1.Intrapleural instillation of OK-432 for malignant pleural effusion.
Ho Yeong LIM ; Joo Hang KIM ; Young Hwan PARK ; Hyun Cheol CHUNG ; Joung Ju CHOI ; Seoung Goo CHOI ; Ho Geun KIM ; Jin Hyuk CHOI ; Nae Chun YOO ; Eun Hee KOH ; Joon CHANG ; Jae Kyung ROH
Journal of the Korean Cancer Association 1992;24(1):47-55
No abstract available.
Picibanil*
;
Pleural Effusion, Malignant*
2.The yield of malignancy for early fixation versus routine fixation of Pleural fluid samples
Ria Katrina B. Cortez ; Richard Baron B. Yee ; Jessie F. Orcasitas
Philippine Journal of Internal Medicine 2022;60(3):205-210
Background:
The etiology of pleural effusion remains unclear in nearly 20% of cases. One way to diagnose malignancy is
by doing pleural fluid cytology. There are factors that influence the yield of pleural fluid cytology and one of them is appropriate and timely fixation of samples. Currently, there is no local consensus regarding the timing with which the specimen should be fixed.
Objective:
The study aims to compare the yield of malignancy between early fixation versus usual fixation of pleural fluid
samples, meaning there is no set time for fixation to be done.
Methodology:
The study employed a prospective cross-sectional research design. All patients with pleural effusion who
fulfilled the criteria set by the study were included. Two sets of pleural fluid samples were collected amounting to 20cc each. First sample was assigned as Bottle #1 and placed immediately with fixative while the second sample was assigned as Bottle #2. Bottle #2 underwent routine fixation which follows no fixed or standard time of fixation. The time difference between the fixation of two sample groups greatly varied with Bottle #1 fixed immediately right after collection while Bottle#2 depends on the time it will be processed by the laboratory personnel. Both samples were submitted for cell block and cell cytology reading.
Results:
Characteristics of the 55 patients included in the study showed age group range from 41 to 65 years of age, with 27 male and 28 female patients. Only one third had history of smoking. There were 21.82% who had family history of cancer and with and suspicious mass on chest radiograph. Out of 55 patients, 29 patients had history of previous diagnosis of cancer, 23 had recurrent pleural effusion, and 28 had chest radiograph with suspicious nodules. Based on gross appearance, there were 20 serous and 21 sanguineous pleural fluid noted. Mean cell count was high (1,115.50 ± 741.02) with lymphocytic predominance (82.56 ± 24.46). Elevated protein concentration (5,388.25 ± 8,230.46) and LDH (484.17 ± 248.72) were noted. Glucose (8.78 ± 6.68 mmol/L) was low. There were 21 patients who had high WBC, 24 with high protein and 16 with elevated LDH. There were 3 patients who were positive for AFB and none for KOH. Comparative analysis showed that the pleural fluid samples assigned to the routinely fixed group which were handed to the nurse after thoracentesis, then forwarded to the laboratory through a ward laboratory aide or patient watcherfor fixation with with 95% alcoholby thelaboratory personnel significantly had a longer duration of 406.62 minutes as compared to immediately fixed at 12.27 minutes (P<0.01). For diagnosis of malignancy, significantly more cases were diagnosed in the immediately fixed group with 36.36% cases versus 18.18% (p=0.016).
Conclusion
Among patients with suspected malignant pleural effusions, early fixation of pleural fluid samples resulted in
higher histopathology yields as compared to those fixed after going through the routine fixation.
Pleural Effusion, Malignant
3.A Case of Papillary Thyroid Cancer Presenting as Pleural Effusion.
Ki Hwan JUNG ; Ji A SEO ; Ju Han LEE ; Won Min JO ; Je Hyeong KIM ; Chol SHIN
Tuberculosis and Respiratory Diseases 2008;64(4):314-317
No abstract available.
Pleural Effusion
;
Pleural Effusion, Malignant
;
Thoracoscopy
;
Thyroid Gland
;
Thyroid Neoplasms
4.Malignant Pleural Effusion: Medical Approaches for Diagnosis and Management.
