Author of

• 20192

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  P3.13 - Radiology/Staging/Screening (ID 729)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24186

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    P3.13-034 - Comparison of Cytological Smears and Cell Blocks of Pleural Fluid Diagnosing Malignant Pleural Effusion in Lung Cancer (ID 10243)

    09:30 - 09:30  |  Author(s): R. Zablockis
    • Abstract
    • Slides

    Background:
    In conventional cytology discrimination of the reactive mesothelium cells and malignant cells is the most important diagnostic problem. Cell block (CB) technique is helpful in discriminating cytological abnormalities or well differentiated adenocarcinoma.
    
    Method:
    95 consecutive patients (52% male, mean age 67±12yrs) with malignant pleural effusion in lung cancer were enrolled. 44% of patients had Eastern Cooperative Oncology Group performance score 0-1 and 66% ≥2. In all patients pleural fluid smears were sent for conventional cytological and CB immunocytochemical examination.
    
    Result:
    In 69 (73%) cases malignant pleural effusion was the first sign of lung cancer and in 26 (27%) cases developed in disease progression. First pleural fluid immunocytochemistry examination confirmed malignancy in 80 (84%) cases: adenocarcinoma – 70 (88%), small cell carcinoma – 7 (9%) and non small cell carcinoma – 3 (3%). First cytological examination was positive in 81 (85%) smears. Adenocarcinoma cells were identified in 51 (63%) cases although of them CB technique confirmed adenocarcinoma in 49 (96%) smears and reactive mesothelium cells in 2 (4%) smears. Out of 30 (37%) specimens that showed malignant cells in cytological examination, CB method confirmed: adenocarcinoma 15 (50%), small cell carcinoma 6 (20%), non small cell carcinoma 3 (10%) and reactive mesothelium cells 6 (20%). Whether first cytological smear was negative, second smear was positive in 4 (27%) cases and identified 1 (25%) adenocarcinoma and 3 (75%) malignant cells in cytological examination, notably out of them CB examination showed reactive mesothelium in 2 (50%) samples, small cell carcinoma in 1 (25%) sample and adenocarcinoma in 1 (25%) sample.
    
    Conclusion:
    Our study aims that pleural fluid cell block immunocytochemistry is more accurate method identifying lung cancer and should be considered as the initial diagnostic approach for malignant pleural effusion in primary investigation in lung cancer, especially in patients with worse performance status.
    
    

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