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Vol. 217. Issue 3.
Pages 144-148 (April 2017)
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Vol. 217. Issue 3.
Pages 144-148 (April 2017)
Brief Original
DOI: 10.1016/j.rceng.2016.11.002
Examination of cytological smears and cell blocks of pleural fluid: Complementary diagnostic value for malignant effusions
Examen del frotis citológico y bloque celular del líquido pleural: valor diagnóstico complementario en los derrames malignos
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J.M. Porcela,
Corresponding author
jporcelp@yahoo.es

Corresponding author.
, M. Quirósa, S. Gatiusb, S. Bielsaa
a Pleural Medicine Unit, Arnau de Vilanova University Hospital, Lleida, Spain
b Department of Pathology, Arnau de Vilanova University Hospital, Lleida, Spain
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Tables (2)
Table 1. Etiology of malignant pleural effusions.
Table 2. Sequential cumulative sensitivity (95% CI) of pleural fluid smears, cell blocks, and their combination for labeling malignancy in 414 patients, based on the number of processed specimens.
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Abstract
Objectives

To evaluate the independent usefulness of pleural fluid smear and cell block (CB) preparations for the diagnosis of malignant effusions.

Patients and methods

A total of 632 cytological smears and 554 CBs from 414 consecutive patients with malignant effusions were retrospectively evaluated.

Results

The diagnostic yield of a first specimen was 44% regardless of whether a smear or CB cytologic examination was performed. The use of subsequent separated specimens increased the identification of malignancy to 56%. Overall, 11% of samples found to be negative by cytologic smears showed malignant cells on CBs, whereas 15% of negative CBs were reported as positive on smear slides. Pleural fluid specimens with low red and/or white blood cell counts more frequently resulted in the generation of suboptimal CB preparations.

Conclusions

If CBs and smears are prepared and examined, the percentage of positive diagnoses will be greater than if only one method is used.

Keywords:
Pleural effusion
Cytology
Cell blocks
Resumen
Objetivos

Evaluar la utilidad independiente de frotis y bloques celulares (BC) del líquido pleural para diagnosticar derrames malignos.

Pacientes y métodos

Se evaluaron retrospectivamente un total de 632 frotis citológicos y 554 BC de 414 pacientes consecutivos con derrame pleural maligno.

Resultados

La sensibilidad diagnóstica de una primera muestra fue del 44%, tanto en frotis como en BC. El análisis de muestras separadas ulteriores aumentó al 56% la identificación de derrames malignos. Globalmente, el 11% de muestras negativas mediante frotis mostraron células malignas en los BC, mientras que el 15% de BC negativos resultaron positivos en el estudio del frotis. Los líquidos pleurales con recuentos bajos de hematíes o leucocitos produjeron con mayor frecuencia BC insuficientes para diagnóstico.

Conclusiones

Si se evalúan frotis y BC, el porcentaje de resultados positivos es superior que si se emplean estas técnicas de forma aislada.

Palabras clave:
Derrame pleural
Citología
Bloques celulares

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