Role of cytoblock on pleural effusion for diagnosis of malignant disease

Abstract

BackgroundThoracocentesis of pleural effusion is a simple technique for pleural fluid examination through cytology. In addition to cytological examination to assess the nature of pleural fluid content, we can also perform more detailed examinations through cytoblocks of residual fluid. These paraffin‐embedded cytoblock samples are important because we can perform examinations as in other bioptic samples. In these samples, immunohistochemical and molecular analyses can be performed.MethodsTwo hundred fifty‐five cytological samples from patients with pleural effusion were examined. In cases in which the presence of malignant cells was identified in the cytological examination, as well as cases that were suspicious but not definitive for the presence of a malignant effusion, a cytoblock was prepared. Histological examination and immunohistochemical analysis were performed.ResultsAmong 255 cases with pleural effusion, 152 had the presence of malignant cells and 6 cases were suspicious, but uncertain for the presence of malignant cells, while 86 cases had inflammatory pleural effusion or other pathologies but were not malignant. After histological analysis of the cytoblock and immunohistochemical analysis, we identified 82 malignant tumors of the lung, 8 malignant tumors of the gastrointestinal tract, 15 malignant tumors of the breast, and 6 malignant tumors of the female genital tract, as well as 24 tumors of undetermined origin.ConclusionsCytoblocks are important for the diagnosis of the primary nature of malignant pleural effusions. The highest importance is primary lung tumors, as well as those tumors in which the primary site of the tumor cannot be determined clinically.

Expression of cytokines in pleural effusions and corresponding cell lines of small cell lung cancer

“…MPEs appear in all cell types of lung cancer with highest incidence in adenocarcinoma (approximately 30%), followed by squamous cell carcinoma (SCC; approximately 9%) and SCLC (approximately 10%) ( 24 , 25 ). Thoracocentesis of pleural effusion allows for the examination through cytology and proof of a malignant process ( 26 ). Accumulation of MPE is due to increased permeability of the pleural vessel cells as well as vasoactive and inflammatory cytokines secreted by invaded tumor cells.…”