Objective The paper discussed the clinical value of differential diagnosis of pleural effusion by combined examination of exfoliative cytology and tumor markers,such as Carcinoembryonic-antigen(CEA),Carbohydrate-antigen1 9-9 (CA1 9-9),Cytoker-antin-1 9-fragment 21-1 (CYFRA21-1)and carbohydrate antigen 125 (CA125).Methods A total of 21 6 patients with pleural effu-sion were divided into malignant group containing 1 96 patients and benign group consisting of remaining patients.Aside from the conventional exfoliative cytology examination,by electrochemical luminescence immunoassay technology,the contents of tumor markers of CEA,CA1 9-9,CYFRA21-1,CA125 in the pleural effusion were measured.Finally,the data were statistically analyzed. Results In malignant group,the positive rate of exfoliative cytologic examination was 82.7%,in which adenocarcinoma accounted for 87.7%.The tumor markers in malignant group was significantly higher than that of benign group.The difference was statisti-cally significant (P < 0.05 ).The sensitivity of CEA is 52.0%,CA1 9-9 48.5%,CA125 41.9%,and the four tumor markers is 74.5%,respectively.For the combined examination of exfoliative cytology and tumor marke,the sensitivity is 96.4%,and specifici-ty is 80%,accuracy is 96.8%.Conclusion The exfoliative cytologic examination is one of the best ways to diagnose malignant pleu-ral effusion.The tumor marker detection is a useful auxiliary method for correct diagnosis and treatment.The sensitivity and accura-cy of the diagnosis of benign and malignant pleural effusion can be improved by the exfoliative cytologic examination combined with tumor marker detection.

Objective To analyze the CT features of primary pulmonary leiomyoma (PPL) and improve the diagnostic ability of PPL.Methods The CT findings and clinical characteristics were retrospectively analyzed in 6 patients with PPL proved by pathology,and the related literatures were reviewed.Results Six PPLs were single lesion from 3.0 to 8.5 cm in size,the shape was round or oval with extremely smooth margin.On CT plain scan,the CT values of all PPL lesions were 25-33 HU,4 lesions presented homogeneous moderate enhancement (40-60 HU) and 2 lesions presented inhomogeneous enhancement after contrast administration.A solid lesion showed obviously patchy enhancement with cystic degeneration,1 lesion presented ring enhancement.All lesions were benign histopathologically,the leiomyoma cells showed spindle shaped or in bundles with pseudocapsule,and with hyaline degeneration in 1 case.Smooth Muscle Actin (SMA) were all marked positive on immunohistochemistry.Conclusions CT findings of PPL have some characteristics,but lack of specificity,the final diagnosis still relies on pathological examination.