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A diagnosis of malignant pleural mesothelioma can be made by effusion cytology: results of a 20 year audit.
MedLine Citation:
PMID:  23222247     Owner:  NLM     Status:  Publisher    
AIMS:: Cytological diagnosis of malignant pleural mesothelioma (MPM) is controversial, but has been used in our institution for over 30 years. To assess the role of effusion cytology in mesothelioma diagnosis we conducted an audit of pleural fluid cytology results over a 20 year period (1988-2007). METHODS:: Pleural samples were received from 6285 patients; data linkage with Western Australian Cancer and Mesothelioma Registries demonstrated that 815 of these patients had a diagnosis of MPM. Cytological examination of a pleural effusion specimen had been performed in 517 (63%) of these 815 patients. RESULTS:: Definitive cytological diagnosis of MPM was made in 377/517 cases, resulting in an 'absolute' sensitivity of 73%. An additional 66 patients were diagnosed as atypical/suspicious, resulting in a 'complete' sensitivity of 86%. If only biopsy/necropsy proven cases are considered, the absolute sensitivity is 68% and the complete sensitivity is 82%. There were no false positive diagnoses of malignancy; two patients with metastatic adenocarcinoma were initially diagnosed as MPM, prior to the availability of specific mesothelial markers, resulting in a positive predictive value of 99%. CONCLUSIONS:: Effusion cytology is an inexpensive, minimally invasive procedure which should be included in the diagnostic work-up of cases of suspected MPM.
Amanda Segal; Gregory F Sterrett; Felicity A Frost; Keith B Shilkin; Nola J Olsen; Arthur William Musk; Anna K Nowak; Bruce William S Robinson; Jenette Creaney
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-6
Journal Detail:
Title:  Pathology     Volume:  -     ISSN:  1465-3931     ISO Abbreviation:  Pathology     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0175411     Medline TA:  Pathology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*PathWest Laboratory Medicine WA, Queen Elizabeth II Medical Centre, Perth †School of Population Health, University of Western Australia, Nedlands ‡National Centre for Asbestos Related Diseases, School of Medicine and Pharmacology, University of Western Australia, Nedlands §Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
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