The Value of Thin Layer Cytology in Cancer Patients’ Pericardial Effusions

<b>Objective:</b> Early diagnosis and treatment of metastatic pericardial disease are crucial to prevent the life-threatening complication of cardiac tamponade. Thin Layer Cytology (TLC), a widely adopted technique in cytology, has gained significant acceptance for most specimens. Our st...

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Main Authors: Christos Lafaras, Evdokia Mandala, Kyranna Lafara, Ioannis Kalafatis, Thomas Achladas, Vasiliki Koukoulitsa, Chrysoula Gouta, Theodora Tsiouda, Soultana Skevoudi
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/6/306
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author Christos Lafaras
Evdokia Mandala
Kyranna Lafara
Ioannis Kalafatis
Thomas Achladas
Vasiliki Koukoulitsa
Chrysoula Gouta
Theodora Tsiouda
Soultana Skevoudi
author_facet Christos Lafaras
Evdokia Mandala
Kyranna Lafara
Ioannis Kalafatis
Thomas Achladas
Vasiliki Koukoulitsa
Chrysoula Gouta
Theodora Tsiouda
Soultana Skevoudi
author_sort Christos Lafaras
collection DOAJ
description <b>Objective:</b> Early diagnosis and treatment of metastatic pericardial disease are crucial to prevent the life-threatening complication of cardiac tamponade. Thin Layer Cytology (TLC), a widely adopted technique in cytology, has gained significant acceptance for most specimens. Our study aimed to assess the utility of TLC in diagnosing metastatic neoplasms and their origins in pericardial effusions, as well as monitoring response to chemotherapy. <b>Methods:</b> We examined 184 pericardial fluids collected by pericardiocentesis and processed using the ThinPrep liquid-based technique. Various immunocytochemical markers were used to determine the site of metastatic neoplasms. We also evaluated the response to therapy in 53 patients with lung and breast cancer. <b>Results:</b> Out of 184 specimens, 113 pericardial fluids were diagnosed as positive for malignancy, while 71 were negative. Twenty-three cases of unknown primary site were included in the total positive cases. Ninety cases positive for malignancy had a known primary site of origin, including 31 lung carcinomas, 22 breast carcinomas, 10 ovarian carcinomas, 6 T-cell lymphomas, 3 urinary bladder carcinomas, 4 renal carcinomas, 5 adenocarcinomas of the colon, 5 prostate carcinomas, 2 parotid adenocarcinomas, and 2 melanomas. Regarding the 53 cases with chemotherapy treatment, the cytologic examination of pericardial fluid showed a remarkable reduction in neoplastic burden after the third dose of cisplatin or thiotepa instilled into the pericardial cavity. ThinPrep provided excellent preservation of cytomorphological features, high cellularity per slide, and a clear background. This comprehensive analysis provides crucial information about the types and distribution of cancerous cells present in the samples. <b>Conclusions:</b> Thin Layer Cytology (TLC) is a valuable diagnostic tool for detecting metastatic pericardial malignancy. It allows the examination of exfoliated cells from the pericardial fluid, providing crucial information for diagnosis, management, and monitoring the acute responsiveness to intrapericardial chemotherapy. Immunocytochemistry (IHC) can identify specific markers for various types of cancer, enabling a more accurate diagnosis and guiding further treatment decisions.
