Analysis of Indeterminate Diagnoses for Pericardial Fluid Cytology

A positive cytology result in pericardial fluid is the gold standard for recognition of malignant pericardial effusion. Unfortunately, in 30–50% of patients with malignant pericardial effusion cytological examination of the pericardial fluid is negative. Tumor marker assessment in pericardial fluid may help to recognize malignant pericardial effusion. The aim of our study was to estimate the value of CYFRA 21-1 and CEA measurement in pericardial fluid for the recognition of malignant pericardial effusion. To our knowledge this is the first study on CYFRA 21-1 assessment in pericardial effusion. The examined group consisted of 50 patients with malignant pericardial effusion and 34 patients with non-malignant pericardial effusion. Median CEA concentrations in malignant pericardial effusion and non-malignant pericardial effusion were 80 ng/mL (0–317) and 0.5 ng/mL (0–18.4), respectively (p<0.001). Median CYFRA 21-1 concentrations in malignant pericardial effusion and non-malignant pericardial effusion were 260 ng/mL (5.3–10080) and 22.4 ng/mL (1.87–317.6), respectively (p<0.001). The optimal cutoff value for CYFRA 21-1 in pericardial effusion was 100 ng/mL. CYFRA 21-1 >100 ng/mL or CEA >5 ng/mL were found in 14/15 patients with malignant pericardial effusion and negative pericardial fluid cytology. We therefore strongly recommend the use of CYFRA 21-1 and/or CEA in addition to pericardial fluid cytology for the recognition of malignant pericardial effusion.

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Diagnostic accuracy of pericardial fluid cytology: An analysis of 53 specimens from 44 consecutive patients

Diagnostic Cytopathology ◽

10.1002/(sici)1097-0339(199609)15:3<197::aid-dc5>3.0.co;2-e ◽

1996 ◽

Vol 15 (3) ◽

pp. 197-204 ◽

Cited By ~ 14

Author(s):

Vassiliki D. Malamou-Mitsi ◽

Aikaterini P. Zioga ◽

Niki J. Agnantis

Keyword(s):

Diagnostic Accuracy ◽

Pericardial Fluid ◽

Fluid Cytology

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Cytology of Pericardial Effusion due to Malignancy

Romanian Journal of Internal Medicine ◽

10.1515/rjim-2016-0026 ◽

2016 ◽

Vol 54 (3) ◽

pp. 179-183

Author(s):

Alexandra Kalogeraki ◽

George Lazopoulos ◽

Georgios Z. Papadakis ◽

Dimitrios Tamiolakis ◽

Iliana Karvela-Kalogeraki ◽

...

Keyword(s):

Pericardial Effusion ◽

False Negative ◽

Pericardial Fluid ◽

Systematic Evaluation ◽

Secondary Process ◽

Cytologic Diagnosis ◽

Malignant Pericardial Effusion ◽

Primary Neoplasms ◽

Therapeutic Recommendation ◽

Fluid Cytology

Abstract Background. Malignant pericardial effusion occurs in one tenth of all cancers. It is a very serious disorder that is mainly a secondary process due to metastasis because primary neoplasms of the pericardium such as mesotheliomas, sarcomas being exceedingly rare. Pericardial effusions with a cardiac tamponade constitute a surgical emergency and the pericardiocentesis represents the first class therapeutic recommendation. Pericardial effusion specimens are uncommon and to the best of our knowledge the current study is the largest systematic evaluation of pericardial fluid cytology performed to date. Material and Methods. Pericardial effusion specimens from 145 patients collected over a 10 year period were studied by cytology and results were compared with pericardial histology results. The minimum pericardial fluid volume used for adequate cytologic diagnosis in these patients was more than 60 mL. Results. Cytological diagnosis revealed malignant pericardial exudates in 100% of the studied patients. There was no any false negative result in comparison with histology. Conclusions. Cytology provides an immediate and accurate means of diagnosis. Immunocytology is very important in the diagnostic evaluation.

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