{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T04:07:09Z","timestamp":1778990829118,"version":"3.51.4"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Esophageal perforation (EP) is a rare but life\u2010threatening condition, and most cases are due to iatrogenic causes. The rest occur spontaneously, due to malignancies, or trauma. The mortality rates can approach 50%, and delayed diagnosis of EP exacerbates patient outcomes. Cytologic recognition of pleural fluid specimens with oropharyngeal contents (e.g., squamous cells,\n                      <jats:italic>Candida<\/jats:italic>\n                      species) or food\/foreign material can expedite the diagnosis of EP. This study presents our institution's experience with cytologic findings in EP patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We reviewed our institutional database over a 25\u2010year period to identify pleural fluid cytology specimens from EP patients. Data on patient demographics, clinical history, and microbiology culture results were collected. Slides were assessed for squamous cells, food\/foreign material, and infectious organisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven pleural fluid cytology specimens from 10 patients with EP (seven males, three females; mean age 68\u2009years) were retrieved. Three cases were atypical, and eight were negative for malignancy. Mortality occurred in four (40%) patients within a mean of 2.2\u2009months post\u2010EP diagnosis. The majority of EP causes were iatrogenic (82%) or associated with malignancy (55%). Squamous cells were present in 27% of specimens, while food\/foreign material and fungi were identified in 36% and 9% of cases, respectively. Cultures were positive in seven (64%) patients, with 46% showing bacterial growth and 55% positive for fungal organisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our experience corroborates that EP carries a high mortality risk, underscoring the need for prompt diagnosis. Although\n                      <jats:italic>Candida<\/jats:italic>\n                      species were present in only a small subset of pleural fluid samples, the presence of squamous cells or food\/foreign material is a helpful diagnostic clue of EP, particularly in patients with a history of recent medical manipulation or malignancy involving the esophagus. Our findings highlight the potential of identifying involved pleural fluid cytology specimens to decrease the time to diagnosis of EP.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70111","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T04:26:46Z","timestamp":1773116806000},"page":"429-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cytologic Findings in Esophageal Perforation: An Institutional Experience With Pleural Fluid Specimens"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2153-6843","authenticated-orcid":false,"given":"Mason","family":"Marshall","sequence":"first","affiliation":[{"name":"Cytopathology Center of Excellence University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5670-6254","authenticated-orcid":false,"given":"Samer","family":"Khader","sequence":"additional","affiliation":[{"name":"Cytopathology Center of Excellence University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-532X","authenticated-orcid":false,"given":"Sigfred","family":"Lajara","sequence":"additional","affiliation":[{"name":"Department of Cytopathology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8182-5503","authenticated-orcid":false,"given":"Liron","family":"Pantanowitz","sequence":"additional","affiliation":[{"name":"Cytopathology Center of Excellence University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"StatPearls","author":"Kassem M. M.","year":"2024"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-19-66"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1250347"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-022-05454-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/1742-6413.111811"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2843"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.102.3.976"},{"issue":"3","key":"e_1_2_9_9_1","first-page":"00290","article-title":"Pleural Effusion Due to Nonmalignant Gastrointestinal Disease","volume":"9","author":"Ferreiro L.","year":"2023","journal-title":"European Respiratory Journal Open Research"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dox013"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3667"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doab039"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1515\/pp-2016-0023"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2010.08.003"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19971225)81:6<365::AID-CNCR11>3.0.CO;2-X"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2010.01794.x"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70111","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.70111","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.70111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T04:03:04Z","timestamp":1778990584000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.70111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/dc.70111"],"URL":"https:\/\/doi.org\/10.1002\/dc.70111","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"assertion":[{"value":"2025-10-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}