Pleural effusion cytology due to malignancy. A combined cytomorphological–immunocytochemical study of 500 cases

Kalogeraki, Alexandra; Tamiolakis, D; Datseri, Galateia; Lazopoulos, George; Karvelas-Kalogerakis, Mihailos; Segredakis, John; Zoi, Iris

doi:10.1016/j.rppnen.2016.03.007

Cited by 6 publications

(12 citation statements)

References 7 publications

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“…23,24 Overall sensitivity and specificity in our study were similar to previous reports. 4,[25][26][27][28][29][30] It is well known that the use of ancillary techniques, such as immunocytochemistry and molecular studies, as well as the incorporation of different cytology preparations, improves the sensitivity of cytological analysis in effusions. 4,5,23,31 Of particular interest in our presented data is the large number of false-negative cases.…”

Section: Discussionmentioning

confidence: 99%

A 2‐year retrospective study on pleural effusions: A cancer centre experience

et al. 2019

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Background Cytopathological examination of pleural effusions is a fast and minimally invasive method for verification of the presence of neoplastic cells. We report our 2‐year experience using a categorised diagnostic system and reporting risks of malignancy (ROMs) for each defined category. Methods Cytological reports of patients between November 2016 and October 2018 were collected, with results primarily classified into a five‐tiered classification scheme. Immunohistochemistry markers used in cytology and their results were also recorded. Final agreement to histology and overall test performance was calculated for cases with available concomitant (up to 3 months) pleural biopsies. Results A total of 519 samples from 385 patients were collected, being 29 (5.6%) classified as non‐diagnostic, 291 (56%) as negative, 28 (5.4%) as atypical, 30 (5.8%) as suspicious and 141 (27.2%) as positive. Most requested markers were calretinin, TTF1, Ber‐EP4 and Gata‐3, being conclusive in 45 (76.3%) cases. Total cyto‐histological agreement was achieved in 49 (80.3%) specimens, with an overall sensitivity and specificity of 69.4% and 93.3%, respectively. Positive predictive value was 96.2% and negative predictive value was of 56%. ROM for each diagnostic category was 50% for non‐diagnostic, 44% for negative, 50% for atypical, 83.3% for suspicious and 96.2% for positive. Conclusions Our 2‐year retrospective study has shown a high specificity and positive predictive value for pleural cytology. The use of a five‐tiered system has also shown to be highly effective, with a concordantly progressive higher ROM for the assigned diagnostic categories.

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Section: Discussionmentioning

confidence: 99%

A 2‐year retrospective study on pleural effusions: A cancer centre experience

et al. 2019

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“…Several recent publications have looked at the risk of malignancy (ROM) for each of these categories. They have shown that values vary between affected cavities [ 5 , 6 , 17 , 18 , 19 , 20 , 21 , 22 ]. Most studies, however, were published before the development and implementation of TIS, with few exceptions [ 5 , 6 , 17 , 18 , 19 , 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Cytohistological Correlation in Pleural Effusions Based on the International System for Reporting Serous Fluid Cytopathology

et al. 2021

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The International System for Reporting Serous Fluid Cytology (TIS) was recently developed. Given its novelty, most studies looking into the risk of malignancy (ROM) of serous effusion diagnostic categories were published before the development of TIS. We searched the database of our department for pleural effusions diagnosed in the last five years, excluding those without a corresponding pleural biopsy. Cases were reviewed and reclassified according to the TIS. A cytohistological correlation was performed. In total, 350 pleural effusion specimens with one or more corresponding pleural biopsies were included. After reclassification, 5 (1.43%) were nondiagnostic (ND), 253 (72.29%) were negative for malignancy (NFM), 7 (2.00%) had atypia of unknown significance (AUS), 14 (4.00%) were suspicious for malignancy (SFM), and 71 (20.57%) were malignant (MAL). Calculated ROM was 40% for ND, 20.16% for NFM, 42.86% for AUS, 78.57% for SFM, and 100% for MAL. Effusion cytology sensitivity and specificity were 60.29% and 98.56%, respectively. This is the first publication looking into the cytohistological correlation of a retrospective cohort of pleural effusions based on the TIS. We add to the body of data regarding the ROM for TIS categories, highlighting areas of potential future research.

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“…Cytology of effusions (pleural, peritoneal and pericardial fluid) and peritoneal lavage is a routine procedure in pathological anatomy laboratories for the diagnosis, staging, determining the primary site of metastatic cancer and followup of patients with high incidence and mortality cancers such as carcinoma of breast, lung, ovary and stomach (9)(10)(11). The cell types usually identified by cytology of benign effusion are mesothelial cells, macrophages and leukocytes.…”

Section: Introductionmentioning

confidence: 99%

“…The cell types usually identified by cytology of benign effusion are mesothelial cells, macrophages and leukocytes. Besides these cells, neoplastic cells may also be observed in malignant effusions (9)(10)(11). Effusions with high cellularity and characteristic morphological aspects enable to define the nature of the malignant cells (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

“…Besides these cells, neoplastic cells may also be observed in malignant effusions (9)(10)(11). Effusions with high cellularity and characteristic morphological aspects enable to define the nature of the malignant cells (9)(10)(11). However, it should be noted that there are instances when the distinction between metastatic cancer cells and reactive or neoplastic mesothelium can be challenging (12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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A panel of markers for identification of malignant and non-malignant cells in culture from effusions

et al. 2017

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The aim of the present study was to identify cell types in primary culture from malignant and non-malignant effusions. Effusion samples were subjected to cytology and culture. Immunocytochemistry was performed in cytological slides to evaluate malignancy (positivity for malignancy markers) and in culture slides for identification of cell types in growth. A total of 143 effusion samples (pleural n=76; peritoneal n=37; pericardial n=4; and peritoneal lavage n=26) were analyzed. Cell growth was observed in 34.9% of all samples and immunocytochemistry for identification of cell types in culture slides was conclusive in 90% of them. In non-malignant samples (n=28), growth of mesothelial cells, macrophages and of both cell types was identified in 82.14, 10.71 and 7.14%, respectively. In malignant samples (n=17, all carcinomas), growth of malignant epithelial cells and of both malignant epithelial and mesothelial cells was identified in 41.17 and 23.52%, respectively. In the remaining 35.29% of malignant samples, the only cells in growth were mesothelial and/or macrophages instead of malignant epithelial cells. In conclusion, in culture of malignant effusions, mesothelial cells may be simultaneously identified with malignant epithelial cells. Besides, mesothelial cells and macrophages may be the only cells identified in malignant effusion culture. Therefore, a broad panel of cell markers should be used for unmistakable identification of cells in studies of effusion primary culture. The ideal malignant effusion sample to obtain culture of neoplastic cells should be that without the presence of mesothelial cells and macrophages.

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Pleural effusion cytology due to malignancy. A combined cytomorphological–immunocytochemical study of 500 cases

Cited by 6 publications

References 7 publications

A 2‐year retrospective study on pleural effusions: A cancer centre experience

A 2‐year retrospective study on pleural effusions: A cancer centre experience

Cytohistological Correlation in Pleural Effusions Based on the International System for Reporting Serous Fluid Cytopathology

A panel of markers for identification of malignant and non-malignant cells in culture from effusions

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