The Role of Cytology in the Diagnosis of Lung Adenocarcinoma in Pleural Effusion

Abstract

Lung cancer is a major global health issue and a leading cause of cancer-related mortality. Accurate and timely diagnosis of lung adenocarcinoma, which is often detected at an advanced stage, is crucial for effective treatment planning. Pleural fluid cytology is a highly effective, minimally invasive standard diagnostic tool that provides rapid results. This academic article aims to systematically review the cytological process, from sample collection, slide preparation, and staining to interpretation based on The International System for Reporting Serous Fluid Cytopathology (TIS), with a focus on the cytomorphological features of adenocarcinoma. Furthermore, the article delves into key diagnostic challenges, including distinguishing primary lung cancer from metastatic disease, differentiating malignant cells from reactive mesothelial cells, and addressing issues of specimen quality. It also presents solutions, emphasizing the use of ancillary techniques, particularly immunohistochemistry (IHC), as a critical tool for enhancing diagnostic accuracy. The integration of morphological evaluation with these ancillary studies is essential for achieving the highest diagnostic precision, ensuring patients receive appropriate and timely treatment.