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[Correlation between sensitivity of the cytogenetic and cytological analysis and thoracoscopic findings in the study of malignant pleural effusions].

We studied 104 patients with pleural effusion. All underwent thoracoscopic exploration to allow direct examination of any pleural lesions present. At the same time pleural biopsies for histopathologic study and samples of pleural fluid for cytopathologic and cytogenetic study were taken. The volume of fluid in pleural cavity was also measured. The aims of the study were: a) to evaluate the sensitivity of cytogenetic analysis and cytopathology, both separately and together, and b) to look for a correlation between the sensitivity of these cell studies and the following thoracoscopic findings: tissue biopsy of pleural neoplasms, volume of pleural effusion and extension of neoplastic lesions in the pleural cavity. Seventeen of the pleural liquids studied were benign and 87 were neoplastic. Cytopathology was sensitive in 55% of the neoplastic cases and cytogenetic study was sensitive in 49%. Sensitivity rose to 74% when both techniques were applied. Cytogenetic study yielded a higher percentage of correct diagnoses in the group with hematologic neoplasia, whereas cytopathology was correct more often in cases of solid tumors, though these differences were not statistically significant. Use of both techniques resulted in correct diagnosis in 92% of patients with mesotheliomas. The number or correct diagnoses achieved with cytopathology tended to increase with size of macroscopic pleural lesion whereas cytogenetic study was more sensitive in patients with minimal or incipient pleural involvement. There were no statistically significant differences in sensitivity of cytopathology and cytogenetic analysis with regard to volume of pleural effusion.