title: The value of the immunoperoxidase slide assay in the diagnosis of malignant pleural effusions in breast cancer.
abstract: Whether immunocytochemical studies of malignant pleural effusions due to breast cancer would increase the diagnostic yield as compared with conventional effusion cytology was examined in 30 cases with biopsy-proven metastatic spread to the pleura. Conventional cytology was performed on air-dried smears as well as on cytocentrifuge preparations stained with the May-Grünwald-Giemsa stain. Immunocytochemistry was performed with monoclonal antibodies against carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA) and human leukocyte antigen (HLA) and the peroxidase-antiperoxidase technique on glass slides after Ficoll-Hypaque centrifugation. By conventional cytology, 13 cases (43%) were positive for malignant cells, 6 cases (20%) were suspicious, and 11 cases (37%) were negative. In marked contrast, all 30 cases were immunocytologically positive for malignancy. Tumor cells in all cases demonstrated a positive reaction for EMA. Some mesothelial cells were also positive for EMA, but their reaction pattern was clearly distinguishable from that of the tumor cells. Twenty-one cases (70%) also showed CEA-positive tumor cells; mesothelial cells never reacted with CEA. Some tumor cells showed a loss of HLA expression. In conclusion, this immunocytologic method can be recommended as a routine procedure for greatly increasing the diagnostic yield of cytology in pleural effusions due to breast cancer.
authors.affiliation: Department of Pathology, University of Freiburg, West Germany.
authors.forename: J
authors.initials: J
authors.lastname: Guzman
authors.forename: U
authors.initials: U
authors.lastname: Costabel
authors.forename: K J
authors.initials: KJ
authors.lastname: Bross
authors.forename: U
authors.initials: U
authors.lastname: Wiehle
authors.forename: F
authors.initials: F
authors.lastname: Grunert
authors.forename: H E
authors.initials: HE
authors.lastname: Schaefer
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D003581:Cytodiagnosis; D006680:HLA Antigens / Q000032:analysis; D006651:Histocytochemistry; D006801:Humans; D007124:Immunoenzyme Techniques; D008562:Membrane Glycoproteins / Q000032:analysis; D018396:Mucin-1; D010996:Pleural Effusion / Q000473:pathology*
chemical_list: D002272:Carcinoembryonic Antigen; D006680:HLA Antigens; D008562:Membrane Glycoproteins; D018396:Mucin-1