1.Clinical, subclinical characteristics and treatment results of 768 patients with pleural effusion
Huong Thi Trinh ; Chau Quy Ngo
Journal of Medical Research 2007;53(5):72-79
Background: A pleural effusion is an abnormal collection of fluid in the pleural space resulting from excess fluid production or decreased absorption. It is the most common manifestation of pleural disease. Objective: To evaluate the etiological, clinical, subclinical characteristics and treatment results of patients with pleural effusions. Subjects and method: This was a retrospective, descriptive study on 768 patients with pleural effusion, who were treated in Department of Respiratory of Bach Mai Hospital, from January 2001 to October 2003. The information was taken from clinical records of patients. Results and conclusions: The causes of pleural effusion were tuberculosis 37.6%, lung cancer 23.8%, pneumonia or lung abscess 8.0%, chronic heart failure disease 7.1%, liver cirrhosis 3.5%, others causes 6.7% of cases. The patients presented with chest pain 81.6%, dyspnea 75.1%, cough 43.8%, expectoration 29.7%, and fever 54.8%, pleural effusion syndrome 92.2% of cases. On chest X-ray images, 75.3% of cases had Damoiseau curve. Pleural ultrasound demonstrated free pleural effusion in 63.8% of cases, loculated pleural effusion and pleural compartmentalization in 19.8%. Rivalta test of pleural fluid was positive in 83.7% of cases, negative in 13.7%. Malignant cells found in pleural fluid of 21.2%. Histology of pleural biopsies demonstrated malignant in 17.4% of cases; in which mesothelioma 4.0%, pleural tuberculosis 30.5%; others 52.1%. After the treatment, recovery accounted for 6.3% of cases, amelioration 58.3%, and no amelioration 37.4%. 66.9% of cases were performed therapeutic thoracocentesis, 2.7% were performed pleural lavage.
Pleural Effusion/ therapy
;
pathology
;
diagnosis
3.Clinical analysis of thoracoscopy of 30 coalworker's pneumoconiosiswith pleural effusion cases.
Yandong LIANG ; Ruiling JIANG ; Chunxiao YU ; Cheng HUANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2015;33(7):541-543
OBJECTIVETo investigate the diagnostic value of thoracoscopy on idiopathic coalworker's pneumoconiosis with pleural effusion in general medicine.
METHODRoutine (general medicine) thoracoscopyof patients suffering from iIdiopathiccoalworker's pneumoconiosis with pleural effusion, pathological examination of lesions obtained (direct vision).
RESULTPathological examination revealed grayish-white miliary nodules with multiple protruding nodules, irregular focal pleura thickening, pulmonary congestion, edema, fibrous adhesion. Thorascopy produced a diagnostic rate of 93.3%. Confirmed cases includes 13 cases of tuberculous pleurisy, 11 cases of malignant pleural effusion, 4 cases of cardiac insufficiency with pleural effusion and 2 cases of idiopathic pleural effusion, with no serious complications.
CONCLUSIONThoracoscopy of idiopathic coalworker's pneumoconiosis with pleural effusion is a safe, accurate diagnostic methodin general medicine, and could benefit the establishment of a treatment method quickly, visual observation of the lesions of patients suffering from coalworker's pneumoconiosis with pleural effusion using thoracoscopy, and at the same time offer preliminary investigationof the correlation between the intensity and compactibilityof coal macule distribution and clinical stages of coalworker's Pneumoconiosis.
Anthracosis ; diagnosis ; Heart Failure ; diagnosis ; Humans ; Lung ; pathology ; Pleural Effusion ; diagnosis ; Pleural Effusion, Malignant ; diagnosis ; Pulmonary Edema ; diagnosis ; Thoracoscopy ; Tuberculosis, Pleural ; diagnosis
4.Intrahepatic biliary cystadenoma presenting with pleural effusion.
