The Differential Diagnosis in Nonlymphoproliferative Malignant Pleural Effusion Cytopathology and Its Correlation with Patients’ Demographics

Abstract

Background: We report our experience with malignant pleural effusion (MPE) and the impact of patients’ demographics on the differential diagnosis at the primary site. Methods: After IRB approval, we searched our pathology database from January 2013 to January 2017 for patients with positive pleural effusions (PEs). Patients’ demographics and clinical histories were noted. Results: 474 patients were identified (288 females [61%] and 186 males [39%]), ranging in age from 19 to 64 years old. Ethnicity was distributed as follows: Caucasian (n = 330, 70%), African American (n = 114, 24%) and Asian (n = 30, 6%). The most common primary sites were the lung (n = 180, 37%), followed by the breast (n = 81, 17%), and the gynecologic system (67, 13%). The lung was the most common primary for all ethnicities (n = 190, 40%). The second-most common primary site was the breast in African Americans and Caucasians and upper gastrointestinal (GI) tract in Asians. In 5 cases (1%), the primary tumor could not be determined. Conclusion: Cytology examination is a useful method to diagnose primary sites of PE. Pulmonary primary is the most common cause of effusion in all ethnicities. In African American and Caucasian patients, the breast was the second-most common site of MPE, while in Asian patients it was the upper GI tract.

Number of mesothelial cells as a measure of adequacy criteria for pleural effusions: A multi‐institutional study

“…Adenocarcinoma of the lung was the most common primary neoplasm involving the pleura in our cohort, followed by clear cell renal, colorectal and breast carcinomas, in accordance to previously published series . Interestingly, negative pleural effusions followed by positive pleural biopsies were more common in men.…”

“…In a previous study by the authors, women were diagnosed more frequently with a positive pleural effusion (61%) than men. This could be partly explained in that study by the high prevalence of tumours from breast and gynaecological origin, which showed a low incidence in the current dataset . Also, a high proportion of metastatic sarcomas was present among the false‐negative pleural effusion samples when taking into account the overall incidence of sarcomas involving effusions reported in the literature .…”

The role of cytology in pleural effusion: a single-center experience

“…In a study examining the demographic data of 474 patients with malignant PE, approximately 85% of the patients diagnosed with malignant cytology were over 50 years of age, which was similar to our findings (12).…”

Pleural metastasis from auricular melanoma: A brief report

“…According to the literature, cutaneous melanoma is known to metastasize to the lung; however, little is known about metastasis limited to the pleura given that this is an exceedingly rare event . The mechanism of tumor localization to the pleura and prognosis of such patients is not known.…”

“…According to the literature, cutaneous melanoma is known to metastasize to the lung; however, little is known about metastasis limited to the pleura given that this is an exceedingly rare event. 6 The mechanism of tumor localization to the pleura and prognosis of such patients is not known. A cytomorphologic diagnosis of metastatic melanoma using effusion cytology is very difficult because malignant effusions associated with metastatic melanoma may exhibit a variable cytological appearance.…”