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<p class="ql-align-justify">Smear shows many papillary and clusters of malignant epithelial looking cells with hyperchromatic nuclei exhibiting moderate anaplasia. Some cells shows intracytoplasmic vacuoles. Background shows a moderate number of mature small lymphocytes and neutrophils with reactive mesothelial cells. According to The International System for Reporting Serous Fluid Cytology (ISRSFC); this is Category V. </p>
<p class="ql-align-justify">Known history of metastatic breast cancer presented with a cough, dyspnea, and bicytopenia, and has been diagnosed with bronchopneumonia and a right pleural effusion requiring diagnostic and therapeutic thoracocentesis.</p>
<p class="ql-align-justify">One smear was prepared and stained from submitted 10 ml yellowish fluid.</p>
<p><strong><em><u>Pleural fluid, cytology</u></em></strong>:</p><ul><li><strong>Positive for malignant clusters, consistent with metastatic recurrence of breast ductal carcinoma.</strong></li><li><strong>(Category V according to The International System for Reporting Serous Fluid Cytology, ISRSFC). </strong></li></ul>
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