Cyto-morphological investigation of cellular content of peripancreatic liquid accumulations in estimation of the clinical course severity in an acute complicated pancreatitis

Abstract

Objective. To study up a character and peculiarities of cyto-morphological changes in cellular material of the peripancreatic liquid accumulations (LA) as a criterion of objective estimation of the clinical course severity in an acute complicated pancreatitis (ACP). Маterials and methods. Results of cyto-morphological investigation of the peripancreatic LA sediment, obtained while doing interventional ultrasonography in 51 (88%) observations and videolaparoscopy - in 7 (12%) observations in 58 patients with an ACP, were analyzed. Results. Of intraabdominal LA (n=37) observations in 10 (27 %) of them a domination of proliferating cells of mesothelium with their polymorphism was revealed, while in 15 (41%) - degenerative-dystrophic changes like a bulging of cytoplasm, appearance of large «signet-ring like» cells, in 12 (32%) - аtipically changed cells of mesothelium with signs of anizocytosis and anizonucleosis, as well as cyto-morphological changes like in neoplastic process. In retroperitoneal localization of LA (n=21) a more essential changes in the granulocytes nuclei were registered, including, in 9 (43%) observations their structure have got irreversible disorders: karyopycnosis, karyorexis and karyolysis. The depth of structural cellular changes in mesoteliocytes and neutrophil granulocytes have depended upon the ACP severity. Conclusion. Determination of depth of the cellular content cytomorphological disorders in the LA sediment may serve an objective criterion in the ACP severity estimation.

Keywords

• acute complicated pancreatitis; liquid accumulations; cytological investigations