Minerva Medica 2021 Jun 28

DOI: 10.23736/S0026-4806.21.07586-8

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Evaluation of Light’s criteria in cytologically proved malignant pleural effusions

Samuel GARCIA-REINA ¹ ✉, Esther FERNÁNDEZ ¹, Alba HERNANDEZ ², Marta LACAMBRA ³, Pedro E. LOPEZ de CASTRO ¹, Antoni ROSELL ⁴

¹ Department of Thoracic Surgery and Thorax Clinic Institute, Hospital Universitari Germans Trias i Pujol, Autonomous University of Barcelona College of Medicine, Badalona, Spain; ² Department of Pathology, Hospital Universitari Germans Trias i Pujol, Autonomous University of Barcelona College of Medicine, Badalona, Spain; ³ Department of Anaesthesiology, Hospital Universitari of Vic, Vic, Spain; ⁴ Thorax Clinic Institute, Hospital Universitari Germans Trias i Pujol, Autonomous University of Barcelona College of Medicine, Badalona, Spain

BACKGROUND: Malignant pleural effusions are usually described as exudates. However, several studies have determined a high incidence of cytologically proved malignant effusions in transudates. The study aims to determine the compliance of cytologically proved malignant pleural effusions with Light’s Criteria and to assess when it is necessary to perform more studies in transudates.
METHODS: We have retrospectively reviewed all the cytologically positive effusions at our institution over six years. Biochemical characteristics were recorded, and Light’s Criteria were determined for each effusion. We analyzed the effusions’ compliance with the criteria and determined whether its primary tumor or the presence of cirrhosis, acute kidney injury or congestive heart failure could interfere in the criteria being met.
RESULTS: 224 patients presented malignant pleural effusions with biochemical pleural fluid analysis. Two (0,9%) were transudative effusions and two hundred and twenty-two (99,1%) were exudative effusions. Lung carcinoma, breast carcinoma and ovarian carcinoma were the most frequent primary tumors. 102(45,94%) patients met three Light criteria, 77(34,68%) patients met two criteria and 43 (19,36%) met one criterion. Both patients with transudative malignant pleural effusions presented concomitant malignant ascites.
CONCLUSIONS: Malignant transudative pleural effusions were 0,9% of our patients. We found no relation between transudative malignant effusions and the presence of cirrhosis, acute kidney injury or congestive heart failure, or the type of tumor. We found no difference between the tumor type and the distribution of Light’s criteria met.

KEY WORDS: Ascites; Cytology; Exudates and transudates; Pleural effusion, malignant; Thoracentesis