EFFUSION CYTOLOGY AFTER EXTRAPLEURAL PNEUMONECTOMY FOR TREATMENT OF MALIGNANT MESOTHELIOMA

Extrapleural pneumonectomy to treat malignant mesothelioma may offer a significant survival advantage for selected patients. The role of eff usion cytology in these patients has not been previously examined. To evaluate this, cytology, pathology, and medical records of 26 cases in 21 patients who underwent extrapleural pneumonoectomy because of mali gnant mesothelioma were reviewed. Positive cytologic results were note d on average 13 months later than negative results. Recurrence was mos t common in the peritoneum, followed by the ipsilateral thorax and con tralateral thorax. Five of 11 true-negative results were secondary to infection; cytologic analysis revealed neutrophils in each case. Four of 5 false-negative cases were from the ipsilateral thorax, and no mes othelial cells were found. When these 4 cases are excluded, the sensit ivity of cytologic examination in this setting, was 91%, and specifici ty was 100%. Effusion cytology in patients after extrapleural pneumone ctomy is an effective means of diagnosing recurrent malignant mesothel ioma.