Abstract
We describe a case of malignant pericardial effusion as an initial presentation of well-differentiated pulmonary adenocarcinoma. A 68-year old Japanese man was brought the emergency department because of dyspnea and chest oain. An echocardiogram demonstrated the presence of a Iarge pericardial effusion. Cytological examination of the aunctuated effusion showed many cell aggregates composed of papillary cell clusters. The neoplastic cells had centrally located round nuclei, coarse granular nuclear chromatin, and abundant clear cytoplasm. Postmortem examination revealed pericardial dissemination of pulmonary adenocarcinoma. We suggest that the morphological variety of cells is an important finding to help distinguish pulmonary adenocarcinoma from malignant mesothelioma.
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