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Malignant pleural effusions. A clinical cytopathologic study.

D R Irani, R D Underwood, E H Johnson

    Archives of Internal Medicine
    |June 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    Cytologic examination of pleural fluid is highly accurate for diagnosing malignant pleural effusions, outperforming needle biopsies. However, survival rates for malignant pleural effusions have not improved over 25 years.

    Area of Science:

    • Pulmonology
    • Oncology
    • Cytopathology

    Background:

    • Malignant pleural effusions are a common complication of various cancers.
    • Accurate diagnosis is crucial for patient management and prognosis.
    • Previous studies have evaluated diagnostic methods for pleural fluid cytology.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of pleural fluid cytology.
    • To compare cytology with pleural core needle biopsy.
    • To assess the impact of treatment on survival in malignant pleural effusions.

    Main Methods:

    • Retrospective review of 620 pleural fluid cytology specimens from 1978-1982.
    • Analysis of false-positive rates and primary cancer sites.
    • Comparison of cytology results with pleural core needle biopsy in 26 patients.

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  • Evaluation of survival data based on treatment received.

    • Main Results:

    • Cytologic examination yielded a 96% positive diagnosis rate, significantly higher than needle biopsy (69%).
    • Adenocarcinoma of the lung was the most frequent primary site (25/61), followed by breast, ovary, and pancreas.
    • Patients receiving chemotherapy and radiotherapy survived longer (328 days) than those receiving no therapy (79 days).
    • False-positive results were low (0.5%).

    Conclusions:

    • Papanicolaou-stained pleural fluid cytology is a superior diagnostic method compared to cell blocks or needle biopsy.
    • Despite diagnostic advancements, mean survival for malignant pleural effusions has shown no significant improvement over 25 years.
    • Timely diagnosis and appropriate treatment, including chemotherapy and radiotherapy, can improve survival outcomes.