The role of cytology in neoplastic cardiac tamponade

Over a 16-year period, 47 samples of pericardial fluid from 34 patients at Hines Veterans Administration Hospital were cytologically evaluated, constituting approximately 0.1% of the total work load in our cytology laboratory. Eleven cellular samples from nine of the patients were positively identified as containing malignant cells that were histologically classifiable. Correlation with the surgical pathology and/or postmortem findings proved no false positives. Two false-negative cases probably represented inadequate sampling. In three patients, the diagnosis of cancer was initially established by the cytologic examination. In all instances, the pericardial fluid cytology helped determine the prognosis and mode of therapy.