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spelling doaj-art-3e601dc740ee4dfcac62485ffcdb95722025-08-20T03:24:32ZengMDPI AGCurrent Oncology1198-00521718-77292025-05-0132630610.3390/curroncol32060306The Value of Thin Layer Cytology in Cancer Patients’ Pericardial EffusionsChristos Lafaras0Evdokia Mandala1Kyranna Lafara2Ioannis Kalafatis3Thomas Achladas4Vasiliki Koukoulitsa5Chrysoula Gouta6Theodora Tsiouda7Soultana Skevoudi8Cardiology-Oncology Department, Theagenion Cancer Hospital, PC54623 Thessaloniki, GreeceDivision of Hematology, Forth Department of Medicine, School of Medicine Aristotle University of Thessaloniki, PC54623 Thessaloniki, GreeceDivision of Hematology, Forth Department of Medicine, School of Medicine Aristotle University of Thessaloniki, PC54623 Thessaloniki, GreeceCardiology-Oncology Department, Theagenion Cancer Hospital, PC54623 Thessaloniki, GreeceDivision of Hematology, Forth Department of Medicine, School of Medicine Aristotle University of Thessaloniki, PC54623 Thessaloniki, GreeceCardiology-Oncology Department, Theagenion Cancer Hospital, PC54623 Thessaloniki, GreeceDepartment of Cytopathology, Theagenion Cancer Hospital, PC54623 Thessaloniki, GreecePulmonology-Oncology Department, Theagenion Cancer Hospital, PC54623 Thessaloniki, GreeceDepartment of Cytopathology, Theagenion Cancer Hospital, PC54623 Thessaloniki, Greece<b>Objective:</b> Early diagnosis and treatment of metastatic pericardial disease are crucial to prevent the life-threatening complication of cardiac tamponade. Thin Layer Cytology (TLC), a widely adopted technique in cytology, has gained significant acceptance for most specimens. Our study aimed to assess the utility of TLC in diagnosing metastatic neoplasms and their origins in pericardial effusions, as well as monitoring response to chemotherapy. <b>Methods:</b> We examined 184 pericardial fluids collected by pericardiocentesis and processed using the ThinPrep liquid-based technique. Various immunocytochemical markers were used to determine the site of metastatic neoplasms. We also evaluated the response to therapy in 53 patients with lung and breast cancer. <b>Results:</b> Out of 184 specimens, 113 pericardial fluids were diagnosed as positive for malignancy, while 71 were negative. Twenty-three cases of unknown primary site were included in the total positive cases. Ninety cases positive for malignancy had a known primary site of origin, including 31 lung carcinomas, 22 breast carcinomas, 10 ovarian carcinomas, 6 T-cell lymphomas, 3 urinary bladder carcinomas, 4 renal carcinomas, 5 adenocarcinomas of the colon, 5 prostate carcinomas, 2 parotid adenocarcinomas, and 2 melanomas. Regarding the 53 cases with chemotherapy treatment, the cytologic examination of pericardial fluid showed a remarkable reduction in neoplastic burden after the third dose of cisplatin or thiotepa instilled into the pericardial cavity. ThinPrep provided excellent preservation of cytomorphological features, high cellularity per slide, and a clear background. This comprehensive analysis provides crucial information about the types and distribution of cancerous cells present in the samples. <b>Conclusions:</b> Thin Layer Cytology (TLC) is a valuable diagnostic tool for detecting metastatic pericardial malignancy. It allows the examination of exfoliated cells from the pericardial fluid, providing crucial information for diagnosis, management, and monitoring the acute responsiveness to intrapericardial chemotherapy. Immunocytochemistry (IHC) can identify specific markers for various types of cancer, enabling a more accurate diagnosis and guiding further treatment decisions.https://www.mdpi.com/1718-7729/32/6/306metastatic pericardial effusionscardiac tamponadeThin Layer Cytologyliquid based cytologyThinPrepimmunocytochemistry
spellingShingle Christos Lafaras
Evdokia Mandala
Kyranna Lafara
Ioannis Kalafatis
Thomas Achladas
Vasiliki Koukoulitsa
Chrysoula Gouta
Theodora Tsiouda
Soultana Skevoudi
The Value of Thin Layer Cytology in Cancer Patients’ Pericardial Effusions
Current Oncology
metastatic pericardial effusions
cardiac tamponade
Thin Layer Cytology
liquid based cytology
ThinPrep
immunocytochemistry
title The Value of Thin Layer Cytology in Cancer Patients’ Pericardial Effusions
title_full The Value of Thin Layer Cytology in Cancer Patients’ Pericardial Effusions
title_fullStr The Value of Thin Layer Cytology in Cancer Patients’ Pericardial Effusions
title_full_unstemmed The Value of Thin Layer Cytology in Cancer Patients’ Pericardial Effusions
title_short The Value of Thin Layer Cytology in Cancer Patients’ Pericardial Effusions
title_sort value of thin layer cytology in cancer patients pericardial effusions
topic metastatic pericardial effusions
cardiac tamponade
Thin Layer Cytology
liquid based cytology
ThinPrep
immunocytochemistry
url https://www.mdpi.com/1718-7729/32/6/306
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