Yuan-quan YU ; Bing-hong LOU ; Hai-chao YAN ; Rui MA ; Yuan-liang XU ; Jing-hong XU ; Naamrata BHUGOWAR ; Yun JIN ; Shu-you PENG ; Jiang-tao LI
Chinese Medical Journal 2012;125(7):1355-1357
Hepatobiliary cystadenomas are rare cystic neoplasms that often occur in middle aged women. The exact etiology of these tumors is unknown. Diagnosis is often delayed in these cases. However, misdiagnosis and inappropriate treatment may result in unfavorable outcome. We report a case of hepatobiliary cystadenoma with pleural effusion. We also review the literature and discuss the current diagnostic and treatment modalities.
Bile Duct Neoplasms
;
diagnosis
;
pathology
;
Bile Ducts, Intrahepatic
;
pathology
;
Cystadenoma
;
diagnosis
;
pathology
;
Female
;
Humans
;
Middle Aged
;
Pleural Effusion
;
diagnosis
;
pathology
5.Chylous pleural effusion caused by mediastinal angiomyolipomas.
Wei-li HAN ; Jian HU ; Aizemaiti RUSIDANMU ; Shu-sen ZHENG
Chinese Medical Journal 2012;125(5):945-946
Classical angiomyolipomas are benign tumors composed of various tissues, including fat, abnormal blood vessels and smooth muscle cells. The present study reports a male patient affected by mediastinal angiomyolipomas with massive chylous pleural effusion. The tumors were characterized with histological and immunohistochemical methods.
Angiomyolipoma
;
complications
;
Humans
;
Male
;
Mediastinum
;
pathology
;
Middle Aged
;
Pleural Effusion
;
diagnosis
;
etiology
6.Differential diagnostic value of B72.3, Ber-EP4 and calretinin in serous effusions.
Xiang-ju LI ; Qin-jing PAN ; Gui-hua SHEN ; Xiu-yun LIU ; Yun-tian SUN
Chinese Journal of Oncology 2005;27(7):438-441
OBJECTIVETo determine the diagnostic value of B72.3, BerEP4 and calretinin in differentiating metastatic carcinoma cells from reactive mesothelial cells (RMC) in serous effusions by using immunocytochemical method (ICC), and to investigate the feasibility of ThinPrep (TP) preparation for ICC.
METHODSOne hundred fifty eight serous effusion specimens were examined by ICC on cell block (CB) sections (CB-ICC) using antibodies against of B72.3, BerEP4 and calretinin. Fourty-nine of the samples, ICC on ThinPrep slides (TP-ICC) and CB-ICC were performed concurrently.
RESULTSThe sensitivities of B72.3 and Ber-EP4 for detecting carcimoma cells were 76.9% and 69.2% respectively, and when combined the sensitivity was increased to 89.7%. The sensitivity and specificity of Calretinin for detecting mesothelial cells were 90.9% and 87.2% respectively. The sensitivity of B72.3 in differentiating cancer cells from reactive mesothelial cells by CB-ICC and TP-ICC was 78.9% and 68.4%. It was 78.9% and 68.4% of BerEP4 respectively. No statistical significance was observed between CB-ICC and TP-ICC in differentiating metastatic carcinoma cells from reactive mesothelial cells.
CONCLUSIONThe combination of antibodies of B72.3, Ber-EP4 and calretinin is quite helpful as an auxiliary in differentiating metastatic carcinoma cells from reactive mesothelial cells. ThinPrep preparation slides may effectively replace the cell block sections for ICC in differential diagnosis of serous effusions.
Antibodies, Monoclonal ; Antibodies, Neoplasm ; Ascitic Fluid ; metabolism ; pathology ; Calbindin 2 ; Cytodiagnosis ; Diagnosis, Differential ; Humans ; Pericardial Effusion ; diagnosis ; pathology ; Pleural Effusion, Malignant ; diagnosis ; pathology ; S100 Calcium Binding Protein G
7.Transudates in malignancy: still a role for pleural fluid.
Tanseli E GONLUGUR ; Ugur GONLUGUR
Annals of the Academy of Medicine, Singapore 2008;37(9):760-763
INTRODUCTIONThe aims of this study were to determine the distribution of transudates and exudates among pathologically proven malignant pleural effusions, and to demonstrate the necessity for cytologic studies in patients with a transudative effusion.
