Diagnostic accuracy of pericardial fluid cytology: an analysis of 53 specimens from 44 consecutive patients.

Over a 7-yr period, a total of 53 pericardial fluid specimens from 44 patients was examined. A correlation between cytological and histological diagnosis was made in 19 of these cases. In the remaining 25 cases, where a biopsy was not performed, the cytological diagnosis was correlated with the final clinical diagnosis and the patients' clinical outcome. Finally, in 9 out of 14 cases of malignancy where both cytological and a histological diagnosis was made, the cytologic prediction of the histologic type of cancer was evaluated. The overall sensitivity was 100%, the overall specificity was 93.3%, and the overall cytological accuracy was 95.4%. The predictive value of the correct histologic type of cancer by cytology was 77.7%. Our findings show that the careful cytomorphological examination of pericardial fluid aspirates is a valuable, reliable, and diagnostically highly accurate method, which could be performed on a routine basis in a busy cytopathology department. Judiciously chosen ancillary procedures, as well as clinicopathological correlation, are of great value for an accurate diagnosis in problematic cases.