Abstract

HERNANDEZ F, Alipio A; OVIEDO DE AYALA, Norma  and  RIVERA, Blanca M. Efusión pleural maligna: estudio citopatológico de 75 casos consecutivos con correlación clínica e histologica. Gac Méd Caracas [online]. 2001, vol.109, n.4, pp.514-525. ISSN 0367-4762.

To assess the role of cytology as a method of diagnosis in patients with malignant pleural effusion, we reviewed clinical histories, cytological specimens, and histological slides of biopsies and autopsies from 75 patients with malignant pleural effusion in whom clinical follow up was available. The anatomoclinical correlation allowed location of the primary tumor as cause of pleural effusion in 88% of the cases. In women the primary tumor originated in breast (34%), in lung (30%), the primary tumor was unknown (12%) or was lymphomas/ leukemias in 10% of the cases. In men lung cancer was the more frequent primary tumor (72%), unknown primary tumor was found in 12% of the cases and lymphomas/leukemias in 8% of them. Adenocarcinoma was the dominant histological type. The percentage of positive malignancy in cytology´s pleural effusion was 87.63% against 64.44% found in biopsies (P= 0.004). The cytological study produced the first diagnosis of malignancy in 5.33% of the patients. A conclusive diagnosis of malignancy was obtained with the first sample of pleural fluid in 90.67% of the patients and in 100% with two samples, whereas the biopsy findings showed positivity in less of 70% of the patients after the third sample. Values of sensibility and specificity were of 100% and 42.86%, respectively. In conclusion, the cytological study of the pleural fluid is a valuable method for studying malignancy in patients with pleural effusion.

Keywords : Pleural effusion; Metastatic carcinoma; Cytology; Pleural biopsy; Sensibility; Specificity.