Accuracy
Cytology is more sensitive than blind biopsy in patients suspected of serosal metastases, presumably because fluid provides a more representative sample. Cytologic examination supplemented by culture of the fluid is more reliable than a biopsy to detect tuberculosis. Cytologic examination of the effusions has a substantial false-negative rate. Some studies estimated the sensitivity of cytology […]
Primary effusion lymphoma
Primary effusion lymphoma It is a large B-cell lymphoma which presents as a pleural, pericardial or peritoneal effusion. There is no associated mass lesion or lymphadenopaty. Most cases arise in the setting of HIV infection. The prognosis is poor. Cytologic diagnostic features Dispersed large cells Round or irregular nuclei, prominent nucleoli Abundant basophilic cytoplasm (Romanowsky […]
Reporting terminology
Diagnoses are reported as negative for malignant cells, positive for malignant cells or suspicious for malignancy, followed by a description. A case is called suspicious when the abnormal cells are too poorly preserved or too few to support a definite diagnosis of malignancy. Criteria for the adequacy of effusion specimens have not been established.
Metastatic tumours
Metastatic tumours Carcinoma Malignant melanoma Non-Hodgkin lymphoma Sarcoma Metastatic carcinoma Metastatic carcinomas are by far the most common tumors found in effusions. Adenocarcinomas are more common than squamous cell or undifferentiated carcinomas. Histologic types which can be diagnosed: Adenocarcinoma Small cell carcinoma Squamous cell carcinoma In most cases the cells are morphologically distinct from mesothelial […]
Benign elements
Benign elements Benign effusions contain mesothelial cells, histiocytes and lymphocytes in varying proportions. Because some bleeding can often occur during specimen collection, red and white blood cells are common. Mesothelial cells Macrophages Lymphocytes Neutrophils Eosinophils Plasma cells Mesothelial cells Usually dispersed as isolated cells Occasional sheets or small clusters with windows Round cells Round nucleus, […]
Effusions
Author (V2.0): Francesco Mauri On completion of this section the cytotechnologist should know: the physiopathology of the effusions the collection and preparation methods the role of cytology in effusions the reporting terminology cytologic features of normal mesothelial cells and inflammatory cells cytologic features of atypical mesothelial cells and the causes of mesothelial atypia cytologic features of […]