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Metastatic transitional cell carcinoma causing a unilateral pleural effusion: a case report
Stephen M McGrath1, Durgesh N Rana, Margaret Lynch
1Manchester Cytology Centre, Manchester, United Kingdom.
Acta Cytologica
|June 11, 2008
Summary
Eosinophilic cytoplasmic inclusions (ECIs) in pleural fluid can indicate metastatic transitional cell carcinoma (TCC). Detecting these inclusions aids in diagnosing TCC spread to the pleura.
Area of Science:
- Cytopathology
- Oncology
- Pulmonology
Background:
- Transitional cell carcinoma (TCC) rarely presents with serous effusions.
- Cytologic diagnosis of metastatic TCC in effusions is infrequently documented.
- Eosinophilic cytoplasmic inclusions (ECIs) are a potential indicator of metastatic TCC.
Observation:
- A case of metastatic TCC diagnosed in pleural fluid from a 50-year-old male patient.
- The patient had a history of poorly differentiated TCC of the urinary bladder and omental metastasis.
- Pleural fluid cytology revealed pleomorphic malignant cells with numerous ECIs.
Findings:
- Metastatic TCC was confirmed in pleural fluid cytology.
- Similar cytologic features, including ECIs, were observed in an omental biopsy.
- The presence of ECIs in malignant pleural effusions suggests metastatic TCC.
Implications:
- ECIs are a significant cytologic finding in malignant pleural effusions.
- Recognition of ECIs can prompt consideration of metastatic TCC.
- This finding enhances diagnostic capabilities for TCC metastasis in cytologic samples.
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