Key result
Pulmonary adenocarcinoma pericardial effusions predominantly exhibit micropapillary and solid patterns with mucin versus pleural effusions.
Why the study?
Malignant pericardial effusions are a common complication in advanced pulmonary adenocarcinoma, where investigating molecular alterations has therapeutic implications, but the utility of cell block technique and the morphological and molecular profiles require evaluation.
What are the morphological and molecular profiles of malignant pericardial effusion compared to malignant pleural effusion in patients with pulmonary adenocarcinoma?
Case-Control (n=33)
What are the morphological and molecular profiles of malignant pericardial effusion compared to malignant pleural effusion in patients with pulmonary adenocarcinoma?
Malignant pericardial effusions in pulmonary adenocarcinoma exhibit distinct morphological patterns and are suitable for oncogenic mutation analysis to guide targeted therapy.
Cell block enables molecular profiling of MPCE in pulmonary adenocarcinoma; leaves open whether findings guide targeted therapy without prospective confirmation.
CONTEXT: Malignant pericardial effusions (MPCEs) is a common complication observed in advanced pulmonary adenocarcinoma. In such cases, investigating molecular alterations can have significant therapeutic implication in determining anticancer drugs. AIM: The objective was to evaluate the significance of cell block technique in the diagnosis of MPCE and further investigate the morphological and molecular profiles of MPCE in patients with pulmonary adenocarcinoma. SETTING AND DESIGN: Cytopathological and molecular profiles of 19 MPCE cases in patients with pulmonary adenocarcinoma were retrospectively analyzed. The control group consisted of 14 malignant pleural effusion (MPE) cases in patients with pulmonary adenocarcinoma. MATERIALS AND METHODS: Anaplastic lymphoma kinase (ALK) and tyrosine-protein kinase Met (C-MET) expression was evaluated by fluorescence in situ hybridization (FISH). Epithelial growth factor receptor (EGFR) and K-Ras (KRAS) mutations were detected by ARMS real-time polymerase chain reaction (RT-PCR). STATISTICAL ANALYSIS USED: Associations between MPCE and MPE were analyzed using Fisher's exact test. RESULTS: MPCE was found to have micropapillary and solid pattern predominant with mucin secretion compared to acinar patterns, as seen in MPE. Seventeen MPCE cases (89.5%) and all MPE cases (100%) underwent molecular analysis. Mutations in EGFR and KRAS, ALK rearrangement, and C-MET amplification were observed in MPCE and MPE with statistical differences. Additionally, two MPCE cases demonstrated EGFR T790M mutation and multiple insertions at L858. CONCLUSIONS: MPCE shows micropapillary and solid cytological patterns predominant with mucin secretion. MPCE are suitable to analyze oncogenic mutations and to develop targeted therapy for patients with pulmonary adenocarcinoma. Further molecular investigations may reveal novel molecular alterations.
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Xiong et al. (2019) conducted a case-control in pulmonary adenocarcinoma (n=33). Malignant pericardial effusion vs. Malignant pleural effusion was evaluated on Morphological patterns and molecular alterations (EGFR, KRAS, ALK, C-MET). Malignant pericardial effusions in pulmonary adenocarcinoma predominantly exhibited micropapillary and solid cytological patterns with mucin secretion compared to malignant pleural effusions.
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