Cytologically proved malignant pleural effusions : Distribution of transudates and exudates

• Published in: Chest Vol. 113; no. 5; pp. 1302 - 1304
• Main Authors: ASSI, Z, CARUSO, J. L, HERNDON, J, PATZ, E. F
• Format: Journal Article
• Language: English
• Published: Northbrook, IL American College of Chest Physicians 01.05.1998
• Subjects: Biological and medical sciences; Cancer; Cellular biology; Confidence intervals; Dehydrogenases; Diagnosis, Differential; Edema; Exudates and Transudates - cytology; Female; Heart failure; Humans; Male; Medical sciences; Metastasis; Middle Aged; Ovaries; Patients; Pleural effusion; Pleural Effusion, Malignant - diagnosis; Pleural Effusion, Malignant - epidemiology; Pleural Effusion, Malignant - pathology; Pneumology; Proteins; Retrospective Studies; Thoracentesis; Tumors; Tumors of the respiratory system and mediastinum; Human; Respiratory disease; Indication; Cytologic investigation; Exploration; Malignant tumor; Pathology; Liquid; Malignant effusion; Pleural disease; Puncture; Comparative study; Pleura
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.113.5.1302

This study attempts to determine the distribution of transudates vs exudates in pathologically proved malignant pleural effusions and the necessity for cytologic studies in patients with a transudative effusion. A retrospective review of all cytologically positive malignant pleural effusions was performed at Duke University Medical Center over an 18-month period. All effusions were characterized as a transudate or an exudate based on standard criteria, including lactate dehydrogenase and protein values. Ninety-eight patients with a mean age of 62 years were identified as having a cytologically positive malignant pleural effusion and blood chemistry values available to distinguish an exudate from transudate. Ninety-seven patients (99%, 95% confidence interval; 0.94 to 0.99) had criteria for an exudative effusion. One patient (1%) with diffuse metastatic lung cancer had a borderline transudate and was in congestive heart failure at the time of thoracentesis. Cytologically positive pleural effusions for malignancy are almost always exudates. Cytologic evaluation for malignant cells of a transudative pleural effusion is not recommended.