Body cavity fluids

Our plain-English summary of Body cavity fluids, by M.J. Thrall (Cancer Treatment and Research, 2014).

The study

• Author: M.J. Thrall
• Journal: Cancer Treatment and Research
• Published: 2014;160:185-210
• Type of article: Review
• Read it: PubMed · Publisher

In plain English

This is a review chapter in a textbook on cancer cytopathology. It is not a research study and reports no new data. The author described how pathologists examine fluid from the pleural, peritoneal and pericardial cavities, and the common sources of diagnostic error. The chapter stated that most cancers found in these fluids are adenocarcinomas, and that mesothelioma is less common. The author wrote that mesothelioma is linked to prior asbestos exposure, particularly to amphibole types. The author added that history-taking almost always reveals some possible exposure, which limits the usefulness of that information, and that testing fluid for asbestos bodies has a very low yield. The chapter said mesothelioma can look very bland under the microscope and that ancillary tests do not separate benign from malignant mesothelium. It noted that spindle-cell mesotheliomas virtually never shed diagnostic cells into fluid. The author reported that many cytologists believe a primary diagnosis of mesothelioma should not be made from fluid, though some do not accept this. The author concluded by stressing the importance of giving pathologists complete patient histories and radiology findings.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review (textbook chapter); no original data
• Who was studied: No study population. The chapter covers cytology specimens of fluid from the pleural, peritoneal and pericardial cavities in general diagnostic practice.
• Exposure: Asbestos exposure was not studied. The chapter mentions it as background: the author linked mesothelioma to prior asbestos exposure, particularly amphibole subtypes, and noted that analysis of fluid for asbestos bodies has a very low yield.
• Main results:
  • The author stated that most malignancies found in body cavity fluids are adenocarcinomas, but that mesothelioma, melanoma and lymphoid malignancies also occur.
  • The author wrote that history-taking almost always reveals some possible asbestos exposure, limiting its usefulness, and that testing fluids for asbestos bodies has a very low yield.
  • The author described mesothelioma as possibly very bland under the microscope, making it hard to tell apart from benign reactive mesothelial cells.
  • According to the author, ancillary studies (electron microscopy, immunocytochemistry) do not distinguish benign from malignant mesothelium.
  • The author reported that many cytologists believe a primary diagnosis of mesothelioma should not be made from body cavity fluid, though some do not accept this position.
  • The author stated that mesotheliomas made up mainly or entirely of spindled cells virtually never shed diagnostic cells into body cavity fluids.
  • For separating mesothelioma from lung adenocarcinoma, the author noted that multiple markers should be used and that expert panels have declined to recommend a particular marker panel.
• The authors' conclusion: The author concluded that body cavity fluid cytology has well-known pitfalls, that false positive, false negative and ambiguous results can occur, and that giving pathologists complete patient histories and radiological information is of great importance.

Related studies

• Current applications of molecular testing on body cavity fluids — D. Pinto, F. Schmitt (2020)
• Rapid and easy method for monitoring oxidative stress markers in body fluids of patients with asbestos or silica-induced lung diseases — K. Syslová, P. Kacer, et al. (2009)
• Establishment of a novel specific ELISA system for rat N- and C-ERC/mesothelin. Rat ERC/mesothelin in the body fluids of mice bearing mesothelioma — Y. Hagiwara, Y. Hamada, et al. (2008)
• Preparation of extrapulmonary tissues and body fluids for quantitative transmission electron microscope analysis of asbestos and other mineral particle concentrations — P.M. Cook (1979)
• Diagnostic use of muscle markers in the cytologic evaluation of serous fluids — A.M. Afify, B.M. Al-Khafaji, et al. (2002)
• Ultrastructural studies of malignant cells in fluids — G.A. Herrera, J.A. Wilkerson (1985)

Browse return to medical research.