Lafaras Christos, Mandala Evdokia, Lafara Kyranna, Kalafatis Ioannis, Achladas Thomas, Koukoulitsa Vasiliki, Gouta Chrysoula, Tsiouda Theodora, Skevoudi Soultana
Cardiology-Oncology Department, Theagenion Cancer Hospital, PC54623 Thessaloniki, Greece.
Division of Hematology, Forth Department of Medicine, School of Medicine Aristotle University of Thessaloniki, PC54623 Thessaloniki, Greece.
Curr Oncol. 2025 May 26;32(6):306. doi: 10.3390/curroncol32060306.
Early diagnosis and treatment of metastatic pericardial disease are crucial to prevent the life-threatening complication of cardiac tamponade. Thin Layer Cytology (TLC), a widely adopted technique in cytology, has gained significant acceptance for most specimens. Our study aimed to assess the utility of TLC in diagnosing metastatic neoplasms and their origins in pericardial effusions, as well as monitoring response to chemotherapy. We examined 184 pericardial fluids collected by pericardiocentesis and processed using the ThinPrep liquid-based technique. Various immunocytochemical markers were used to determine the site of metastatic neoplasms. We also evaluated the response to therapy in 53 patients with lung and breast cancer. Out of 184 specimens, 113 pericardial fluids were diagnosed as positive for malignancy, while 71 were negative. Twenty-three cases of unknown primary site were included in the total positive cases. Ninety cases positive for malignancy had a known primary site of origin, including 31 lung carcinomas, 22 breast carcinomas, 10 ovarian carcinomas, 6 T-cell lymphomas, 3 urinary bladder carcinomas, 4 renal carcinomas, 5 adenocarcinomas of the colon, 5 prostate carcinomas, 2 parotid adenocarcinomas, and 2 melanomas. Regarding the 53 cases with chemotherapy treatment, the cytologic examination of pericardial fluid showed a remarkable reduction in neoplastic burden after the third dose of cisplatin or thiotepa instilled into the pericardial cavity. ThinPrep provided excellent preservation of cytomorphological features, high cellularity per slide, and a clear background. This comprehensive analysis provides crucial information about the types and distribution of cancerous cells present in the samples. Thin Layer Cytology (TLC) is a valuable diagnostic tool for detecting metastatic pericardial malignancy. It allows the examination of exfoliated cells from the pericardial fluid, providing crucial information for diagnosis, management, and monitoring the acute responsiveness to intrapericardial chemotherapy. Immunocytochemistry (IHC) can identify specific markers for various types of cancer, enabling a more accurate diagnosis and guiding further treatment decisions.
转移性心包疾病的早期诊断和治疗对于预防危及生命的心脏压塞并发症至关重要。薄层细胞学检查（TLC）是细胞学中广泛采用的技术，已被大多数标本广泛接受。我们的研究旨在评估TLC在诊断心包积液中转移性肿瘤及其起源以及监测化疗反应方面的效用。我们检查了通过心包穿刺收集并使用ThinPrep液基技术处理的184份心包液。使用各种免疫细胞化学标志物来确定转移性肿瘤的部位。我们还评估了53例肺癌和乳腺癌患者的治疗反应。在184份标本中，113份心包液被诊断为恶性阳性，而71份为阴性。总阳性病例中包括23例原发部位不明的病例。90例恶性阳性病例有已知的原发部位，包括31例肺癌、22例乳腺癌、10例卵巢癌、6例T细胞淋巴瘤、3例膀胱癌、4例肾癌、5例结肠腺癌、5例前列腺癌、2例腮腺腺癌和2例黑色素瘤。对于53例接受化疗的病例，心包液的细胞学检查显示在心包腔内注入第三剂顺铂或噻替派后肿瘤负荷显著降低。ThinPrep能出色地保存细胞形态特征，每张玻片细胞含量高，背景清晰。这种综合分析提供了有关样本中癌细胞类型和分布的关键信息。薄层细胞学检查（TLC）是检测转移性心包恶性肿瘤的有价值诊断工具。它允许检查心包液中的脱落细胞，为诊断、管理和监测心包内化疗的急性反应提供关键信息。免疫细胞化学（IHC）可以识别各种类型癌症的特异性标志物，从而实现更准确的诊断并指导进一步的治疗决策。
