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Journal articles on the topic 'Neoplastic effusions'

Author: Grafiati
Published: 4 June 2021
Last updated: 13 February 2022

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1

Nestor, Derek D., Sheila M. McCullough, and David J. Schaeffer. "Biochemical Analysis of Neoplastic Versus Nonneoplastic Abdominal Effusions in Dogs." Journal of the American Animal Hospital Association 40, no. 5 (September 1, 2004): 372–75. http://dx.doi.org/10.5326/0400372.

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This prospective study of 15 dogs evaluated biochemical parameters in abdominal effusions of neoplastic and nonneoplastic origin in an attempt to identify markers for malignant effusions. Dogs in the neoplastic group had statistically significant lower glucose concentrations (mean, 72.6 mg/dL versus 110.0 mg/dL; P=0.0431) and higher lactate levels (mean, 3.81 mmol/L versus 1.68 mmol/L; P=0.0377) in their abdominal fluid than did dogs in the nonneoplastic group, indicating that low glucose and high lactate in abdominal effusions may be markers for neoplasia.
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2

Lissoni, Paolo, Sandro Barni, Antonio Ardizzoia, Franco Paolorossi, Elisabetta Tisi, Sergio Crispino, and Gabriele Tancini. "Intracavitary Administration of Interleukin-2 as Palliative Therapy for Neoplastic Effusions." Tumori Journal 78, no. 2 (April 1992): 118–20. http://dx.doi.org/10.1177/030089169207800211.

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Cytokines have recently appeared to be effective in the palliative therapy of neoplastic effusions. The present study was carried out to evaluate the efficacy and the tolerability of an intracavitary injection of IL-2 in patients with neoplastic effusion due to solid tumors. The study included 14 patients with cytologically positive effusion (pleura, 11; peritoneum, 2; pericardium, 1). Tumor histotypes were: mesothelioma, 5; non-small cell lung cancer, 3; breast cancer, 2; ovarian cancer, 2; cervix carcinoma, 1; unknown primary tumor, 1. The efficacy was evaluated according to the criteria of Paladine et al. (Cancer 38: 1903, 1976). An objective response was achieved in 10/14 (71 %) patients (4 CR, 6 PR), with a median duration of 4 months (range, 2-8). No important toxicity was seen. This preliminary study showed that low dose IL-2 given intracavitarily is an effective and well-tolerated therapy in patients with neoplastic effusions.
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3

Nunes, Nilson Júnior da Silva, Naila Cristina Blatt Duda, Juliana Pereira Matheus, Ana Paula Soares Borenstein, Bruno Albuquerque de Almeida, and Stella De Faria Valle. "Approach to Classification of Cavitary Effusion and Comparison between Manual and Automatic Methods for Total Nucleated Cell Count." Acta Scientiae Veterinariae 46, no. 1 (September 17, 2018): 8. http://dx.doi.org/10.22456/1679-9216.84760.

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Background: Two classifications are used to categorize cavitary effusions using total nucleated cell count (TNCC): protein concentration and pathophysiology of its formation. The aims of the present study were to evaluate the correlation between the TNCC values of cavitary effusions obtained in the automatic and the manual method, and also evaluating the classification methodology. Materials, Methods & Results: Cavitary effusions were analyzed for physical, chemical and cytological aspects, as well as manual and automatic cell counts for the correlation between the traditional methods and those suggested by Stockham & Scott. Bland-Altman regression and Spearman correlation analysis were performed. Of the total, 44 were abdominal effusions (73.3%), 15 thoracic (25%) and 1 pericardial (1.7%). According to the traditional classification, most of the effusions were classified as modified transudates (40%) and according to the classification of Stockham and Scott, as transudates poor in protein (31.7%). The correlation between cell counting techniques between pure, modified and exudate transudates was 0.94, 0.97 and 0.94, respectively, indicating an excellent correlation between the parameters (p = 0.95%).Discussion: Considering the concentration of proteins and CCNT, the effusions classified as modified transudate were mainly caused by neoplastic processes (carcinomas/adenocarcinomas), since there are several mechanisms of their formation, such as large variation of protein concentration. According to the Stockham & Scott classification a unique classification is considered for exfoliative neoplastic effusions, the variation of the protein concentration of the effusion does not alter its classification. In neoplastic effusions, classified as exudates, lymphomas were the most prevalent, and hypercellularity (approximately 150,000 cells / μL) allowed this classification. When considering low-protein transudates, the findings related to low concentrations did not differ much from the traditional classification. In the ruptures of viscera and vessels, the hemorrhagic ones were the most frequent, thus, the cytological diagnosis is essential, since it can give information about the contamination with blood during the collection. Most of these were due to neoplasia as the underlying cause. A case of chylotorax was diagnosed by comparing cholesterol and triglyceride values of effusion and serum. In cases of uroperitoneum, the presence of urine in the abdominal cavity promotes the dilution of the fluid from the cavity, being initially classified as pure transudate and, with its permanence in the cavity, increasing the CCNT, becomes an exudate. As in cases of exfoliative neoplastic effusions, the classification of the uroperitoneum, according to Stockham & Scott, is classified directly into effusion due to rupture of the viscera, giving a quick and clear diagnosis. According to Stockham & Scott, cases classified as nonseptic exudates (n = 3), two of which resulted from feline infectious peritonitis (PIF). The effusive form of PIF presents with accumulations of fluid in the abdomen, having an inflammatory character, but according to the traditional classification, they enter the category of modified transudates, because, despite containing protein concentrations close to or above the serum level, they present a CCNT lower than an exudate. Cavitary effusions were classified as septic exudates when intracellular bacteria were present and in the present study, two effusions were classified as such in two patients, one with septic peritonitis and in the other the final diagnosis was not found. The high values of Spearman correlation coefficients found when comparing the automatic counts with the manual demonstrate that there is an excellent correlation between the methods and, the Bland-Altman test showed significant agreement between them.
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4

Gulyas, Miklos, Janos Fillinger, Andras D. Kaposi, and Miklos Molnar. "Use of cholesterol and soluble tumour markers CEA and syndecan-2 in pleural effusions in cases of inconclusive cytology." Journal of Clinical Pathology 72, no. 8 (April 26, 2019): 529–35. http://dx.doi.org/10.1136/jclinpath-2018-205650.

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AimsIn order to improve diagnostics in pleural effusions, additional value of effusion cholesterol, carcinoembryonic antigen (CEA) and syndecan-2 assays to cytology was studied.MethodsBiomarkers were measured in effusion supernatants from 247 patients, of whom 126 had malignant pleural involvement, and their additional diagnostic efficacy to cytology was assessed.ResultsSyndecan-2 measurement, although gave detectable concentrations in all effusions with highest median value in mesotheliomas, was non-discriminative between different pathological conditions. CEA concentrations exceeding 5 ng/mL cut-off point indicated carcinomas, regardless of pleural involvement, which gave a sensitivity of 62% and specificity of 100% for carcinoma. Cholesterol concentration over 1.21 mmol/L cut-off value indicated neoplastic pleural involvement with 99% sensitivity and ‘merely’ 69% specificity, the latter mainly due to raised levels being associated also with benign inflammatory effusions. Combined CEA and cholesterol determinations increased the sensitivity for diagnosing carcinomatosis from 70% with cytology alone to 84% and established the correct diagnosis in 16 of 31 carcinomatosis cases with inconclusive cytology. Cholesterol measurement alone, with elevated level, in combination with absence of substantial number of inflammatory cells in effusion sediment proved to be a magnificent marker for neoplastic pleural involvement with 99% efficacy, and recognised all 36 such cases with inconclusive cytology.ConclusionsSimultaneous measurement of CEA and cholesterol concentrations in effusion, or at least cholesterol alone, in combination with non-inflammatory fluid cytology, provides additional specific information about neoplastic pleural involvement, and can therefore be used as an adjunct to cytology, above all, in inconclusive cases.
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5

Cozzi, Sergio, Sergio Montanara, Annalisa Luraschi, Paola Fedeli, Paola Buscaglia, Vincenzina Amodei, Ornella Fossati, Aldo Gioria, Elisabetta Garzoli, and Gianmarco Ferrari. "Management of Neoplastic Pericardial Effusions." Tumori Journal 96, no. 6 (January 2010): 926–29. http://dx.doi.org/10.1177/548.6510.

