Faculty Collaboration Database

Diagnostic yield of cytopathology in evaluating pericardial effusions: Clinicopathologic analysis of 419 specimens. Cancer Cytopathol 2017 Feb;125(2):128-137

Date

02/17/2017

Pubmed ID

28207201

DOI

10.1002/cncy.21790

Scopus ID

2-s2.0-85013115218 (requires institutional sign-in at Scopus site)   39 Citations

Abstract

BACKGROUND: Pericardial effusions can cause considerable morbidity and potentially may lead to mortality. Malignant pericardial effusions are uncommon, and data on malignancies encountered in pericardial effusion cytology specimens are limited.

METHODS: Relevant records of all pericardial effusions from January 2008 to September 2014 were examined and compared with pericardial biopsy results when performed. Discrepant cases were reviewed to determine the cause of the disagreement.

RESULTS: In total, 419 pericardial effusion specimens obtained from 364 patients were examined. Cytologic diagnostic categories included: negative for malignancy (332 specimens; 79%), equivocal (25 specimens; 6%), and positive (62 specimens from 51 patients; 15%). Forty-seven patients who had positive effusions were known to have malignancy. The most common primary malignancies were breast (39.3%) and lung (39.3%) cancers in women and lung cancer (47.4%) in men. A concurrent pericardial biopsy was performed in 46% of patients. Excluding equivocal cytologic diagnoses, cytology and biopsy were concordant in 153 of 173 paired samples (88.4%). The sensitivity of cytology in diagnosing malignancy was 92.1% compared with 55.3% for pericardial biopsy.

CONCLUSIONS: Cytologic examination has significant diagnostic utility in the evaluation of pericardial effusions and exhibits a lower false-negative rate compared with pericardial biopsy. Submission of pericardial biopsy alongside effusion cytology is associated with increased sensitivity for detecting malignancy and may be especially useful in the setting of low-volume pericardial effusion. Cancer Cytopathol 2017;125:128-137. © 2016 American Cancer Society.

Author List

Saab J, Hoda RS, Narula N, Hoda SA, Geraghty BE, Nasar A, Alperstein SA, Port JL, Giorgadze T

Author

Tamara Giorgadze MD Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Breast Neoplasms
Child
Child, Preschool
Cytodiagnosis
Female
Humans
Lung Neoplasms
Male
Middle Aged
Pericardial Effusion
Pleural Neoplasms