ArticlePulmonary medicine2026
Diagnostic Yield of Malignant Pleural Effusion in Various Primary and Metastatic Cancers: Insights Across Cancer Subtypes.
Article in Pulmonary medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Diagnostic Yield of Malignant Pleural Effusion in Various Primary and Metastatic Cancers: Insights Across Cancer Subtypes.Pulmonary medicine · 2026Article
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Authors and funding
7 authors.
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Abstract
OBJECTIVE/
backgroundPleural fluid cytology remains a cornerstone in diagnosing malignant pleural effusions (MPEs); however, its diagnostic yield varies considerably across cancer subtypes. This study is aimed at evaluating the diagnostic performance of cytology stratified by malignancy type.
methodsWe conducted a retrospective study at a tertiary referral center in Raleigh, North Carolina, enrolling patients aged 18-100 years who underwent thoracentesis for suspected MPE between January 2015 and August 2018. MPE was defined by positive pleural fluid cytology, VATS findings, or histopathological confirmation. Variables analyzed included demographics, cytology results, thoracoscopic findings, and pleural biopsy histopathology.
resultsOf the 779 pleural fluid samples, we included 667 patients (99 malignant and 482 benign); the remaining 86 samples included therapeutic thoracenteses, dry taps, and inadequate volume for cytology. Cytology diagnosed 86 cases of MPE (86.86%), while VATS identified additional eight cases. Overall cytology specificity was 99.8% (95% CI: 99.3%-100%). Adenocarcinoma demonstrated the highest cytologic sensitivity (90.24%), particularly in breast cancer-related MPE (67.44%). Among 482 cytology-negative cases, 130 had documented cancer histories, most frequently lung cancer (17.69%), hematological malignancies (12.30%), and breast cancer (10.76%). Skin and prostate cancers were more likely to yield false-negative cytology results. Malignant mesothelioma requires repeat cytology or VATS for definitive diagnosis in most cases.
conclusionPleural fluid cytology is highly specific and most sensitive for lung and breast adenocarcinomas. Combined cytology and VATS demonstrate superior diagnostic accuracy and should be the standard approach when initial cytology is negative and malignancy remains clinically suspected.
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