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6

Teixeira, L. V., T. A. Guerra, F. O. Conrado, S. R. Terra, D. G. Gerardi, and F. H. D. González. "Evaluation of tumor markers carcinoembryonic antigen, cytokeratin 19 fragment and cancer-associated antigen 72-4 in neoplastic and non-neoplastic canine effusions differentiation." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 66, no. 5 (October 2014): 1311–16. http://dx.doi.org/10.1590/1678-6820.

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The concentration of tumor markers in body fluids can be used for diagnosis and prognosis of patients. This study aimed to investigate the performance of tumor markers cytokeratin 19 fragment (CYFRA 21-1), cancer-associated antigen 72-4 (CA 72-4) and carcinoembryonic antigen (CEA) in the neoplastic and non-neoplastic canine effusions. In thirty-two neoplastic (n=16) and non-neoplastic (n=16) samples of canine thoracic or abdominal effusions, tumor markers were measured. Significant statistical difference was found only for the CYFRA 21-1 marker. The levels were significantly higher for the neoplastic group. The lack of significance between groups for markers CA 72-4 and CEA can be explained by the presence of other diseases in the non-neoplastic group, causing elevated levels of these markers. This study concludes that CYFRA 21-1 performed well, showing good sensitivity, specificity and accuracy in the diagnosis of neoplastic effusions in dogs. However, further investigations are necessary in patients with malignancy as those with benign effusions.
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7

Martinoni, Alessandro, Carlo Maria Cipolla, Maurizio Civelli, Daniela Cardinale, Guiseppina Lamantia, Marco Colleoni, Filippo DeBraud, et al. "Intrapericardial Treatment of Neoplastic Pericardial Effusions." Herz 25, no. 8 (December 2000): 787–93. http://dx.doi.org/10.1007/pl00001998.

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8

Feldman, Bernhard F., Erik Brummerstedt, Liselotte S. Larsen, and Steen Larsen. "Fibronectin in Neoplastic Peritoneal Effusions in Dogs." Acta Veterinaria Scandinavica 29, no. 3-4 (September 1988): 273–79. http://dx.doi.org/10.1186/bf03548618.

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9

Chhabra, Akansha, Vikramjit Mukherjee, Mudit Chowdhary, Mauricio Danckers, and David Fridman. "Black Pleural Effusion: A Unique Presentation of Metastatic Melanoma." Case Reports in Oncology 8, no. 2 (May 7, 2015): 222–25. http://dx.doi.org/10.1159/000430907.

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Metastatic melanoma is a rare form of skin cancer, but one that comes with a high mortality rate. Pulmonary involvement is frequently seen in metastatic melanoma with only 2% of malignant melanoma patients with thorax metastasis presenting with pleural effusions. Herein, we report an extremely rare case of black pleural effusion from thoracic metastasis of cutaneous malignant melanoma. A 74-year-old man with known metastatic melanoma presented with a 1-month history of worsening lower back and hip pain and was found to have extensive osseous metastatic disease and multiple compression fractures. The patient underwent an uneventful kyphoplasty; however, the following day, he became acutely hypoxic and tachypneic with increased oxygen requirements. Radiographic evaluation revealed new bilateral pleural effusions. Bedside thoracentesis revealed a densely exudative, lymphocyte-predominant black effusion. Cytological examination showed numerous neoplastic cells with melanin deposition. A diagnosis of thoracic metastasis of malignant melanoma was established based on the gross and microscopic appearance of the pleural fluid. To the best of our knowledge, this is the first reported case of black pleural effusions secondary to metastatic melanoma in the United States. Despite the rarity of this presentation, it is important to determine the etiology of the black pleural effusion and to keep metastatic melanoma as a differential diagnosis.
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10

Rahman, Md Lutfar, Mohammad Arifur Rahman, and Nizam Uddin Ahmed. "Management of Malignant Pleural Effusions." KYAMC Journal 9, no. 4 (January 31, 2019): 182–89. http://dx.doi.org/10.3329/kyamcj.v9i4.40151.

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Malignant pleural effusions (MPE) are a common clinical problem in patients with neoplastic disease. In adults, 95% of neoplastic pleural effusions arise from a metastatic source, with lung and breast carcinoma accounting for 75% of all cases. Median survival following diagnosis ranges from 3 to 12 months and is dependent on the stage and type of the underlying malignancy. Most pleural metastases arise from tumor emboli to the visceral pleural surface, with secondary seeding to the parietal pleura. Other possible mechanisms include direct tumor invasion, hematogenous spread to parietal pleura, and lymphatic involvement. Dyspnoea is the most common presenting symptom and is occasionally accompanied by chest pain and cough. Chest radiographs confirm the size and location of the pleural collection. Thoracocentesis is usually diagnostic and also therapeutic. Exudative and hemorrhagic collections should be considered metastatic until proved otherwise. Various modalities are available in the management of MPE. Careful consideration of the patient's expected survival and quality of life is needed when deciding the optimum treatment modality in such patients. KYAMC Journal Vol. 9, No.-4, January 2019, Page 182-189
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11

Okafor, Ndubuisi C., Ayodeji A. Oso, Amanke C. Oranu, Steven M. Wolff, and John J. Murray. "Eosinophilic Pleural Effusion: A Rare Manifestation of Hypereosinophilic Syndrome." Case Reports in Medicine 2009 (2009): 1–3. http://dx.doi.org/10.1155/2009/635309.

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Several causes of eosinophilic pleural effusions have been described with malignancy being the commonest cause. Hypereosinophilic syndrome (HES) is a rare disease and very few cases have been reported of HES presenting as eosinophilic pleural effusion (EPE). We report a case of a 26-year-old male who presented with shortness of breath. He had bilateral pleural effusions, generalized lymphadenopathy, splenomegaly, and leukocytosis with marked peripheral blood eosinophilia. The pleural fluid was exudative, with 25%–30% eosinophilis, and absence of neoplastic cells. Hypereosinophilic syndrome was diagnosed after other causes of eosinophilia were excluded. He continued to be dyspneic with persistent accumulation of eosinophilic pleural fluid, even after his peripheral eosinophil count had normalized in response to treatment. This patient represents a very unusual presentation of HES with dyspnea and pleural effusions and demonstrates that treatment based on response of peripheral eosinophil counts, as is currently recommended, may not always be clinically adequate.
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12

Queiroz, Conceição, Manoel Barral-Netto, and Carlos Eduardo Bacchi. "Characterizing Subpopulations of Neoplastic Cells in Serous Effusions." Acta Cytologica 45, no. 1 (2001): 18–22. http://dx.doi.org/10.1159/000327182.

