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<p>Smear shows many degenerated clusters and balls as well as many separate forms of large sized atypical epithelial cells exhibiting focal cytoplasmic vacuolation. Nuclei are vesicular. There are many small lymphocytes and neutrophils in background with many reactive mesothelial cells. Such cytological features are more in consistency with metastatic adenocarcinoma. However, mesothelioma can not completely excluded.</p>
<p>Right Pleural efusion.</p>
<p>One smears was made and pap stained.</p>
<p><strong><em><u>Pleural fluid, cytology: </u></em></strong></p><ul><li><strong>Positive for atypical epithelial looking cells, uncertain of epithelial (metastatic adenocarcinoma) or mesothelial (mesothelioma).</strong></li><li><strong> (Category V according to The International System for Reporting Serous Fluid Cytology, ISRSFC). </strong></li></ul><p><br></p><h5><strong><u>COMMENT:</u></strong></h5><h5><strong>Correlation with radiological findings (to ensure or exclude the presence of pleural mass lesion) as well as careful metastatic work-up (especially of lungs) are both advised to confirm the diagnosis of metastasis and to exclude the less likely possibility of mesothelioma.</strong></h5>
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