A FIVE-YEAR RETROSPECTIVE AUDIT OF CYTOLOGY SPECIMENS AT A TERTIARY CENTRE IN SOUTHEASTERN NIGERIA: PATTERNS, DIAGNOSTIC OUTCOMES, AND CLINICAL IMPLICATIONS
Formerly Published in Vol 14 No. 6 Jan. – Jun., 2026
Keywords:
Fluid cytology, FNAC, diagnostic patterns, malignancy detection, Nigeria, Southeast Nigeria, retrospective studyAbstract
Background: Cytopathology, encompassing body fluid cytology and fine needle aspiration cytology (FNAC) of solid tissues, plays a crucial role in the diagnosis and management of malignant effusions, solid mass lesions, infections, and inflammatory conditions, particularly in resource-limited settings. Understanding the patterns and diagnostic outcomes of cytological examinations is essential for improving clinical practice and patient outcomes.
Objective: This retrospective study aimed to analyze the distribution, diagnostic patterns, and clinical significance of cytology specimens comprising body fluid cytology and fine needle aspiration cytology (FNAC) of solid tissues examined at the Federal Medical Centre, Umuahia over a five-year period (2020–2024).
Methods: A retrospective analysis of 259 cytology cases (body fluid specimens and FNAC of solid tissues) was conducted. Data extracted included patient demographics (age, sex), specimen types, clinical presentations, and cytological diagnoses. Specimens were categorized according to standardized cytology reporting systems. Statistical analysis included descriptive statistics, chi-square tests, and independent t-tests.
Results: The study analyzed 259 cases with a mean age of 46.31 ± 18.24 years (range: 2-95 years). Among the 241 cases with documented sex, female patients predominated (68.5%, n=165) with a female-to-male ratio of 2.17:1; sex was not recorded in 18 cases (6.9%). Pleural Pioneer Medical Journal 1 Vol 14. No 6. Jan – Jun. 2026 Jegede et al., Cytology patterns and outcomes fluid samples constituted the largest proportion (32.4%, n=84), followed by fine needle aspiration cytology of solid tissues (23.9%, n=62) and ascitic/peritoneal fluids (17.4%, n=45). The majority of specimens were diagnosed as benign (C2, 57.9%), while the combined malignancy rate (C4+C5) was 16.6% (n=43; 95% CI: 12.1%–21.8%). Ascitic/peritoneal fluids showed the highest malignancy rate (24.4%), followed by FNAC specimens (21.0%) and pleural fluids (13.1%). No significant association was found between sex and malignancy (χ²=0.804, p=0.370) or between age and malignant diagnosis (t=1.067, p=0.287).
Conclusion: Cytopathology, encompassing both body fluid cytology and FNAC, remains a valuable and cost-effective diagnostic tool in clinical practice. The relatively high malignancy detection rate in ascitic and FNAC specimens underscores the importance of cytological examination in patient management. These findings provide baseline data for quality improvement initiatives and contribute to understanding cytopathology practice patterns in Nigerian tertiary healthcare settings.
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