ArticleInternal medicine journal2022
Evaluation of pleural fluid cytology for the diagnosis of malignant pleural effusion: a retrospective cohort study.
Article in Internal medicine journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 29 citations in OpenAlex.
- Combined PET-CT and VATS biopsy in pleural effusion: diagnostic accuracy, surgical factors, and prognosis-a retrospective study.General thoracic and cardiovascular surgery · 2026Article
- Malignancy Presenting As Recurrent Empyema: A Report of Two Cases and a Systematic Review.Cureus · 2026Article
- Multidisciplinary international expert consensus recommendations on tissue acquisition in non-small cell lung cancer.EBioMedicine · 2026Article
- The cancer ratio plus in the differential diagnosis of pleural effusions: a scoping review of current evidence.Biochemia medica · 2026Article
- Diagnostic Yield of Malignant Pleural Effusion in Various Primary and Metastatic Cancers: Insights Across Cancer Subtypes.Pulmonary medicine · 2026Article
- Lung Ultrasound for Pleural Effusion in Cancer Patients: Advanced Ultrasound for Pleural Lesions-A Narrative Review.Cancers · 2025Review
- MOC31 for the Diagnosis of Metastatic Carcinoma and Mesothelial Lesions in Effusion Fluid-A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2025Review
- Pleural fluid human epididymis secretory protein 4 in differentiating between malignant and benign pleural effusions: a systematic review and meta-analysis.Journal of thoracic disease · 2025Article
- Dextroposition of the Heart From Tension Hydrothorax in a Patient With Malignant Pleural Effusion.Cureus · 2025Article
- Mini-Invasive Pleural Probe-Based Confocal Laser Endomicroscopy for Malignant Pleural Effusion Diagnosis.Respiration; international review of thoracic diseases · 2025Article
- Comparative genomic and immunopathologic analysis of lung adenocarcinomas with and without cytology-proven malignant pleural effusions.Cancer cytopathology · 2024Article
- Article
- Thyroid Troubles: A Case of Hypothyroidism-Associated Recurrent Massive Pleural Effusion.Cureus · 2024Article
- IR808@MnO nano-near infrared fluorescent dye's diagnostic value for malignant pleural effusion.Respiratory research · 2024Observational
- Article
- Updates in Management of Malignant Pleural Mesothelioma.Current treatment options in oncology · 2023Review
- Deep Learning in Cytopathology: The Potential for Multimodal Synergy of Clinical and Cytological Input Data.Journal of cytologyReview
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCytological examination of pleural fluid has good specificity, but imperfect sensitivity for the diagnosis of malignant pleural effusion (MPE). Published estimates of sensitivity vary and predictors of false negative cytology are not well established.
aimsTo estimate pleural fluid cytology sensitivity and identify risk factors for false negative cytology.
methodsWe conducted a retrospective cohort study of patients who had cytology testing of pleural fluid at Christchurch Hospital, New Zealand, from July 2017 to October 2019. Data on clinical and pleural fluid characteristics were collected. MPE was defined by positive pleural fluid cytology, tissue histology or multidisciplinary meeting consensus. We estimated sensitivity of the first pleural cytology assessment. We performed multivariate logistic regression to ascertain patient groups at greatest risk of false negative results.
resultsInitial pleural fluid cytology was diagnostic in 117 of 156 patients, providing a sensitivity (95% confidence interval (CI)) of 75.0% (67.4-81.6%). The sensitivity was 79.0% (66.8-88.3%) for lung cancer, 91.3% (72.0-98.9%) for breast cancer and 33.3% (95% CI 11.8-61.6%) for mesothelioma. Cloudy appearance of pleural fluid (odds ratio (OR) 0.12; 95% CI 0.03-0.54) and yellow/gold pleural fluid (OR 0.24; 95% CI 0.06-0.96) reduced the odds of false negative pleural cytology. Pleural thickening on computed tomography scan (OR 3.3; 95% CI 1.2-9.4) was a risk factor for false negative cytology.
conclusionSensitivity of pleural fluid cytology was greatest in primary lung and breast cancer, and lowest in mesothelioma. Clinicians should be alert to false negative results when suspecting mesothelioma or if pleural thickening is present.
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