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13

Ford, R., A. Tamayo, B. Martin, K. Niu, K. Claypool, F. Cabanillas, and J. Jr Ambrus. "Identification of B-cell growth factors (interleukin-14; high molecular weight-B-cell growth factors) in effusion fluids from patients with aggressive B-cell lymphomas." Blood 86, no. 1 (July 1, 1995): 283–93. http://dx.doi.org/10.1182/blood.v86.1.283.bloodjournal861283.

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The molecular basis of neoplastic B-cell growth is complex and poorly understood. Cytokines have been postulated to contribute to neoplastic cell growth, and many in vitro studies have confirmed this prediction, but little is known about the in vivo role of these growth factors. We have examined the production of interleukin-14 (IL-14) (high molecular weight [HMW], B-cell growth factor [BCGF]) by aggressive intermediate (diffuse large cell) lymphomas of the B-cell type non-Hodgkin's lymphoma (NHL-B) in four patients with lymphomatous effusions. In these studies, IL-14 was detected in the effusion fluids by Western blots and IL-14 mRNA was constitutively expressed in the freshly isolated lymphoma cells that also expressed the receptor for IL-14 (IL14R). Lymphoma B cells placed at low serum and cell density proliferated in vitro to either purified IL-14 or IL-14 derived from effusion fluids. Antibodies to IL-14 removed the growth-stimulating cytokine(s) from the effusions. Cell lines developed from these patients produced IL-14 in vitro and antisense oligos to IL-14 blocked their growth in vitro. Thus, autocrine or paracrine production of IL-14 may play a significant role in the rapid proliferation of aggressive NHL-B. Interrupting this pathway could be a useful goal of therapy for patients resistant to conventional chemotherapy.
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14

Cappellari, Antonio, Mariangela Bagarella, Sylvie Ménard, Marcella Calabrese, and Maria Ines Colnaghi. "Use of a Pool of Monoclonal Antibodies in Diagnosing Cells from Serous Cavities." Tumori Journal 79, no. 3 (June 1993): 211–13. http://dx.doi.org/10.1177/030089169307900311.

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Aims and Background The usefulness of monoclonal antibodies that recognize markers of neoplastic lesions in complementing conventional cytology was evaluated by the avidin-biotin-peroxidase complex, indirect immunoperoxidase technique. Methods In order to enhance the sensitivity of the traditional method, a pool of seven combined monoclonal antibodies (Pool C7), which reacts specifically with cells of epithelial origin and is able to distinguish between mesothelial and malignant cells, was tested on cytologic smears of 262 serous effusions. The effusions were benign or neoplastic, mainly from breast, ovary and lung cancers. Results Immunocytochemical method showed an 100 % specificity and 100 % of predictivity whereas the sensitivity was 98 %, 96 % and 95 % for breast ovarian and lung carcinomas, respectively. Conclusions The results demonstrated that the pool when used together with conventional methods, is useful in analysis of serous effusions in diagnostic investigations.
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15

Buňatová, Karin, Nataša Obermajer, Jaromír Kotyza, Miloš Pešek, and Janko Kos. "Levels of Cathepsins S and H in Pleural Fluids of Inflammatory and Neoplastic Origin." International Journal of Biological Markers 24, no. 1 (January 2009): 47–51. http://dx.doi.org/10.1177/172460080902400107.

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Cathepsins S and H are present in immune cells and tissues and may play a role in the activation of an adoptive immune response. Our goal was to assess their protein levels in pleural fluids from 82 patients who underwent thoracentesis or thoracoscopy for therapeutic or diagnostic reasons and to relate them to an inflammatory, neoplastic or hemodynamic origin. Pleural effusions were also analyzed for a panel of 13 inflammatory or proliferative markers to test possible links to a nonspecific host reaction. Increased levels of cathepsin S were found in parainflammatory and cancer-related effusions compared to transudates. Cathepsin H levels were elevated only in parainflammatory effusions, whereas the levels in cancer-related effusions were comparable to transudates. Cathepsin S values significantly correlated with LDH, alpha-1-AT, VEGF, sICAM, sVCAM, MPO, uPA, MMP-9/TIMP-1, IL-8 and MCP-1, but not with CRP, IL-10 or cathepsin H. In contrast to cathepsin S, cathepsin H values did not correlate with markers of inflammation, indicating a specific role for cathepsin H in the pleural host response. In conclusion, the estimation of cathepsin S and cathepsin H may help to distinguish between effusions of different etiology.
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16

Wong-Arteta, J., M. Rey, L. Aragón, E. Gil, and L. Bujanda. "Comprehensive diagnosis of neoplastic effusions from the clinical laboratory." Clinica Chimica Acta 493 (June 2019): S432—S433. http://dx.doi.org/10.1016/j.cca.2019.03.919.

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17

Hristov, Tsanko. "Vascular Endothelial Growth Factor (VEGF) in Abdominal Fluid in Dogs with Oncological and Non-Oncological Diseases." Macedonian Veterinary Review 42, no. 2 (October 1, 2019): 163–68. http://dx.doi.org/10.2478/macvetrev-2019-0021.

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Abstract The vascular endothelial growth factor (VEGF) is a multifunctional cytokine stimulating the growth of vascular endothelial cells, survival and proliferation, inhibiting apoptosis. It is one of the most potent stimulants of vascular permeability. VEGF is found at high levels in inflammatory and tumour-associated pleural and abdominal effusions and is involved in their occurrence. In the present study, the blood plasma and abdominal fluid VEGF levels were assayed in thirty-one client-owned dogs with neoplastic and non-neoplastic diseases by means of enzyme-linked immunosorbent assay (ELISA). The VEGF concentration in abdominal fluid of dogs (n=6) with ascites was 190.70±34.35 pg/ml, in dogs (n=6) with peritonitis: 1449.81±365.42 pg/ml and in dogs (n=9) with tumour-associated effusion: 1993.13±202.56 pg/ml. Blood plasma VEGF of healthy dogs (control group, n=10) was 36.79±5.72 pg/ml, in dogs with ascites: 57.92±2.88 pg/ml, in dogs with peritonitis: 76.98±7.24 pg/ml and in dogs with tumour-associated effusion: 173.50±40.9 pg/ml. There were substantial differences between blood plasma and abdominal fluid VEGF levels.
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18

Parazzi, Fiamma, Bruno Faravelli, Luigi Gallo, Marco Nosenzo, Alfredo Razzetti, Daniela Barone, Roberto Bandelloni, and Eugenio D'Amore. "Tissue Polypeptide Antigen (TPA) in Pleural Effusions." Tumori Journal 73, no. 1 (February 1987): 33–36. http://dx.doi.org/10.1177/030089168707300106.