Tuberculosis and Respiratory Diseases 2014;76(5):211-217
Malignant pleural effusions (MPEs) are the second leading cause of exudative pleural effusions after parapneumonic effusions. In the vast majority of cases, a MPE signifies incurable disease associated with high morbidity and mortality. Considerable advances have been made for the diagnosis of MPEs, through the development of improved methods in the specialized cytological and imaging studies. The cytological or histological confirmation of malignant cells is currently important in establishing a diagnosis. Furthermore, despite major advancements in cancer treatment for the past two decades, management of MPE remains palliative. This article presents a comprehensive review of the medical approaches for diagnosis and management of MPE.
Diagnosis*
;
Disease Management
;
Mortality
;
Pleural Effusion
;
Pleural Effusion, Malignant*
5.Correlation of Gross Appearance or RBCs Numbers with Pleural Histocytology and Pleural Fluid Carcinoembryonic Antigen Values in Malignancy Associated Pleural Effusions.
Kang Hyun AHN ; Soo Jin PARK ; Jae Min PARK ; Jun Gu LEE ; Yoon Soo CHANG ; Seung Won CHOI ; Dong Kyu YANG ; Se Kyu KIM ; Joon CHANG ; Sung Kyu KIM ; Won Young LEE
Tuberculosis and Respiratory Diseases 1998;45(5):1031-1038
BACKGROUND: Most of malignant pleural effusions are serous but 8-33% of them are bloody. We wanted to evaluate the relationships between gross appearance and pleural CEA level or results of histocytology in malignancy associated pleural effusions. We also tried to reevaluate the meaning of CEA measurement in histocylogically proved or unproved malignancy associated pleural effusions. METHODS: We studied 98 cases of malignancy associated pleural effusions, 50 cases of histocylologically proven malignant effusions and 48 cases of histologically unproven paramalignant effusions. We had observed gross appearance and conventional laboratory values and CEA levees for pleural effusions. RESULTS: 44.9% of malignancy associated effusions were bloody(63.6% of bloody effusions were histstocytologically proven malignant effusion). 65.0% of malignancy associated pleural effusions which have RBCs numbers over 100,000/mm3 were cytologically proven malignant effusions. 72.7% of cytologically proven malignant effusions had increased pleural fluid CEA level over 10 ng/ml. 58.2% of cases with pleural CEA over 10ng/ml had positive results in pleural histocytology. There was no definable relationships between pleural fluid CEA elevation and RBCs numbers and results of pleural fluid cytology. CONCLUSION: About half of the cases with malignancy associated pleural effusions were bloody. Histocytologically proven malignant effusions were more common in bloody effusion than non-bloody effusion (63.6% Vs 38.9%). But increased red blood cell numbers was not associated with positivity of pleural histocytology. Pleural fluid CEA elevation(over 10 ng/ml) was not correlated with positive pleural histocytology. But pleural fluid CEA elevation was rare In nonmalignant pleural effusions, and than pleural CEA measurement in uncertain pleural effusions maybe helpful to distinguishes its origin.
Carcinoembryonic Antigen*
;
Erythrocytes
;
Pleural Effusion*
;
Pleural Effusion, Malignant
6.Ovarian Cancer That Was Initially Diagnosed as Malignant Pleural Effusion of Unknown Primary Origin
Toshihiko Fukuoka ; Eisuke Matsuoka ; Sahoko Chiba ; Satoshi Takayama ; Satoshi Ohno
Journal of Rural Medicine 2008;4(1):41-44
We report a case of adenocarcinoma detected in the right pleural effusion of a 75-year-old woman. Investigations failed to reveal the site of the primary lesion, and the case was treated as primary unknown cancer. The pleural effusion disappeared after chemotherapy; however, as there was serious bone marrow suppression, the clinical course was observed at an outpatient clinic without chemotherapy. A search for the primary lesion was repeated, but it was not found. One year after first admission, a chest X-ray showed left pleural effusion. Adenocarcinoma was detected in the effusion and a tumor mass obtained from the pleural cavity. Ovarian cancer was diagnosed based on the histological, serological and MRI findings. Thus, this was a rare case of ovarian cancer in which the diagnosis was confirmed by repeated evaluation and in which the initial diagnosis had been primary unknown cancer with malignant pleural effusion only.
