Pathology of the Pleura and Mediastinum

2018 Edition
| Editors: Timothy Craig Allen, Saul Suster

The Role of Cytology in the Diagnosis of Pleural Neoplasia

  • Linh M. DangEmail author
  • Rodolfo Laucirica
Reference work entry


Malignant pleural effusion; MPE


A pleural effusion is excess fluid that is collected in the pleural cavity due to decreased absorption or excess fluid production. Pleural effusions are divided into transudates and exudates based on the physical, chemical, and microscopic findings of the fluid. A transudative effusion is fluid that is generally clear with low specific gravity, low protein content, and low lactate dehydrogenase (LDH). An exudate is usually cloudy fluid with high specific gravity, high protein content, and high LDH. Transudates are due to systemic factors that affect hydrostatic and/or oncotic pressures, such as in cirrhosis or congestive heart failure. On the other hand, exudates are due to local factors, such as inflammation, infection, or neoplasia. These changes can lead to increase in vascular permeability or impair lymphatic drainage.

After pleural fluid (PF) is recovered, it is sent for chemical analysis. According to Light’s criteria, pleural...

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References and Further Reading

  1. Antunes, G., Neville, E., Duffy, J., & Ali, N. (2003). BTS guidelines for the management of malignant pleural effusions. Thorax, 58((Suppl II)), ii29–ii38.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Heffner, J. E., & Klein, J. S. (2008). Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clinic Proceedings, 82(2), 235–250.CrossRefGoogle Scholar
  3. Husain, A. N., Colby, T. V., Ordonex, N. G., Krausz, T., Borczuk, A., Cagle, P. T., et al. (2009). Guidelines for pathologic diagnosis of malignant mesothelioma: A consensus statement from the international mesothelioma interest group. Archives of Pathology & Laboratory Medicine, 133, 1317–1331.Google Scholar
  4. Laucirica, R., & Schultenover, S. (2000). Body cavity fluids. In I. Ramzy (Ed.), Clinical cytopathology and aspiration biopsy (pp. 205–223). New York: McGraw-Hill.Google Scholar
  5. Marchevsky, A. M. (2008). Application of immunohistochemistry to the diagnosis of malignant mesothelioma. Archives of Pathology & Laboratory Medicine, 132, 397–401.Google Scholar
  6. Moriarty, A. T., Schwartz, M. R., Ducatman, B. S., Booth, C. N., Haja, J., Chakraborty, S., & Williamson, B. (2008). A liquid concept – Do classic preparations of body cavity fluid perform differently than thinprep cases? Archives of Pathology & Laboratory Medicine, 132(11), 1716–1718.Google Scholar
  7. Ozyurtkan, M. O., Balci, A. E., & Cakmak, M. (2010). Predictors of mortality within 3 months in the patients with malignant pleural effusion. European Journal of Internal Medicine, 21, 30–34.CrossRefPubMedGoogle Scholar
  8. Westfall, D. E., Fan, X., & Marchevsky, A. M. (2010). Evidence-based guidelines to optimize the selection of antibody panels in cytopathology: Pleural effusions with malignant epithelioid cells. Diagnostic Cytopathology, 38, 9–14.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Path Advantage AssociatedDallasUSA
  2. 2.Department of Pathology and ImmunologyBaylor College of MedicineHoustonUSA