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The usefulness of tumor marker assay in pleural effusions for differential diagnosis is still debated. From the observation of common antigens on tissue polypeptide antigen (TPA) and keratins 8, 18 and 19 and vimentin, all substances contained in normal and neoplastic mesothelium, we felt it opportune to evaluate the use of TPA assay in 105 pleural effusions (46 benign and 59 malignant). The values were much higher than those found in blood. In hydrothorax the median value was 454 U/l (range, 59–1923), in exudative effusions 846 U/l (range, 258–4485), in metastatic pleural effusions 1277 U/l (range, 58–32352) and in mesotheliomas 7705 (range, 759–16000). The maximum value found in nonmalignant effusions was 4485 U/l; this value was taken as a cutoff level, so only 29.9 % of the tumors were positive to the test. Our results showed this assay to be not very important for a differential diagnosis of malignant and nonmalignant pleural effusions. Nevertheless, the different TPA patterns in mesotheliomas (66.6 % positive) and metastatic pleural effusions (15.9 %) suggest that further studies are warranted.
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19

MANTOVANI, G., A. MACCIO, P. LAI, S. ESU, M. GHIANI, E. TURNU, R. VERSACE, and G. S. DEL GIACCO. "Tumor-Associated Lymphocytes (TAL) from Pleural and Peritoneal Neoplastic Effusions." Journal of Immunotherapy 17, no. 2 (February 1995): 125. http://dx.doi.org/10.1097/00002371-199502000-00049.

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20

Brimo, Fadi, Gizelle Popradi, René P. Michel, and Manon Auger. "Primary effusion lymphoma involving three body cavities." CytoJournal 6 (October 9, 2009): 21. http://dx.doi.org/10.4103/1742-6413.56361.

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Primary effusion lymphoma (PEL) is a human herpes virus-8 (HHV8)-associated large-cell non-Hodgkin lymphoma localized in body cavities and presenting as pleural, peritoneal, or pericardial lymphomatous effusions. It typically affects immunocompromised patients and usually involves only one body site. We describe herein a case of PEL affecting three body cavity sites in an immunocompetent patient. A 69-year-old HIV-negative man presented with upper gastrointestinal bleeding and ascites. An examination of the fluid by cytology showed large atypical lymphocytes with abundant basophilic cytoplasm, either central or eccentric nuclei having irregular outlines, and multiple prominent nucleoli. The neoplastic cells showed positive staining for CD45, CD3, HHV8 latent nuclear antigen (LNA), and Epstein-Barr virus-encoded RNA. A diagnosis of PEL was rendered. Despite chemotherapy and valganciclovir, the disease progressed to involve the pleural and pericardial cavities and the patient died 5 months following the initial diagnosis. Although PEL is a B-cell lymphoma, it is usually of null phenotype by immunohistochemistry, and can rarely aberrantly express T-cell markers, as seen in the current case. The key to the diagnosis of PEL rests on identifying HHV8 in the neoplastic cells. Therefore, restricting the term of PEL only to those cases that are HHV8 positive is important in order to differentiate PEL from other lymphomas that can present as serous effusions and that carry, in general, a more favorable prognosis than PEL
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21

Hamzaoui, A., K. Hamzaoui, A. Kahan, and A. Chabbou. "Levels of soluble VCAM-1, soluble ICAM-1, and soluble E-selectin in patients with tuberculous pleuritis." Mediators of Inflammation 5, no. 4 (1996): 276–79. http://dx.doi.org/10.1155/s0962935196000403.

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Tuberculosis is characterized by the presence of activated mononuclear cells both in the peripheral circulation and in pleural fluid. Expression and up-regulation of adhesion molecules is the basis of cell-cell adhesion in granuloma formation and in leukocyte migration to the inflammatory site. Soluble isoforms of adhesion molecules have been described, and their expression at high levels indicated an activated state. The purpose of this study was to evaluate levels of soluble adhesion molecules in serum and pleural fluid from patients with tuberculous pleural effusions, compared with non-tuberculous pleural effusions. We analysed levels of soluble vascular cell adhesion molecule-1 (s.VCAM-1), soluble intercellular adhesion molecule-1 (s.ICAM-1), and soluble E-selectin (sE-selectin) in serum and pleural fluid from patients with tuberculous pleuritis, by sandwich ELISA. Serum levels of s.ICAM-1 and s.VCAM-1 in patients with tuberculosis were higher than those in healthy controls (p < 0.001). Levels of sE-selectin levels were in the normal range compared with control groups. In pleural fluid, levels of s.VCAM-1 and s.ICAM-1 were increased in pleural effusions. Patients with tuberculous pleural effusion exhibited high levels of s.ICAM-1 compared with patients with neoplastic pleural involvement. Up-regulation of s.VCAM-1 and s.ICAM-1 in serum, along with increased levels of sE-selectin in pleural effusions from tuberculous patients, may result in transmigration of activated inflammatory cells inducing pleural damage, which may contribute to the pathological processes involved.
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Sharma, Dinesh Chandra, and Deepanjali Sharma. "Myelomatous pleural effusion as an initial presenting sign in a case of multiple myeloma." International Journal of Research in Medical Sciences 8, no. 2 (January 27, 2020): 777. http://dx.doi.org/10.18203/2320-6012.ijrms20200274.

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Multiple Myeloma (MM) is a neoplastic disease which mainly affects bone marrow but rarely may infiltrate extramedullary tissues as well. Myelomatous pleural effusions (MPE) develop due to extension of plasmacytoid cell lesions of thoracic bones into pleural tissue and directly presenting as an initial sign in a case of MM is exceedingly rare. It indicates poor prognosis, resistance to treatment and more chance of relapse in spite of aggressive chemo-radiotherapy. The effusions of serous cavities in MM generally develop as a late complication of the disease like heart failure, renal failure, pneumonia and amyloidosis. We are reporting a rare case of IgG subtype myelomatous pleural effusion demonstrating abundance of plasmacytoid cells in pleural fluid. Bone marrow smear examination favoured the diagnosis of multiple myeloma with the presence of predominant population of plasma cells with high cellularity. There were also presence of a heterogenous myelomatous mass lesion in the right infratemporal fossae, multiple erosive lesions in ribs, vertebral bodies, skull and pelvic bones. Pleural fluid and serum protein electrophoresis demonstrated the presence of gamma monoclonal protein peaks confirming the diagnosis.
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23

Schönherr, Alexandra, Mary Bayer, and Alfred Böcking. "Diagnostic and Prognostic Value Of Ki67 Proliferation Fraction in Serous Effusions." Analytical Cellular Pathology 26, no. 1-2 (January 1, 2004): 57–62. http://dx.doi.org/10.1155/2004/285681.

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The Ki67 proliferation rate of mesothelial cells was determined in 20 effusions due to malignant mesotheliomas and in 20 non‐neoplastic effusions, to investigate if this marker may be useful to identify neoplastic mesothelioma cells and if there is a correlation between proliferation rate and survival time. Using the ABC‐method, effusions were immunostained and the marker Ki67 was evaluated quantitatively. Ki67 proliferation fraction showed rates from 2.3% to 70% in malignant mesothelioma cells and from 1.8% to 25.5% in reactive mesothelial cells. A significant difference was found (p=0.05) between those two groups. Assuming a threshold at 26%, a sensitivity of 25% and specificity of 100% resulted. Yet, due to its low sensitivity this marker seems not to be useful for differential diagnosis. Plotting surviving period against Ki67 proliferation fraction a correlation was observed which was not significant. Long term survivors (>28 month) showed proliferation rates below 3.8%. Unexpectedly a highly significant difference (p=0.001) between Ki67 proliferation rates of mesothelial cells from patients with malignant tumors other than mesothelial origin (7.0% to 25.5%) and mesothelial cells of patients without any malignant disease (1.8% to 16.3%) were observed. Setting a threshold at 10% for identification of a malignant disease, a sensitivity of 77.8% and specificity of 90.9% resulted.
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24

Cappellari, Antonio, Claudio Furlan, Pietro Cardellini, Mariangela Bagarella, and Giuseppe Corradi. "Morphologic Analysis of Serous Effusion Cells by Scanning Electron Microscopy." Tumori Journal 78, no. 1 (February 1992): 10–12. http://dx.doi.org/10.1177/030089169207800103.

