Introduction/Background Cytology should be sent on all ascitic fluid presumably of malignant ovarian neoplasm. The overall sensitivity of cytology smears for the detection of malignant cells is 58 to 75 percent. The sensitivity of cytology depends upon the amount of fluid sent,number of specimens processed, the quality of processing including the cell block preparation. It has been suggested that at least 50 mL of ascitic fluid be submitted and either hand-carried to the laboratory or placed immediately into a fixative. We tried to increase the sensitivity of cytological diagnosis by increasing the amount of fluid and adding cell block to it.

Methodology 45 cases of presumably advanced ovarian malignancy was chosen which could not be debulked optimally upfront over a period of 6 months from October 2021 to end of April 2022.It is a single arm retrospective observational study. Inclusion Criteria: Age more than 40 years,presence of atleast mild ascites,adnexal mass & omental thickening in CT films,normal upper GI endoscopy & bilateral usg breasts.Data obtained from opd & daycare records.Variables like upfront abdominal girth at the outset, fluid colour,ADA,cell type & count,amount of fluid drained were kept.

Results In all 45 cases pleural fluid at least 500 ml of ascitic fluid were sent for cytology & cell block.Initially in 10 cases only cytology were sent they were all -ve later on both cytology & cell block were sent, they were all +ve on cell bloclk.Hence forth cytology & cell block were sent in all. Out of 45 cases only in two cases, malignant cells were not found. 40 cases the fluid was straw coloured, 4 cases haemorrhagic, 1 case chylous.

Conclusion By increasing the amount of the ascitic fluid drained and adding cell block to it the sensitivity almost approaches 100%. i.e 95%.However we require a larger sample size to make our observation statistically significant.