Effusion cytology of esophageal carcinoma

Renshaw, Andrew A.; Nappi, Carmela; Sugarbaker, F.C.C.P. David J.; Swanson, Scott J.

doi:10.1002/(sici)1097-0142(19971225)81:6<365::aid-cncr11>3.0.co;2-x

Cited by 12 publications

(7 citation statements)

References 13 publications

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“…We included carcinomas from these 3 sites because they are the most common carcinomas in malignant pleural effusions . However, metastases to the pleura from numerous other sites, including prostate, upper gastrointestinal tract, colorectal, and pancreatic primary tumors are encountered. Although the differential diagnosis for AE1/AE3‐positive and WT1–negative cells consists mostly of nonovarian carcinomas, other keratin‐positive neoplasms such as epithelioid sarcoma have been reported in pleural fluids .…”

Section: Discussionmentioning

confidence: 99%

Wilms tumor 1/cytokeratin dual‐color immunostaining reveals distinctive staining patterns in metastatic melanoma, metastatic carcinoma, and mesothelial cells in pleural fluids: An effective first‐line test for the workup of malignant effusions

Conner

Cibas

Hornick

et al. 2014

Cancer Cytopathology

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BACKGROUND:The workup of a malignant effusion usually requires immunostaining with a panel of markers. Although nuclear Wilms tumor 1 (WT1) expression is widely used to detect tumors of ovarian and mesothelial origin, it is less well known that WT1 is also expressed in the cytoplasm of melanomas and mesenchymal tumors. Because to the authors' knowledge the diagnostic utility of cytoplasmic WT1 expression has not been explored to date, the usefulness of a WT1=AE1=AE3 dual-color immunostain in the workup of malignant effusions was evaluated. METHODS: A total of 86 pleural effusions, including 17 metastatic melanomas, 31 metastatic adenocarcinomas, 10 malignant mesotheliomas, 10 lymphoproliferative disorders, 5 metastatic sarcomas, and 13 benign specimens, were immunostained using a peroxidase-based brown chromogen for WT1 and an alkaline phosphatase-based red chromogen for AE1=AE3 on cell block sections. RESULTS:The majority of malignant effusions stained in 1 of 4 distinctive patterns: 1) all lung and breast adenocarcinomas demonstrated cytoplasmic AE1=AE3 expression without nuclear or cytoplasmic WT1 expression; 2) serous carcinomas of M€ ullerian origin, mesotheliomas, and benign mesothelial cells were positive for cytoplasmic AE1=AE3 as well as nuclear WT1; 3) melanomas, sarcomas, and a subset of plasma cell neoplasms were positive for cytoplasmic expression of WT1 but negative for AE1=AE3; and 4) large B-cell lymphomas and a subset of plasma cell neoplasms were negative for both markers. CONCLUSIONS: A WT1=AE1=AE3 dual-color immunostain can reliably identify malignancy in pleural effusions and group malignant cells into discrete subsets, thereby narrowing the differential diagnosis. This simple double stain can be a cost-effective, first-line test in the workup of patients with malignant effusions. Cancer (Cancer Cytopathol) 2014;122:586-95.

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Section: Discussionmentioning

confidence: 99%

Wilms tumor 1/cytokeratin dual‐color immunostaining reveals distinctive staining patterns in metastatic melanoma, metastatic carcinoma, and mesothelial cells in pleural fluids: An effective first‐line test for the workup of malignant effusions

Conner

Cibas

Hornick

et al. 2014

Cancer Cytopathology

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“…Some authors reported that the incidence of cytological positivity of pleural lavage specimens was significantly higher in adenocarcinoma than in squamous cell carcinoma. 7,9 In this series, all patients had squamous cell carcinoma.…”

Section: Discussionmentioning

confidence: 64%

“…7,8 There have been few reports, however, on the cytological findings for pleural lavage fluid in esophageal carcinoma. 9 The aim of this study was to determine whether intraoperative cytological examination of pleural lavage fluid could be used as an indicator of recurrence and patient prognosis in esophageal carcinoma.…”

mentioning

confidence: 99%

Intraoperative Pleural Lavage in Esophageal Carcinoma

et al. 1999

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“…[12] Some other rare causes of pleural effusion with squamous cells have been described in the literature. Malignant pleural effusions can rarely be seen in patients with metastatic squamous cell carcinoma of the esophagus,[13] cervix[14] or penis. Benign squamous cells have also been described in an instance of rupture of a mediastinal benign cystic teratoma into a pleural space.…”

Section: Discussionmentioning

confidence: 99%

Cytomorphology of Boerhaave's syndrome: A critical value in cytology

2013

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Spontaneous esophageal perforation into the pleural cavity (Boerhaave's syndrome) is a rare life-threatening condition, which requires early diagnosis and urgent management. The diagnosis of such critical condition in many cases is delayed because of atypical clinical presentation, resulting in increased morbidity and mortality. Cytological examination of pleural fluid can provide early, fast and accurate diagnosis of such critical condition and help in better and early management of this disease. We describe a case of an 81-year-old female with esophageal perforation who presented with a left sided pleural effusion. The correct diagnosis was established in this case by observing gastrointestinal-like fluid characteristics of the thoracic drainage upon cytological and chemical analyses and the rupture was confirmed by esophagography. The cytological examination of pleural fluid revealed benign reactive squamous cells, fungal organisms, bacterial colonies, and vegetable material consistent with a ruptured esophagus. Cytological examination of pleural fluid is a rapid and accurate technique that can help in establishing the diagnosis of this challenging entity and guide initiation proper management of this unusual entity.

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Effusion cytology of esophageal carcinoma

Cited by 12 publications

References 13 publications

Wilms tumor 1/cytokeratin dual‐color immunostaining reveals distinctive staining patterns in metastatic melanoma, metastatic carcinoma, and mesothelial cells in pleural fluids: An effective first‐line test for the workup of malignant effusions

Wilms tumor 1/cytokeratin dual‐color immunostaining reveals distinctive staining patterns in metastatic melanoma, metastatic carcinoma, and mesothelial cells in pleural fluids: An effective first‐line test for the workup of malignant effusions

Intraoperative Pleural Lavage in Esophageal Carcinoma

Cytomorphology of Boerhaave's syndrome: A critical value in cytology

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