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The authors used scanning electron microscopy (SEM) to examine the cells obtained from serous effusions of patients affected with a neoplasm or benign disease. Cellular morphology was studied in non-neoplastic effusions to distinguish benign cells from cancer cells with which they are almost always suspended in malignant effusions. Tumor cells differ in some features such as shape, size, arrangement and especially in surface structures (microvilli), the latter being very noticeable when using this method. The investigation enabled us to note several changes in the cell surface that could reflect particular activities of the cells themselves. For this reason we believe that the technique may be considered very useful to gain knowledge of cellular morphology. However, it cannot be considered suitable for making routine diagnostic conclusions.
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Ganjei, P., F. A. Esclopis, B. Dickenson, M. Nassiri, and M. Nadji. "BCL-2 AND p53 IN REACTIVE AND NEOPLASTIC BODY CAVITY EFFUSIONS." Southern Medical Journal 88 (October 1995): S91. http://dx.doi.org/10.1097/00007611-199510001-00207.

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26

Kumar, Perikala V., Sajjad Eqbali, Ahmad Monabati, and Abdol Rasool Talei. "Bull’s Eye (Target) Inclusions in Neoplastic Cells in Malignant Serous Effusions." Acta Cytologica 44, no. 4 (2000): 543–46. http://dx.doi.org/10.1159/000328527.

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27

P Awasthi, Namrata, and Anshima S. "T-Lymphoblastic lymphoma presenting with obstructive jaundice and pleural effusion; role of flow cytometry on pleural fluid: A case report." IP Journal of Diagnostic Pathology and Oncology 6, no. 3 (September 15, 2021): 237–41. http://dx.doi.org/10.18231/j.jdpo.2021.051.

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T-cell lymphoblastic lymphoma often presents as a large mediastinal mass in the anterior mediastinum with shortness of breath as chief complaint. We, put forward a case of T-LBL, presenting with obstructive jaundice and, later developing pleural effusion. Diagnosis was clinched by Flow Cytometry (FCM) performed on the pleural fluid, which revealed, neoplastic lymphoid cells; suggesting T-cell Lymphoproliferative disorder.Bone marrow examination and immunohistochemistry revealed CD3+, TDT+, CD10+, CD34- and CD20- blasts. Thus, diagnosis of T-ALL/LBL was rendered. Clinicians should be mindful that TALL/LBL can uniquely present with obstructive jaundice, proffering serious diagnostic dilemma. FCM should be attempted on any available body fluids/effusions, in appropriate clinical settings, as it can contribute substantially, in making a rapid diagnosis and, initiating early therapy. 1. Leukemia/lymphoma should be considered in the differential diagnoses, when the initial work-up for obstructive jaundice, is inconclusive; 2. FCM can be performed on any fluid/effusion sample for hematolymphoid neoplasm and can aid in making a rapid diagnosis.
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28

Rodriguez, Erika F., Robert Jones, Matthew Gabrielson, Dustin Santos, Ricardo G. Pastorello, and Zahra Maleki. "Application of the International System for Reporting Serous Fluid Cytopathology (ISRSFC) on Reporting Pericardial Effusion Cytology." Acta Cytologica 64, no. 5 (2020): 477–85. http://dx.doi.org/10.1159/000507311.

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Introduction: The International System for Reporting Serous Fluid Cytopathology (ISRSFC) has recently been announced. Pericardial effusion (PE) is a clinical manifestation of a large variety of both neoplastic and non-neoplastic conditions. Herein, we have applied the ISRSFC on reporting PE cytopathology and report our experience in a large academic institution. Method and Materials: After the Institutional Research Board approval, the electronic pathology database of a large academic institution was queried for PEs collected from January 2014 to January 2019. The diagnosis, patient demographics, and specimen volume were recorded for each case. The ISRSFC was applied and the cases were divided into 5 categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). Each category was evaluated separately. Results: A total of 299 cases were identified, 162 females and 137 males. The age of the subjects ranged from less than a year to 89 years (average 51.25 years). The volume ranged from 3 to 1,700 mL (average 298 mL). There were 252 NFM (84.3%), 13 AUS (4.3%), 4 SFM (1.3%), and 30 MAL (10%) cases. Metastatic lung cancer followed by metastatic breast cancer were the most common malignancies involving pericardial fluid (PF). No cases were diagnosed as ND. However, no mesothelial cells were seen in 97 specimens (38% of the negative cases). None of these patients developed malignant PE in at least 6 months of follow-up. Conclusion: The ISRSFC is a user-friendly reporting system which is easily applicable on serous fluid including PF. The vast majority of PEs was benign (84.3%). Our study shows that the presence of mesothelial cells is not necessary for specimen adequacy in serous effusions as no mesothelial cells were identified in 38% of the negative cases. Metastatic lung carcinoma was the most common diagnosis of malignant effusions.
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Fine, Deborah M., Anthony H. Tobias, and Kristin A. Jacob. "Use of Pericardial Fluid pH to Distinguish between Idiopathic and Neoplastic Effusions." Journal of Veterinary Internal Medicine 17, no. 4 (July 2003): 525–29. http://dx.doi.org/10.1111/j.1939-1676.2003.tb02473.x.

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30

Linari, A., and G. Bussolati. "Evaluation of impact of immunocytochemical techniques in cytological diagnosis of neoplastic effusions." Journal of Clinical Pathology 42, no. 11 (November 1, 1989): 1184–89. http://dx.doi.org/10.1136/jcp.42.11.1184.

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31

Lackner, E. M., M. T. Krauth, R. Kondo, L. Rebuzzi, K. Eigenberger, A. Vales, G. V. Kornek, C. C. Zielinski, and P. Valent. "Expression and secretion of VEGF in solid tumor cells is mediated by the mammalian target of rapamycin (mTOR)." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 14123. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.14123.

