ABSTRACT
Background 252 Historical perspective 252 Current role in management of patients 252 Accuracy of cytological diagnosis 253 Reporting protocols 253
Specimen collection and laboratory processing 253 Non-neoplastic effusions 254
Non-specific “reactive” pleural effusions 254 Lymphocytic pleural effusions 254 Neutrophilic pleural effusions 255 Macrophage-rich pleural effusions 255 Eosinophilic pleural effusion 255
Rheumatoid effusions 256 Systemic lupus erythematosus 256 Effusion in Boerhaave syndrome 256
Malignant effusions 256 Malignant pleural mesothelioma 256 Metastatic carcinoma 261 Lymphoma and leukemia 264 Other uncommon malignancies 264
Fine-needle aspiration and core imprint cytology 264 Acknowledgments 265
References 265
e development of cytodiagnosis in pleural eusions is well documented in major texts and only needs brief comment here, mainly to highlight general changes that have occurred over the last 40 years. Teaching for earlier generations of cytopathologists began with a purely morphological approach, whereby pitfalls in diagnosis were highlighted and cell blocks were either seldom prepared, or for those pathologists without a background in cytodiagnosis, where cell blocks provided the only acceptable diagnostic material. A malignant diagnosis was undertaken with trepidation and was the province of highly experienced practitioners with outstanding skills in cytomorphology. ere was oen a large gulf between histopathologists and cytopathologists in terms of types of training and cytodiagnosis was oen viewed with some suspicion. Diagnostic pointers to the range and type of tumors which could be diagnosed were limited and clinical background was paramount in assigning tumor type.
