Diagnostic Utility of Cyfra 21-1 and Cea Assays in Pericardial Fluid for the Recognition of Neoplastic Pericarditis

2005 ◽  
Vol 20 (1) ◽  
pp. 43-49 ◽  
Author(s):  
M. Szturmowicz ◽  
W. Tomkowski ◽  
A. Fijalkowska ◽  
W. Kupis ◽  
A. Cieślik ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Gold Standard ◽  
Pericardial Fluid ◽  
Optimal Cutoff ◽  
Positive Cytology ◽  
Cytological Examination ◽  
Malignant Pericardial Effusion ◽  
Negative Tumor ◽  
Cytology Result ◽  
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.

scholarly journals Cytology of Pericardial Effusion due to Malignancy

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.

scholarly journals Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110360
Author(s):  
Lardinois Benjamin ◽  
Goeminne Jean-Charles ◽  
Miller Laurence ◽  
Randazzo Adrien ◽  
Laurent Terry ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Cardiac Toxicity ◽  
Checkpoint Inhibitors ◽  
Final Diagnosis ◽  
Pericardial Fluid ◽  
Malignant Pericardial Effusion ◽  
Typical Cell ◽  
High Fluorescence ◽  
Tomography Scan

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

Malignant pericardial effusion not diagnosed by pericardial fluid and biopsy: Importance of CT scan

2007 ◽  
Vol 117 (1) ◽  
pp. e53-e55 ◽  
Author(s):  
Seung Hwan Han ◽  
Kwang Kon Koh ◽  
Sang Jin Lee ◽  
Jong Gu Seo ◽  
Su Jin Choi ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Ct Scan ◽  
Pericardial Fluid ◽  
Malignant Pericardial Effusion

scholarly journals Gambaran Hasil Pemeriksaan Sitologi Cairan Asites di Instalasi Patologi Anatomi RSUD Arifin Achmad Provinsi Riau Periode Januari 2013 – Desember 2017

2019 ◽  
Vol 13 (1) ◽  
pp. 51
Author(s):  
Ilhami Romus ◽  
Ina Farida Rangkuti ◽  
Vini Jum’atur Rahmah
Keyword(s):  
Ovarian Carcinoma ◽  
Gold Standard ◽  
Peritoneal Fluid ◽  
Underlying Disease ◽  
Age Group ◽  
Malignant Cells ◽  
Positive Cytology ◽  
Abnormal Accumulation ◽  
Anatomical Pathology ◽  
Fluid Cytology

Ascites is abnormal accumulation fluid in the peritoneal cavity. Many underlying disease can be responsiblefor causing ascites. Peritoneal fluid cytology remains the gold standard for detection of malignant cells inascites which is useful in determining staging, treatment and prognosis. This aim of this study is to describethe characteristic of the result ascitic cytology examination at Anatomical Pathology Department of ArifinAchmad Hospital Period January 2013 – December 2018. This study reviewed the anatomy pathology data.A total of 171 cases consisted of 91.8% were females and males were 8.2%. The highest number caseswere in the age group of 41-50 years (26.9%). Most ascitic fluid came from Department of Obstetric andGynecology (81.9%). The more frequent clinical diagnosis were ovarian carcinoma (19.3%) and ovariancyst (18.7%). Most ascitic cytology examination results was positive cytology (64,9%). Adenocarcinomawas commonest positive cytology (46,2%).

Intrapericardial tetracycline sclerosis in the treatment of malignant pericardial effusion: an analysis of thirty-three cases.

1984 ◽  
Vol 2 (6) ◽  
pp. 631-636 ◽  
Author(s):  
S Davis ◽  
P Rambotti ◽  
F Grignani
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Performance Status ◽  
Signs And Symptoms ◽  
Pericardial Fluid ◽  
Complete Control ◽  
Malignant Pericardial Effusion ◽  
Efficacious Treatment ◽  
Clinically Significant ◽  
Premature Removal

Thirty-three unselected patients with cardiac tamponade secondary to malignant pericardial effusion were treated by intrapericardial instillation of tetracycline hydrochloride. Complete control of the initial signs and symptoms of tamponade was obtained in 30 patients without concomitant chemotherapy or radiotherapy. The procedure did not result in clinically significant complications. Failure of the technique was related to premature removal of the catheter by the patient (one patient) or the inability to totally remove hemorrhagic, clot-filled pericardial fluid (two patients). Survival ranged between 28-704 days and extended survival was related to the performance status and/or chemoradiosensitivity of the primary cancer. No patient successfully treated subsequently developed recurrent cardiac tamponade or alternatively, constrictive pericarditis. Tetracycline pericardial instillation remains a safe, simple, and efficacious treatment of tamponade secondary to malignant disease.

scholarly journals Cardiac tamponade due to malignant pericardial effusion in breast cancer: A case report

2016 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Sultan Mahmud ◽  
Omar Sadeque Khan ◽  
Md. Aftabuddin ◽  
Asit Baran Adhikary
Keyword(s):  
Breast Cancer ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Duct Cell ◽  
Pericardial Fluid ◽  
Pericardial Window ◽  
Severe Respiratory Distress ◽  
Malignant Pericardial Effusion ◽  
History Of ◽  
Subxiphoid Pericardial Window

We present a case of 35 years old women who presented to our institution with a history of bilateral infiltrating duct cell carcinoma of breast, chest pain with heaviness, severe respiratory distress and hypotension. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade. The patient was treated with urgent pericardiocentesis followed by subxiphoid pericardial window drainage of 500ml of haemorrhagic pericardial fluid. Cytological examina­tion confirmed the previous suspicious of malignancy. The patient tolerated the procedure very well, immediate sympto­matic relief was observed.

