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Cytopathological evaluation of serous effusions using the ISRSFC system: Risk of malignancy and demographic
Magdi M Salih1, Shatha Abdullah Alotaibi1, Ashwag Mohammed Al Talhi1
1From the Department of Clinical Laboratory Sciences (Salih), College of Applied Medical Sciences, Taif University; from the Laboratory Medical Science (Alotaibi, Al Talhi, Hassan, Bhaket), King Faisal Medical Complex; from the Pathology Department (Bakhsh), King Abdulaziz Specialist Hospital, Taif, Kingdom of Saudi Arabia.
Objectives:
To classify serous effusions using the ISRSFC and assess malignancy risk across diagnostic categories, considering patient demographics and clinical features. Serous fluid cytopathology is a minimally invasive, cost-effective method for diagnosing benign and malignant conditions. The International System for Reporting Serous Fluid Cytopathology (ISRSFC) standardizes reporting, yet data from Saudi Arabia are limited.
Methods:
A prospective observational study was conducted from October 2023 to June 2024. Serous fluid samples (peritoneal, pleural, pericardial) were stained with the Papanicolaou method and evaluated microscopically.
Results:
Among 153 effusions, peritoneal (60.7%) was most common. Patients aged 41-66 comprised the largest group (41.2%). Cytologically, 36% were negative for malignancy, 19% atypia of undetermined significance (AUS), and 18.3% malignant. Risk of malignancy by ISRSFC category was: nondiagnostic (3.2%), negative for malignancy (5.4%), AUS (6.8%), suspicious for malignancy (52.7%), malignant (100%). Significant associations were found with clinical and demographic factors.
Conclusion:
The ISRSFC effectively classifies effusions and stratifies malignancy risk. Peritoneal effusion was most frequent, highlighting cytology's diagnostic value and the need for further regional studies.
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