Application of international system for reporting serous fluid cytology (ISRSFC) in effusion samples-a prospective study in an oncology setting

INTRODUCTION

Serous fluid cytology is a cost-effective procedure that can help in the diagnosis, staging, and origin of the malignancy. Recently introduced International System for Reporting Serous Fluid Cytology (ISRSFC) standardizes the reporting of serous fluid cytology in the 5 categories: Category 1: Nondiagnostic (ND), Category 2: negative for malignancy (NFM), Category 3: atypia of undetermined significance (AUS), Category 4: suspicious for malignancy (SFM), and Category 5: malignant (MAL). Here, we present our experience adopting the ISRSFC.

MATERIALS AND METHODS

We implemented ISRSFC in December of 2019 at our institute and included a cohort of 555 prospective effusion samples. The pertinent surgical pathology, radiology, and clinical follow-up were also extracted to assess the risk of malignancy (ROM) and performance parameters.

RESULTS

The assessment of interobserver reliability indicated substantial concordance (κ = 0.717) between the 2 investigators for serous fluid categorization. A total of 555 effusion samples were classified as follows: ND, 14 (2.5%); NFM, 394 (71%); AUS, 12 (2.2%); SFM, 13 (2.3%); and MAL, 122 (22%). The ROM for the ND, NFM, AUS, SFM, and MAL categories was 57.1%, 9.9%, 66.7%, 66.7%, and 97.2%, respectively, in peritoneal effusions and 57.1%, 7.1%, 66.7%, 100%, 100%, respectively, in pleural effusions. The ROM for NFM and MAL was 0% and 100%, respectively, in pericardial effusion.

CONCLUSIONS

Application of the proposed ISRSFC can help in achieving uniformity and reproducibility in diagnoses and also help in risk stratification in cytology. ISRSFC was successfully adopted by our cytology laboratory and clinicians, with overall diagnostic performance similar to previous studies.

CLINICO-RADIOGRAPHIC EVALUATION OF XENOGRAFTS IN MAXILLOFACIAL SURGERY

An endeavour to find a suitable substitute for autogenous bone graft in corrections of maxillofacial deformities has been going on. Evaluation of commercially processed xenograft (SURGIBONE) has been carried out as a substitute for autogenous grafts in various maxillofacial surgical procedures in the Department of Dental Surgery at Armed Forces Medical College. Clinical and radiographic evaluation in 15 patients revealed highly satisfactory result with complete integration of the graft without any adverse host tissue reaction within the follow-up period lasting from 12-18 months.

OSSEOINTEGRATED TITANIUM PLASMA COATED IMPLANTS IN RECONSTRUCTION OF EDENTULOUS MANDIBLE

Fifteen patients underwent surgical insertion of titanium plasma sprayed screws in the mandible ridge over the symphysis region. In 3 patients, along with the screws in the symphysis region, hollow basket implant type 'H', one each in the mandible first/second molar region were inserted. Implants were fixed only in those patients who had retention and stability problems of mandibular artificial denture. Indication, technique and biocompatibility of titanium implants and tissue supported over denture have been discussed.