Pre- and postresection thoracic washings in non-small cell carcinoma of the lung: A cytological study of 44 patients without pleural effusion

The presence of malignant pleural effusion in patients with non-small cell bronchogenic cancer has a poor prognostic significance and is indicative of advanced disease (T4, IIIB). The present study will investigate the role o f cytology and identify the various cellular components seen in thoracic wa shings, in the absence of and fusion, and will identify the potential pitfa lls in diagnosing these specimens The sensitivity, specificity, and positiv e and negative predictive values will be determined, as well as the associa ted predictive factors. From November 1996 to July 1997, 96 thoracic washin gs were performed on 44 patients with non-small cell carcinoma of the hmg p rior to and following resection. The specimens were processed routinely To assess the false- negative or false-positive cases, all cases were rescreen ed and then correlated with the surgical pathology. Seven (15.9%) patients had positive findings detected on the pre-and/or postresection thoracic was hings. One (2.3%) patient had a negative preresection, but cytolagically at ypical cells were found on the postresection. Thirty-six (81.8%) patients h ad negative pre- and postresection thoracic washings. There were no false-p ositive diagnoses in the study; however; two false-negative diagnoses were made. The finding of positive cytology in 7 of 44 (15.9%) patients appears significant Thoracic washings may provide evidence of cancer beyond the ple ura in patients without pleural effusion which may be indicative of advance d disease. (C) 2000 Wiley-Liss,Inc.