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

Abstract

Objective: As a fast and effective method, cytopathological examination of the pleural fluid is the diagnostic tool of choice in determining the etiology of a spectrum of inflammatory to neoplastic conditions. The aim of the present study was to investigate the role of pleural cytology samples examined within a certain time period in determining the presence of malignant cells. Materials and Methods: Cytological materials of 433 patients with pleural effusion (PE) were retrospectively analyzed. Clinical parameters and cytological diagnosis were recorded in consecutive patients with PE. Results: Of the 433 cases enrolled in the study, 264 (61%) were male, and 169 (39%) were female. 15.6% (67/433) of the cases were reported as malignant, and 85% were aged >50 years. It was found that the contribution of repeated cytological examination of a material to diagnosis was approximately 3%. The sensitivity and specificity of the cytological method were calculated as 34% and 99%, respectively. Immunocytochemistry was performed in 50 patients who received cell-block techniques, and 42.4% of those were diagnosed as malignant. Molecular tests were also performed in 5 patients. Conclusion: Although the sensitivity is low, cytological examination of the pleura can be considered a diagnostic tool of vital importance, especially in patients with an advanced-stage disease and poor performance, who can benefit from rapidly evolving and changing treatment options.

Diagnostic sensitivity of pleural fluid cytology in malignant pleural effusions: systematic review and meta-analysis

“…The database search yielded 3732 studies for screening with 181 potential studies identified for analysis. After full-text analysis, a total of 36 studies met inclusion criteria 2 3 7–40. A summary of the literature search is shown in figure 1.…”