Diagnostic yield of pleural fluid cytology in malignant pleural effusion

ABSTRACT

Pleural effusion is a common presenting feature of patients presenting in the pulmonology OPD. Examination of pleural fluid obtained by thoracocentesis is a simple way to diagnose pathologies of the pleura and peripheral parts of the lung. To determine the diagnostic yield of pleural fluid cytology in malignant pleural effusions keeping pleural biopsy as the gold standard. This retrospective study was carried out at Pakistan Institute of Medical Sciences, Islamabad, from November 2010 to November 2011. Twenty six patients [65% females; 35% males] presenting with pleural effusion in whom pleural fluid cytology with concurrent pleural biopsy was carried out were included in the study. The diagnostic yield of pleural fluid was determined keeping pleural biopsy as the gold standard. The age range of the patients was 23-76 years. Pleural fluid was positive for malignant cells in 15 out of 26 patients, whereas pleural biopsy yielded definite evidence of malignancy in 21 cases. In 5 cases diagnosis of atypical infiltrate was rendered and immunohistochemistry was suggested for confirmation of malignancy. The diagnostic yield of pleural fluid cytology came out to be 58%. Pleural fluid cytological examination followed by pleural biopsy remains the initial diagnostic procedure in management of patients with suspected malignant pleural effusion.