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14123 Background: Tumor progression and metastasis formation are often associated with enhanced angiogenesis and with the formation of malignant effusions. Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis and a mediator of vascular permeability. We here describe that VEGF is produced and secreted by neoplastic cells in various solid tumors and its production mediated through mTOR. Methods and Results: As assessed by ELISA, the VEGF protein was detected in supernatants of cell lines derived from breast cancer (MDA-MB231), pancreatic carcinoma (BxPC-3), lung cancer (A-427), colon carcinoma (HCT8), and cholangiocellular carcinoma (EGI-1). In addition, VEGF was detected in supernatants of primary tumor cells obtained from malignant effusions in various malignancies (breast cancer, n=4; pancreatic cancer, n=1; ovarial cancer, n=1; parotic carcinoma, n=1; oesophageal carcinoma, n=1). In each case, VEGF protein was detectable in neoplastic cells by immunocytochemistry, and was found to accumulate in supernatants of cultured tumor cells over time, suggesting constant production and secretion. Correspondingly, as assessed by RT-PCR, primary tumor cells as well as the cell lines tested were found to express VEGF mRNA in a constitutive manner. Since mTOR is a well known regulator of VEGF synthesis, we applied rapamycin on primary neoplastic cells and on tumor cell lines. Rapamycin (20–200 nM) was found to counteract the production and secretion of VEGF in all tumor cells tested (VEGF in supernatants in cultures supplemented with rapamycin at 100 nM compared to control=100% on day 6: MDA-MB231: 11.8±0.2%; BxPC-3: 23.6±18.8%; A-427: 30.1±3.4%; HCT8 17.2±0.5%; EGI-1 28.4±1.1%; p<0.05). By contrast, neither rapamycin nor VEGF were found to modulate growth of primary tumor cells or the growth of the tumor cell lines tested. Conclusions: Various human tumor cells express and secrete VEGF. VEGF production is mediated through mTOR. These observations may have implications for the design of new treatment approaches attempting to counteract VEGF production/secretion and thus VEGF-dependent angiogenesis and effusion- formation in solid tumors. No significant financial relationships to disclose.
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32

HATZIGIANNAKIS (Χ.Γ. ΧΑΤΖΗΓΙΑΝΝΑΚΗΣ), C. G., M. E. MYLONAKIS (Μ. Ε. ΜΥΛΩΝΑΚΗΣ), M. N. SARIDOMICHELAKIS (Μ.Ν. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ), M. PATSIKAS (Μ. ΠΑΤΣΙΚΑΣ), D. PSALLA (Δ. ΨΑΛΛΑ), and A. F. KOUTINAS (Α.Φ. ΚΟΥΤΙΝΑΣ). "Cardiac tamponade secondary to hemorrhagic pericardial effiision in five dogs." Journal of the Hellenic Veterinary Medical Society 56, no. 1 (November 29, 2017): 9. http://dx.doi.org/10.12681/jhvms.15064.

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A 7-year old female collie (case 1), a 3-year old male Caucasian-cross (case 2) and three male German shepherds with an age of 11 (case 3), 8.5 (case 4) and 10 (case 5) years, respectively, were admitted with a history of decreased appetite, depression, exercise intolerance, dyspnea and progressive abdominal enlargement, for the last 10 to 60 days. Poor body condition (5/5), muffled heart sounds (5/5), weak femoral pulse (5/5), ascites (5/5), inspiratory or inspiratory-expiratory dyspnea (5/5), pulsus paradoxus (2/5) and jugular vein distension (2/5) were the prominent clinical findings, while mature neutrophilic leukocytosis (3/5), lymphopenia (3/5), eosinopenia (3/5), hypoproteinemia (5/5) and increased urea nitrogen (3/5) were the most prevalent clinicopathologic abnormalities. Apart from a space-occupying lesion onto the right atrial wall of one dog (case 4), radiographic and ultrasound examination showed a globe-shaped cardiac silhouette (5/5), pericardial effusion (5/5), ascites (5/5) and pleural effusion (4/5). A large amount of non-clotting hemorrhagic effusion was drained during pericardiocentesis, resulting in rapid clinical recovery. Physical, chemical and cytological evaluation of the pericardial fluid was non-contributory in the differentiation between neoplastic and non-neoplastic causes of these effusions. Case 3 died 25 days post-pericardiocentesis; right atrium hemangiosarcoma and pulmonary metastases were documented on post mortem histopathological examination. Another dog (case 5) died of unknown causes one month after pericardiocentensis. On the contrary, dogs 1, 2 and 4 were still clinically healthy for a followup period of 16, 2 and 8 months, respectively.
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33

Lissoni, P., S. Barni, G. Tancini, A. Ardizzoia, E. Tisi, M. Angeli, and A. Rizzi. "Intracavitary therapy of neoplastic effusions with cytokines: comparison among interferon ?, ? and interleukin-2." Supportive Care in Cancer 3, no. 1 (January 1995): 78–80. http://dx.doi.org/10.1007/bf00343925.

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34

Bailey, Michael E., Richard W. Brown, Dina R. Mody, Philip Cagle, and Ibrahim Ramzy. "Ber-EP4 for Differentiating Adenocarcinoma from Reactive and Neoplastic Mesothelial Cells in Serous Effusions." Acta Cytologica 40, no. 6 (1996): 1212–16. http://dx.doi.org/10.1159/000333982.

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35

Pérez, Celeste L., and Silvia Rudoy. "Anti-CD20 Monoclonal Antibody Treatment of Human Herpesvirus 8-Associated, Body Cavity-Based Lymphoma with an Unusual Phenotype in a Human Immunodeficiency Virus-Negative Patient." Clinical Diagnostic Laboratory Immunology 8, no. 5 (September 1, 2001): 993–96. http://dx.doi.org/10.1128/cdli.8.5.993-996.2001.

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ABSTRACT Human herpesvirus 8 (HHV-8), or Kaposi's sarcoma-associated herpesvirus, is a gammaherpesvirus first detected in Kaposi's sarcoma tumor cells and subsequently in primary effusion lymphoma (PEL) tumor cells and peripheral blood mononuclear cells from PEL patients. PEL has been recognized as an individual nosologic entity based on its distinctive features and consistent association with HHV-8 infection. PEL is an unusual form of body cavity-based B-cell lymphoma (BCBL). It occurs predominantly in human immunodeficiency virus (HIV)-positive patients but occasionally also in elderly HIV-negative patients. We describe a case of PEL, with ascites, bilateral pleural effusions, and a small axillary lymphadenopathy, in a 72-year-old HIV-negative man. PCR performed on a lymph node specimen and in liquid effusion was positive for HHV-8 and negative for Epstein-Barr virus. The immunophenotype of the neoplastic cells was B CD19+ CD20+ CD22+ with coexpression of CD10 and CD23 and with clonal kappa light chain rearrangement. The patient was treated with Rituximab, a chimeric (human-mouse) anti-CD20 monoclonal antibody. Thirteen months later, the patient continued in clinical remission. This is the first report of an HHV-8-associated BCBL in an HIV-negative patient in Argentina.
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36

Arabi, Haitham, Nida Yousef, Liying Han, Sudeshna Bandyopadhyay, Jining Feng, and Mousa Al-Abbadi. "Accuracy and Added Value of Triage Beyond Segregating Potentially Neoplastic Effusions in Immediate Wet Preparation." Acta Cytologica 53, no. 1 (2009): 71–76. http://dx.doi.org/10.1159/000325086.

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37

Shen, Hongqiang, Yongmin Tang, Xiaojun Xu, Lie Wang, Qingqing Wang, Weiqun Xu, Hua Song, Zhengyan Zhao, and Jianli Wang. "Rapid detection of neoplastic cells in serous cavity effusions in children with flow cytometry immunophenotyping." Leukemia & Lymphoma 53, no. 8 (March 2012): 1509–14. http://dx.doi.org/10.3109/10428194.2012.661050.

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38

Motherby, Helma, Natalia Pomjanski, Mary Kube, Alexandra Boros, Thomas Heiden, Bernhard Tribukait, and Alfred Böcking. "Diagnostic DNA-Flow- vs. -Image-Cytometry in Effusion Cytology." Analytical Cellular Pathology 24, no. 1 (2002): 5–15. http://dx.doi.org/10.1155/2002/840210.

