RESUMO
OBJECTIVE: To examine the frequency and diagnostic implications of malignant pericardial effusions. STUDY DESIGN: The clinical and histologic records of pericardial effusions diagnosed cytologically as malignant were reviewed. We investigated the relationship between malignancy and type of tumor, interval between diagnosis of the primary tumor and development of the pericardial effusion, and length of survival after the onset of the effusion. RESULTS: There were 375 pericardial effusions among 23,592 effusions studied over 24 years; 65 of them were diagnosed as malignant. The mean age at onset was 53.6 years. In 92% of the cases the primary tumor was epithelial, lung the most frequent in males and breast in females. In 48% of cases the pericardial effusion constituted the first sign of malignancy. CONCLUSION: Diagnosis of a pericardial effusion as malignant carried an ominous prognosis: 86% of patients died within the first year and nearly one-third within the first month. Breast carcinomas were linked with the longest survival and longest interval of latency prior to the onset of the pericardial effusion. There were two effusions associated with lymphoblastic lymphomas; they have had no recurrence 10 and 17 years after the effusion, and the patients can be considered cured.
Assuntos
Neoplasias/patologia , Derrame Pericárdico/patologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias/diagnóstico , Neoplasias/mortalidade , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/mortalidade , Prognóstico , Estudos Retrospectivos , Distribuição por Sexo , Taxa de Sobrevida , Resultado do TratamentoRESUMO
OBJECTIVE: To investigate the frequency and diagnostic implications of extramedullary hematopoietic effusions. STUDY DESIGN: Smears of the effusions diagnosed cytologically as myeloid metaplasia or extramedullary hematopoiesis and their clinical records were reviewed and compared with the histologic diagnoses. RESULTS: There were 7 pleural and 1 peritoneal effusion from 5 patients out of 20,793 pericardial, peritoneal and pleural effusions studied during a period of 21 years. CONCLUSION: When compensatory responses can be ruled out, the diagnosis of extramedullary hematopoietic effusion points toward replacement of the bone marrow by a metastatic process. The first primary to consider in males is lung carcinoma.