Cytopathology of Pleural, Peritoneal, and Pericardial Fluids

  • Kitai Kim
  • Bernard Naylor


Cytologic examination of spontaneously occurring serous effusions is widely performed, especially with a view to detecting cancer cells in the fluid. The finding of cancer cells in such a fluid is of the gravest prognostic significance, denoting that the patient has cancer that is not only advanced but which is almost certainly incurable. Apart from cancer cells, examination of a serous fluid may reveal inflammatory changes, usually nonspecific, but which may be specific for certain diseases. Cytologic examination of serous fluids may also reveal infection with bacteria, fungi, parasites, or viruses. It may also reveal the presence of a fistulous connection with a serous cavity.


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  1. 1.
    Kern WH. Benign papillary structures with psammoma bodies in culdocentesis fluid. ActaCytol. 1969;13:178–180.Google Scholar
  2. 2.
    Dekker A, Graham T, Bupp PA. The occurrence of sickle cells in pleural fluid: Report of a patient with sickle cell disease. ActaCytol. 1975;19:251–254.Google Scholar
  3. 3.
    Veress JF, Koss LG, Schreiber K. Eosinophilic pleural effusions. ActaCytol. 1979;23:40–44.Google Scholar
  4. 4.
    Spriggs AI, Boddington MM. Atlas of Serous Fluid Cytopathology. A Guide to the Cells of Pleural, Pericardial, Peritoneal and Hydrocele Fluids, Vol. 14, Current Histopathology Series, Gresham GA, ed. Dordrecht: Kluwer Academic Publishers; 1989.Google Scholar
  5. 5.
    Kumar NB, Naylor B. Megakaryocytes in pleural and peritoneal fluids: Prevalence, significance, morphology, and cytohistological correlation. J ClinPathol. 1980;33:1153–1159.CrossRefGoogle Scholar
  6. 6.
    Ashfaq-Drewett R, Allen C, Harrison RL. Detached ciliary tufts.Comparison with intestinal protozoa and a review of the literature.Am J ClinPathol. 1990;93:541–545.Google Scholar
  7. 7.
    Sidawy MK, Chandra P, Oertel YC. Detached ciliary tufts in female peritoneal washings.A common finding.ActaCytol. 1987;31:841–844.Google Scholar
  8. 8.
    Domagala W, Emerson EE, Koss LG. T and B lymphocyte enumeration in the diagnosis of lymphocyte-rich pleural fluids. ActaCytol. 1981;25:108–110.Google Scholar
  9. 9.
    Ghosh AK, Spriggs AI, Mason DY. Immunocytochemical staining of T and B lymphocytes in serous effusions. J ClinPathol. 1985;38:608–612.CrossRefGoogle Scholar
  10. 10.
    Naylor B. The pathognomonic cytologic picture of rheumatoid pleuritis. ActaCytol. 1990;34:465–473.Google Scholar
  11. 11.
    Osamura RY, Shioya S, Handa K, Shimizu K. Lupus erythematosus cells in pleural fluid. Cytologic diagnosis in two patients.ActaCytol. 1977;21:215–217.Google Scholar
  12. 12.
    Dubois EL. Lupus Erythematosus. 2nd ed. Los Angeles: University of Southern California Press; 1974.Google Scholar
  13. 13.
    Smith-Purslow MJ, KM SR, Naylor B. Cells of squamous cell carcinoma in pleural, peritoneal and pericardial fluids. Origin and morphology.ActaCytol. 1989;29:245–253.Google Scholar
  14. 14.
    Salhadian A, Nasiell M, Nasiell K, et al. The unique cytologic picture of oat cell carcinoma in effusions. ActaCytol. 1976;20:298–302.Google Scholar
  15. 15.
    Spriggs AI, Boddington MM. Oat-cell bronchial carcinoma. Identification of cells in pleural fluid.ActaCytol. 1976;20:525–529.Google Scholar
  16. 16.
    Hajdu SI, Savino A. Cytologic diagnosis of malignant melanoma. ActaCytol. 1973;17:320–327.Google Scholar
  17. 17.
    Yamada T, Itou U, Watanabe Y, Ohashi S. Cytologic diagnosis of malignant melanoma. ActaCytol. 1972;16:70–76.Google Scholar
  18. 18.
    Ordóñez NG, Sneige N, Hickey RC, Brooks TE. Use of monoclonal antibody HMB-45 in the cytologic diagnosis of melanoma.ActaCytol. 1988;32:684–688.Google Scholar
  19. 19.
