The value of clinical question for the cytological judgement upon effusions

Cytological investigation of the cell sedimentation of body cavity effusions is neither screening nor method of earlier cancer detection. Cytology rather means in these cases etiological enlightment of a manifest morbid state. You unwarrantedly compress the possibility of information if you restrict the examination of seeking only for cancer cells. The reason for it is the fact that exfoliation of tumour cells or of tumour cell-clusters does not occur in all cases of malignancy and that on the other side 50 p.c. and more of all fluids are of benign etiology. Certainly the specific morphological signs permit per se the diagnosis of malignancy. But the question is in all other cases whether reactions of the hematopoietic system or of the serosa or of both you will recognize, evoked by different impulses. The kind of clinical question will then be the key for a correct cytological judgment. The cytologist acts as a counsellor of the clinician. In such a position he urgently needs informations on anamnesis, development of the disease and reports concerning to the direction of the provisional clinical diagnosis.