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Cytopathology of pericardial effusions

Experience from a tertiary center of cardiology

Zytopathologie des Perikardergusses

Erfahrungen eines kardiologischen Zentrums der Maximalversorgung

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An Erratum to this article was published on 20 July 2017

This article has been updated

Abstract

Background

Pericardial effusion (PE) is a common clinical condition that can develop as a result of systemic or cardiac diseases. Here, we report the results of cytology for patients who underwent pericardiocentesis for PE.

Methods

The study comprised 283 patients who underwent primary percutaneous pericardiocentesis between 2007 and 2016. The mean age of the patients was 60.0 ± 16.6 years; 162 (57.2%) were male and 121 (42.8%) were female. The presence of reactive mesothelial cells, acute and chronic inflammatory cells, and/or blood without evidence of malignant cells was considered as benign. The presence of malignant cells with/without reactive mesothelial cells, inflammatory cells, and/or blood was considered as malignant.

Results

The vast majority of PE specimens (219 cases; 77.4%) were classified as benign. Only 20 cases (7.1%) were classified as atypical, and malignant cells were present in the PE specimens of 44 cases (15.5%). The most common diagnosis was benign PE. The most commonly encountered malignancy was lung cancer. The rate of malignancy was 1.9% in the serous group and 24% in the hemorrhagic group, which was statistically significant.

Conclusion

Benign PE was the most frequent cytological diagnosis in our study. Chronic nonspecific pericarditis was the most frequent type of pericarditis in the benign PE group, while lung adenocarcinoma was the most frequent malignancy in the malignant PE group. The rate of malignancy was significantly higher in the hemorrhagic group than in the serous group.

Zusammenfassung

Hintergrund

Ein Perikarderguss (PE) ist ein häufiges klinisches Ereignis, dass infolge systemischer oder kardialer Erkrankungen auftreten kann. Im vorliegenden Beitrag wird über die zytologischen Ergebnisse von Patienten berichtet, bei denen wegen eines PE eine Perikardpunktion erfolgte.

Methoden

Die Studie umfasste 283 Patienten, bei denen zwischen 2007 und 2016 eine primäre Perikardpunktion durchgeführt wurde. Das Durchschnittsalter der Patienten lag bei 60,0 ± 16,6 Jahren; 162 (57,2 %) Männer und 121 (42,8 %) Frauen. Das Vorliegen reaktiver Mesothelialzellen, akuter und chronischer Entzündungszellen und/oder von Blut ohne Anhalt für maligne Zellen wurde als benigne eingestuft. Das Vorliegen maligner Zellen mit/ohne reaktive Mesothelialzellen, Entzündungszellen und/oder Blut wurde als maligne eingestuft.

Ergebnisse

Die überwiegende Mehrheit der PE-Punktate (219 Fälle; 77,4 %) wurde als benigne klassifiziert. Nur 20 Fälle (7,1 %) wurden als atypisch eingestuft, und in den PE-Punktaten von 44 Fällen (15,5 %) lagen maligne Zellen vor. Die häufigste Diagnose war ein benigner PE. Häufigstes Malignom war das Bronchialkarzinom. Die Malignomrate betrug 1,9 % in der Gruppe mit serösem PE, aber 24 % in der Gruppe mit hämorrhagischem PE, was statistisch signifikant war.

Schlussfolgerung

Ein benigner PE war die häufigste zytologische Diagnose in der vorliegenden Studie. In der Gruppe mit benignem PE kam als häufigster Typ der Perikarditis die chronische nichtspezifische Form vor, während in der Gruppe mit malignem PE das Bronchialkarzinom das häufigste Malignom darstellte. Die Malignomrate war in der Gruppe mit hämorrhagischem PE signifikant höher als in der Gruppe mit serösem PE.

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Change history

  • 20 July 2017

    An erratum to this article has been published.

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Authors and Affiliations

  1. Department of Cardiology, Kartal Kosuyolu Heart & Research Hospital, 34846, Istanbul, Turkey

    C. Gecmen MD, G. G. Gecmen, D. Ece, M. Kahyaoğlu, A. Kalayci, C. Y. Karabay, O. Candan, M. E. Isik, F. Yilmaz, O. Akgun, M. Celik, I. A. Izgi, C. Kirma & S. Keser

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  1. C. Gecmen MD
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  2. G. G. Gecmen
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  3. D. Ece
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  4. M. Kahyaoğlu
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Correspondence to C. Gecmen MD.

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C. Gecmen, G.G. Gecmen, D. Ece, M. Kahyaoğlu, A. Kalayci, C.Y. Karabay, O. Candan, M.E. Isik, F. Yilmaz, O. Akgun, M. Celik, I.A. Izgi, C. Kirma, S. Keser declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Gecmen, C., Gecmen, G.G., Ece, D. et al. Cytopathology of pericardial effusions. Herz 43, 543–547 (2018). https://doi.org/10.1007/s00059-017-4596-8

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