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1.
Biomicrofluidics ; 18(4): 044108, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39184284

RESUMEN

The study unveils a simple, non-invasive method to perform micromixing with the help of spatiotemporal variation in the Lorentz force inside a microchannel decorated with chemically heterogeneous walls. Computational fluid dynamics simulations have been utilized to investigate micromixing under the coupled influence of electric and magnetic fields, namely, electromagnetohydrodynamics, to alter the direction of the Lorentz force at the specific locations by creating the reverse flow zones where the pressure gradient, ∇ p = 0 . The study explores the impact of periodicity, distribution, and size of electrodes alongside the magnitude of applied field intensity, the flow rate of the fluid, and the nature of the electric field on the generation of the mixing vortices and their strength inside the microchannels. The results illustrate that the wall heterogeneities can indeed enforce the formation of localized on-demand vortices when the strength of the localized reverse flow overcomes the inertia of the mainstream flow. In such a scenario, while the vortex size and strength are found to increase with the size of the heterogeneous electrodes and field intensities, the number of vortices increases with the number of heterogeneous electrodes decorated on the channel wall. The presence of a non-zero pressure-driven inflow velocity is found to subdue the strength of the vortices to restrict the mixing facilitated by the localized variation of the Lorentz force. Interestingly, the usage of an alternating current (AC) electric field is found to provide an additional non-invasive control on the mixing vortices by enabling periodic changes in their direction of rotation. A case study in this regard discloses the possibility of rapid mixing with the usage of an AC electric field for a pair of miscible fluids inside a microchannel.

2.
Pract Neurol ; 24(5): 422-427, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-38960597

RESUMEN

We report unusual cases of combined central and peripheral demyelination in two siblings related to pregnancy, each presenting with progressive tetraparesis and cranial nerve palsies. The elder sister had a relapsing-remitting course with optic nerve dysfunction and died during a relapse from respiratory insufficiency. The younger sister presented with disorientation and acute-onset limb and facial weakness. She responded well to corticosteroid therapy. Their clinical presentation, response to immunomodulatory therapy, nerve conduction studies, cerebrospinal fluid and histology supported an acquired demyelinating cause. Whole-exome sequencing identified variants in two genes not previously linked to this clinical phenotype. Serological tests for antibody-mediated demyelination were negative. Despite the undefined pathogenesis, these cases provide a platform to explore the confluence of genetic, immune and environmental factors in the context of acquired demyelination. We discuss the differential diagnosis and a diagnostic approach to such cases from the perspectives of neuroimmunology and neurogenetics.


Asunto(s)
Enfermedades Desmielinizantes , Hermanos , Humanos , Femenino , Enfermedades Desmielinizantes/genética , Enfermedades Desmielinizantes/diagnóstico , Adulto
3.
Vaccines (Basel) ; 12(7)2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39066417

RESUMEN

Tuberculosis (TB) remains a global health threat, necessitating innovative strategies for control and prevention. This comprehensive review explores the Mycobacterium tuberculosis Lysine Exporter (LysE) gene, unveiling its multifaceted roles and potential uses in controlling and preventing tuberculosis (TB). As a pivotal player in eliminating excess L-lysine and L-arginine, LysE contributes to the survival and virulence of M. tuberculosis. This review synthesizes findings from different electronic databases and includes 13 studies focused on the LysE of M. tuberculosis. The research unveils that LysE can be a potential drug target, a diagnostic marker for TB, and a promising candidate for vaccine development. The absence of LysE in the widely used BCG vaccine underscores its uniqueness and positions it as a novel area for TB prevention. In conclusion, this review underscores the significance of LysE in TB pathogenesis and its potential as a drug target, diagnostic marker, and vaccine candidate. The multifaceted nature of LysE positions it at the forefront of innovative approaches to combat TB, calling for sustained research efforts to harness its full potential in the global fight against this infectious disease.

