Cytology - Pericardial Fluid

Cytology – Pericardial Fluid:

Why Cytology – Pericardial Fluid Test?

CLINICAL INFORMATION

The pericardium consists of the outer fibrous layer and inner serous layer. Pericardial fluid is the serous fluid secreted by the serous layers of the pericardium into the pericardial cavity. The fluid serves to cushion the smooth functioning of the heart (cardiac function with least friction lubricating epicardial surface). Pericardial fluid is a clear straw-coloured fluid, consists of high concentrations of enzyme lactate dehydrogenase (LDH), protein and lymphocytes. In certain pathological conditions such as ischemic heart disease, there is an accumulation of angiogenic growth factors along with the pericardial fluid (which is indicative of angiogenesis in the arteries – arteriogenesis, thus helping to prevent myocardial ischemia). Other causes that contribute to abnormal accumulation of pericardial fluid are cardiac perforation, cardiac trauma, congestive heart failure, pericarditis rupture of a ventricular aneurysm etc.  Chronic complications with pericardial pathologies can lead to cardiac tamponade (large and rapidly accumulating effusions) can lead to a life-threatening condition where the excessive pericardial fluid pressure on the heart prevents the ventricles from filling correctly. Pericardiocentesis is a procedure used to remove the abnormally excess pericardial fluid from the pericardial cavity under the guidance using ultrasound. Pericardial fluid analysis is used to help diagnose the cause leading to fluid accumulation in the pericardial fluid, to differentiate either exudate or transudate i.e. if the cause is due to inflammation of the pericardium (pericarditis), or fluid accumulation around the heart (pericardial effusion). If the cause of fluid accumulation around the heart is due to an imbalance of pressure within blood vessels or due to the inflammation of the pericardium.  Hence this differential diagnosis would enable to confirm of the cause for effective treatment. Causes of pericardial effusion are lung cancer, blunt trauma to the chest, penetrating and iatrogenic injury to the myocardium, aorta, coronary blood vessel rupture can lead to accumulation of blood within the pericardial sac. Signs of pericardial effusion are shortness of breath (dyspnea), discomfort while lying down, chest pain behind the left breast bone, chest-full-ness, lightheadedness etc. Cytological examination of pericardial fluid helps in the diagnosis of underlying malignancies and thus also plays a vital role in staging, prognosis and planning treatment for the patients. Cytological examination of Pericardial fluid also helps in inflammatory cases where WBCs are excessively seen on microscopic evaluation. Additional tests include an echocardiogram.

General Instructions:

Sample Requirement: Specimen –Pericardial fluid. Test Preparation: None.

NOTE - Sample for specimen collections may vary based on the patient’s condition/cases according to the patient’s presenting complaints/signs or symptoms:

SPECIMEN REQUIREMENT (Special or Rare Cases) - As instructed and guided by Physician / Clinician / Pathologist / as per Laboratory’s requirements, according to procedures and protocols.

This Multi-Specialty Clinical Referral Laboratory RTDIAGNOSTICS provides precise and accurate tests with an extensive range of testing services to the medical centres to help in the diagnosis and identification of pathology in the test specimens for infectious diseases and also to evaluate the function of organ systems of the patient. It prevents further complications and helps to stabilize and restore health to near normalcy at the earliest without delay.