Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Dec;10(12):6903-6911.
doi: 10.21037/jtd.2018.11.127.

Comparison of cytology, chest computed and positron emission tomography findings in malignant pleural effusion from lung cancer

Clement Brun  1 , Pierre Gay  1 , Michele Cottier  2 , Georgia Karpathiou  3 , Arnaud Patoir  4 , Oliviet Tiffet  4 , Fabrice-Guy Barral  5 , Jean-Michel Vergnon  1 , Marios E Froudarakis  1
Affiliations

Comparison of cytology, chest computed and positron emission tomography findings in malignant pleural effusion from lung cancer

Clement Brun et al. J Thorac Dis. 2018 Dec.

Abstract

Background: Malignant pleural effusion (MPE) is a common medical problem in lung cancer (LC). Pleural fluid cytology (PFC), chest computed tomography (CCT) and positron emission tomography (PET) findings are helpful as first line approach. The objectives of this study were to evaluate whether there is a correlation between PFC, CCT and PET in patients with MPE due to LC.

Methods: We selected patients from our electronic files. Data of PFC, pleural biopsy (PB), CCT and PET have been recorded and analyzed.

Results: A total of 101 consecutive patients (66 males, 65.3%) with a mean age of 66.2±31 years were selected. Types of LC were adenocarcinoma in 71 patients (70.2%), squamous in 13 (12.8%), small-cell in 12 (11.8%) and large cell in 5 (4.9%). CCT showed nodules in 6 (5.9%), pleural thickening in 8 (7.9%) and both in 17 (16.8%) patients. PFC was positive in 55/91 thoracentesis (60.4%) and 32/52 thoracoscopy (61.5%), while PB in 38/40 performed (95%). PET fixation was found in 32/47 (68%) patients who had MPE at diagnosis. When we associate PFC to CCT and PET findings, the yield in our study becomes 90%. No correlation was observed between CCT findings and PFC (P=0.62) between PFC and PET fixation (P=0.63) or between CCT and PET (P=0.06).

Conclusions: In our cohort of LC patients with MPE, we observed a high sensitivity for PFC, while in most of the cases no findings were observed in CCT. PET had a relative low sensitivity. However, when all 3 methods were combined the yield was 90%.

Keywords: Lung cancer (LC); chest computed tomography (CCT); cytology; malignant effusion; pleural disease; positron emission tomography (PET); thoracoscopy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curve of all patients (n=101) from the time of diagnosis of their lung carcinoma.
Figure 2
Figure 2
Kaplan-Meier survival curves of all patients presented with PE at diagnosis of their carcinoma versus those who presented their effusion during follow-up.
Figure 3
Figure 3
Patients’ survival curves measured only after pleural effusion occurrence: at the time of diagnosis versus follow-up.
Figure 4
Figure 4
Chest computed tomography of a patient with lung adenocarcinoma showing (A) pleural masses and (B) pleural thickening associated to small nodules.
Figure 5
Figure 5
Positron emission tomography of a patient with lung adenocarcinoma showing (A) pleural masses and (B) metastatic pleural thickening associated to nodules.
See this image and copyright information in PMC

Comment in

References

    1. Froudarakis ME. Diagnostic work-up of pleural effusions. Respiration 2008;75:4-13. 10.1159/000112221 - DOI - PubMed
    1. Chernow B, Sahn SA. Carcinomatous involvement of the pleura: An analysis of 96 patients. Am J Med 1977;63:695-702. 10.1016/0002-9343(77)90154-1 - DOI - PubMed
    1. Froudarakis ME. Pleural effusion in lung cancer: more questions than answers. Respiration 2012;83:367-76. 10.1159/000338169 - DOI - PubMed
    1. Porcel JM, Esquerda A, Vives M, et al. Etiology of pleural effusions: analysis of more than 3,000 consecutive thoracenteses. Arch Bronconeumol 2014;50:161-5. - PubMed
    1. Porcel JM, Gasol A, Bielsa S, et al. Clinical features and survival of lung cancer patients with pleural effusions. Respirology 2015;20:654-9. 10.1111/resp.12496 - DOI - PubMed