Cytological Evaluation of Body Fluids: Diagnostic Role and Patterns in a Tertiary Care Centre of North Bihar

Abstract

Background: Fluid cytology plays a pivotal role in the evaluation of serous effusions and other body fluids. It offers a minimally invasive, cost-effective, and rapid diagnostic tool for identifying a wide spectrum of benign and malignant conditions. Despite being a vital part of diagnostic pathology, the utility and diagnostic spectrum of cytological examination in body fluids remain underexplored in certain regional healthcare settings, such as Bihar. Objective: To assess the diagnostic utility, spectrum of cytological findings, and the distribution of benign versus malignant cases in various body fluids (pleural, peritoneal, and cerebrospinal fluid) over a one-year period at a tertiary care hospital in Bihar. Materials and Methods: A retrospective study was conducted in the Department of Pathology, Darbhanga Medical College and Hospital, Darbhanga, Bihar, over a period of 12 months (August 2024 to July 2025). A total of 125 fluid samples were included, comprising pleural, peritoneal, and cerebrospinal fluids received in the cytology section. All samples were processed using standard centrifugation, smear preparation, and staining techniques (Papanicolaou, Giemsa, and H&E where needed). Cytological findings were categorized into benign, suspicious, and malignant categories. Results: Out of the 125 fluid samples analyzed, 102 (81.6%) were diagnosed as benign/reactive, 13 (10.4%) were malignant, and 10 (8%) were suspicious for malignancy. Among malignant cases, adenocarcinoma was the most frequently identified malignancy, predominantly involving pleural fluid. The diagnostic yield was highest for pleural effusions, followed by ascitic and cerebrospinal fluids. Cytological examination provided significant diagnostic clues in cases of suspected malignancy and infection, thus aiding in clinical decision-making. Conclusion: Fluid cytology is an indispensable diagnostic modality in the assessment of body fluids. Its non-invasive nature, combined with reasonable accuracy, makes it a valuable first-line investigation. In resource-constrained settings like Bihar, it proves to be both practical and cost-effective, especially in early detection of malignancies and infectious diseases.