{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T15:57:50Z","timestamp":1791734270802,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Timely diagnosis of malignant pleural effusions is critical to guide prognosis and management decisions. Cytological analysis of pleural fluid has been the first\u2010line diagnostic test for many decades, with highly variable reported sensitivities of 40\u201390%. Its diagnostic accuracy in modern practice in Australia needs to be understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the diagnostic yield of pleural fluid cytology for the detection of malignant pleural effusions and to determine the aetiologies of pleural effusions at our centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study involved the retrospective chart review of all pleural fluid samples submitted for cytological analysis at a tertiary referral centre in Melbourne, Australia, over a 12\u2010month period. Aetiology of all effusions was determined, and sensitivity, specificity, negative predictive value and diagnostic accuracy for the detection of malignant pleural effusions were calculated. We also examined diagnostic yield based on tumour cell type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 153 cases analysed, 61 (39.9%) were malignant. Lung cancers accounted for 44.3% of malignant effusions, followed by mesothelioma (18%), ovarian carcinoma (11.5%) and lymphoma (8.2%). The commonest single causes of a benign effusion were cardiac (16.3%) and parapneumonic (13%). Sensitivity for diagnosis of malignant effusions was 67.2% overall, but 87.9% for adenocarcinomas and only 45.5% for mesothelioma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tumour type is an important determinant of pleural fluid cytology diagnostic yield. Cytology has good sensitivity and specificity for the diagnosis of adenocarcinoma, but if another tumour type is suspected, particularly mesothelioma, clinicians should be aware of the limitations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13991","type":"journal-article","created":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T08:24:32Z","timestamp":1528187072000},"page":"1318-1324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Diagnostic yield of pleural fluid cytology in malignant effusions: an Australian tertiary centre experience"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8491-3848","authenticated-orcid":false,"given":"Paula","family":"Loveland","sequence":"first","affiliation":[{"name":"Department of General Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micheal","family":"Christie","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Hammerschlag","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Irving","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Steinfort","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcm032"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00217114"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006757"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12496"},{"key":"e_1_2_6_6_1","volume-title":"UpToDate","author":"Midthun DE","year":"2017"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24168"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hct245"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000278"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.136978"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22190"},{"key":"e_1_2_6_12_1","first-page":"173","article-title":"Accuracy of pleural fluid cytology in malignant effusions [Article in Spanish]","volume":"25","author":"Bielsa S","year":"2008","journal-title":"An Med Interna"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850815)56:4<905::AID-CNCR2820560435>3.0.CO;2-U"},{"key":"e_1_2_6_14_1","first-page":"609","article-title":"Pleural effusions: role of commonly available investigations","volume":"47","author":"How SH","year":"2006","journal-title":"Singapore Med J"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2840030103"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2013.11.007"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.122.6.1913"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)60848-3"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31812f3c1a"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2005.02.022"},{"key":"e_1_2_6_21_1","first-page":"19","article-title":"The diagnostic yield of pleural fluid cytology in malignant pleural effusions","volume":"41","author":"Ong KC","year":"2000","journal-title":"Singapore Med J"},{"key":"e_1_2_6_22_1","first-page":"320","article-title":"Diagnostic efficacy of pleural biopsy as compared with that of pleural fluid examination","volume":"4","author":"Nance KV","year":"1991","journal-title":"Mod Pathol"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-12-428"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0b013e32835bc848"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60212-2"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.20"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2017-0124-RA"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.6394"},{"key":"e_1_2_6_29_1","first-page":"665","article-title":"The value of multiple fluid specimens in the cytological diagnosis of malignancy","volume":"7","author":"Garcia LW","year":"1994","journal-title":"Mod Pathol"},{"key":"e_1_2_6_30_1","first-page":"3550","article-title":"Diagnostic yield of cytology in malignant pleural effusion: impact of volume and repeated thoracentesis","volume":"38","author":"Solooki M","year":"2011","journal-title":"Eur Respir J"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9371.50799"},{"key":"e_1_2_6_32_1","first-page":"42","article-title":"Diagnosing malignant pleural effusions: how do we compare?","volume":"126","author":"Lim MH","year":"2013","journal-title":"N Z Med J"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.136994"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.30875\/9f925144-en"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.13991","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13991","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.13991","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.13991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T12:55:57Z","timestamp":1694264157000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.13991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":33,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/imj.13991"],"URL":"https:\/\/doi.org\/10.1111\/imj.13991","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]},"assertion":[{"value":"2017-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}