title: A Minimum Volume of More Than 60 mL Is Necessary for Adequate Cytologic Diagnosis of Malignant Pericardial Effusions.
abstract: OBJECTIVE
  This study aims to determine the minimum pericardial fluid volume necessary for adequate cytologic diagnosis.
  
  
  METHODS
  We identified 480 pericardiocentesis specimens, divided them by volume into six bins, and calculated the malignancy fraction (percentage of malignant diagnoses) for each bin. We then combined bins at various cutoffs to determine a minimum threshold volume and evaluated their sensitivity.
  
  
  RESULTS
  The malignancy fraction increased from 6.5% for specimens 10 mL or less to 20.7% for more than 600 mL (P = .03). While the cumulative malignancy fraction was 18.1% above a cutoff of 60 mL, it was 10.6% below this threshold (P = .03). The sensitivity of cytology compared with pericardial biopsy was 70.0% for 60 mL or less and 91.1% for more than 60 mL (P = .14).
  
  
  CONCLUSIONS
  Small-volume pericardiocentesis specimens detect fewer malignancies and have inferior sensitivity compared with pericardial biopsy. A volume of more than 60 mL should be submitted to cytology to ensure adequate diagnosis of pericardial fluids.
authors.affiliation: From the Departments of Pathology and.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Rooper
authors.affiliation: From the Departments of Pathology and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Syed Z
authors.initials: SZ
authors.lastname: Ali
authors.affiliation: From the Departments of Pathology and.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Olson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis*; D000069236:Pericardial Fluid; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D055815:Young Adult
keywords: Cardiovascular; Cytology; Cytopathology; Pericardial biopsy; Pericardial cytology; Pericardial effusion; Specimen volume