title: The cell block method increases the diagnostic yield in exudative pleural effusions accompanying lung cancer.
abstract: OBJECTIVE
  Thoracentesis is the first investigation to be performed in a patient with lung cancer and pleural effusion. The diagnostic yield of conventional smear studies varies in the first thoracentesis. In this study, we aimed to investigate if the cell block method increases the diagnostic yield in exudative pleural effusions accompanying lung cancer.
  
  
  METHODS
  Forty patients with lung cancer and exudative pleural effusions were included. Ten mililiters of fresh pleural fluid was obtained by thoracentesis from all patients in the initial evaluation. The pleural fluid sample was divided into two equal parts. One part was subjected to conventional smear and the other to the cell block method. Conventional smears were stained with May-Grünwald-Giemsa and Hematoxylin-Eosin. Cell block sections were stained with Hematoxylin-Eosin and mucicarmine. Conventional smear findings were grouped as "benign cytology" or "malignant cytology". Th e cell block sections were evaluated for the presence of single tumor cells, acinary or papillary pattern, solid islands and staining with mucicarmine.
  
  
  RESULTS
  There were 20 patients each in the benign and malignant conventional smear group. In the benign group, adding the cell block method to conventional smear provided a diagnosis of malignancy in 4 more patients and the diagnosis of malignant effusion was increased by a ratio of 10% (4/40). In the malignant group, adding the cell block technique provided the subtyping of lung cancer as adenocarcinoma in 7 patients (7/20, 35%).
  
  
  CONCLUSIONS
  Our study confirms that the cell block method combined with conventional smear increases the diagnostic yield in exudative pleural effusions accompanying lung cancer.
authors.affiliation: Department of Chest Diseases, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, ANKARA, TURKEY.
authors.forename: Deniz
authors.initials: D
authors.lastname: Köksal
authors.forename: Funda
authors.initials: F
authors.lastname: Demırağ
authors.forename: Hülya
authors.initials: H
authors.lastname: Bayız
authors.forename: Adem
authors.initials: A
authors.lastname: Koyuncu
authors.forename: Neslihan
authors.initials: N
authors.lastname: Mutluay
authors.forename: Bahadır
authors.initials: B
authors.lastname: Berktaş
authors.forename: Mine
authors.initials: M
authors.lastname: Berkoğlu
mesh_terms: D000368:Aged; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000473:pathology*