Serous Effusion Cytology
Cytological evaluation of serous fluids plays an important role in the diagnosis and clinical management of patients. The etiology of pathological accumulation of serous fluids is broad, including both benign diseases, such as inflammation and infection, and malignant conditions, such as mesothelioma and metastatic carcinomas. Serous cavities are common sites of involvement by many metastatic tumors. The diagnosis of metastatic tumors is usually straightforward because most patients have a known malignant history, but challenges arise in difficult cases, such as in patients without a known malignant history, or in distinguishing a mesothelioma from an adenocarcinoma. Furthermore, the separation of reactive mesothelial cells from malignant mesothelioma can be difficult, usually requiring a panel of immunomarkers. Immunomarkers are also necessary for the identification of the primary site of a metastasis. This chapter summarizes current knowledge and guidelines regarding fluid cytology, key features of both benign and malignant lesions, differential diagnosis of a variety of benign and malignant effusions, and state-of-the-art ancillary tests using serous fluid specimens.
KeywordsSerous effusion cytology Pleural effusion Ascites Reactive mesothelial cells Benign and malignant effusions Mesothelioma Metastatic carcinoma
The author sincerely thanks Dr. Yurong Y. Wheeler from the Department of Pathology at East Tennessee State University for her editorial help with the chapter.
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