WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Esraa Abd Al Hamza Jawad and Prof. Dr. Ban Jumaah Qasim

ABSTRACT

Introduction: The International System for Reporting Serous Fluid Cytopathology was applied to assess pleural effusions. Because pleural cavity can be affected by a variety of distinct processes ranging from benign (autoimmune, infectious) to malignant (primary or metastatic neoplasms), effusion Cytopathological diagnosis can be challenging. The aim of the study: This study aims to assess pleural fluid cases in a sample of Iraqi patients according to the International System for Reporting Serous Fluid Cytopathology (TIS) in correlation with age, sex, presenting symptoms, type of pleural fluid, radiological findings, laterality and associated diseases. Subjects and methods: A retrospective study included 153 randomly chosen pleural fluid samples that were sent to the Teaching Laboratories of Al-Emamain Al-Kadhmain Medical City (AS) between January 2022 and June 2024. Results: The mean age of the patients in this study was 56.20 ±19.19 years. 80 patients (53.3%) were male, and 73 patients (47.7%) were female. 141 patients (92.15%) exhibiting shortness of breath. Regarding fluid cytological diagnosis according to the International System For Reporting Serous Fluid Cytopathology, non-diagnostic (ND) was found in 14 patients (9.2%), negative for malignancy (NFM) in 83 patients (54.3%), atypia of undetermined significance (AUS) in 21 patients (13.7%), suspicious for malignancy (SFM) in 25 patients (16.3%) and malignant (MAL) in 10 patients (6.5%). Eighty-six patients (56%) with pleural effusion had exudate fluid, transudate was found in 53 patients (35%). Regarding radiological finding 38 patients (25%) had pleural effusion with finding suggesting benign disease of them (24%) had pulmonary infection including 8 patients (5%) had TB, 22 patients (14%) with finding suggesting malignant disease of them 7 patients (5%) had solitary lung mass suggesting primary origin. Eighty four patients (55%) of these effusions were unilateral, while 69 patients (45% were bilateral. Associated malignant disease was found in 18 patients (12%); GIT origin (3%) and breast (2.6%) were the most encountered cases. Diagnostic categories were found to be significantly correlated to the type of fluid, radiological finding and associated diseases (p value < 0.00001). Conclusion: Pleural effusion patients are commonly encountered in clinical practice and in cytopathological laboratories, tend to occur more in middle age men, shortness of breath was the most encountered presenting symptom, the majority of patients were classified as negative for malignancy (NFM) 54%, other categories: suspicious for malignancy (SFM) 16%, atypia of unknown significance (AUS) 14%, nondiagnostic (ND) 9%, and malignant (MAL) 7%. Diagnostic categories were found to be significantly correlated with the presence of associated diseases, type of pleural fluid and radiological findings.