Positivity of pleural fluid cytologic examination in transudative pleural effusions
Por:
Foresti V., Scolari N., Villa A.
Publicada:
1 ene 1998
Resumen:
Purpose: The pleural fluid from a malignant pleural effusion (MPE) is an exudate. The diagnosis of a MPE is established by demonstrating malignant cells by cytologic examination of the pleural fluid. The accuracy of the cytologic diagnosis of MPEs has been reported to be between 40 and 87%. In less than 5% of the cases, the pleural fluid from a MPE is a transudate using Light's criteria. The purpose of our study was to evaluate the number of patients (pts) with positivity of pleural fluid cytologic examination and pleural fluid characteristics of transudate. Methods: We prospectively studied 368 pts with pleural effusions: 20.1% were transudates (82.4% due to heart failure, 17.6% to liver cirrhosis), 33.1% were benign exudates, 43.8% were malignant exudates, 3.0% were paraneoplastic exudates. Results: Four of 368 pts (1.1%) had transudate with positivity of pleural fluid cytologic examination: 1 patient had breast adenocarcinoma, 1 had lung adenocarcinoma, 1 had undetermined adenocarcinoma, and 1 had NH lymphoma. Light's criteria were as follows: protein LDH pleural fluid patient ratio ratio LDH (U/L) 1 0.36 0.44 138 2 0.42 0.24 296 3 0.40 0.49 142 4 0.21 0.49 204 Conclusions: These data confirm a small number of pts with cytologically proved MPE, where pleural fluid showed the characteristics of a transudate according to Light's criteria. Clinical Implications: The pathological valuation of pleural fluid by cytology must be performed in every pleural effusion also in transudates.
Filiaciones:
Foresti V.:
Fatebenefratelli Hospital, Milan, Italy
Scolari N.:
Fatebenefratelli Hospital, Milan, Italy
Villa A.:
Fatebenefratelli Hospital, Milan, Italy
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