Cytology exam of pleural fluid

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Alternative names
Pleural fluid cytology

Definition
This is an examination of pleural fluid to detect the presence of malignant (cancerous) cells. The pleural space surrounds the lungs and normally contains only enough fluid to lubricate the pleura, the lining of the lung.

How the test is performed
The test is performed by obtaining a sample of pleural fluid by a procedure called thoracentesis (a needle is inserted into the pleural space to draw off the fluid). The sample of fluid is examined under the microscope for the presence of abnormal cells.

How to prepare for the test
Food or fluid is not restricted. Do not move, cough, or breathe deeply during the test.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

• Infant test or procedure preparation (birth to 1 year)
  
• Toddler test or procedure preparation (1 to 3 years)
  
• Preschooler test or procedure preparation (3 to 6 years)
  
• School age test or procedure preparation (6 to 12 years)
  
• Adolescent test or procedure preparation (12 to 18 years)

How the test will feel
The skin is cleansed, and shaved if necessary, around the insertion site. Local anesthetic to numb the site may be injected into the skin. There may be a pressure or sticking sensation as the needle enters the skin and pleural space. Inform the health care provider if shortness of breath develops after the test.

Why the test is performed
The test is performed to determine the cause of a pleural effusion (fluid accumulation in the pleural space) or when cancer is suspected.

Normal Values
Normal cells are seen.

What abnormal results mean
In an abnormal test, malignant (cancerous) cells are present and may indicate a cancerous tumor. Breast cancer, lung cancer, and lymphoma are the types of tumor most frequently detected by this test.

Additional conditions under which the test may be performed:

• Metastatic cancer to the lung

What the risks are

The risks include:

• bleeding
  
• infection
  
• collapse of the lung (pneumothorax)
  
• re-accumulation of fluid, and mediastinal shift (a shifting in the location of chest structures, which can put pressure on blood vessels)

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