Utility of Immunohistochemistry on Cell Blocks for Detection of Malignancies using Body Cavity Fluids in a Tertiary Care Hospital

Zainab  Taj; Tariq  Sarfraz; Saba  Aneeqa; Rubina  Riaz; Aaminah  Hanif; Ghazala  Rustam

doi:10.51253/pafmj.v76iSUPPL-6.13784

Authors

Zainab Taj Department of Histopathology, Foundation University Medical College, Rawalpindi Pakistan https://orcid.org/0009-0005-4297-6962
Tariq Sarfraz Department of Histopathology, Foundation University Medical College, Rawalpindi Pakistan
Saba Aneeqa Department of Histopathology, Foundation University Medical College, Rawalpindi Pakistan
Rubina Riaz Department of Histopathology, Foundation University Medical College, Rawalpindi Pakistan
Aaminah Hanif Department of Histopathology, Foundation University Medical College, Rawalpindi Pakistan
Ghazala Rustam Department of Pathology, Foundation University Medical College, Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-6.13784

Keywords:

Ascites, Carcinoma of Unknown Primary, Cell Block, Cytology, Immunohistochemistry, Pleural Effusion

Abstract

Objective: To determine the utility of cell block technique and immunohistochemistry in diagnosing the abdomino-pelvic and thoracic malignancies using body fluids.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Histopathology, Foundation University Medical College/Fauji Foundation Hospital, Rawalpindi Pakistan, from Jan 2023 to Dec 2024.

Methodology: Data was obtained from the Department of Histopathology. All body fluid samples which underwent cell block preparation following initial cytological evaluation were noted. Those cell blocks on which immunohistochemistry was applied were evaluated to see the final diagnosis.

Results: Cytology fluids were received from a total of 136 patients. Out of these, 76 revealed malignant cells on cytology and cell block. Immunohistochemistry was applied on 50 cell blocks, and the primary origin of malignancy were ovary (90%), breast (4%), lung (4%) and endometrium (2%).

Conclusion: In all cases showing malignant cells on cytology, cell blocks confirmed the presence of malignant cells and highlighted architectural details of carcinoma. Immunohistochemistry gave final diagnosis of the primary malignancy which eliminated the need for biopsy in patients with carcinoma of unknown primary.

Downloads

Download data is not yet available.

References

1. Du L, Wei N, Maiwall R, Song Y. Differential diagnosis of ascites: etiologies, ascitic fluid analysis, diagnostic algorithm. Clin Chem Lab Med 2024; 62(7): 1266.

https://doi.org/10.1515/cclm-2023-1112

2. Ikegami T, Ishiki H, Kadono T, Ito T, Yokomichi N. Narrative review of malignant ascites: epidemiology, pathophysiology, assessment, and treatment. Ann Palliat Med 2024; 13(4): 84257.

https://dx.doi.org/10.21037/apm-23-554

3. Gonnelli F, Hassan W, Bonifazi M, Pinelli V, Bedawi EO, Porcel JM, et al. Malignant pleural effusion: current understanding and therapeutic approach. Resp Res 2024; 25(1): 47.

https://dx.doi.org/10.1186/s12931-024-02684-7

4. He J, Zhang HP. Research progress and treatment status of malignant ascites. Front Oncol 2024; 16(14): 1390426.

https://dx.doi.org/10.3389/fonc.2024.1390426

5. Saharti S. Contemporary art of cell-block preparation: overview. Cytojournal 2024; 21: 5.

https://dx.doi.org/10.25259/Cytojournal_56_2023

6. Torous VF, Cuda JM, Manucha V, Randolph ML, Shi Q, VandenBussche CJ, et al. Cell blocks in cytology: review of preparation methods, advantages, and limitations. J Am Soc Cytopathol 2023; 12(2): 77.

https://dx.doi.org/10.1016/j.jasc.2022.11.003

7. Rani SS, Vamshidhar IS, John NA, John J. Diagnosis of Pleural Fluid Effusions by Cell Block and Pleural Biopsy–A Comparative Study. J Cytol 2022; 39(4): 169.

https://dx.doi.org/10.4103/joc.joc_91_21

8. Jhala N, Arriola A, Pantanowitz L. Serous cavity metastasis: Evaluation of unknown primary. Cytojournal 2022; 19: 16.

https://dx.doi.org/10.25259/CMAS_02_11_2021

9. Manzoor F, Rehman F, Hameed S, Ahmad S, Sarfraz R. Diagnostic Accuracy of Cell block Using HistoGel Tube Method in Breast Cancer in Pakistan. Ann King Edw Med Univ 2024; 30(2): 197.

