VOLUM OMAGIAL - Facultatea de Ştiinţe ale Naturii şi Ştiinţe Agricole

Ana Maria Creţu et al. / Ovidius University Annals, Biology-Ecology Series 14: 157-162 (2010)
However, comparing the results, after
performing peritoneal fluid cytology, with those
obtained by macroscopic evaluation, of the 40
effusions associated with at least one malignancy,
only 6 (15%) were founded to be red colored
(hemorrhagic), emphasizing that it does not exist any
relationship between peritoneal fluid containing
cancer cells and fluid color.
After conducting the Riwalta reactions [10], the
81 peritoneal effusions were classified in: 29
(35.80%) transudates peritoneal fluid (with low cell
density and low protein content, which is usually
accumulated in benign conditions) and 43 (53.08%)
exudate (effusions with high cell density and high
protein content, which is accumulated most in
malignant conditions), and 9 (11.11%) mixed,
intermediate peritoneal effusions. Thus, peritoneal
fluids were classified into three groups: group I
(transudates), group II (intermediate, mixed) and
group III (exudates) (Table 2).
Table 2. Distribution of cases after Riwalta reaction
Lots Primary
cancer
Lot I
(n=41)
Lot II
(n=40)
Transudates
(N=29)
Mixed
(N=9)
Exudates
(N=43)
CB 21 3 17
CH (4) 1 1 2
CO (18) 3 0 15
CGI (9) 1 2 6
CM (4) 2 2 0
CP (3) 1 1 1
MP (2) 0 0 2
Since only 26/40, 65% of peritoneal effusions
associated with different type of cancer resulted to
have characters of exudates, and only 21/41, 51.21%
of effusions associated with liver cirrhosis were
shown to be transudates, it follows that, by
conducting the Riwalta reaction, it can determine the
benign or malignant nature of effusions in a
proportion of 58.10% (Fig.6).
Cell smear appearance had a various cells
populations and the quantitative analysis of effusions
was not enough useful in establishing the final
diagnosis. There were observed 7 cell types present
in variable number. Proliferative capacity of tumor
cells - tumor aggressiveness - is an important
161
element in cytology grading of malignancy, and was
quantified by mitosis counting.
Fig 6. The benign or malignant nature of effusions
after conducting the Riwalta reaction
In smears classified as benign, isolated cells
represented 90% of total cells, cell groups recovered
to a rate of 10%. 5% were represented by free
nucleus or cells with damaged cytoplasm.
Mesothelial cells (33%) (33 cells of 100
elements) and lymphocytes (30%) were the majority
cell type in the group of benign peritoneal effusions,
followed by macrophages (17%), polymorphonuclear
leukocytes (PMN) (9%) and erythrocytes (7%).
Average of total number of mitosis founded in
studied smears was 3mitosis/smears (Table 3).
Cellular composition of effusions founded to
be suspicious for malignancy was similar with the one
of benign peritoneal effusions: mesothelial cells
(28%) (28 cells of 100 items) and lymphocytes (26%)
were the majority cell type, followed by neutrophils
(13%), atypical cells, suspicious for malignancy
(9%), erythrocytes (9%) and macrophages (7%).
Average of total number of mitosis founded in
studied smears was 7 mitosis/smears (Table 3).
In the group of patients with malignant cancer,
mesothelial cells represented 29% and erythrocytes
21%, followed by lymphocytes (18%),
polymorphonuclear leukocytes (16%), macrophages
(4%) and malignant cells (4%), average of total
number of mitosis was 9 mitoses / cell smear (Figure
7).