Objective: To determine if eosinophilic cytoplasmic inclusions (Melamed-Wolinska bodies) (ECIs) can help to distinguish metastatic transitional cell carcinoma (TCC) from pulmonary carcinoma (PC) in pleural effusions.
Study design: The presence of ECIs was evaluated in malignant pleural effusions from 8 cases (5 patients) of TCC and 38 cases of pulmonary carcinoma (PC). ECIs were categorized as absent, rare (< 2 per case), occasional (2 per case to < 1 per high-power field), frequent (1-2 per high-power field) or numerous (> 2 per high-power field).
Results: In pleural fluids with TCC, ECIs were numerous in 1 case, frequent in 2 cases, occasional in 3 cases and absent in 2 cases. In contrast, in pleural fluids with PC, ECIs were occasional in 1 case, rare in 5 cases and absent in 32 cases.
Conclusion: While not present in every case, frequent ECIs in a malignant pleural effusion are suggestive of TCC rather than PC.