ỨNG DỤNG HỆ THỐNG QUỐC TẾ 2020 VỀ TẾ BÀO HỌC DỊCH CÁC MÀNG TRONG CHẨN ĐOÁN TẾ BÀO HỌC DỊCH MÀNG PHỔI

Abstract

Background: Pleural effusion (PE) is a common clinical condition with diverse etiologies, including infections, inflammatory diseases, and malignancies. The increasing number of PE cases in Vietnam highlights the need for a standardized, accurate, and clinically applicable cytological reporting system. Objective: To investigate the cytological characteristics of pleural effusion according to the International System for Reporting Serous Fluid Cytopathology 2020 (TIS 2020) at the Department of Pathology, Pham Ngoc Thach Hospital, and to evaluate its applicability in routine practice. Materials and Methods: A retrospective cross-sectional descriptive study was conducted on pleural effusion cytology specimens collected from January 2024 to August 2024. Cytological slides were independently evaluated by three experienced cytopathologists and classified according to TIS 2020. Results: The median age was 59 years, with a male-to-female ratio of 1.9. Atypical cells were identified in 42.5% of cases. Common cytological features included high cellularity, three-dimensional clusters, papillary formations, large cells with nuclear enlargement, pleomorphism, hyperchromasia, irregular nuclear membranes, coarse or salt-and-pepper chromatin, prominent nucleoli, high nuclear-to-cytoplasmic ratio, tumor necrosis, and abnormal mitotic figures. According to TIS 2020, the distribution was as follows: non-diagnostic (0.8%), negative for malignancy (62.8%), atypia of undetermined significance (6.9%), suspicious for malignancy (14.2%), and malignant (15.3%). Conclusion: The application of TIS 2020 in pleural effusion cytology is feasible and effective, contributing to standardized reporting, improved diagnostic consistency, and better clinical decision-making.