Key result
Cytological examination of pericardial fluid >60 mL, combined with immunocytochemistry, identified malignant pericardial exudates with 100% diagnostic accuracy and no false negatives compared to histology.
Why the study?
Does cytological examination accurately diagnose malignant pericardial effusion compared to histology in patients with cardiac tamponade?
Observational (n=145)
No
Does cytological examination accurately diagnose malignant pericardial effusion compared to histology in patients with cardiac tamponade?
Cytological examination of pericardial fluid, especially when combined with immunocytochemistry and using adequate volumes (>60 mL), provides 100% diagnostic accuracy for malignant pericardial effusions.
May support cytology with immunocytochemistry for malignant pericardial effusion diagnosis; leaves open validation in larger prospective cohorts before practice change.
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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Kalogeraki et al. (2016) conducted an observational in Malignant pericardial effusion with cardiac tamponade (n=145). Cytological examination of pericardial fluid vs. Histological examination was evaluated on Diagnostic accuracy of cytology for malignant pericardial effusion. Cytological examination of pericardial fluid >60 mL, combined with immunocytochemistry, identified malignant pericardial exudates with 100% diagnostic accuracy and no false negatives compared to histology.
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