Original article / research
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Application of International System for Reporting Serous Fluid Cytology and Risk of Malignancy Assessment in Serous Effusion: A Cross Sectional Study |
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| Correspondence
Address : Naila Durrani, E 2 14, Indravihar Colony Airport Road, Bhopal-462030, Madhya Pradesh, India. E-mail: nailather@gmail.com |
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Introduction: Serous fluid cytology is a safe, effective and minimally invasive procedure helping in the early diagnosis and prognosis of malignant effusions. However, due to the lack of a uniform reporting system and the morphological overlap between certain reactive and malignant conditions, there are limitations. The International System for Reporting Serous Fluid Cytology (ISRSFC) divides the serous effusions into five categories to assist in diagnosing and managing cases of serous effusion according to the Risk of Malignancy (ROM) in different categories. Aim: To reclassify serous fluids according to the ISRSFC and evaluate the ROM in each category. Materials and Methods: The present retrospective cross-sectional study was conducted in the Department of Pathology, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India, from January 2023 to December 2023. In the present study, serous effusion cases were cytologically evaluated and categorised according to the ISRSFC, and the ROM for each category was calculated. A total of 570 cases of serous fluids were evaluated cytologically and classified according to the ISRSFC. The ROM in different categories was calculated. Data was presented as number and percentage. Results: The age of the patients ranged from 12-81 years, with a mean age of 43 years. The volume of the samples ranged from 1-1000 mL. The ROM in different categories for pleural, peritoneal, and pericardial fluid, respectively, was as follows: Category I {Non Diagnostic (ND)} constituted 1/15 (6.6%) and 1/19 (5.2%); Category II {Negative for Malignancy (NFM)}showed 3/186 (1.6%), 4/220 (1.8%), and 0/3 (0%); Category III {Atypia of Undetermined Significance (AUS)} comprised 1/4 (25%) and 0/3 (0%); Category IV {Suspicious for Malignancy (SFM)} showed 81.8% (9/11) and 75% (6/8); and in Category V {Malignant Lesions (MAL)}, the ROM was 100% (20/20, 22/22, 2/2) for all. Conclusion: The ISRSFC is a standardised and effective system for serous fluid cytology. It provides consistent reporting terminology and better communication with clinicians and thus improving patient care. In the present study, the authors assessed the efficacy of this novel classification both as a means of communication between clinicians and pathologists and as a guideline for patient management. |
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