https://doi.org/10.21649/akemu.v30i2.5424

10. Khan SU, Khattak N, Shareef HG, Tahir M, Khan MS, Nadeem S. Morphological Features and Ki67 Immunohistochemical Analysis in Trophoblastic Diseases: A Five-Year Retrospective Study: Ki67 Immunohistochemical Analysis in Trophoblastic Diseases. Pak J Health Sci 2025: 84-89.

https://doi.org/10.54393/pjhs.v6i7.3135

11. Rickard BP, Conrad C, Sorrin AJ, Ruhi MK, Reader JC, Huang SA, et al. Malignant ascites in ovarian cancer: cellular, acellular, and biophysical determinants of molecular characteristics and therapy response. Cancers 2021; 13(17): 4318.

https://dx.doi.org/10.3390/cancers13174318

12. Ford CE, Werner B, Hacker NF, Warton K. The untapped potential of ascites in ovarian cancer research and treatment. Brit J Cancer 2020; 123(1): 9.

https://dx.doi.org/10.1038/s41416-020-0875-x

13. Lisio MA, Fu L, Goyeneche A, Gao ZH, Telleria C. High-grade serous ovarian cancer: basic sciences, clinical and therapeutic standpoints. Int J Mol Sci 2019; 20(4): 952.

https://dx.doi.org/10.3390/ijms20040952

14. Nishal AJ, Naik KS, Modi J. Analysis of spectrum of ovarian tumours: a study of 55 cases. Int J Res Med Sci 2015; 3(10): 2714.

http://doi.org/10.18203/2320-6012.ijrms20150820

15. Ye J, Findeis-Hosey JJ, Yang Q, McMahon LA, Yao JL, Li F, et al. Combination of napsin A and TTF-1 immunohistochemistry helps in differentiating primary lung adenocarcinoma from metastatic carcinoma in the lung. Appl Immunohistochem Mol Morphol 2011; 19(4): 313.

https://dx.doi.org/10.1097/PAI.0b013e318205b059

16. Cimino-Mathews A, Subhawong AP, Illei PB, Sharma R, Halushka MK, Vang R, et al. GATA3 expression in breast carcinoma: utility in triple-negative, sarcomatoid, and metastatic carcinomas. Human Pathol 2013; 44(7): 1341.

https://dx.doi.org/10.1016/j.humpath.2012.11.003

17. Zhao L, Guo M, Sneige N, Gong Y. Value of PAX8 and WT1 immunostaining in confirming the ovarian origin of metastatic carcinoma in serous effusion specimens. Am J Clin Pathol 2012; 137(2): 304. https://dx.doi.org/10.1309/AJCPU0FION3RKKFO

18. Yemelyanova A, Gown AM, Holmes BJ, Ronnett BM, Vang R. PAX8 expression in uterine adenocarcinomas and mesonephric proliferations. Int J Gynecol Pathol 2014; 33(5): 492.

https://dx.doi.org/10.1097/PGP.0b013e3182a54afa

19. McEachron J, Baqir AW, Zhou N, Jabbar A, Gupta R, Levitan D, et al. Evaluation of the incidence and clinical significance of WT-1 expression in uterine serous carcinoma. Gynecol Oncol Rep 2022; 39: 100918. https://dx.doi.org/10.1016/j.gore.2021.100918

20. Desouki MM, Kallas SJ, Khabele D, Crispens MA, Hameed O, Fadare O. Differential vimentin expression in ovarian and uterine corpus endometrioid adenocarcinomas: diagnostic utility in distinguishing double primaries from metastatic tumors. Int J Gynecol Pathol 2014; 33(3): 274.

https://dx.doi.org/10.1097/PGP.0b013e31829040b5

21. Thapar M, Mishra RK, Sharma A, Goyal V, Goyal V. Critical analysis of cell block versus smear examination in effusions. J Cytol 2009; 26(2): 60.

https://dx.doi.org/10.4103/0970-9371.55223

22. Köksal D, DEMİRAĞ F, BAYİZ H, Koyuncu A, Mutluay N, Berktaş B, et al. The cell block method increases the diagnostic yield in exudative pleural effusions accompanying lung cancer. Turk J Pathol 2013; 29(3).

https://dx.doi.org/10.5146/tjpath.2013.01184