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2013, Volume 29, Number 3, Page(s) 165-170
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DOI: 10.5146/tjpath.2013.01184 |
The Cell Block Method Increases the Diagnostic Yield in Exudative Pleural Effusions Accompanying Lung Cancer |
Deniz KÖKSAL1, Funda DEMİRAĞ2, Hülya BAYİZ3, Adem KOYUNCU1, Neslihan MUTLUAY1, Bahadır BERKTAŞ1, Mine BERKOĞLU1 |
1Department of Chest Diseases, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, ANKARA, TURKEY 2Department of Pathology, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, ANKARA, TURKEY 3Department of Chest Diseases, İstanbul Gebze Medikal Park Hospital, İSTANBUL, TURKEY |
Keywords:
Lung carcinoma, Pleural eff usion, Cytology, Cytological Techniques |
Objective: Thoracentesis is the first investigation to be performed in
a patient with lung cancer and pleural effusion. The diagnostic yield
of conventional smear studies varies in the first thoracentesis. In this
study, we aimed to investigate if the cell block method increases the
diagnostic yield in exudative pleural effusions accompanying lung
cancer.
Material and Method: Forty patients with lung cancer and
exudative pleural effusions were included. Ten mililiters of fresh
pleural fl uid was obtained by thoracentesis from all patients in the
initial evaluation. The pleural fluid sample was divided into two
equal parts. One part was subjected to conventional smear and the
other to the cell block method. Conventional smears were stained
with May-Grünwald-Giemsa and Hematoxylin-Eosin. Cell block
sections were stained with Hematoxylin-Eosin and mucicarmine.
Conventional smear findings were grouped as “benign cytology”
or “malignant cytology”. Th e cell block sections were evaluated for
the presence of single tumor cells, acinary or papillary pattern, solid
islands and staining with mucicarmine.
Results: There were 20 patients each in the benign and malignant
conventional smear group. In the benign group, adding the cell block
method to conventional smear provided a diagnosis of malignancy in
4 more patients and the diagnosis of malignant effusion was increased
by a ratio of 10% (4/40). In the malignant group, adding the cell block
technique provided the subtyping of lung cancer as adenocarcinoma
in 7 patients (7/20, 35%).
Conclusion: Our study confirms that the cell block method combined
with conventional smear increases the diagnostic yield in exudative
pleural effusions accompanying lung cancer.
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