CWM Hospital Fiji School of Medicine Depts' of Medicine

1
CWM Hospital / Fiji School of Medicine Depts. of
Medicine Pathology
CPC Meeting 8/8/2002

• Malignant Pericardial Effusion

2
History

• 53 Year old Fijian female
• Acute shortness of Breath
• Essential hypertension on treatment
• Past history of TB
• Cervical lymphadenopathy
• Chest X-ray globular heart shadow
• Pericardial effusion 300 ml bloody fluid
  aspirated.

3
History

• Effusion analysis Exudate, few lymphocytes, and
  abnormal cells
• Following aspiration, chest radiograph showed
  bilateral multiple small opacities.
• Pericardial fluid cytology discussed.

4
Pericardial fluid cytology

• Increased cells. Papillary clusters.
• WBC, (Blue dots)
• Papillary clusters

5
Pericardial fluid cytology

• Pleomorphic cells (varying size and shape)
• Secretions in cytoplasm (signet ring cells)
• WBC in background
• Irregular large lobulated nuclei.

6
Discussion

• Pleomorphic cells in loose and papillary
  clusters.
• Cells show pale blue vacuolated cytoplasm
• Secretions in cytoplasm pushing the nucleus to a
  side giving signet ring appearance.
• Features suggest Papillary adenocarcinoma
• Breast, Thyroid, Ovary, Endometrium to be
  explored.