Pleural Fluid Characteristics of Paramalignant Effusion

Gurung, Puncho; Goldblatt, Mark R.; Huggins, John T.; Doelken, Peter; Sahn, Steven A.

doi:10.1016/s0012-3692(16)47987-0

Cited by 9 publications

(6 citation statements)

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“…However, in the presence of a highly suspected mass, a pleural fluid with negative malignant cells is called a para-malignant effusion [ 10 ]. Para-malignant pleural effusion can range from concordant exudate to transudate with mediastinal lymphadenopathy as the most common cause [ 11 ]. It occurs as a result of multiple mechanisms, including when malignant cells lose adhesion and dislodgement from the primary tumor site, blood vessel wall penetrating/migrating through the pleura, and induction of angiogenesis [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Pleural Effusion Revealing a Diagnosis of Ewing Sarcoma

Ali¹,

Habib²,

Taha³

et al. 2021

Cureus

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Section: Discussionmentioning

confidence: 99%

Pleural Effusion Revealing a Diagnosis of Ewing Sarcoma

Ali¹,

Habib²,

Taha³

et al. 2021

Cureus

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“…68 Not surprisingly, paramalignant effusions, pleural effusions in those with solid tumors but no malignancy identified on pleural fluid cytology, were also noted to have decreased mortality of 7.49 months compared with those with lung cancer and no evidence of effusion of 12.65 months. 68,69 Given the significant mortality, symptom palliation and hospital-free days are important aspects to consider in MPE management. With multiple therapeutic options available and varying mortality ranges, it is important to accurately determine mortality risk and the efficacy of possible interventions.…”

Section: Malignant Pleural Effusionsmentioning

confidence: 99%

Pleurodesis

Lamb

Thakkar

et al. 2019

Semin Respir Crit Care Med

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Symptomatic pleural disease, specifically malignant pleural effusion, refractory benign pleural effusion, and pneumothoraces are common diseases that often require therapeutic interventions. The spectrum of management strategies often includes selection of a chemical pleurodesis agent administered in combination with an indwelling pleural catheter or chest tube.Additionally, there is a role for minimally invasive techniques which include medical thoracoscopy or more advanced video-assisted thoracoscopic approaches. Ongoing clinical trials continue to evolve best practices regarding the optimal sclerosant agents and procedural approaches in the management of these diseases.

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“…1,4,7 The presence of malignant cells in the effusion implies metastasis to the pleural wall, which is thought to occur either by direct dissemination from adjacent tissue or by lymphatic invasion. 1,4,8 However, up to half of breast cancerassociated MPEs are cytology negative, 9 suggesting a paramalignant pleural effusion and no pleural metastasis, 1 where the mechanism of pleural effusion formation and hence prognosis of these patients is unknown. 1,8 Our ability to diagnose pleural metastases and detect malignant cells in the pleural fluid can be challenging.…”

Section: Introductionmentioning

confidence: 99%

Single‐cell RNA sequencing captures patient‐level heterogeneity and associated molecular phenotypes in breast cancer pleural effusions

Whitfield,

Berthelet,

Mangiola

et al. 2023

Clinical & Translational Med

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BackgroundMalignant pleural effusions (MPEs) are a common complication of advanced cancers, particularly those adjacent to the pleura, such as lung and breast cancer. The pathophysiology of MPE formation remains poorly understood, and although MPEs are routinely used for the diagnosis of breast cancer patients, their composition and biology are poorly understood. It is difficult to distinguish invading malignant cells from resident mesothelial cells and to identify the directionality of interactions between these populations in the pleura. There is a need to characterize the phenotypic diversity of breast cancer cell populations in the pleural microenvironment, and investigate how this varies across patients.MethodsHere, we used single‐cell RNA‐sequencing to study the heterogeneity of 10 MPEs from seven metastatic breast cancer patients, including three Miltenyi‐enriched samples using a negative selection approach. This dataset of almost 65 000 cells was analysed using integrative approaches to compare heterogeneous cell populations and phenotypes.ResultsWe identified substantial inter‐patient heterogeneity in the composition of cell types (including malignant, mesothelial and immune cell populations), in expression of subtype‐specific gene signatures and in copy number aberration patterns, that captured variability across breast cancer cell populations. Within individual MPEs, we distinguished mesothelial cell populations from malignant cells using key markers, the presence of breast cancer subtype expression patterns and copy number aberration patterns. We also identified pleural mesothelial cells expressing a cancer‐associated fibroblast‐like transcriptomic program that may support cancer growth.ConclusionsOur dataset presents the first unbiased assessment of breast cancer‐associated MPEs at a single cell resolution, providing the community with a valuable resource for the study of MPEs. Our work highlights the molecular and cellular diversity captured in MPEs and motivates the potential use of these clinically relevant biopsies in the development of targeted therapeutics for patients with advanced breast cancer.

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Pleural Fluid Characteristics of Paramalignant Effusion

Cited by 9 publications

References 0 publications

Pleural Effusion Revealing a Diagnosis of Ewing Sarcoma

Pleural Effusion Revealing a Diagnosis of Ewing Sarcoma

Pleurodesis

Single‐cell RNA sequencing captures patient‐level heterogeneity and associated molecular phenotypes in breast cancer pleural effusions

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