A comparative study of conventional cytology and cell block method in the diagnosis of pleural effusion

Assawasaksakul, Theerada; Boonsarngsuk, Viboon; Incharoen, Pimpin

doi:10.21037/jtd.2017.08.52

Cited by 40 publications

(50 citation statements)

References 17 publications

(37 reference statements)

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“…In fact, CB specimens can be stored and multiple sections taken for immunocytochemistry and also molecular testing. CB methodology is becoming be validated in advanced non‐small cell lung cancer patient diagnosis and also in immunocytochemical analysis of predictive markers such as ALK, ROS1 and PD‐L1, and molecular testing for target therapies . We have presented a case of PPHL diagnosed by CB obtained from FNA in a patient with large, partially cavitated, cystic lesions of right upper pulmonary lobe.…”

Section: Discussionmentioning

confidence: 99%

Primary pulmonary Hodgkin lymphoma presenting as multiple cystic lung lesions: diagnostic usefulness of cell block

et al. 2020

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Classic primary pulmonary Hodgkin lymphoma (PPHL) is a rare event usually presenting as single or multiple nodules and more rarely as multiple cystic lesions. A patient affected by PPHL is often debilitated with impaired cardiorespiratory function and not suitable for invasive procedure to acquire a biopsy sample for histological diagnosis. Transthoracic ultrasound-guided fine needle aspiration (TUS-FNA) is a non-invasive procedure which gives the possibility to obtain a cytological sample that can be used to perform cell-block (CB). CB preparation can provide a diagnostic sample useful for additional analysis, such as immunocytochemical studies and molecular profiling. | C A S E HIS TORYA 18-year-old woman, without previous oncological history, presented to our Institution with fever, weight loss, dyspnoea and asthenia. At clinical evaluation, decreased air entry and fine crepitations at right upper pulmonary zone were present. Blood count was within normal limits. Erythrocyte sedimentation rate (120 mm/h) and C-reactive protein (20 mg/dL) were elevated. Blood cultures, expectorate and bronchioalveolar lavage did not identify infectious agents. Enhanced chest computed tomography scan (Figure 1C) showed large, partially cavitated lesions, 8 cm in maximum diameter, involving the right lung, predominantly the upper lobe. No mediastinal lymph node enlargement was detected. The clinical condition improved on steroid treatment. | MATERIAL S AND ME THODSTUS-FNA of one of the cystic lesions was performed. Specifically, ultrasound convex transducers with a central hole for needle passage ( Figure 1A) allows TUS-FNA using a dedicated convex probe: this method allows real-time visualisation of the needle ( Figure 1B) and acquisition cytological samples for CB preparation (Figure 1D).A 4-mL sample of pinky, non-corpuscolated fluid sample ( Figure 1D) was obtained and processed as CB preparation. Calcium chloride and plasma solution at 1:1 was added to fluid sample obtained from TUS-FNA until a clot was formed and subsequently admixed with 10% buffered formalin. Finally, the solid clot was automatically processed and embedded in paraffin. CB sections were prepared and stained with haematoxylin and eosin.

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Section: Discussionmentioning

confidence: 99%

Primary pulmonary Hodgkin lymphoma presenting as multiple cystic lung lesions: diagnostic usefulness of cell block

et al. 2020

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“…A number of markers can be used to predict TPEs and AD-MPEs, although their use of markers is considerably less speci c than histology. However, the results can complement each other [15]. As a routine diagnostic work-up, PT, FIB, FDP and D-D are often used to manage coagulation and brinolysis in patients; however, this is the rst study to utilize coagulation indicators to distinguish TPEs from AD-MPEs.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of four coagulation function indicators for distinguishing between tuberculous pleural effusions and malignant pleural effusions due to lung adenocarcinoma

Li¹,

Gao²,

Lin³

et al. 2020

Preprint

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Background: Coagulation function indicators are often used to evaluate patients’ coagulation function.They are rarely used in disease diagnosis;their use is limited to somecoagulopathies. We described the pattern of coagulation function indicators in patients with pleural effusions and determined the diagnostic value of different abnormal patterns of these indicators for distinguishing tuberculous pleural effusions (TPEs) from malignant pleural effusions associated with lung adenocarcinoma (AD-MPEs).Methods: Patients with AD-MPEs or TPEs participated in this retrospective study.Coagulation functionindicators, including activated partial thromboplastin time, prothrombin time (PT), fibrinogen (FIB), thrombin time, fibrinogen degradation products (FDP), and D-dimer(D-D), were measured; their levels and abnormal patterns were analyzed separately and in combination,to determine the diagnostic performance of individual and combined values and the optimal diagnostic model.Results: One hundred patients with AD-MPEs and 84 patients with TPEs participated.PT, FIB, FDP, and D-Dlevels in patients with TPE were significantly higher than those in patients with AD-MPE (all P<0.01).Receiver operating characteristiccurves revealed that PT, FIB, FDP, and D-Dvalues, particularly FDP and D-D, could distinguish betweenAD-MPE and TPE. The diagnostic performance was better for the combination of the four indicators than for any single indicator (Youden’s index: 0.513; area under the curve: 0.810).The proportion of patients with abnormal patterns of all four indicators was significantly higher in those with TPE than in those with AD-MPE (P<0.001).Conclusions: Thecombined values of PT, FIB, FDP, and D-Dhave diagnostic value for distinguishing TPE from AD-MPE.

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“…More than 90% of MPE are exudates and half of them haemorrhagic. Diagnostic yield ranges from 61% to 90% [79,81,82]. When two consecutive cytological examinations are negative, a video-assisted thoracoscopic surgery (VATS) is recommended due to its sensitivity >0.90 and low rate of complications [79,81,83].…”

Section: Thoracocentesismentioning

confidence: 99%

Lung cancer staging: a concise update

et al. 2018

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Diagnosis and clinical staging of lung cancer are fundamental to planning therapy. The techniques for clinical staging, anatomic and metabolic imaging, endoscopies and minimally invasive surgical procedures, should be performed sequentially and with an increasing degree of invasiveness. Intraoperative staging, assessing the magnitude of the primary tumour, the involved structures, and the loco-regional lymphatic spread by means of systematic nodal dissection, is essential in order to achieve a complete resection. In resected tumours, pathological staging, with the systematic study of the resected specimens, is the strongest prognostic indicator and is essential to make further decisions on therapy. In the present decade, the guidelines on lung cancer staging of the American College of Chest Physicians and the European Society of Thoracic Surgeons are based on the best available evidence and are widely followed. Recent advances in the classification of the adenocarcinoma of the lung, with the definition of adenocarcinoma , minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma, and the publication of the eighth edition of the tumour, node and metastasis classification of lung cancer, have to be integrated into the staging process. The present review complements the latest guidelines on lung cancer staging by providing an update of all these issues.

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A comparative study of conventional cytology and cell block method in the diagnosis of pleural effusion

Abstract: In MPE, CB provides a similar diagnostic performance to CS, while application of both techniques can significantly increase the diagnostic yield. However, in other pleural diseases, CB and CS had limited values in diagnosis.

Cited by 40 publications

References 17 publications

Primary pulmonary Hodgkin lymphoma presenting as multiple cystic lung lesions: diagnostic usefulness of cell block

Primary pulmonary Hodgkin lymphoma presenting as multiple cystic lung lesions: diagnostic usefulness of cell block

Diagnostic value of four coagulation function indicators for distinguishing between tuberculous pleural effusions and malignant pleural effusions due to lung adenocarcinoma

Lung cancer staging: a concise update

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