Cytopathological evaluation of serous effusions using the ISRSFC system: Risk of malignancy and demographic associations in a Saudi cohort

Authors

• Magdi M. Salih, From the Department of Clinical Laboratory Sciences (Salih), College of Applied Medical Sciences, Taif University; from the Laboratory Medical Science (Alotaibi, Al Talhi, Hassan, Bhaket), King Faisal Medical Complex; from the Pathology Department (Bakhsh), King Abdulaziz Specialist Hospital, Taif, Kingdom of Saudi Arabia
• Shatha Abdullah Alotaibi, From the Department of Clinical Laboratory Sciences (Salih), College of Applied Medical Sciences, Taif University; from the Laboratory Medical Science (Alotaibi, Al Talhi, Hassan, Bhaket), King Faisal Medical Complex; from the Pathology Department (Bakhsh), King Abdulaziz Specialist Hospital, Taif, Kingdom of Saudi Arabia
• Manal Ali Hassan, From the Department of Clinical Laboratory Sciences (Salih), College of Applied Medical Sciences, Taif University; from the Laboratory Medical Science (Alotaibi, Al Talhi, Hassan, Bhaket), King Faisal Medical Complex; from the Pathology Department (Bakhsh), King Abdulaziz Specialist Hospital, Taif, Kingdom of Saudi Arabia
• Khwaimsa Mohammad Bhaket, From the Department of Clinical Laboratory Sciences (Salih), College of Applied Medical Sciences, Taif University; from the Laboratory Medical Science (Alotaibi, Al Talhi, Hassan, Bhaket), King Faisal Medical Complex; from the Pathology Department (Bakhsh), King Abdulaziz Specialist Hospital, Taif, Kingdom of Saudi Arabia
• Nesreen Ahmad Bakhsh, From the Department of Clinical Laboratory Sciences (Salih), College of Applied Medical Sciences, Taif University; from the Laboratory Medical Science (Alotaibi, Al Talhi, Hassan, Bhaket), King Faisal Medical Complex; from the Pathology Department (Bakhsh), King Abdulaziz Specialist Hospital, Taif, Kingdom of Saudi Arabia

Abstract

ABSTRACT Objectives: To classify serous effusions using the ISRSFC and assess malignancy risk across diagnostic categories, considering patient demographics and clinical features. Serous fluid cytopathology is a minimally invasive, cost-effective method for diagnosing benign and malignant conditions. The International System for Reporting Serous Fluid Cytopathology (ISRSFC) standardizes reporting, yet data from Saudi Arabia are limited. Methods: A prospective observational study was conducted from October 2023 to June 2024. Serous fluid samples (peritoneal, pleural, pericardial) were stained with the Papanicolaou method and evaluated microscopically. Results: Among 153 effusions, peritoneal (60.7%) was most common. Patients aged 41–66 comprised the largest group (41.2%). Cytologically, 36% were negative for malignancy, 19% atypia of undetermined significance (AUS), and 18.3% malignant. Risk of malignancy by ISRSFC category was: nondiagnostic (3.2%), negative for malignancy (5.4%), AUS (6.8%), suspicious for malignancy (52.7%), malignant (100%). Significant associations were found with clinical and demographic factors. Conclusion: The ISRSFC effectively classifies effusions and stratifies malignancy risk. Peritoneal effusion was most frequent, highlighting cytology’s diagnostic value and the need for further regional studies.

Article Type

Research Article

First Page

1371

Last Page

1375

Recommended Citation

Salih, Magdi M.; Alotaibi, Shatha Abdullah; Hassan, Manal Ali; Bhaket, Khwaimsa Mohammad; and Bakhsh, Nesreen Ahmad (2025) "Cytopathological evaluation of serous effusions using the ISRSFC system: Risk of malignancy and demographic associations in a Saudi cohort," Saudi Medical Journal: Vol. 46: Iss. 11, Article 14.
DOI: https://doi.org/10.15537/smj.2025.46.11.20250438