MATERIALS AND METHODSThis study is a retrospective review of all subjects diagnosed with malignant or paramalignant pleural effusion over a 10-year period at a tertiary hospital. The study included 67 subjects with malignant mesothelioma, 45 subjects with metastatic disease, and 36 subjects with paramalignant effusions.
RESULTSThere were 55 female and 93 male subjects; the mean age of the sample was 62 years. Malignant pleural effusions were transudative in 1.5% of malignant mesotheliomas, 6.8% of metastatic diseases, and 11.1% of paramalignant effusions.
CONCLUSIONSCytological examination of pleural fluid in patients with unexplained transudative effusion is essential to rule out malignant processes.
Cohort Studies ; Exudates and Transudates ; Female ; Humans ; Male ; Mesothelioma ; diagnosis ; pathology ; Middle Aged ; Pleural Effusion, Malignant ; pathology ; Pleural Neoplasms ; diagnosis ; pathology ; secondary ; Retrospective Studies
8.Application of combined telomerase activity analysis and immunocytochemistry in cytopathologic diagnosis.
Yan LIU ; Mei-lin XU ; Jing WANG ; Bing-quan WU ; Hao-hao ZHONG ; Wei-gang FANG
Chinese Journal of Pathology 2012;41(3):181-185
OBJECTIVETo evaluate the application of traditional cytomorphology, telomerase activity analysis and immunocytochemistry in cytopathologic diagnosis of pleural effusion and bronchoalveolar lavage samples.
METHODSA total of 123 agar-paraffin double-embedded pleural effusion and bronchoalveolar lavage fluid samples were enrolled into study. The cytomorphologic features were reviewed and correlated with immunocytochemical findings and telomerase activity.
RESULTSTelomerase activity was detected in 53 specimens using the real-time telomeric repeat amplification protocol. Amongst the cases studied, 39 samples (31.7%) contained overtly malignant cells while 20 cases (16.0%) were equivocal by conventional cytology. After verification by immunocytochemistry and clinical follow-up data, the diagnostic accuracy of telomerase activity and cytology was 87.0% and 82.1%, respectively. The sensitivity (97.6%) and specificity (100.0%) of cytology examination, when combined with telomerase activity analysis, were greater than those of cytology examination or telomerase activity analysis alone.
CONCLUSIONSTelomerase activity analysis can be used as an adjunctive investigative tool in cytology assessment of pleural effusion and bronchoalveolar lavage samples. The diagnostic accuracy can be further improved with the application of immunocytochemistry on agar-paraffin double-embedded cell block tissues.
Breast Neoplasms ; diagnosis ; enzymology ; pathology ; Bronchoalveolar Lavage Fluid ; chemistry ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; diagnosis ; enzymology ; pathology ; Pleural Effusion ; diagnosis ; enzymology ; pathology ; Pleural Effusion, Malignant ; diagnosis ; enzymology ; pathology ; Sensitivity and Specificity ; Telomerase ; metabolism
9.Medical thoracoscopy in the diagnosis of complicate pleural effusion.
Hong-Zhong YANG ; Cheng-Ping HU ; Hua-Ping YANG ; Su-Jie QU
Journal of Central South University(Medical Sciences) 2007;32(1):160-162
OBJECTIVE:
To evaluate the role of medical thoracoscopy in the diagnosis of the pleural effusion of unknown etiology.
METHODS:
The results of 36 patients with the pleural disease of unknown etiology diagnosed by medical thoracoscopy were retrospectively analyzed, including the pathologic results and the complications.
RESULTS:
Among the 36 patients, 35 were determined with positive rate of 97.2%, and no serious complications was found.
CONCLUSION
Medical thoracoscopy is an important method of diagnosing complicate pleural effusion, and has high positive rate. It is a simple operation, with no serious complication, and fast recovery.
Adolescent
;
Adult
;
Aged
;
Female
;
Humans
;
Male
;
Middle Aged
;
Pleural Effusion
;
diagnosis
;
pathology
;
Pleural Neoplasms
;
diagnosis
;
pathology
;
Retrospective Studies
;
Sensitivity and Specificity
;
Thoracoscopy