DOI: 10.36347/sjams.2019.v07i02.023

Pages: 543-547

Aim & objectives: 1) To evaluate the TLC, DLC in pleural fluid on day 0,1,3 & 5 by manual and automated methods and also the cytomorphological changes and compare the changes over time. 2) To compare the TLC between manual and automated method. Methodology: 36 samples of pleural fluid were included and evaluated within 4 hrs on day 0 and analysed again on 1st, 3rd, and 5th day after storage. TLC was done using improved Neubauer chamber as well as automated hematology analyser. The DLC was done in stained smears and the morphological changes were also noted. Rsults: Both the manual and the automated analyser showed a significant reduction of TLC over 5 days with p values of 0.161 and 0.006 respectively (ANOVA). Also change in neutrophil lymphocyte ratio was observed with a significant reduction in the neutrophils (p<.05) and increase in lymphocyte (p<.05) over 5 days. There was positive correlation between the TLC in manual and automated method with a highly significant p values (<.001). The first morphological changes noted were vacuolization with cell swelling, loss of lobular structure and cytoplasmic rim and nuclear changes were other changes. Conclusion: The pleural fluid samples should be processed timely (preferably within 4 hrs) for accurate results, however, under unavoidable circumstances can be delayed till 24 hrs without many changes. The TLC and DLC is not reliable in the fluid processed >24 hrs and almost 90% cells are degenerated by day 5.The automated and manual methods are comparable.