Combination of Biochemical and Cytological Findings for Better Diagnosis in Pleural Effusions
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Combination of Biochemical and Cytological Findings for Better Diagnosis in Pleural Effusions. / Elmas, Hatice; Biancosino, Christian; Önal, Binnur; Schmitt, Fernando; Buyucek, Seyma; Nordholt, Gerhard; Sauter, Guido; Welker, Lutz.
in: ADV EXP MED BIOL, Jahrgang 1374, 2022, S. 51-62.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Combination of Biochemical and Cytological Findings for Better Diagnosis in Pleural Effusions
AU - Elmas, Hatice
AU - Biancosino, Christian
AU - Önal, Binnur
AU - Schmitt, Fernando
AU - Buyucek, Seyma
AU - Nordholt, Gerhard
AU - Sauter, Guido
AU - Welker, Lutz
N1 - © 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.
PY - 2022
Y1 - 2022
N2 - Serous pleural effusions result from increased permeability and changed hydrostatic or colloid osmotic pressure. Laboratory biochemical findings provide conclusions about the effusion compositions. Together with the anamnesis and clinical assessment, they enable the evaluation of the effusion nature. The present study retrospectively analyzed combined biochemical and morphological findings in 2307 effusions of patients from two clinical centers: LungenClinic Grosshansdorf in Germany and Duzce University in Turkey. The effusion cytology results of 1771 and 536 patients from the respective centers were combined with clinical/radiological/biochemical findings and counter compared with the final diagnoses. Cytology verified 738 malignant tumors (643 and 95, respectively). Most effusions were benign (n = 1569; 77%) and 367 of them were paramalignant (293 and 74, respectively) and 594 were inflammatory (465 and 129, respectively). There was a distinctly lower number of malignant tumors in transudates than exudates (87 vs. 725; p < 0.0001). Squamous cell carcinoma was more frequent in paramalignant pleura effusions (122 cases out of the 367 effusions) than pleural carcinomatosis (32 cases out of the 780 malignant tumors; p < 0.0001). The cell formula was a suitable marker for malignant mesothelioma, predominantly mesothelial, or neutrophilic characterized by elevated LDH (>500 U/L) in the early stage of empyema or its late manifestation. İn conclusion, most effusions are benign. Cytologists, assisted by clinical and biochemical data and microscopic findings, can make significant differential diagnostic contributions beyond the sole detection of malignancy.
AB - Serous pleural effusions result from increased permeability and changed hydrostatic or colloid osmotic pressure. Laboratory biochemical findings provide conclusions about the effusion compositions. Together with the anamnesis and clinical assessment, they enable the evaluation of the effusion nature. The present study retrospectively analyzed combined biochemical and morphological findings in 2307 effusions of patients from two clinical centers: LungenClinic Grosshansdorf in Germany and Duzce University in Turkey. The effusion cytology results of 1771 and 536 patients from the respective centers were combined with clinical/radiological/biochemical findings and counter compared with the final diagnoses. Cytology verified 738 malignant tumors (643 and 95, respectively). Most effusions were benign (n = 1569; 77%) and 367 of them were paramalignant (293 and 74, respectively) and 594 were inflammatory (465 and 129, respectively). There was a distinctly lower number of malignant tumors in transudates than exudates (87 vs. 725; p < 0.0001). Squamous cell carcinoma was more frequent in paramalignant pleura effusions (122 cases out of the 367 effusions) than pleural carcinomatosis (32 cases out of the 780 malignant tumors; p < 0.0001). The cell formula was a suitable marker for malignant mesothelioma, predominantly mesothelial, or neutrophilic characterized by elevated LDH (>500 U/L) in the early stage of empyema or its late manifestation. İn conclusion, most effusions are benign. Cytologists, assisted by clinical and biochemical data and microscopic findings, can make significant differential diagnostic contributions beyond the sole detection of malignancy.
KW - Carcinoma, Squamous Cell/diagnosis
KW - Diagnosis, Differential
KW - Humans
KW - Pleural Effusion/diagnosis
KW - Pleural Effusion, Malignant/diagnosis
KW - Pleural Neoplasms/diagnosis
KW - Retrospective Studies
U2 - 10.1007/5584_2021_703
DO - 10.1007/5584_2021_703
M3 - SCORING: Journal article
C2 - 35147931
VL - 1374
SP - 51
EP - 62
JO - ADV EXP MED BIOL
JF - ADV EXP MED BIOL
SN - 0065-2598
ER -