engleski

Preanalytical aspects in hemorrhagic pleural fluids

Objective: Point out coagulated hemorrhagic samples as inadequate material for cytological analysis. Methods: Two drops of heparin have been routinely added in pleural fluid (PF) samples on the procedure site and samples delivered to cytological laboratory as soon as possible. For the purposes of this study records of 216 PF samples with suspicious cytological findings in the period from year 2008. to 2012. were reviewed. All PF samples were macroscopically examined and described as clear, purulent or hemorrhagic, routinely prepared, stained and analysed. In the study were included hemorrhagic and coagulated hemorrhagic PF samples with cells difficult to categorise microscopically and interpreted as suspicious. The differences in number and appearance of cells between hemorrhagic and coagulated hemorrhagic suspicious samples were noted after re-microscopic evaluation. Result: During five year observation period 216 (5, 5%) samples of PF were interpreted as suspicious. Minimum number of suspicious pleural fluid (SPF) samples was 27 (3, 5%) in 2009. and maximum number was 61 (8, 9%) in 2012. In all, 133 (61, 5%) SPF samples were macroscopically hemorrhagic and only 13 of them (6, 01%) were coagulated hemorrhagic. Hemorrhagic samples contained large number of well preserved or haemolysed erythrocytes while suspicious cells were present in small number as individual cells or scanty papillary groups. Coagulated hemorrhagic samples were less cellular. Clusters of haemolysed erythrocytes and a few individual poorly preserved suspicious cells were seen. Conclusion: Absence or inadequate amount of anticoagulant may results in coagulated hemorrhagic samples of PF. Cells remain trapped in the coagulum with inability to centrifuge. Insufficient number of cells causes interpretation difficulties. Procedure standardisation for sample collection and consistent education of healthcare professionals improves preanalytical aspects control and reduce suspicious final results that require repeating of PF aspiration.

Preanalytical aspects ; pleural flui ; pulmonary cytology

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