The Diagnostic Value of Pleural Fluid Cytology in Benign and Malignant Pleural Effusions
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- Category: Vol. 80, June 2012
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The Diagnostic Value of Pleural Fluid Cytology in Benign and Malignant Pleural Effusions,SAMAR A. EL-SHEIKH
Abstract
In developing countries, where investigations and health facilities are inadequate and cost of treatment is unaffordable, cytological examination of body fluids is considered a cheap, rapid, and highly effective tool in identification of the etiology of effusion with prediction of the underlying disease. Cyto-logical examination can detect malignant cells in effusions and sometimes it's superior to biopsy in detecting serosal malignancy. Good clinical history, history of asbestos exposure, absence of other malignancy elsewhere in the body and radiologic findings are very important aids in confirmation of cytological diagnosis of malignancy. Sometimes, the definite diagnosis is not reached by cytology alone and the need for tissue biopsy or even other ancillary methods becomes man-datory. This work aimed at studying the different cytomor-phological features of pleural effusion samples in relation to other clinicopathological variables with special highlights on malignant cases in order to identify the role of cytology as an important diagnostic tool in cancer detection even before the clinical diagnosis. To perform this study, the slides of 606 cases of pleural effusion stained with H & E, Giemsa, and papanicolaou stains were collected from the archives of the Cytology Unit, Pathology Department, Faculty of Medicine, Cairo University, Kasr Al-Aini Hospitals, during the period from January 1, 2006 till December 31, 2010. The slides were revised and the results were statistically analysed. This study has found a statistical correlation between the clinical presen-tation and the cytological diagnosis. Also the relation between the gross appearance of effusion and the cytological diagnosis was statistically significant. In conclusion, these findings suggest that cytologic examination of pleural fluid is of great diagnostic value in both non-neoplastic and neoplastic effu-sions. Cytology also plays a central role in the etiological clarification of pleural effusion specially if good clinical data are available and sometimes it has an instructive significance in diagnosis of malignancy even before the clinical diagnosis.