Monte S A, Ehya H, Lang W R
Acta Cytol. 1987 Jul-Aug;31(4):448-52.
During a period of four years (1981 to 1984), 641 ascitic, 860 pleural and 47 pericardial fluid specimens were examined cytologically. Of these, 154 ascitic samples, 174 pleural specimens and 10 pericardial effusions, obtained, respectively, from 108, 133 and 7 patients, were found to contain malignant cells. In 7 patients, ascites, and in 18 cases, pleural effusions were the first indication of cancer. None of the positive pericardial fluids was the initial presentation of malignancy. The cytologic findings and follow-up data on these 25 patients are the subject of this study. The most common type of neoplasm in these effusions was adenocarcinoma (86% of the ascitic and 78% of the pleural fluids). Most of the malignant neoplasms in ascitic fluids were derived from ovarian tumors (5 of 7) while those in pleural effusions came mainly from lung tumors (12 of 18). Mammary carcinoma, which was the most common malignant tumor found in cases of pleural effusions, did not present initially with an effusion in any of our cases. The cytologic diagnosis was confirmed in all cases by either biopsy or strong clinical evidence. The prognosis in patients who initially presented with an effusion was poor. All of the patients with an adequate follow-up died within 29 months in cases of ascites and within 19 months in cases of pleural effusions.
在四年期间（1981年至1984年），对641份腹水、860份胸水和47份心包积液标本进行了细胞学检查。其中，分别从108例、133例和7例患者获得的154份腹水样本、174份胸水标本和10份心包积液中发现含有恶性细胞。7例患者的腹水和18例患者的胸水是癌症的首发表现。所有阳性心包积液均不是恶性肿瘤的初始表现。本研究的主题是这25例患者的细胞学检查结果和随访数据。这些积液中最常见的肿瘤类型是腺癌（腹水的86%和胸水的78%）。腹水中的大多数恶性肿瘤起源于卵巢肿瘤（7例中的5例），而胸水中的恶性肿瘤主要来自肺部肿瘤（18例中的12例）。乳腺癌是胸水中最常见的恶性肿瘤，但在我们所有病例中均未以积液作为初始表现。所有病例的细胞学诊断均通过活检或有力的临床证据得到证实。以积液作为首发表现的患者预后较差。所有进行了充分随访的患者，腹水患者在29个月内死亡，胸水患者在19个月内死亡。
