Diagnostic yield of cytopathology in evaluating pericardial effusions: Clinicopathologic analysis of 419 specimens

Saab, Jad; Hoda, Rana S.; Narula, Navneet; Hoda, Syed A.; Geraghty, Brian E.; Nasar, Abu; Alperstein, Susan; Port, Jeffrey L.; Giorgadze, Tamara

doi:10.1002/cncy.21790

Cited by 46 publications

(55 citation statements)

References 28 publications

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“…A direct cancer involvement of the pericardium is seen in 7%–44% of pericardial effusions (table 1). 1 4–8 13–15…”

Section: Prevalence and Aetiologymentioning

confidence: 99%

“…The prevalence and extent of neoplastic pericardial involvement differ depending on the type of cancer (table 2). 3 5–8 11–18…”

Section: Prevalence and Aetiologymentioning

confidence: 99%

“…In patients with cancer, pericardial involvement results from several different pathophysiological mechanisms: (1) direct extension or metastatic spread of the underlying disease, (2) complication of systemic tumour treatment (radiation therapy and/or chemotherapeutic toxicity), (3) opportunistic infection in the setting of antineoplastic therapies, and (4) metabolic derangements in the liver and/or renal and/or cardiac function from cancer or cancer therapy (less common) (figure 2). 3 19 Malignant pericardial effusion can be explained either by direct local extension to the pericardium (ie, lung and breast cancer, oesophageal carcinoma) or by haematogenous and lymphangitic tumour spread (ie, haematological malignancies, melanoma, Kaposi sarcoma) 5–15. Additionally, pericardial effusion may arise from mediastinal lymphatic drainage obstruction by tumour infiltration.…”

Section: Pathophysiologymentioning

confidence: 99%

“…Once pericardial effusion is detected, diagnostic work-up should focus on the potential cause and its haemodynamic impact. Cardiac tamponade, causing haemodynamic compromise, occurs in 50% of patients with malignant pericardial effusions, expression of advanced, terminal disease 8 14–16. Moderate-to-large pericardial effusions often had specific aetiologies in up to 90% of cases (eg, neoplasms, tuberculosis, systemic inflammatory diseases), and clinical presentation is important to suspect them.…”

Section: Diagnostic Work-up and Managementmentioning

confidence: 99%

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Pericardial diseases in patients with cancer: contemporary prevalence, management and outcomes

Imazio

Colopi

Ferrari

2020

Heart

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Neoplastic pericardial effusion is a common and serious manifestation of advanced malignancies. Lung and breast carcinoma, haematological malignancies, and gastrointestinal cancer are the most common types of cancer involving the pericardium. Pericardial involvement in neoplasia may arise from several different pathophysiological mechanisms and may be manifested by pericardial effusion with or without tamponade, effusive-constrictive pericarditis and constrictive pericarditis. Management of these patients is a complex multidisciplinary problem, affected by clinical status and prognosis of patients.

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“…A direct cancer involvement of the pericardium is seen in 7%–44% of pericardial effusions (table 1). 1 4–8 13–15…”

Section: Prevalence and Aetiologymentioning

confidence: 99%

“…The prevalence and extent of neoplastic pericardial involvement differ depending on the type of cancer (table 2). 3 5–8 11–18…”

Section: Prevalence and Aetiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Diagnostic Work-up and Managementmentioning

confidence: 99%

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Pericardial diseases in patients with cancer: contemporary prevalence, management and outcomes

Imazio

Colopi

Ferrari

2020

Heart

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“…In many clinical situations, the fluid sample is split up between clinical chemistry, microbiology, haematology, and cytopathology. A minimum of 50‐100 mL effusion fluid should be dedicated to cytological examination …”

Section: Acquisitionmentioning

confidence: 99%

Management of cytological material, pre‐analytical procedures and bio‐banking in effusion cytopathology

et al. 2019

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Serous effusion fluid is one of the most commonly encountered specimens in routine cytopathology practice. It provides invaluable information about the patient and the clinical status; but to get the most of it, specimen handling and processing must be carried out properly. Cytomorphology is the basis of a successful analysis which should complemented by ancillary tests when needed. A wide spectrum of ancillary techniquesranging from immunocytochemistry and flow cytometry to different assays of molecular pathologycan be applied to serous effusions. This article describes the acquisition and management of serous effusion fluids, methods for preservation and transportation, different techniques of cytopreparation, application of immunocytochemistry, flow cytometry, and fluorescence in-situ hybridization (FISH), as well as DNA extraction for polymerase chain reaction (PCR) and next generation sequencing (NGS). Principles of bio-banking of effusion samples are also discussed which is getting more important in correlation with the developments in personalized medicine. K E Y W O R D S bio-banking, effusion cytology, fluorescence in situ hybridisation, immunocytochemistry, molecular tests, preparation techniques, serous effusion 1 | INTRODUCTION Serous effusion fluid-pleural effusion, ascites and pericardial effusion-is one of the most commonly examined specimen types in cytopathology. Serous effusions occur in the context of a wide spectrum of benign and malignant diseases. In many clinical situations, effusion fluid is the first sample obtained and analysed, and, more often than not, this sample is the key to precise and timely diagnosis. Classical cytomorphology is still the basis of the application of all ancillary techniques. Immunocytochemistry can be accepted as part of the routine procedure since it has been used as a complementary method for years to increase the diagnostic accuracy of effusion cytology. All ancillary tests, including the modern techniques of molecular pathology, can be applied to serous effusions in routine workflow. It is a rapidly evolving field; however, some basics do not change, such as the selection of the right area/sample for DNA extraction or for fluorescence in situ hybridisation (FISH) analysis. This paper intends to be a practical handout for readers who deal with effusion samples. The acquisition and management of effusion samples are considered; preparation techniques for morphological examination and application of ancillary tests are discussed. The last part of the text deals with bio-banking of effusion specimens, which deserves sincere attention for the future of effusion cytology, regarding the new therapy options and research facilities. | ACQUISITIONEffusion fluid can be obtained in three ways:• by thoracentesis, paracentesis, pericardiocentesis with aspiration of fresh fluid into a syringe or vial,

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Clinico‐cytopathologic analysis of 574 Pericardial Effusion Specimens: Application of the international system for reporting serous fluid cytopathology (ISRSFC) and long‐term clinical follow‐up

Song

Jeong

et al. 2021

Cancer Medicine

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Diagnostic yield of cytopathology in evaluating pericardial effusions: Clinicopathologic analysis of 419 specimens

Cited by 46 publications

References 28 publications

Pericardial diseases in patients with cancer: contemporary prevalence, management and outcomes

Pericardial diseases in patients with cancer: contemporary prevalence, management and outcomes

Management of cytological material, pre‐analytical procedures and bio‐banking in effusion cytopathology

Clinico‐cytopathologic analysis of 574 Pericardial Effusion Specimens: Application of the international system for reporting serous fluid cytopathology (ISRSFC) and long‐term clinical follow‐up

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