Abstract
Serous cavity effusions in children are usually related to infectious diseases, and malignant effusions are distinctly uncommon. The latter, when seen, typically include malignant tumors of the small round blue cell family such as neuroblastoma, nephroblastoma, Wilms’ tumor, hepatoblastoma, and rhabdomyosarcoma. In one large series (Wong et al. ), the incidence was lymphoma and leukemia (52%), neuroblastoma (14%), Wilms’ tumor (9%), gonadal and extragonadal germ cell neoplasms (8%), bone and soft tissue sarcomas (7%), epithelial neoplasms (5%), Ewing’s sarcoma/PNET (2%), and other neoplasms (3%). Cancers were encountered in 47% of pleural fluids, 23% of ascitic fluids, 27% of peritoneal washings, and 43% of pericardial fluids. Pleural fluids were the most common specimen type and showed the highest proportion of positivity. Others (Hallman and Geisinger) have shown that the major diagnostic difficulty in interpreting pediatric effusion cytology is in distinguishing neoplasms of the small-cell type from mononuclear inflammatory cells. The usefulness of peritoneal washings in pediatric patients is similar to that in adults.
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