4.
Heliyon ; 10(7): e28023, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38576556

RESUMEN

Vacuum impregnation (VI) is a novel, non-thermal treatment that aims to modify the composition of food material by partially removing water and air and impregnating it with physiologically active compounds without affecting the structural integrity of food matrix. Application of VI accelerates the mass transfer processes, which leads to few changes in food composition and improves dehydration. Large volumes in intracellular spaces of fruit and vegetable tissues make it suitable to introduce different agents like nutrients, cryoprotectants, browning inhibitors, enzymes, and chemicals; enhancing texture profile and inhibiting tissue softening, or compounds lowering water activity and pH. water activity Thus, the VI may help to achieve new product quality associated with physicochemical features and sensory attributes. This review highlights the evolution and mechanism of VI technique, major factors affecting VI of fruits and vegetables and their responses to processing, and industrial relevance. Vacuum impregnation consists ability to revolutionize various aspects of food processing and preservation. VI serves as a versatile tool that enhances the quality, shelf life, and nutritional content of processed fruits and vegetables. It offers unique advantages of altering product composition by introducing desired compounds while preserving structural integrity. VI improves mass transfer processes, reduces water content, enhances the absorption of nutrients, antioxidants, and preservatives. This technology finds application in producing fortified foods, extending shelf life, and creating innovative products with improved sensory attributes. VI's ability to efficiently impregnate substances into porous materials, combined with its energy-saving potential and compatibility with other processing methods, makes it a valuable tool in the food industry. As consumers demand healthier and long-lasting products, VI emerges as a promising solution for meeting market demands.

5.
Langmuir ; 40(12): 6471-6483, 2024 03 26.
Artículo en Inglés | MEDLINE | ID: mdl-38466805

RESUMEN

Nanocarriers have attracted considerable interest due to their prospective applications in the delivery of anticancer medications and their distinct bioactivities. Biogenic nanostructures can be effective nanocarriers for delivering drugs as a consequence of sustainable and biodegradable biomass-derived nanostructures that perform specific functions. In this case, a vanadium oxide (V2O5) and mesoporous carbon@V2O5 (C@V) composite was developed as a possible drug delivery system, and its bioactivities, including antioxidant, antibacterial, and anticancer, were investigated. Doxorubicin (DOX), an anticancer drug, was introduced to the nanoparticles, and the loading and release investigation was conducted. Strong interfacial interactions between mesoporous carbon (MC) and V2O5 nanostructures have been found to improve performance in drug loading and release studies and bioactivities. After incubation, the potent anticancer effectiveness was seen based on C@V nanocomposite. This sample was also utilized to research potential biomedical uses as an antioxidant, antibacterial, and anticancer. The most effective antioxidant, the C@V sample (61.2%), exhibited a higher antioxidant activity than the V-2 sample (44.61%). The C@V sample ultimately attained a high DOX loading efficacy of 88%, in comparison to a pure V2O5 sample (V-2) loading efficacy of 80%. Due to the combination of mesoporous carbon and V2O5, which increases specific surface area and surface sites of action as well as the morphology, it proved that the mesoporous carbon@V2O5 composite (C@V) sample demonstrated greater efficacy.


Asunto(s)
Antineoplásicos , Nanoestructuras , Carbono/química , Antioxidantes/farmacología , Antineoplásicos/farmacología , Antineoplásicos/química , Doxorrubicina/química , Nanoestructuras/química , Antibacterianos/farmacología , Antibacterianos/uso terapéutico
7.
J Clin Med ; 12(20)2023 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-37892651

RESUMEN

The aim of the study was to examine the best-tolerated dose of pirfenidone, the adverse effects profile, and potential factors other than drug dose influencing the tolerability of pirfenidone in patients with fibrosing interstitial lung diseases (ILDs). We performed an observational retrospective study of 113 patients with IPF and other fibrosing ILDs treated with pirfenidone. Baseline liver function tests (LFTs) and dose escalation of pirfenidone were recorded for all patients. The best-tolerated dose was continued if the patient did not tolerate full dose (2400 mg) despite repeated dose escalation attempts. Potential risk factors such as age, height, weight, body mass index (BMI), body surface area (BSA), gender, smoking, and presence of comorbidities were analyzed between 3 groups of best-tolerated pirfenidone doses: 2400 mg/day vs. <2400 mg/day, 2400 mg/day vs. 1800 mg/day, and 2400 mg/day vs. 1200 mg/day. A total of 24 patients tolerated 2400 mg/day, and 89 patients tolerated <2400 mg/day (43 tolerated 1800 mg/day, 45 tolerated 1200 mg/day and 1 tolerated 600 mg/day). Patients who tolerated 2400 mg/day were taller and had a larger BSA as compared to those tolerating <2400 mg/day. Overall, males tolerated the drug better. Presence of comorbidities or smoking did not affect the tolerance of pirfenidone, except for the presence of cerebrovascular diseases. Various adverse effects did not have any significantly different frequencies between the compared groups. Moreover, 71.7% of patients experienced at least one side effect. 1200 mg/day was the best-tolerated dose in the majority of the patients. Male patients with a larger BSA and greater height showed better tolerability of pirfenidone overall.

