Determination of Primary Site by Examination of Cancer Cells in Body Fluids

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Abstract
Murphy, William M., and Ng, Alan B. P.: Determination of primary site by examination of cancer cells in body fluids. Am. J. Clin Pathol. 58: 479–488, 1972. Many articles concerning the accuracy of diagnosis of malignant tumor cells in serous effusions have appeared in the literature, but few authors have attempted to describe the characteristics of these cells as they relate to tumors of specific primary sites. Still fewer have dealt with determination of the site of the primary tumor by examination of effusions. In this paper, 87 well-documented cases of pleural and peritoneal serous effusions containing malignant tumor cells derived from carcinoma of the breast, lung, ovary, endometrium, and stomach were examined and characterized. Sufficient cytologic similarities occurred to permit classification into three distinct patterns in 84.6% of the cases. Grouping the cases according to these patterns and combining this with knowledge of the patient’s sex and the site of effusion allowed the pathologist to determine the site of the primary tumor with as much as 96% accuracy. Criteria of classification, as well as pitfalls in evaluation, are discussed in detail.

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