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

Humans ; Mesothelioma/pathology* ; Mesothelioma, Malignant ; Pleural Neoplasms/diagnosis* ; Pleural Effusion, Malignant ; Pleural Effusion/pathology*

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

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

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

Pleural effusion in chronic myeloid leukemia (CML) is poorly understood and rarely reported in the literature. When the pleural effusion is caused by leukemic pleural infiltration, the differential white blood cell count of the effusion is identical to that of the peripheral blood, and the fluid cytology reveals leukemic blasts. We report here a case of bilateral pleural involvement of atypical CML in an 83-yr old male diagnosed with pancreatic cancer with abdominal wall metastasis and incidental peripheral leukocytosis. Based on bone marrow examination, chromosome analysis and polymerase chain reaction he was diagnosed with Philadelphia chromosome negative, BCR/ABL gene rearrangement negative CML. Following 3 months of treatment with gemcitabine for pancreatic cancer, he developed bilateral pleural effusions. All stages of granulocytes and a few blasts were present in both the pleural fluid and a peripheral blood smear. After treatment with hydroxyurea and pleurodesis, the pleural effusion resolved.
Pleural Effusion/*etiology/pathology ; Male ; Leukemic Infiltration/*pathology ; Leukemia, Myeloid, Chronic/complications/*pathology ; Humans ; Aged, 80 and over ; Aged

Both T helper IL-17-producing cells (Th17 cells) and regulatory T cells (Tregs) have been found to be increased in malignant pleural effusion (MPE). However, the possible imbalance between Th17 cells and Tregs, as well as the association of Th17/Treg and Th1/Th2 cells in MPE remains to be elucidated. The objective of the present study was to investigate the distribution of Th17 cells in relation to Tregs, as well as Th1/Th2 balance in MPE. The number of Th17, Tregs, Th1, and Th2 cells in MPE and peripheral blood was determined by using flow cytometry. The relationship among the number of Th17, Tregs, Th1, and Th2 cells was explored. It was found that the number of Th17, Tregs, Th1, and Th2 cells was all increased in MPE as compared with the corresponding peripheral blood. The number of Th17 cells was correlated negatively with Tregs in MPE, but not in blood. Th17 cells and Th17/Treg ratio were positively, and Tregs were negatively, correlated with Th1 cells, but not with either Th2 cells or Th1/Th2 ratio in MPE. This study supports earlier data that both Th17 cells and Treg are present at higher frequencies in MPE than in the autologous blood. For the first time, we show that Th17/Treg imbalance exists in MPE.
Adult ; Female ; Humans ; Male ; Middle Aged ; Pleural Effusion, Malignant ; immunology ; pathology ; T-Lymphocytes, Regulatory ; immunology ; pathology ; Th17 Cells ; immunology ; pathology

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

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

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