8.
Langmuir ; 39(33): 11910-11924, 2023 08 22.
Artículo en Inglés | MEDLINE | ID: mdl-37552874

RESUMEN

Scientists have investigated the possibility of employing nanomaterials as drug carriers. These nanomaterials can preserve their content and transport it to the target region in the body. In this investigation, we proposed a simple method for developing distinctive, bioderived nanostructures with mesoporous carbon nanoparticles impregnated with tungsten oxide (WO3). Prior to characterizing and encapsulating WO3 with bioderived mesoporous carbon, the anticancer drug doxorubicin (DOX) was added to the nanoparticles and examined loading and release study. The approaches for both nanoparticle production and characterization are discussed in detail. Colloidal qualities of the nanomaterial can be effectively preserved while also allowing transdermal transportation of nanoparticles into the body by forming them into green, reusable, and porous nanostructures. Although the theories of nanoparticles and bioderived carbon each have been studied separately, the combination presents a new route to applications connected to nanomedicine. Furthermore, this sample was used to study exotic biomedical applications, such as antioxidant, antimicrobial, and anticancer activities. The W-3 sample had lower antioxidant activity (44.01%) than the C@W sample (56.34%), which was the most potent. A high DOX entrapment effectiveness of 97% was eventually achieved by the C@W sample, compared to a pure WO3 entrapment efficiency of 91%. It was observed that the Carbon/WO3 composite (C@W) sample showed more efficacy because the mesoporous carbon composition with WO3 increases the average surface area and surface-active locations.


Asunto(s)
Nanocompuestos , Nanopartículas , Neoplasias , Humanos , Portadores de Fármacos/química , Carbono/química , Doxorrubicina/química , Nanopartículas/química , Neoplasias/tratamiento farmacológico , Porosidad
9.
Chem Biodivers ; 20(8): e202300332, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37461844

RESUMEN

The present study shows the chemical profile, antimicrobial, antiproliferative, and apoptotic effects of Stemodia viscosa extracts. Thirteen bioactive compounds were identified in the 80 % ethanolic extract by GC/MS analysis. The acetone extract exhibited a higher content of flavonoids and phenols of 805.10 µg QE/mg DW and 89.31 µg GAE/mg DW extracts, respectively. Furthermore, the acetone extract possessed the highest antioxidant activity (IC50 =9.96 µg/mL). The 80 % ethanolic extract exhibited significant antimicrobial activity; the highest activity was observed against Staphylococcus aureus with a zone of inhibition of 25±0.51 mm, MIC value of 4 mg/mL, and MBC value of 8 mg/mL. The antiproliferative results revealed the presence of anticancer activity with an IC50 =91.562 and 74.362 µg/mL against the B16F10 skin and COLO205 colon cancer cells, respectively. The flow cytometric analysis shows that the plant extracts cause cancer cell death through the induction of apoptosis. Our findings confirmed that Stemodia viscosa is a potential source of biologically active compounds.


Asunto(s)
Acetona , Antiinfecciosos , Acetona/análisis , Antiinfecciosos/química , Extractos Vegetales/química , Fitoquímicos/farmacología , Fitoquímicos/química , Cromatografía de Gases y Espectrometría de Masas , Antioxidantes/química , Flavonoides/farmacología
10.
Neurol India ; 71(1): 55-61, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36861575

