Effusion Cytology
Effusion cytology is generally safe and does not cause any major risks or discomfort.

Effusion cytology, also called pleural fluid cytology, refers to the lab examination of the fluid collected in the space around the lungs, called pleural space. It usually identifies any cancerous cells or other cell types, such as precancerous cells or cells seen in systemic lupus erythematosus (SLE) called the LE cells.

The term cytology refers to the study of cells and effusion refers to the collected fluid.

What is pleural effusion?

Pleural effusion is a lung condition in which an excess of fluid collects in the pleural space (the space between the lungs and the chest wall).

  • The lungs are covered by a thin tissue layer called the pleura.
  • There is a small space between the layers of the pleura in which it secretes a small amount of fluid called pleural fluid.
  • This fluid helps keep the pleura moist and reduces friction between its layers when the lungs move during breathing.

Normally, the pleural fluid is present in minimal quantities, about 10 to 20 mL. In some conditions, however, excess amounts of pleural fluid may collect in the pleural space, leading to pleural effusion. This excess fluid may interfere with the functioning of the lungs due to pressure effects. It could be a favorable site for infections to develop.

How is effusion cytology done?

Cytological examination of pleural effusion is done by collecting a small sample of pleural fluid through a procedure called thoracentesis.

Before the procedure

  • Your doctor will explain the details and how it will feel and discuss your symptoms.
  • Inform your doctor if you have any allergies, are on any medications, or have any underlying conditions, including bleeding disorders.
  • Generally, no special preparation is required for the test.

During the procedure

  • You will sit comfortably on a bed or a chair with your head and arms resting on a support, such as a table.
  • The doctor will clean the skin around the procedure site with an antiseptic solution.
  • They will inject a numbing medicine (local anesthetic) at the site.
  • The doctor then inserts a needle through the skin and muscles of the chest wall into the pleural space. This could be done under ultrasound guidance.
  • You must not move, cough, or breathe deeply when the needle is inserted.
  • The fluid is collected through the needle.
  • The needle is withdrawn and the site on the skin is bandaged.
  • The fluid is then sent to the lab for cytology examination.

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What do my results mean?

Because cytology focuses on the examination of cells, a normal result will mean no malignant or abnormal cells were detected in your pleural fluid.

Abnormal results or cancerous cells could be seen in the case of lung cancer or cancerous cells spreading from other sites (metastasis), such as:

In some cases, you may get a negative result (no abnormal cells detected) despite the presence of cancer. Your doctor may recommend other investigations in such cases if there is a high suspicion of malignancy (cancer).

What are the complications of the effusion cytology procedure?

The procedure is generally safe and does not cause any major risks or discomfort. You may feel a little pain when the local anesthetic is injected. Some pain or pressure could be felt when the needle is injected into the pleural space. You must tell your doctor immediately if the pain is intense or you feel breathless or develop chest pain.

Some of the associated risks of effusion cytology include:

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Medically Reviewed on 10/28/2022
References
Image Source: Getty image

Cytology exam of pleural fluid. https://medlineplus.gov/ency/article/003866.htm

Effusion Cytology. https://www.sciencedirect.com/science/article/abs/pii/S0272271218305638

Physiology, Pleural Fluid. https://www.ncbi.nlm.nih.gov/books/NBK513353/