Evaluation and Management of Pericardial Effusion in Patients with Neoplastic Disease

Maisch, Bernhard; Ristić, Arsen; Pankuweit, Sabine

doi:10.1016/j.pcad.2010.06.003

Cited by 123 publications

(77 citation statements)

References 35 publications

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“…Unlike metastatic carcinomas, diagnosis of angiosarcoma is based on open cardiac biopsy or surgical resection of a right atrial mass with no data showing an ability to diagnose this tumor based on effusion cytology alone. The diagnostic capabilities of cytology for cardiac angiosarcoma appear to be similar to what is seen in dogs with hemangiosarcoma resulting in differing diagnostic yields 22, 28, 29, 30, 31…”

Section: Discussionmentioning

confidence: 79%

Diagnostic Yield of Cytologic Analysis of Pericardial Effusion in Dogs

Cagle

Epstein

Owens

et al. 2013

Veterinary Internal Medicne

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BackgroundPericardial effusion cytology is believed by many to be of limited value, yet few studies have evaluated its diagnostic utility.ObjectivesTo determine the diagnostic utility of cytologic analysis of pericardial effusion in dogs and to determine if consideration of additional data could improve the diagnostic yield.AnimalsTwo hundred and fifty‐nine dogs with cytologic analysis of pericardial effusion performed between April 1990 and June 2012.MethodsElectronic medical records from a university teaching hospital were retrospectively reviewed; signalment, complete blood count, serum biochemistry, cytologic analysis of pericardial effusion, and echocardiographic data were recorded. Cytology was classified as diagnostic (infectious or neoplastic) or nondiagnostic (hemorrhagic or other) and groups were compared with multiple Student's t‐tests.ResultsCytology was grouped as nondiagnostic (92.3%) or diagnostic (7.7%) and characterized as hemorrhagic (90%), neoplastic (4.6%), infectious (3.1%), or other (2.3%). Overall cytologic analysis of pericardial effusion diagnostic utility was 7.7% and increased to 20.3% if the effusion hematocrit (HCT) <10%; echocardiographic evidence of a mass did not result in a significant increase in the diagnostic utility.Conclusions and Clinical ImportanceThe diagnostic utility of cytologic analysis of canine pericardial effusion is variable depending on the underlying etiology. In this group of dogs, the diagnostic yield of cytologic analysis was greater for pericardial effusion samples in which the HCT was less than 10%.

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Section: Discussionmentioning

confidence: 79%

Diagnostic Yield of Cytologic Analysis of Pericardial Effusion in Dogs

Cagle

Epstein

Owens

et al. 2013

Veterinary Internal Medicne

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“…Maisch, Burchert, Moll, and Pankuweit report on a patient in whom pericardioscopy with targeted epicardial and pericardial biopsy enabled the distinction between neoplastic, radiogenic, or cardiotoxic pericardial effusion after effective treatment of the neoplastic process, including stem cell therapy. The assessment of a correct, etiologically-based diagnosis was the prerequisite for successful intrapericardial treatment [6,7], which in this case was intrapericardial high-dose triamcinolone.…”

Section: How Can We Assess Cardiotoxicity Early?mentioning

confidence: 99%

“…Metastatic pericardial disease is by far the most frequent neoplastic disorder affecting the heart [6,7]. The differential diagnosis of a pericardial effusion of unknown etiology can be difficult, whereby the differentiation of malignant from non-malignant pericardial effusion obviously has an immense prognostic impact.…”

mentioning

confidence: 99%

Cardiovascular disease in cancer patients… only the tip of the iceberg?

Maisch

2011

Herz

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“…Pericardioscopy allows safe biopsies under optical control and has opened a new window to the heart [21,22] as illustrated by convincing images and the contribution by Maisch and coworkers in the issue. An etiologically based intrapericardial therapy in malignant effusions [23,24] or with triamcinolone in autoimmune perimyocardial disorders [25] depends on the yield and the diagnosis from targeted biopsy sampling. Pericardioscopy has opened a new diagnostic and therapeutic window to the heart.…”

mentioning

confidence: 99%

“…When the pericardial effusion is large and pericardiocentesis and tissue sampling has excluded the viral genome, intrapericardial triamcinolone is the treatment of choice [3,4,25]. Similarly, intrapericardial cis-platin or thiotepa together with systemic tumor treatment should be given to patients with malignant pericardial effusions [4,23,24], which conforms with the European guidelines [3].…”

mentioning

confidence: 99%