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Ascitis is a consequence or complication of a number of diseases. It often presents as a common diagnostic and therapeutic dilemma to the pathologists and physicians. Both non neoplastic and neoplastic causes of ascitis can be identified by the relatively non invasive technique of ascitic fluid cytology. The present study aims to assess the value of ascitic fluid cytology in the differential diagnosis of ascitis and its usefulness in the patient management. This prospective study was conducted from June 2014 to June2018. Total 1600 patients with ascitis were included in the study. Total cell count of ascitic fluid was done with improved Neubauers counting chamber. Smears were studied for cell type and cellular features. Most common cause of ascitis was cirrhosis [80.7%]. Malignant ascitis was noted in 4.5% cases. It was mostly (98.6%) due to metastasis from ovarian, gastrointestinal, unknown primary and pancreatic malignancies. The conditions like spontaneous bacterial peritonitis, eosinophilic ascitis and filarial ascitis were readily diagnosed by total cell count and ascitic fluid cytology. Ascitic fluid cytology was useful not only in the diagnosis but also to assess the response to treatment in these cases. The careful cytomorphological examination of ascitic fluid is a valuable, simple, rapid, inexpensive and reliable technique in the differential diagnosis of ascitis, particularly in resource limited settings.

Ascitic fluid cytology and its implications in the clinical approach