RESUMEN

Background: Fibrin glue as an adjunct in peripheral nerve injuries has gained recent popularity. Whether fibrosis and inflammatory processes which are the major hindrances in repair reduce with fibrin glue has more of theoretical support than experimental. Methodology: A prospective nerve repair study was conducted between two different species of rats as donor and recipient. Four comparison groups with 40 rats were outlined with or without fibrin glue in immediate post-injury period with fresh or cold preserved grafts were examined based on histological, macroscopic, functional, and electrophysiological criteria. Results: There was suture site granuloma along with neuroma formation and inflammatory reaction and severe epineural inflammation in allografts with immediate suturing (Group A), whereas suture site inflammation and epineural inflammation were negligible in cold preserved allografts with immediate suturing (Group B). Allografts with minimal suturing and glue (Group C) had less severe epineural inflammation with less severe suture site granuloma and neuroma formation as compared to first two groups. Continuity of nerve was partial in later group as compared to other two. In fibrin glue only group (Group D), suture site granuloma and neuroma were absent, with negligible epineural inflammation, but continuity nerve was partial to absent in most of the rats with some showing partial continuity. Functionally, microsuturing with or without glue demonstrated significant difference with better SLR and toe spread (p = 0.042) as compared with only glue. Electrophysiologically, NCV was maximum in Group A and least in Group D at 12 weeks. We report significant difference in CMAP and NCV between microsuturing group vs. only glue group (p < 0.05) and also between microsuturing with glue group vs. only glue group (p < 0.05). Conclusion: There may be more data required with proper standardization for adept usage of fibrin glue. Though our results have shown partial success, it nonetheless highlights the lack of sufficient data for widespread glue usage.


Asunto(s)
Neuroma , Traumatismos de los Nervios Periféricos , Animales , Ratas , Adhesivo de Tejido de Fibrina/uso terapéutico , Traumatismos de los Nervios Periféricos/cirugía , Estudios Prospectivos , Suturas , Inflamación , Anastomosis Quirúrgica , Nervio Ciático/cirugía
12.
Biochem Biophys Res Commun ; 637: 267-275, 2022 12 31.
Artículo en Inglés | MEDLINE | ID: mdl-36410276

RESUMEN

Phosphoinositide 3-kinase (PI3K) pathway mediates key signaling events downstream to B-cell receptor (BCR) for survival of mature B-cells, and overexpression or overactivation of PI3Kδ is crucial for B-cell malignancies such as diffuse large B-cell lymphoma (DLBCL). Small molecule PI3Kδγ inhibitors, with a known potential to reduce activated B-cell (ABC)-DLBCL transformation, form an important class of therapeutics approved for follicular lymphoma (FL), chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL). In this study, we describe discovery of a potent, selective and efficacious dual PI3Kδγ inhibitor, LL-00084282, having a differentiated efficacy profile in human ABC- and germinal center B-cell (GCB)-DLBCL cell lines. LL-00084282 displayed high potency and superior PI3Kδγ engagement with excellent selectivity over other PI3K isoforms at both IC50/90 concentrations in biochemical and cell-based assays. In contrast to selective PI3Kδ inhibitors, LL-00084282 showed superior and potent anticancer activity in both ABC- and GCB-DLBCL cell lines. LL-00084282 demonstrated in-vivo efficacy in OCI-Ly10 and SU-DHL-6 xenografts with good tolerability. Furthermore, LL-00084282 inhibited pro-inflammatory cytokine secretion and reduced basophil activation in human PBMCs, showing potential implications in immunoinflammatory conditions. Good pharmacokinetic properties in higher species and desirable efficacy profile highlights potential of this novel PI3Kδγ inhibitor for further clinical evaluation in DLBCL patients.


Asunto(s)
Leucemia Linfocítica Crónica de Células B , Linfoma de Células B Grandes Difuso , Inhibidores de las Quinasa Fosfoinosítidos-3 , Humanos , Linfocitos B , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Fosfatidilinositol 3-Quinasas , Inhibidores de las Quinasa Fosfoinosítidos-3/farmacología , Línea Celular Tumoral
14.
Cytojournal ; 19: 42, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35928527

RESUMEN

The cervical cancer screening has been based conventionally on cytologic analysis. With advances in understanding the role of human papillomavirus, cotesting has been applied. But most of the patients subjected to colposcopy did not benefit, except in cases with HSIL [high-grade squamous intraepithelial lesion] cytology. Because of this, a step to increase the sensitivity to detect cancers and pre-cancers but with higher specificity with minimal overdiagnosis leading to prevention of unindicated cervical biopsies is highly desired. Such triaging step in cases with abnormal screening results is expected to minimize invasive interventions because of low false positivity. With availability of methodologies leading to quantitatively and qualitatively enhanced cell-blocks from residual liquid based cytology specimens, immunostaining can be performed for multiple immunomarkers with potential objectivity to triage initial screening test results. This is enhanced further with inclusion of AV marker in the cell-blocks and application of SCIP (subtractive coordinate immunoreactivity pattern) approach. The cell-blocks are also resource for performing other ancillary studies including molecular pathology and proteomics/metabolomics as potential tests in future. This review explores application of residual liquid based cytology specimen for cell-blocking with application of ancillary studies in algorithmic manner as adjunct to ASCCP management guidelines for improved patient care.

