title: The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences.
abstract: BACKGROUND
  Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature.
  
  
  METHODS
  We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis.
  
  
  RESULTS
  Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously.
  
  
  CONCLUSIONS
  Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.
authors.affiliation: Department of Thoracic Surgery, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yildirim
authors.affiliation: Department of Thoracic Surgery, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Ustaalioglu
authors.affiliation: Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Erkan
authors.affiliation: Department of Medical Oncology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.
authors.forename: Bala Basak Oven
authors.initials: BB
authors.lastname: Ustaalioglu
authors.affiliation: Department of Thoracic Surgery, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Demirbag
authors.affiliation: Department of Thoracic Surgery, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yasaroglu
authors.affiliation: Department of Thoracic Surgery, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ilgaz
authors.initials: I
authors.lastname: Dogusoy
authors.affiliation: Department of Thoracic Surgery, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Okay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D000069236:Pericardial Fluid / Q000166:cytology*; D010496:Pericardium / Q000473:pathology*; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity