The Value of Cytology in the Diagnosis of Pleural Effusions

Tetikkurt, Cuneyt; Kara, Banu; Tetikkurt, Seza; Yilmaz, Nail; Yasar, I.; Dişçi, Rian

doi:10.9734/bjmmr/2014/7165

Cited by 4 publications

(12 citation statements)

References 13 publications

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“…It is impossible to differentiate a tuberculous effusion from a malignant pleural effusion on clinical grounds alone and usually more invasive diagnostic interventions are needed. As the results of our study suggests, the absence or the scarcity of mesothelial cells along with the presence of more than 50% small lymphocytes should be regarded as a strong evidence for tuberculosis [1] . The absence of mesothelial cells is attributed to the deposition of fibrin on the pleural surface, either sealing off the mesothelial cells, destroying them or both [14] .…”

Section: Discussionmentioning

confidence: 52%

“…Although the etiologic spectrum is wide, most effusions occur due to malignancy, heart failure, tuberculosis or bacterial infection. [1,7,8,9] Because the effusions develop as a manifestation of an underlying disease, it is difficult to determine the precise incidence. Cytological examination is often the initial diagnostic step for its etiologic identification.…”

Section: Discussionmentioning

confidence: 99%

“…Almost all adenocarcinomas were diagnosed with cytology, but the yield was less with squamous cell carcinomas, Hodgkin's disease and sarcomas [1] . This may be due to the fact that the adenocarcinoma cells are more easily identified cytological and large tissue biopsies are usually needed for the diagnosis of lymphoma and sarcomas.…”

Section: Discussionmentioning

confidence: 99%

“…Cytology can be the key to direct diagnosis or can indicate the next step leading the clinician in the correct pathway for final diagnosis even when not diagnostic on its own, and thus precluding unnecessary invasive interventions. In most diseases related to pleural effusion, the pleural fluid analysis yields important diagnostic information and in certain cases it provides the final diagnosis [1] . …”

Section: Discussionmentioning

confidence: 99%

“…It may lead to final diagnosis and provide useful information for treatment. The diagnostic yield of the cytological analysis may be attributable to the cell population present in the sediment that is representative of a much larger surface area than the pleural biopsy [1,2] . It is very useful in the very first initial work up for the management of the case of pleural effusion.…”

Section: Introductionmentioning

confidence: 99%

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Cytological Study of Pleural Effusions and its Utility in Clinical Approach

Gojiya

Goswami²,

Shah³

2017

APALM

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IntroductionPleural fluid cytology is a simple and a minimally invasive technique as the preliminary step for the diagnostic evaluation of pleural effusions, assisting the clinician in establishing the differential diagnosis. It may lead to final diagnosis and provide useful information for treatment. The diagnostic yield of the cytological analysis may be attributable to the cell population present in the sediment that is representative of a much larger surface area than the pleural biopsy [1,2] . It is very useful in the very first initial work up for the management of the case of pleural effusion. It may also provide crucial clues for the identification of both non-malignant pleural and transudative effusions. Sensitivity will be higher if the clinical, radiological and laboratory results are collaborated. This study was carried out to determine the diagnostic utility of pleural fluid cytology. Materials and MethodsThe study was conducted in the Department of PathologyCytology section of Govt. Medical College and Sir T Hospital, Bhavnagar (Gujarat). It's a retrospective study of cytology impression of pleural fluids for one year duration from January 2015 to December 2015. Pleural fluids which received for cytological analysis from the various departments of our institute with the proper complete history and clinical brief are included in the study. These fluid samples were examined for physical properties like the volume, color, appearance, turbidity, presence of clot coagulum. Fluids samples are then centrifuged at 2000 rpm for five minutes. Smears made from the sediment part of centrifuged fluid and stained with Giemsa, Hematoxylineosin and Papanicolaou stains. Smears were examined for the differential cell count and reported descriptively, final impression given as malignant or non-malignant pleural effusion. Malignant pleural effusions were further classified according to its morphometrics. Study results then analyzed with the help of tables and charts and discussed for its incidence rate. ResultIn our study during the year 2015 total 295 cases of pleural fluids were examined for cytology. Out of 295 pleural fluids specimens 84 samples were of females and remaining 211 were of males, so here male is to female ratio of pleural fluid specimens was 2.5:1CHART-1. The pulmonary department had sent pleural fluid examination mostly among the all other departments. Pleural effusions