    Pinto MM. An immunoperoxidase study of S-100 protein in neoplastic cells in serous effusions. Use as a marker for melanoma. ActaCytol. 1986;30:240–244.Google Scholar
  20. 20.
    McCaughey WTE, Kannerstein M, Churg J. Tumors and Pseudotumorsof the Serous Membranes. Atlas of Tumor Pathology, Second series,fascicle 20. Washington, DC: Armed Forces Institute of Pathology;1985.Google Scholar
  21. 21.
    Bell DA, Scully RE. Benign and borderline serous lesions of the peritoneum in women. In Rosen PP, Fechner RE, eds. Pathology Annual, 1989: Part 2. East Norwalk: Appleton and Lange; 1989:1–21.Google Scholar
  22. 22.
    Castor WC, Naylor B. Acid mucopolysaccharide composition of serous effusions. Study of 100 patients with neoplastic and non-neoplastic conditions.Cancer. 1967;20:462–466.PubMedCrossRefGoogle Scholar
  23. 23.
    Koss LG. Diagnostic Cytology and Its Histopathologic Bases. 3rd ed. Philadelphia: JB Lippincott; 1979.Google Scholar
  24. 24.
    Naylor B. The exfoliative cytology of diffuse malignant mesothelioma. J PatholBacteriol. 1963;86:293–298.Google Scholar
  25. 25.
    Whitaker D, Shilkin KB. Diagnosis of pleural malignant mesothelioma in life-a practical approach.J Pathol. 1984;143:147–175.PubMedCrossRefGoogle Scholar
  26. 26.
    Kannerstein M, Churg J, Magner D. Histochemistry in the diagnosis of malignant mesothelioma. Ann Clin Lab Sci. 1973;3:207–211.PubMedGoogle Scholar
  27. 27.
    Kobzik L, Antman KH, Warhol MJ. The distinction of mesothelioma from adenocarcinoma in malignant effusions by electron microscopy.ActaCytol. 1985;29:219–225.Google Scholar
  28. 28.
    Ordonez NG. The immunohistochemical diagnosis of mesothelioma: Differentiation of mesothelioma and lung adenocarcinoma. Am J SurgPathol. 1989;13:276–291.Google Scholar
  29. 29.
    Johnston WW, Szpak CA, Thor A, Simpson J, Schlom J. Antibodies to tumor-associated antigens: Applications in clinical cytology. In: Wied GL, Keebler CM, Koss LG, Reagan JW, eds. Compendium on Diagnostic Cytology. 6th ed. Chicago: Tutorials of Cytology; 1988:567–578.Google Scholar
  30. 30.
    Ashton PR, HoUingsworth AS, Johnston WW. The cytopathology of metastatic breast cancer.ActaCytol. 1975;19:1–6.Google Scholar
  31. 31.
    Spriggs AI, Jerrome DW. Intracellular mucous inclusions.A feature of malignant cells in effusions in the serous cavities, particularly due to carcinoma of the breast. J ClinPathol. 1975;28:929–936.CrossRefGoogle Scholar
  32. 32.
    Costa M, Oertel Y. Cytology of pseudomyxomaperitonei: Report of two cases arising from appendicealcystadenomas. DiagnCytopathol. 1989;6:201–203.Google Scholar
  33. 33.
    Spriggs AJ, Vanhegan RI. Cytological diagnosis of lymphoma in serous effusions.J ClinPathol. 1981;34:1311–1325.Google Scholar
  34. 34.
    Katz RL, Raval P, Manning JT, McLaughlin P, Barlogie B. A morphologic, immunologic, and cytometric approach to the classification of non-Hodgkin’s lymphoma in effusions. DiagnCytopathol. 1987;3:91–101.Google Scholar
  35. 35.
    Martin SE, Zhang H-Z, Magyarosy E, Jaffe ES, Hsu S-M, Chu EW Immunologic methods in cytology: Definitive diagnosis of non-Hodgkin’s lymphomas using immunologic markers for T and B-cells. Am J ClinPathol. 1984;82:666–673.Google Scholar
  36. 36.
    Yam LT, Lin DG, Janckila AJ, Li C-Y Immunocytochemical diagnosis of lymphoma in serous effusions. ActaCytol. 1985;29:833–841.Google Scholar
  37. 37.
    Hajdu SI, Hajdu EO. Cytopathology of Sarcomas and Other Nonepithelial Malignant Tumors. Philadelphia: WB Saunders; 1976.Google Scholar

Copyright information

© Springer-Verlag New York, Inc. 1992

Authors and Affiliations

  • Kitai Kim
    • 1
    • 2
  • Bernard Naylor
    • 3
    • 4
  1. 1.Medical College of OhioToledoUSA
  2. 2.Medical College HospitalsToledoUSA
  3. 3.The University of MichiganAnn ArborUSA
  4. 4.The University of Michigan HospitalsAnn ArborUSA

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