Serous fluid cytopathology

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The foundation of E-sc@n:

E-sc@n is a network of european pathologists currently in progress. It was initated in June 2008 by Eric Piaton, MD (Lyon, France) and Philippe Vielh, MD (Villejuif, France) with the aid and support of a number of friends and colleagues throughout Europe. All contributors or sympathizers are professionals in cyto- or histopathology and are members or leaders of national cytology societies. EP is currently secretary general of the French Society of Clinical Cytology (SFCC), whereas PV is secretary general of the European Federation of Cytology Societies (EFCS).

Ben Davidson (Oslo, Norway) and Katharina Glatz (Basel, Switzerland) are early partners of the E-sc@n project. They kindly accepted to share their skill and experience in the molecular biology and telecytology/quiz parts of the site. Gilbert Francz (Basel, Switzerland) kindly allowed us to use the Flexiform software to build surveys and quiz. Véronique Hofman (Nice, France) provided a lot of cyto- and histopathological cases, most of them remaining to be included in the educative part of the blog. We hope that we will be able to keep their confidence, in spite of the slowness and difficulties linked to daily hard work and lack of secretaryship.

The aims of E-sc@n:

The vocation of  E-sc@n is to develop exchanges between practicing pathologists involved in the evaluation of serous effusions in humans. The website, under construction, is designed as a blog. The idea is primarily to create ties between european pathologists and have research projects and publications in common. In this way, E-sc@n could contribute to influence renewing international perspectives on quality assurance in cytopathology. It also aims at building an educative, peer-reviewed and thoroughly illustrated content in the field of serous fluid cytopathology. It will ease content sharing, also by non-expert users such as thesis students.

The architecture of E-sc@n:
The educative content will be divided into four parts:

PATHOBIOLOGY: It aims at explaining the etiology and pathogenesis as well as the background of biochemical disorders affecting the serous cavities. It will particularly investigate the role of the fluid tests when considering malignancy: nucleated cell count and differential, total protein, LDH, glucose, pH, amylase, and cytology.

TECHNICAL REQUIREMENTS: The section will address the requirements that are needed to agree that a slide is technically adequate for assessment. Because ancillary techniques are treated elsewhere, this part will only concern conventional preparatory methods such as cell fixation and concentration, elimination of RBC, cell block method and LBC. Staining schedules will also be described.

MORPHOLOGICAL CRITERIA: This part aims at identifying the cellular and architectural features that allow accurate diagnosis. Cells in a fluid bear little resemblance with their counterparts in tissue specimens. Therefore, interpretation criteria are somewhat different.

MOLECULAR BIOLOGY: Considerable improvements have been achieved in recent years through the use of molecular biology techniques on cell blocks and LBC material. These advances now allow a significant body of data in the diagnosis, classification, and prediction of biological behaviour of effusions to be obtained.

The cooperative work of E-sc@n:

The first cooperative work of E-sc@n was initiated in 2009 but was not transformed into full-text article or formal presentation. A questionnaire on all aspects of serous fluid cytopathology (from the receipt to the transmission of the results) was built. The survey was then completed by members of the E-sc@n project. The results will be presented as soon as the data will be formatted.

Don't hesitate to give your opinion about the project in progress and to register at the Newsletter, in order to keep informed of all further developments.