الفهرس 
Anatomy and histologyOnly 14 pages are availabe for public view
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Abstract
Four hundered and fifty one cases with serous effusions were examined including 285 pleural effusions,164 ascitic fluids and two pericardial fluids . from them, cytologic smears, cell blocks and cytospin I1 smears were prepared. Out of 285 cases of pleur a1 fluids, 196 were benign and 74 cases were malignant. Out of the malignant cases, 73 cases were due to secondaries in the pleura while one case only was due to primary pleural mesothelioma. Correct positive cytologic diagnosis was available in 74 cases and suspecious cases was detected in 15 cases. The false positive results could not be completely assessed due to the lack of follow up in Tanta University Hospitals . The false positive results could be avoided by the use of cytochemistry. Out of 73 pleural effusions secondary to metaststic carcinomas, 23 cases were due to carcinoma of the lung . Out of which, 12 cases were due to adenocarcinoma, 2 cases were due to small1 cell carcinoma, 4 cases were due to bronchioloalveolar carcinoma, two cases were due to squamous cell carcinoma and three cases were due to giant cell carcinoma. Breast carcinoma was responsible for 28 malignant pleural effusions. Two of them were lobular and the rest were ductal. Five cases were due to adenocarcinoma of the GIT. Out of them, three were of gastric and two were of colonic origin . Metastatic squamous cell carcinoma of the urinary bladder was responsible for pleural effusion in one case. Lymphoma was responsible for malignant pleural effusions in three cases. Two non Hodgkin’s and one Hodgkin’s lymphoma. Anaplastic undifferentiated carcinoma was responsible for 13 cases. Benign pleural effusions were as follows, 85 tuberculous, 56 cases were due to postpneumonic, 41 cases were epyemic, 6 cases were cirrhotic, 4 cases were due to congestive heart failure, two were due to pulmonary infarction and two cases were due to postpneumonic effusions. In peritoneal effusions, 136 were benign and 24 were malignant and four cases were suspecious but by the application of cytochemistry, one cases was interpretated as anaplastic carcinoma and the three cases were negative. Benian peritoneal effusions were as follows, 97 bilharzial ascites, 25 cirrhotic, 7 combined bilaharzial and cirrhotic, 4 tuberculous, 2 nephrotic and one case due to congestive heart failure. Malignant peritoneal effusions were as follows, 3 gastric, 6 colonic, 5 ovarian, 5 breast and 8 anaplastic undifferentiated carcinoma. There was no cases of peritoneal mesothelioma. Smears ,cell blocks and Cytospin I1 preperations were stained routinely with Papanicolaou’s stain or H.E.or both. Then, the available smears or sections were stained with PAS, PAS-D and mucicarmine stains. Also prepared for air dried smears to be stained with Giemsa stain. Toluidine blue was used for detection of the cellularity as a wet rapid stain. There was no difference between the staining with H.&E. or Papanicolaou’ stain because the presentation of squamous cell was nearly infrequent and when present, the shape of the cell pattern of the chromatin as well as other nuclear features helps in its identification. Also, Papanicolaou stain did not solve the problem of non keratinizing squamous cell carcinma which could not be identified on cytological basis but usually included in the undifferentiated carcinoma group. The wet stain (Toluidine Blue) is simple and rapid stain. It helps the first look evaluation including the cellularity of smears as well as the nature of aggregates. Even more,by this stain, one could check the nature of cells with provisional diagnosis. The PAS stain is also simple could be routinely used cytochemical stain which was strongly positive in malignant cells but was negative in histiocytes and some resting mesothelila cells. The reactive mesothelial cells and some resting , were faintly rective in the form of peripheral cytoplasmic granules. The malignant mesothelial cells were PAS positive as those of the reactive ones. Perior treatment with diastase in PAS staining was positive in malignant adenocarcinomatous and anaplastic cells but not in squamous cell carcinoma, lymphoma nad mesothelioma.