The Role Of Conventional Cytology, Immunocytochemistry And Image Analysis In The Evaluation Of Pleural Effusions

Many diseases are manifested by pleural effusions. The inability to detect malignant cells in cytologic specimens casts a di’ cult problem in clinical management. The uifferential diagnosis between mesot-eliomas and adenocarcinomas is very important, necessitating the corr ’ation between clinical history and pathologic examination of tissues and. ells. The use of special ancillary techniques has proved ,i- great value in the differential diagnosis between mesotheliomas and eo-_ocarcnomas. It was found that immunocytochemical detection ;”. epithelial cells using monoclonal antibody against epithelial membrane ntigen, plays a role in this differential diagnosis. Another important criterion, is the detection of mrothelial cells by using special marker called calretinin. It was found to ste ” both reactive and malignant mesothelial cells.The aim of this work is to study and evaluate the role of different andUary techniques to achieve the most accurate dl)gnosis in the differentiation between mesotheliomas and primary or metar.atic carcinomas.Thts study was carried out on SO pleural effusion samples referred to Pathology Department, Zagazig University. All samples vU”e subjected to the following procedure.i) Haematoxylin and Eosin for routine cytologic diagr” ;is.ii) Histochemical staining using PAS and Alcian blue ,: .Jns.iii) Immunocytochemical staining for:~ Epithelial membrane antigen EMA.~ Specific mesothelial cell antigen Calretinin.~ The staining results was assisted by both cell image analyzer technique (CAS. 200) and semiquantitative methods.