Cytologically Positive Pericardial Effusion Encountered during Surgery for Lung Cancer

In surgery for locally advanced lung cancer, pericardial effusion with positive cytology is sometimes encountered. The aim of this study is to reveal the significance of cytologically positive pericardial effusion in surgery for lung cancer. Intraoperative cytological examinations were performed in 81 lung cancer patients. Twelve cases were positive and 69 were negative. In positive cases, pleural dissemination and mediastinal lymph node involvement were frequent, which seemed to indicate some relationship with the mechanism of how cancer cells enter the pericardial sac. Ten patients out of the twelve with positive cytologies died of disease within one year after operation. Because of their extremely poor postsurgical prognosis, there seems to be no indication for resection in patients with cytologically positive pericardial effusion.