Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
EFFUSIONS
Cancer Growth Prog; 7:195-213 1989. Unique Identifier : AIDSLINE ICDB/90658282 Ulirsch RC; Gomez DM; Hematology Section, Dept. of Pathology, Loyola Univ. of Chicago; Medical Center, Maywood, IL 60153
Abstract:
Effusions may develop in any of the serous membrane-lined body cavities. The peritoneal, pleural, and pericardial spaces are the principal mesothelial-lined cavities that cause clinical diagnostic problems. Excessive accumulation of fluid in these spaces may compromise normal organ functions. Diagnosis, classification, and cytology of effusions; mechanisms of effusion accumulation; and the use of biopsy are described; malignant neoplasms associated with effusions and the evaluation, treatment, and prognosis of effusions are reviewed. Topics include mesothelioma, adenocarcinoma, lymphoma/leukemia, squamous cell carcinoma, and other malignant neoplasms. New approaches to the evaluation of effusions are discussed, including immunochemical methods, flow cytometry, morphometrics, biochemical analysis, cytogenetics, and electron microscopy. Different anatomic areas of the body are preferentially affected by metastases from specific organ sites. Pleural involvement and generation of effusions is seen most commonly with breast (24%), lung (19%), and lymphoreticular neoplasms (16%). In the peritoneal cavity, the most commonly observed neoplasms are ovarian carcinoma (32%), breast carcinoma (13%), and lymphoreticular neoplasms (7%). Malignant disease with progression to peritoneal involvement and consequent development of intractable accumulation of ascitic fluid is an ominous clinical occurrence. Most patients (pts) in this clinical situation have a very short survival time. Some pts with severe neoplastic ascites require control of fluid accumulation for palliation. Management of malignant ascites requires not only various drainage procedures but also attempts to eradicate neoplastic cells in the local area where they cause complicating fluid accumulations. There is a tendency to regard all malignant effusions as an indication of far advanced, and therefore hopeless, disease. This is not always the case. It is critical to establish that an effusion in a pt is actually due to neoplastic involvement of the body cavity in question. Pts who have effusions due to benign disease may suffer from adverse effects of unneeded therapy. (208 Refs)
Keywords: Acquired Immunodeficiency Syndrome/PATHOLOGY Adenocarcinoma/PATHOLOGY Ascites/PATHOLOGY Biopsy Carcinoma, Squamous Cell/PATHOLOGY Exudates and Transudates/*CYTOLOGY Human Leukemia/PATHOLOGY Lung Neoplasms/PATHOLOGY Lymphoma/PATHOLOGY Mesothelioma/PATHOLOGY Neoplasms/*PATHOLOGY Pericardial Effusion/PATHOLOGY Peritoneal Neoplasms/PATHOLOGY Pleural Effusion/PATHOLOGY Pleural Neoplasms/PATHOLOGY JOURNAL ARTICLE REVIEW, TUTORIAL REVIEW 900228
M9020578
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
