Clinical Characteristics and Prognosis of Lymphocyte Dominant Exudative Pleural Effusion with Low ADA, Low CEA, Negative Cytology and Negative AFB Smear.
- Author:
Young Ae KANG
1
;
Young Soon YOON
;
Sei Won LEE
;
Chang Min CHOI
;
Deog Kyeom KIM
;
Hee Seok LEE
;
Dong Seok KO
;
Chul Gyu YOO
;
Young Whan KIM
;
Sung Koo HAN
;
Young Soo SHIM
;
Jae Joon YIM
Author Information
- Publication Type:Original Article
- Keywords: Pleural effusion; Etiology; Prognosis
- MeSH: Adenosine Deaminase; Anti-Bacterial Agents; Arteries; Carcinoembryonic Antigen; Chylothorax; Diagnostic Tests, Routine; Humans; Kidney Failure, Chronic; Liver Cirrhosis; Lymphocytes*; Medical Records; Pleural Effusion*; Prognosis*; Pulmonary Embolism; Retrospective Studies; Tuberculosis, Pulmonary
- From:Tuberculosis and Respiratory Diseases 2005;58(1):5-10
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND: A pleural effusion is a common medical problem. Despite several diagnostic tests, 15-20% of pleural effusions go undiagnosed. The aim of this study was to evaluate the clinical characteristics and prognosis of a lymphocyte dominant exudative pleural effusion with a low adenosine deaminase (ADA), low carcinoembryonic antigen (CEA), negative cytology and negative acid fast bacilli (AFB) smear. METHOD: From Jan 2000 to Aug 2001, 43 patients with lymphocyte dominant exudative pleural effusions whose AFB smear and cytologic exam were negative, their pleural fluid ADA level was < 40 IU/L, and their CEA level was < 10 ng/mL were enrolled in this study. A retrospective analysis of the patients' medical records was carried out. RESULT: Among 31 of the 43 cases (72%), probable underlying diseases causing the pleural effusion were identified: 21cases of malignant diseases, 4 cases of liver cirrhosis, 2 cases of pulmonary tuberculosis, 1 case of end stage renal disease, 1 case of a chylothorax, 1 case of a post?CABG (coronary artery bypass graft) state, 1 case of a pulmonary embolism. No clinically suspected etiology was identified in the remaining 12 cases (28%). Of these 12 pleural effusions, 7 cases spontaneously resolved, 2 effusions resolved with antibiotics, and the other 2 cases were persistent. CONCLUSION: Lymphocyte dominant exudative pleural effusions with a low ADA, low CEA, negative cytological exam, and negative AFB smear, but without a definite cause might have a benign course and clinicians can observe them with attention.
