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<p class="ql-align-justify">Smear shows a moderate number of small lymphocytes and neutrophils admixed with many variable sized sheets and clusters of hyperplastic mesothelial cells, some exhibiting moderate atypia. Other scattered small and large clusters and separate formed of cells showing irregular hyperchromatic nuclei and vacuolated cytoplasm are also seen. Such cytological features may produce by atypical mesothelial cells hyperplasia, epithelioid mesothelioma or metastatic adenocarcinoma.</p>
<p>Chest pain and pleural effusion</p>
<p>Three smears were submitted and stained.</p>
<p><strong><em><u>Pleural fluid, cytology</u></em></strong>:</p><ul><li><strong>Suspicious atypical cells, uncertain of mesothelial or epithelial nature.</strong></li><li><strong>Category IV according to The International System for Reporting Serous Fluid Cytology, ISRSFC)</strong></li><li><strong> Recommended for further studies (see comment).</strong></li></ul><p><br></p><p><strong><u>COMMENT</u></strong><u>:</u></p><ul><li>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 all advised to establish a final diagnosis.</li></ul>
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