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cytological Study of Pleural Effusions and its Utility in Clinical Approach

Gojiya

Goswami²,

Shah³

2017

APALM

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Cytologic analysis of body fluids with an emphasis on malignant effusions

Sudha¹,

Korti²,

Prabhala³

et al. 2020

IJPO

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Introduction: Fluid cytology, a relatively non invasive technique, throws light on both malignant and non malignant causes of effusions. It especially contributes in cancer research and staging of various tumors. Materials and Methods: This was a retrospective study done over a period of two years from January 2014 to December 2015 in the department of Pathology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad. The body fluids included in the study were pleural, peritoneal, pericardial and synovial fluids. All other fluids were excluded. The relevant clinical data was noted. Gross, cell count and cytomorphological examinations of fluid were done.Results: Out of 302 cases, pleural fluids, 148 (49.0%) cases, were most common, followed by peritoneal fluid, 125 (41.39%) cases and least common was pericardial fluid, 8 (2.64%) cases. The maximum numbers of cases was in 5 th decade. The age range was 3 years to 84 years. Female preponderance was observed with M: F ratio of 1: 1.17. Lymphocyte rich exudates were most common in pleural effusion. In peritoneal and pericardial effusions, transudates were more and suppurative inflammation was predominant in synovial fluid analysis. Over all, malignant effusions constituted 18.54% of effusions. Metastatic adenocarcinoma was the commonest malignancy detected in all body cavity effusions. Conclusions: Fluid cytology is relatively painless, simple, cost effective, rapid technique that yields quick and reliable results. Some cases may present major interpretative challenges to the pathologist. Ancillary studies such as cell count, biochemical, microbiologic evaluation, cell block and immunohistochemistry (IHC) study help in accurate identification of diagnosis.

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Malignant pleural effusions with unknown primary sites: A 6 years cytological study

Singh¹,

Aggarwal²,

Sood³

et al. 2020

IJPO

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Introduction: Malignant pleural effusion is an important complication found in patients of advanced cancers and lead on to exudative effusions. Not much data is available regarding malignant pleural effusions with unknown primary sites so we had conducted a retrospective study to highlights the primary sites in cases of malignant pleural effusions. Materials and Methods: The present study was conducted at a tertiary care centre at Ludhiana, Punjab. Retrospective analysis of case records of 104 patients, diagnosed as malignant pleural effusions on cell cytology out of 2948 cases of pleural fluids during a 6 years period (2012 to 2017) was done and the results were analysed to assess the causes and various primary sites of malignant pleural effusion. Results and Conclusion:A total of 104 pleural fluid samples were found to be positive for malignancy out of 2948 cases of pleural fluids during the study period time. Lung carcinoma was found to be the most common cause of malignant pleural effusion. On morphology, adenocarcinoma was the most common type of cytological diagnosis in all pleural effusions. Unknown primary malignancies presented as pleural effusions in many cases with no specific signs & symptoms. Cytological study can reveal the morphological diagnosis & clinch the primary site of origin in more than 50% of cases. Cytological analysis of pleural fluid should be the initial diagnostic approach to diagnose malignant pleural effusions and tapped effusions must always be sent for cytological study.

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The Value of Cytology in the Diagnosis of Pleural Effusions

Cited by 4 publications

References 13 publications

Cytological Study of Pleural Effusions and its Utility in Clinical Approach

Cytological Study of Pleural Effusions and its Utility in Clinical Approach

Cytologic analysis of body fluids with an emphasis on malignant effusions

Malignant pleural effusions with unknown primary sites: A 6 years cytological study

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