Bronchoalveolar Carcinoma Presenting as Malignant Pericardial Effusion

1997 ◽  
Vol 5 (4) ◽  
pp. 244-246
Author(s):  
Raju S Iyer ◽  
Sanjeev Agarwal ◽  
Bharadwaja Vamaraju ◽  
Srinivasu Kola ◽  
Srinivas Bhavanarushi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Lung Lesion ◽  
Pericardial Fluid ◽  
Malignant Cells ◽  
Computed Tomography Scan ◽  
Rare Presentation ◽  
Malignant Pericardial Effusion ◽  
Tomography Scan

A 35-year-old male underwent emergency pericardiectomy for repeated tamponade. A computed tomography scan of the thorax showed a consolidated lung lesion with pleural effusion. Emergency aspiration removed hemorrhagic pericardial fluid and straw colored pleural effusion. Both fluids tested negative for malignant cells. He later underwent a pneumonectomy after a biopsy revealed carcinoma of the lung. The case is reported to illustrate this rare presentation of bronchoalveolar carcinoma.

scholarly journals Case report of large malignant pericardial effusion in a post-surgical setting of endometrial mixed carcinoma: A description of unique cytological, histological, and immunohistochemical findings

2020 ◽  
Vol 8 ◽  
pp. 2050313X2093091
Author(s):  
Seiya Mizuguchi ◽  
Akihiro Shioya ◽  
Toshiyuki Sasagawa ◽  
Sumire Yamada ◽  
Kenichi Mizutani ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Endometrial Carcinoma ◽  
Serous Carcinoma ◽  
Psammoma Bodies ◽  
Cytological Examination ◽  
Surgical Specimen ◽  
Malignant Pericardial Effusion ◽  
Cancer Breast ◽  
Adenocarcinoma Cells ◽  
Mrna Binding

Appearance of endometrial carcinoma in pericardial effusion is extremely rare. Its major etiological factors include lung cancer, breast cancer, lymphoma, and leukemia. We herein report a case of a large malignant pericardial effusion 7 years after surgery for endometrial carcinoma. A 66-year-old woman who underwent modified radical hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for endometrial carcinoma 7 years ago and who had self-interrupted subsequent chemotherapy was presented with vertigo and vomiting. Chest computed tomography revealed pericardial effusion. Cytological examination diagnosed it as adenocarcinoma with psammoma bodies and mitoses. Immunohistochemistry analysis revealed that adenocarcinoma cells were positive for p53, p16, and insulin-like growth factor II mRNA-binding protein-3, but negative for estrogen receptor. Adenocarcinoma cells in pericardial effusion were morphologically and immunohistochemically similar to the serous carcinoma component of the surgical specimen. The appearance of psammoma bodies in cytological examination triggered the diagnosis.

Intracavitary chemotherapy with thiotepa in malignant pericardial effusions: an active and well-tolerated regimen.

1998 ◽  
Vol 16 (7) ◽  
pp. 2371-2376 ◽  
Author(s):  
M Colleoni ◽  
G Martinelli ◽  
F Beretta ◽  
C Marone ◽  
A Gallino ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Current Treatment ◽  
Pericardial Fluid ◽  
Unknown Primary ◽  
Rapid Improvement ◽  
Computed Tomographic ◽  
Malignant Pericardial Effusion ◽  
Pericardial Effusions ◽  
Short Course ◽  
Intracavitary Therapy

PURPOSE Malignant pericardial effusion, although highly variable, is an uncommon complication of cancer. It is often associated with symptoms like dyspnea, chest pain, and cough, which may be severe and disabling. We analyzed the results of our current treatment policy to evaluate the effectiveness and tolerance of a new approach for this disorder. PATIENTS AND METHODS Patients with malignant pericardial effusions were treated with intracavitary thiotepa (15 mg on days 1, 3, and 5) through an indwelling pericardial cannula after extraction of as much pericardial fluid as possible on day 0. Responses were assessed by clinical examination, computed tomographic (CT) scan, and echocardiography before treatment, 1 month after treatment, and every 2 months thereafter. Twenty-three patients with malignant symptomatic pericardial effusion were treated and all were assessable for effectiveness and tolerance of the procedure. RESULTS Nine patients with breast cancer, 11 with lung cancer, two with an unknown primary tumor, and one with metastatic melanoma were treated. In all but three patients, systemic medical treatment was started after completion of intracavitary therapy. Nineteen patients responded to treatment (83%; 95% confidence interval, 61% to 95%) with a rapid improvement of symptoms. The median time to pericardial effusion progression was 8.9 months (range, 1 to 26). No significant side effects were registered, except one patient who had transient grade III thrombocytopenia and leukopenia and one patient who had grade I leukopenia. CONCLUSION A short course of intracavitary treatment with thiotepa is highly effective and well tolerated in the treatment of malignant pericardial effusion.

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