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Cytologically proved malignant pleural effusions: distribution of transudates and exudates Assi Z; Caruso JL; Herndon J; Patz EF JrChest 1998[May]; 113 (5): 1302-4PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: Cytologically positive pleural effusions for malignancy are almost always exudates. Cytologic evaluation for malignant cells of a transudative pleural effusion is not recommended.|Diagnosis, Differential[MESH]|Exudates and Transudates/cytology[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Pleural Effusion, Malignant/diagnosis/epidemiology/*pathology[MESH]|Retrospective Studies[MESH] |