16.
Cytojournal ; 19: 31, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35673694

RESUMEN

The Pap smear is a well-known screening tool for squamous lesions of the uterine cervix. However, its screening role in glandular lesions is less effective. The incidence of squamous cell carcinoma of the cervix has dramatically decreased with the advent of Pap smear and recent understanding related to HPV carcinogenesis of cervical cancers including the advent of HPV vaccines. However, in recent years, the incidence of glandular abnormalities, diagnosed on Pap smears, has increased with greater sensitivity and precision. The incidence of atypical glandular cells (AGC) is approximately 0.18-0.74% of all cervical smears with a reported prevalence of 2.5% among all Pap smears. A high degree of suspicion, good clinical history, and the presence of diagnostic cytomorphological findings are essential for the proper interpretation of glandular cell abnormalities. A methodical approach to evaluate Pap smear greatly helps interpretation and avoids the diagnostic pitfalls. The Bethesda System for reporting cervical cytology has categorized glandular cell abnormalities into various categories as follows: Endocervical adenocarcinoma in situ (AIS)Atypical glandular cells (AGCs) Endocervical cells: a1 NOS or specify in comments; a2 Favor neoplasticEndometrial cells: NOS or specify in comments Adenocarcinoma (AdCa) EndocervicalEndometrialExtrauterineNOS Subtle differences in quantitative and qualitative cytologic features are essential for distinguishing one category from another. In this chapter, we highlight an organized approach for the interpretation of glandular abnormalities in Pap smear for our readers. This is an overview of the Bethesda categories, the reason for classification, and differential diagnosis with key characteristic features. An approach to the methodical evaluation of hyperchromatic crowded groups is discussed with key cytomorphologic differences. An algorithmic approach is suggested to facilitate the interpretation of various AGC categories.

17.
Cytojournal ; 19: 6, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35541029

RESUMEN

Definitive cytopathological interpretation of some of the effusion fluids may not be possible based on cytomorphological evaluation alone. As discussed in other reviews, this is due to various reasons specifically applicable to effusion fluids including remarkably wide morphologic spectrum of reactive mesothelial cells overlapping with some well to moderately differentiated metastatic carcinoma. The challenge is subject to various factors including level of interpreter training or experience, institutional demographics (such as type of prevalent diseases, predominant sex and age group), technical advances in ancillary support, and expertise in cytopreparatory processing. In such cases immunohistochemistry performed on cell-block sections is simple objective adjunct with or without other ancillary techniques. Ongoing increase in number of immunomarkers along with rabbit monoclonal antibodies with relatively higher affinity is further refining this field. SCIP (subtractive coordinate immunoreactivity pattern) approach, discussed as separate dedicated review article, facilitates refined interpretation of immunoreactivity pattern in coordinate manner on various serial sections of cell-blocks. However, many variables such as delay after specimen collection, specimen processing related factors including fixation and storage; ambient conditions under which paraffin blocks are archived (for retrospective testing); antigen retrieval method; duration of antigen retrieval step; antibody clone and dilution; and antibody application time are common with application of immunohistochemistry in other areas. This review is dedicated to highlight technical aspects including processing of effusion specimens for optimum immunocytochemical evaluation along with commonly used immunomarkers in effusion cytopathology. This review focuses on the technical and general information about various immunomarkers.

18.
Cytojournal ; 19: 5, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35541031

RESUMEN

Accumulation of fluid in serous cavities as effusions may have to be drained for therapeutic and diagnostic indications. As compared to many other procedures, the technicality of paracentesis procedures is relatively easy. As a result, effusion fluids comprise a significant proportion of specimens in most of the laboratories, including those in community settings. Because of relative complexities in the cytopathologic evaluation of effusion fluids, application of appropriately standardized protocol is critical for achieving optimum results by applying standardized steps from handling of specimens during the initial stages of collection to the final interpretation phase. Understanding various limitations and challenges during collection and processing phases by all the personnel involved, including clinicians, pathologists, and technologists is critical for optimum diagnostic yield. This review highlights various cytopreparatory techniques applicable to effusion cytology in one place. It is organized by projecting the details predominantly in the form of different tables and figures including summary of the recommended protocols with reagents and stains used. Also included is a sample of cytopathology report based on the approach discussed in this series.

