CYTOMORPHOLOGICAL STUDIES OF CELL COMPONENTS OF THE PERIPANCREATIC FLUID COLLECTIONS IN THE EVALUATION OF CLINICAL COURSE SEVERITY OF ACUTE COMPLICATED PANCREATITIS

Abstract

Abstract. Purpose. To study the character and peculiarities of cytomorphological changes of cellular sediment material of fluid collections (FC) as criterion for objective assessment of the clinical course severity in acute complicated pancreatitis (ACP). Materials and methods. The results of cytological researches of peripancreatic sediments of FC obtained during interventional ultrasonography in 51 (88%) and videolaparoscopy in 7 (12%) observations in 58 patients on ACP were analysed. Results. It was found that in intraabdominal FC (n=37) in 10 (27%) cases the dominating of proliferative mesothelium with its polymorphism was observed. In 15 cases (41%) degenerative-dystrophic changes of cytoplasm whippings with the appearance of large “ring-similar” cells were manifested. In 12 studies (32%), atypically altered mesothelium cells with anisocytosis and anisonucleosis, as well as cytomorphological changes similar to the neoplastic process were detected. In retroperitoneal localization of FC (n=21) more significant changes were observed in granulocyte-nuclei cells, in particular, in 9 cases (43%), irreversible violations of their structure were identified as phenomena of cariopicnosis, carioresix and cariolysis. Was established that depth of structural changes of mesotheliocyte cells and neutrophil granulocytes depended on degree of ACP severity. Conclusions. Estimation of cytomorphological changes of the FC cell components can serve as objective criterion of the ACP severity.