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Aims: To determine the sensitivity and specificity of flow‐ and image‐cytometry for the detection of DNA‐aneuploidy as a marker for malignant cells in effusions.Methods: 200 effusions (80 tumor cell‐positive, 74 negative and 46 cytologically equivocal) were stained with DAPI‐SR for DNA‐flow‐ and with Feulgen‐Pararosaniline for ‐image‐cytometry. They were measured using a PAS‐flow‐cytometer and an AutoCyte‐QUIC‐DNA‐workstation according to the ESACP consensus reports for DNA‐flow‐ and ‐image‐cytometry, respectively [7,23,29,49].Results: Sensitivity of DNA‐aneuploidy for the identification of malignant cells was 32.1% for DNA‐flow‐ and 75.0% for ‐image‐cytometry, specificity of ‐euploidy in benign cells was 100.0% for both methods. Positive predictive value of DNA‐aneuploidy for the identification of malignant cells was 100.0% for both techniques, negative predictive value of DNA‐euploidy was 48.6% for DNA‐flow‐ and 72.0% for ‐image‐cytometry.Conclusions: Searching for DNA‐aneuploidy as a diagnostic marker for neoplastic cells in serous effusions image‐cytometry revealed superior sensitivity as compared with monoparametric flow cytometry.
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39

Gupta, Sanjay, Pushpa Sodhani, and Shyama Jain. "Cytomorphological profile of neoplastic effusions: An audit of 10 years with emphasis on uncommonly encountered malignancies." Journal of Cancer Research and Therapeutics 8, no. 4 (2012): 602. http://dx.doi.org/10.4103/0973-1482.106574.

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40

Ocaña, Inma, Jose M. Martinez-Vazquez, Esteban Ribera, Rosa M. Segura, and Carlos Pascual. "Adenosine deaminase activity in the diagnosis of lymphocytic pleural effusions of tuberculous, neoplastic and lymphomatous origin." Tubercle 67, no. 2 (June 1986): 141–45. http://dx.doi.org/10.1016/0041-3879(86)90008-5.

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41

Kutteh, W. H., C. E. Welander, H. D. Homesley, and G. J. Doellgast. "Specificity and activity of autologous antibodies eluted from membrane fragments isolated from human ovarian epithelial neoplastic effusions." Gynecologic Oncology 20, no. 2 (February 1985): 262. http://dx.doi.org/10.1016/0090-8258(85)90188-x.

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42

Savoia, P., P. Quaglino, S. Osella-Abate, A. Comessatti, T. Nardò, and M. G. Bernengo. "Tyrosinase mRNA RT-PCR Analysis as an Additional Diagnostic Tool for the Identification of Melanoma Cells in Biological Fluid Samples other than Blood: A Preliminary Report." International Journal of Biological Markers 20, no. 1 (January 2005): 11–17. http://dx.doi.org/10.1177/172460080502000103.

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Reverse transcription polymerase chain reaction (RT-PCR) of tyrosinase mRNA has been applied for the detection of melanoma cells in the peripheral blood, lymph nodes and bone marrow of melanoma patients. We evaluated the diagnostic accuracy of RT-PCR in comparison to standard cytology and immunocytochemistry (ICC) for the identification of melanoma cells in biological fluids other than blood. Tyrosinase expression was evaluated together with standard cytology and ICC (anti-S100, HMB-45 and Melan-A antibodies) in biological fluid samples collected from 17 melanoma patients according to the site of metastatic involvement or clinical suspicion (eight cerebrospinal fluid (CSF) samples; three pleural effusions; four ascites; one bile sample, one pericardial effusion); 17 samples collected from patients with non-melanoma metastatic cancer were used as controls. Tyrosinase expression in the biological fluid sample was compared with the expression determined at the same time in peripheral blood. Positive tyrosinase expression was found in 12/17 melanoma and 3/17 non-melanoma cancer patients. Cytology/ICC showed the presence of neoplastic cells in only 7/12 melanoma samples with positive tyrosinase expression: radiological evidence of disease involvement was found in all these patients (three meningeal, two pleural, two peritoneal). Clear-cut radiological evidence of disease involvement at the sampling site was found in the five patients with negative cytology/ICC and positive RT-PCR (one CSF; four serous membrane effusions); all patients died of disease progression within four months of sampling. The five patients who were negative for both cytology/ICC and RT-PCR did not show any clinical evidence of disease recurrence at the sampling site. Only five of the 12 metastatic patients with positive tyrosinase expression in biological fluid showed positivity for tyrosinase in the peripheral blood. These preliminary results suggest that the analysis of biological fluids other than blood could be considered as a new potential clinical field of application for the tyrosinase mRNA assay.
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43

Lissoni, Paolo, Mario Mandalà, Giuseppe Curigliano, Gianluigi Ferretti, Cecilia Moro, Antonio Ardizzoia, Fabio Malugani, et al. "Progress Report on the Palliative Therapy of 100 Patients with Neoplastic Effusions by Intracavitary Low-Dose Interleukin-2." Oncology 60, no. 4 (2001): 308–12. http://dx.doi.org/10.1159/000058525.

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44

Cesana, Clara, Catherine Klersy, Barbara Scarpati, Bruno Brando, Elisabetta Volpato, Giambattista Bertani, Maurizio Faleri, et al. "Clinical Follow-up Demonstrates Differential Accuracy of Flow Cytometry and Cytomorphology for the Detection of Hematologic Malignancy in Hypercellular Body Cavity Fluids." Blood 114, no. 22 (November 20, 2009): 5018. http://dx.doi.org/10.1182/blood.v114.22.5018.5018.

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Abstract Abstract 5018 Flow cytometry (FCM) and cytomorphology (CM) evaluation of hematologic malignancy in hypercellular body cavity fluids (BCF) needs clinical validation and standardized approaches for definitive sample assessment. A total of 1,011 hypercellular BCF analyzed by FCM between 2002 and 2009 were retrospectively examined. As a prerequisite for inclusion in the study, each of the following was needed: suspected or known hematologic malignancy at withdrawal, CM performed on the same sample, and availability of follow-up data for reliable retrospective clinical outcome (RCO). Ninety-two BCF [61 effusions, 31 bronchoalveolar lavage fluids (BALF)] were selected for the analysis. Results obtained by the two methods were matched with RCO. A combined method assessment (CMA) was also tested, accounting as negative those samples not assessed as frankly positive by at least one method. Thirty-six percent of BCF resulted RCO-positive. By applying each method to RCO, concordant results between FCM and CM were observed in 69 cases (75%). Fifty-six cases (61%) were double true negative (TN), 11 cases (12%) were double true positive (TP), and 2 cases (2%) were double false negative (FN). The latter were BALF samples from patients with primary pulmonary lymphomatoid granulomathosis in which FCM revealed a prominent inflammatory background of CD3+ T-cells; clonality could not be assessed due to the small number of B-cells. Mismatched results between FCM and CM were observed in 23 cases (25%). FCM gave TP results in 19 cases (20.5%) with FN or uncertain CM, TN results in 3 cases (3%) with uncertain CM, and FN results in 1 case (1%) with TP CM. This was a pleural effusion in which, in the presence of anaplastic cell features, primary effusion lymphoma was definitively diagnosed by immunocytochemical staining for ORF73/latent nuclear antigen-1 of HHV-8 on B-cell marker negative neoplastic cells. By applying the CMA to RCO, 59 TN results (64%), 31 TP results (33.5%) and 2 (double) FN results (2%) were obtained. Overall, 100% specificity and positive predictive value were detected for each method. FCM/CMA sensitivity was significantly higher than CM sensitivity (p<.0001). The highest sensitivity for each method was displayed in the analysis of samples from B/T-cell precursor lymphoma/leukemia. FCM sensitivity was significantly higher than that of CM in the evaluation of effusions (p<.005) and of samples from B/T-cell differentiated lymphoma (p<.0001). CMA sensitivity was the highest in the latter, and reached 100% in the former. In the BALF setting, FCM/CMA displayed 75% sensitivity, while CM being non-diagnostic in each of RCO-positive samples. In conclusion, clinical follow-up demonstrates FCM to retain significantly higher accuracy than CM in detecting hematologic malignancy contamination in both effusions and BALF, especially in the subset of differentiated lymphomas. Combining methods improves diagnostic performance almost completely by means of FCM. Disclosures No relevant conflicts of interest to declare.
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45

