Haydarpasa Numune Med J. Ahead of Print: HNHJ-50465 | DOI: 10.14744/hnhj.2021.50465

The Role Of The Second and Third Liquid Cytology in The First Liquid Cytology Negative Findings in The Diagnosis of Malignant Pleural Liquids

Þeyma Özden¹, IÞIL Gökdemir², Ayþin Durmaz³, Murat KIYIK⁴, Yasin Özden^5
1Süreyyapaþa Chest Diseases and Thoracic Surgery Training and Research Hospital, Chest Diseases Department
²Sancaktepe Prof. Dr. Ýlhan Varank Training and Research Hospital,Intensive Care Unit Department
³Baðcýlar Training and Research Hospital, Chest Diseases Department
⁴Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Chest Diseases Department
⁵Dr.Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital,Department of Cardiovascular Surgery

INTRODUCTION: In this study, we wanted to investigate the role of pleural fluid cytology, which is examined for the second and third times in malignant pleural fluid cases that cannot be diagnosed by first pleural fluid cytology.

METHODS: A total of 116 patients were evaluated in this retrospective study. 2nd samplings of pleural effusions were evaluated via thoracentesis in 105 patients (90.51%)with negative cytology results on the first thoracentesis attempt, and 3rd samplings were evaluated for 34 patients (29.31%). Pleural biopsy using a cope needle was performed on patients who could not be diagnosed upon pleural fluid cytology. If pleural biopsy did not yield any diagnosis, VATS (video assisted thoracoscopy) was performed, and pleural decortication was performed in some patients who could not be diagnosed with VATS. Pleural fluid cytology results suspected to be malignant were considered to be negative and the same procedure was performed as above
RESULTS: 7 out of the 116 cases ( % 6,03) were found to be cytologically positive on the first thoracentesis. Out of the cases found to be negative on first attempt, 29 (% 26,6) were diagnosed positive upon second attempt. 34 cases which were not diagnosed at first and second attempt underwent a third thoracentesis attempt and were evaluated cytologically. Out of the 34 cases, 11(%32) were diagnosed in the 3rd attempt. A total of 47 cases (40,5%) were diagnosed with pleural fluid cytology. In the presence of primary lung cancer, the rate of diagnosis by 2nd fluid cytology was statistically significant compared to other types of malignancy (p <0.05)

DISCUSSION AND CONCLUSION: n cases with negative pleural fluid cytology at the first examination, examination of fluid cytology for the second and third times should be considered with a high contribution to the diagnosis, especially in patients who are unable to apply more invasive diagnostic methods

Keywords: pleural effusion, thoracentesis, liquid cytology

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Malign Plevral Sývýlarýn Tanýsýnda Birinci Sývý Sitolojisi Negatif Saptanan Olgularda Ýkinci ve Üçüncü Sývý Sitolojisinin Tanýdaki Rolü

Þeyma Özden¹, IÞIL Gökdemir², Ayþin Durmaz³, Murat KIYIK⁴, Yasin Özden^5
1Süreyyapaþa Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Ana Bilim Dalý
²Sancaktepe Prof. Dr. Ýlhan Varank Eðitim ve Araþtýrma Hastanesi, Yoðun Bakýn Ana Bilim Dalý
³Baðcýlar Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Ana Bilim Dalý
⁴Yedikule Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Ana Bilim Dalý
⁵Dr. Siyami Ersek Göðüs ve Kalp Damar Cerrahisi Eðitim ve Araþtýrma Hastanesi, Kalp ve Damar Cerrahisi Ana Bilim Dalý

GÝRÝÞ ve AMAÇ: Bu çalýþmada birinci plevral sývý sitolojisi ile taný konulamayan malign plevral sývý olgularýnda 2. ve 3. kez bakýlan plevral sývý sitolojisinin tanýdaki rolünü araþtýrmak istedik.
YÖNTEM ve GEREÇLER: Toplam 116 hasta retrospektif olarak deðerlendirildi,birinci torasentez ile plevral sývý sitolojisi gönderilen ve negatif gelen 105 olguda (%90.51) 2.kez, 34 olguda (%29.31) 3.kez sývý sitolojisi gönderilmiþti.Sývý sitolojileri ile taný alamayan olgularda cope iðnesi ile kapalý plevra biopsisi(KÝPB) yapýlmýþtý.Plevra biyopsisi ile de taný gelmemiþse video yardýmlý torakoskopi (VATS) yapýlmýþ, VATS ile de taný gelmeyen bazý olgularda dekortikasyon yapýlmýþtý.Sývý sitolojisinde malignite þüphesi sonucu gelen olgularda da negatifmiþ gibi düþünülerek ayný prosedürler uygulanmýþtý.
BULGULAR: 16 olgunun 7 sinde (%6.03) 1.sývý sitolojisi malignite açýsýndan pozitif saptandý. 1. sývý sitolojisi malignite açýsýndan negatif saptanan hastalarýn 29 unda (%26.6) 2. sývý sitolojisi malignite açýsýndan pozitif saptandý.1. ve 2. sývý sitolojisi ile taný konulamayan toplam 34 olgudan 3. kez torasentez yapýlarak sývý sitolojisi çalýþýldý. 34 olgunun 11 inde (%32.35) 3. sývý sitolojisi malignite açýsýndan pozitif saptandý. Toplam olarak 47 olguda (%40.5) plevral sývý sitolojisi ile taný konulabildi. Primer akciðer kanseri varlýðýnda 2. Sývý sitolojisi ile taný konulma oraný diðer malignite türlerine göre istatistiksel olarak anlamlý bulundu(p <0.05).
TARTIÞMA ve SONUÇ: Plevral sývý sitolojisi ilk incelemede negatif gelen olgularda 2.ve 3.kez sývý sitolojisinin incelenmesinin tanýya katkýsý yüksek olup özellikle daha invaziv taný yöntemleri uygulanamayacak durumda olan hastalarda akýlda olmasý gerekmektedir.

Anahtar Kelimeler: plevral efüzyon, torasentez, sývý sitolojisi

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