Evaluation of Light's criteria in cytologically proved malignant pleural effusions.

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: Overall, 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. One hundred and two (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.

Results of fusion prostate biopsy comparing with cognitive and systematic biopsy.

PURPOSE: Our study aims to determine whether there are differences in the degree of detection of prostate cancer (PCa) and CsPCa between fusion prostate biopsy (FPB), cognitive biopsy (PCB), and randomized, systematic biopsy (SB). METHODS: A retrospective analysis was carried out of 195 patients with suspected PCa at the San Cecilio University Clinical Hospital in Granada who underwent a prostate biopsy between January and December 2021. Patients were divided into three groups: group 1, patients undergoing FPB transperineally with ultrasound BK 3000 (N = 87); group 2, PCB (N = 59) transperineally; and group 3, transrectal SB (N = 49), the latter two, with an ultrasound BK Specto. RESULTS: We found differences in favor of image-directed biopsies (FPB and PCB) with a percentage of positive biopsies of 52.8% and 50%, respectively, compared to 41.4% with SB, but without these differences being significant. Given the controversy in performing prostate biopsies in PI-RADS 3 lesions reported in the literature, a subanalysis was performed excluding the FPB performed for PI-RADS 3 lesions (PI-RADS 4 and 5 are included), finding significant differences when comparing FPB with PCB and SB (group 1, 64% vs group 2, 45.8%; p = 0.05) (group 1, 64% vs group 3, 42.9%; p = 0.035). CONCLUSION: With the results obtained in our series, we conclude that the finding of a PI-RADS 3 lesion in mpMRI should not be an absolute criterion to indicate prostate biopsy. On the other hand, for PI-RADS 4 and 5 lesions, FPB is recommended, which in this case turns out to be superior to PCB and SB.