Cytology Reflex to cell block and relevant IHC Body fluid

Cytology Reflex to Cell Block and Relevant IHC – Body Fluid

Test Purpose:
Cytological examination of body fluid with reflex preparation of a cell block and application of relevant immunohistochemistry (IHC) markers when required to characterize atypical/suspicious cells and determine their origin.

Specimen:

• Pleural fluid
• Peritoneal/ascitic fluid
• Pericardial fluid
• Other body fluids, as clinically indicated

Methodology:

• Cytospin/conventional cytology examination
• Cell block preparation when indicated
• H&E staining
• Reflex IHC based on cytomorphology and clinical suspicion

Clinical Indications:

• Suspected malignant cells in body fluid
• Evaluation of metastatic carcinoma
• Differentiation of carcinoma, lymphoma, melanoma and reactive mesothelial cells
• Determination of the likely primary site in metastatic malignancy
• Further characterization of an atypical or indeterminate cell population

IHC Markers:
Markers are selected according to the morphology and clinical context. Depending on the case, panels may include pan-cytokeratin, CK7, CK20, BerEP4, MOC31, calretinin, WT1, D2-40, GATA3, TTF-1, Napsin A, PAX8, ER, PR, CDX2, SATB2, PSA, NKX3.1, SOX10/S100, and lymphoid markers such as CD45, among others.

Report Includes:

• Cytological interpretation
• Cell block adequacy
• Presence/absence of malignant cells
• IHC findings, when performed
• Integrated interpretation with likely cell/tumor origin, where possible

Turnaround Time: Typically 2–5 working days, depending on the number and complexity of IHC markers required.

Note: Reflex IHC is performed selectively based on cytological findings and may require additional specimen or testing if cellularity is insufficient.