19.
Cytojournal ; 19: 3, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35541032

RESUMEN

Due to the remarkably wide morphologic spectrum of reactive mesothelial cells, some of the effusion fluids may be difficult to interpret with objective certainty by cytomorphology alone. Cytomorphology of well to moderately differentiated adenocarcinomas (responsible for the bulk of malignant effusions) may overlap with floridly reactive mesothelial cells. Even mesotheliomas including diffuse malignant epithelioid mesothelioma, are usually cytomorphologically bland without unequivocal features of malignancy. The intensity of challenge depends on the interpreter's training or experience level, institutional demographics of patients (such as type of prevalent diseases, predominant sex and age group), technical support, and quality of cytopreparatory processing. In general immunocytochemistry is valuable adjunct to facilitate objective interpretation with or without other ancillary techniques as indicated. An increasing number of immunomarkers is further refining the contribution of immunohistochemistry to this field. However, application of immunohistochemistry to effusion fluids is relatively challenging because of many variables. Multiple factors such as delay after specimen collection, specimen processing related factors including fixation and storage; ambient conditions under which paraffin blocks are archived (for retrospective testing); antigen retrieval method; duration of antigen retrieval step; antibody clone and dilution; and antibody application time are identical to application of immunohistochemistry in other areas. The significant challenge related to the potential compromization of the immunoreactivity pattern due to exposure to non-formalin fixatives / reagents is also applicable to effusion fluid specimens. The immunoreactivity results would be compared and corelated with cumulative metadata based on the reported studies performed and validated on formalin-fixed paraffin-embedded tissue sections. Deviating from such protocols may lead to suboptimal results, which is not uncommon in clinical practice with potential compromization of patient care and related liability. Because of this, it is critical to perform immunocytochemistry on formalin-fixed cell-block sections only. In addition, unless the interpretation criteria for immunohistochemical evaluation of effusion fluids are not modified specifically, it may not be productive in resolving some challenging cases. However, this aspect is not well elaborated in the literature. A basic and critical challenge is finding and locating the cells of interest in cell-block sections of effusion fluids. A unique approach is to choose a fundamental immunopanel which highlight the mesothelial and inflammatory cells in reactive effusion fluids to create the basic map. This allows detection of a 'second-foreign' population which can be immunocharacterized further with the help of subtractive coordinate immunoreactivity pattern (SCIP) approach elaborated here.

20.
Cytojournal ; 19: 4, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35541033

RESUMEN

Serous cavity may be involved by any neoplasm, including very rare examples of involvement by central nervous system tumors leading to a malignant effusion. The serous cavity lining is rich in lymphatics with lymphatic lacunae opening directly through narrow gaps (stoma) in the lining. Carcinomas mainly metastasize to serosa via the lymphatic vessels, which may be blocked leading to effusion. Primary carcinomas of organs such as lung, intestines, liver, ovary, etc., lined by serosal membranes may spread by direct extension, resulting in malignant effusions. As standard of practice, unless specified, cytopathologic examination of serous effusions implies detection of malignant cells. As compared to a surgical biopsy from a small focal area of an extensive serosal surface, effusion fluid from respective cavity exfoliates the cells from the entire serosal surface with minimal chance of sampling artifact. Because of this, effusion fluid cytology generally provides a higher diagnostic yield as compared to biopsy of the serous lining, as demonstrated by some studies. However, various challenges related to effusion fluid cytology makes the interpretation of effusion fluid cytology a field with potential misinterpretations, especially for those without proper experience or training. Developing and following a methodical approach is important for appropriate cytologic examination of effusion fluids. Proper approach may achieve definitive interpretation even without ancillary tests. However, lack of appropriate approach and processing may introduce a significant variation in interpretation due to combination of well-recognized diagnostic pitfalls, which may lead to lower reproducibility and even serious misinterpretations. Current review discusses in brief appropriate approach to processing and evaluating effusion fluid cytology for metastatic carcinoma. At general level, this is comparable to that of other specimens; however, it is critical to modify with reference to the limitations associated with effusion cytology.

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