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<p class="ql-align-justify">Smear shows scattered clusters and balls of large sized atypical epithelial cells exhibiting focal cytoplasmic vacuolation. Nuclei are vesicular. There are many small lymphocytes in background with many reactive mesothelial cells. Such cytological features are more in consistency with metastatic adenocarcinoma. </p>
<p>Pleural effusion.</p>
<p class="ql-align-justify">One smear was prepared and pap stained from submitted 50 ml pale yellow fluid.</p>
<p><strong><em><u>Pleural fluid, cytology:</u></em></strong></p><ul><li><strong>Positive for atypical epithelial looking cells, consistent with metastatic adenocarcinoma.</strong></li><li><strong>Category V according to The International System for Reporting Serous Fluid Cytology, ISRSFC.</strong></li><li><strong>Recommended for confirmatory further studies (see comment).</strong></li></ul><p><br></p><p><strong><u>COMMENT:</u></strong></p><p>Correlation with radiological findings (to ensure or exclude the presence of pleural mass lesion) as well as careful metastatic work-up (especially of breasts and lungs) are both advised to confirm the diagnosis of metastasis and to exclude the less likely possibility of mesothelioma.</p>
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