Could the cytological evaluation of pericardial effusions illuminate our path?

Abstract

Objective: Pericardial effusion (PE) is a common clinical condition that can develop as a result of systemic or heart disease. In our study, we synthesized the cytopathological and clinical results of patients who underwent pericardiocentesis due to pericardial effusion. Method: A total of 213 patients who underwent percutaneous pericardiocentesis between 2007-2017 were included in the study: their cytologic and histopathologic diagnoses were noted and their relations were examined. Results: Hundred and thirty-two cases were male (61.9%), 81 were female (38.1%) and the mean of the study population age was 59.9 (min 13-max 97) years. Hundred and sixty-eight patients had benign (78.9%), 10 suspicious (4.6%), 3 non-diagnostic (1.4%) and 32 malignant cytologies (15.1%). Benign pericardial effusion was the most common diagnosis. Malignant cytology findings were interpreted as lung carcinoma (n=20: 62.5%), rhabdomyosarcoma (n=1: 3.1%), poorly differentiated adenocarcinoma (n=2: 6.2%), a gastrointestinal system carcinoma (n=4: 12.5%), undifferentiated epithelial tumor (n=1: 3.1%), breast carcinoma (n=1: 3.1%), and unspecified malignant tumor (n=3: 9%). Four (2.4%) of the 168 patients having diagnosis of benign cytology had previously received diagnosis of a malignant disease, however examination of cytological specimen. Did not reveal any malignancy. Three (30%) of the 10 patients with suspicious cytology, had received diagnosis of a malignant disease previously. Conclusion:In developed countries, it is reported that more than 50% of the PE's are idiopathic. The percentage of cancer-associated PE's is 10-25%. In our study, 78.9% of our cases had a benign diagnosis, and 15.1% had malignant PE consistent with the literature findings. Cytological sampling in pericardial fluid is a method that can shed light on the diagnosis of many diseases.

Etiologic, Echocardiographic, Cytological and Biochemical Characteristics of Patients with Significant Pericardial Effusion requiring Pericardiocentesis in a Tertiary Hospital

“…The cytological examination of our study group revealed benign findings by 83% and malignant findings by 17%. Similarly, in another study conducted in Turkey, the cytological examination of 213 patients undergoing pericardiocentesis revealed that 78,9% of the findings was benign while 15,1% was malignant (25). In a study examining 128 pericardial fluid materials, 74.2% were found to be benign, 24.2% were found to be malignant and 1.6% were found to have atypical cells and interstingly 23.1% of the patients in the same study were found to have malignancy although their cytology was benign (26).…”