Hinkamp, Colin Andrew, Shanup N. Dalal, Yasmeen Butt, and Alberto V. Cabo Chan. "Diffuse epithelioid malignant mesothelioma of the pleura presenting as a hydropneumothorax and vertebral body invasion." BMJ Case Reports 13, no. 1 (January 2020): e231987. http://dx.doi.org/10.1136/bcr-2019-231987.

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Malignant mesothelioma is an uncommon form of neoplastic transformation of the mesothelial cells that line the serosal surfaces of the body. It most commonly affects the pleura and is often associated with pleural effusions and pleural-based masses. The annual incidence in the United States is only 3300 cases, representing less than 0.3% of all cancers worldwide, although this is likely underestimated. We present a case of diffuse epithelioid malignant pleural mesothelioma in a patient with remote, short-term asbestos exposure complicated by recurrent left-sided hydropneumothoraces and pleural-based invasion of the T12 vertebral body, which represent two rare coexisting complications. This case illustrates the importance of maintaining a broad differential for hydropneumothorax, particularly as the risk factors may be decades removed and the degree of asbestos exposure to induce a malignant mesothelioma may be smaller than has been traditionally thought.
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46

Sales, Roberta K., Márcia Seiscento, Francisco S. Vargas, Lisete R. Teixeira, Vera L. Capelozzi, Milena M. Acencio, Marcelo A. Vaz, and Leila Antonangelo. "A COST-MINIMIZING DIAGNOSIS MODELS FOR DISCRIMINATION BETWEEN NEOPLASTIC AND TUBERCULOUS PLEURAL EFFUSIONS UTILIZING ROUTINE CLINICAL AND LABORATORY VARIABLES." Chest 128, no. 4 (October 2005): 401S. http://dx.doi.org/10.1378/chest.128.4_meetingabstracts.401s-a.

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47

Maharjan, Sushana, Sabin Ranabhat, Mamata Tiwari, Anita Bhandari, Bidur Prasad Osti, and Puja Neopane. "Exfoliative cytology analysis from different sites of the body." Journal of Chitwan Medical College 7, no. 2 (June 30, 2017): 33–39. http://dx.doi.org/10.3126/jcmc.v7i2.23674.

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Background: Cytological study of body fluids a non-invasive, simple procedure, relatively inexpensive, and helps in faster reporting that has high population acceptance. The present study aims to determine the proportion of malignant and non malignant lesions. Methods: A total of 1129 specimens of exfoliative cytology were examined during the period over five years from year January 2011 to December 2016 at Department of Pathology at Chitwan Medical College Teaching Hospital, Nepal. The fluid received was centrifuged at 3000 revolutions per minute for five minutes. Smears were made from the sediment. Two to three slides were air dried and stained with Giemsa stain. One slide was immediately fixed in 95% alcohol and stained with Papanicolaou (Pap) stain for cytological evaluation. Results: Pleural fluid was most common specimen (49.3%) with peritoneal fluid (32%), pericardial fluid (1%), BAL (7.8%), CSF (4%), sputum (3.4%), synovial fluid (2%) and urine (0.5%) specimens. Male to female ratio was 1.33:1. Maximum cases belonged to age group of 50-69 years. Only (5.8%) 67 cases were neoplastic. The maximum cases of malignant neoplasm were detected in pericardial fluid and pleural fluid, each 21 (1.8%) cases, and 20 (1.7%) cases BAL. Malignant effusions were detected in 46 (4%) cases. Maximum malignant cases were adenocarcinoma (71.6%), followed by squamous cell carcinoma (20.8%). Conclusion: Exfoliative cytology should be suggested in all cases of effusion and suspected malignancies which helps in reaching at a particular diagnosis and aids in further management.
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48

Shimada, Kazuyuki, Fumihiko Hayakawa, and Hitoshi Kiyoi. "Biology and management of primary effusion lymphoma." Blood 132, no. 18 (November 1, 2018): 1879–88. http://dx.doi.org/10.1182/blood-2018-03-791426.

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Abstract Primary effusion lymphoma (PEL) is a rare B-cell malignancy that most often occurs in immunocompromised patients, such as HIV-infected individuals and patients receiving organ transplantation. The main characteristic of PEL is neoplastic effusions in body cavities without detectable tumor masses. The onset of the disease is associated with latent infection of human herpes virus 8/Kaposi sarcoma–associated herpes virus, and the normal counterpart of tumor cells is B cells with plasmablastic differentiation. A condition of immunodeficiency and a usual absence of CD20 expression lead to the expectation of the lack of efficacy of anti-CD20 monoclonal antibody; clinical outcomes of the disease remain extremely poor, with an overall survival at 1 year of ∼30%. Although recent progress in antiretroviral therapy has improved outcomes of HIV-infected patients, its benefit is still limited in patients with PEL. Furthermore, the usual high expression of programmed death ligand 1 in tumor cells, one of the most important immune-checkpoint molecules, results in the immune escape of tumor cells from the host immune defense, which could be the underlying mechanism of poor treatment efficacy. Molecular-targeted therapies for the activating pathways in PEL, including NF-κB, JAK/STAT, and phosphatidylinositol 3-kinase/AKT, have emerged to treat this intractable disease. A combination of immunological recovery from immune deficiency, overcoming the immune escape, and the development of more effective drugs will be vital for improving the outcomes of PEL patients in the future.
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49

Mantovani, G., A. Macciò, M. Pisano, R. Versace, P. Lai, S. Esu, E. Massa, et al. "Tumor-associated lymphomonocytes (TALM) from neoplastic effusions are immunologically defective but are capable of releasing high levels of various cytokines." Immunology Letters 56 (May 1997): 165. http://dx.doi.org/10.1016/s0165-2478(97)85659-3.

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50

Mottolese, M., I. Venturo, R. Perrone Donnorso, C. Gallo Curcio, M. Rinaldi, and P. G. Natali. "Use of selected combinations of monoclonal antibodies to tumor associated antigens in the diagnosis of neoplastic effusions of unknown origin." European Journal of Cancer and Clinical Oncology 24, no. 8 (August 1988): 1277–84. http://dx.doi.org/10.1016/0277-5379(88)90215-5.

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