were from the ascitic fluid. The agreement for both methods to identify Benign was 76.0% with moderate kappa statistics of 0.487% and sensitivity of 89.7%. While the positive and negative predictive values were 74.2% and 80.0%, respectively.
Conclusion
The study concludes that the cell block technique when used as an adjuvant to routine smear examination increases the diagnostic yield because of availability of more material for evaluation and better preservation of the cytoarchitectural pattern.