Ovarian Cancer
;
Pleural Effusion, Malignant
;
Pleural Effusion
;
Unknown
;
Beginning
8.Intrapleural chemotherapy with cisplatin and cytarabine in the management of malignant pleural effusion.
Korean Journal of Medicine 2000;58(2):250-252
No abstract available.
Cisplatin*
;
Cytarabine*
;
Drug Therapy*
;
Pleural Effusion, Malignant*
9.TNF-alpha in the Pleural Fluid for the Differential Diagnosis of Tuberculous and Malignant Effusion.
Hye Jin KIM ; Kyeong Cheol SHIN ; Jae Woong LEE ; Kyu Jin KIM ; Yeong Hoon HONG ; Jin Hong CHUNG ; Kwan Ho LEE
Tuberculosis and Respiratory Diseases 2005;59(6):625-630
BACKGROUND: Determining the cause of an exudative pleural effusion is sometimes quite difficult, especially between malignant and tuberculous effusions. Twenty percent of effusions remain undiagnosed even after a complete diagnostic evaluation, including pleural biopsy. The activity of tumor necrosis factor-alpha (TNF-alpha), which is the one of proinflammatory cytokines, is increased in both infectious and malignant effusions. The aim of this study was to investigate the diagnostic efficiency of TNF-alpha activity in distinguishing tuberculous from malignant effusions. METHODS: 46 patients (13 with malignant pleural effusion, 33 with tuberculous pleural effusion) with exudative pleurisy were included. TNF-alpha concentrations were measured in the pleural fluid and serum samples using an enzyme- linked immunosorbent assay (ELISA). In addition, TNF-alpha ratio (pleural fluid TNF-alpha : serum TNF-alpha) was calculated. RESULTS: TNF-alpha concentration and TNF-alpha ratio in the pleural fluid were significantly higher in the tuberculous effusions than in the malignant effusions (p<0.05). However, the serum levels of TNF-alpha in the malignant and tuberculous pleural effusions were similar (p>0.05). The cut off points for the pleural fluid TNF-alpha level and TNF-alpha ratio were found to be 136.4 pg/mL and 6.4, respectively. The sensitivity, specificity and area under the curve were 81%, 80% and 0.82 for the pleural fluid TNF-alpha level (p<0.005) and 76%, 70% and 0.72 for the TNF-alpha ratio (p<0.05). CONCLUSION: We conclude that pleural fluid TNF-alpha level and TNF-alpha ratio can distinguish a malignant pleural effusion from a tuberculous effusion, and can be additional markers in a differential diagnosis of tuberculous and malignant pleural effusion. The level of TNF-alpha in the pleural fluid could be a more efficient marker than the TNF-alpha ratio.
Biopsy
;
Cytokines
;
Diagnosis, Differential*
;
Humans
;
Pleural Effusion
;
Pleural Effusion, Malignant
;
Pleurisy
;
Tuberculosis
;
Tumor Necrosis Factor-alpha*
10.Diagnostic Value of Cyfra 21-1 in Differential Diagnosis of Pleural Effusion.
Hak Jun LEE ; Kwan Ho LEE ; Kyeong Cheol SHIN ; Chang Jin SHIN ; Hye Jung PARK ; Yeung Chul MUN ; Kyung Hee LEE ; Jin Hong CHUNG ; Myung Soo HYUN ; Hyun Woo LEE
Tuberculosis and Respiratory Diseases 1999;47(1):50-56
BACKGROUND: Pleural effusion is a common clinical problem and many clinical and laboratory evaluations, such as tumor marks, have been studied to discriminate malignant pleural fluid from benign pleural fluid. However their usefulness in the diagnosis of pleural effusion is still not established fully. We studied the diagnostic value of cyfra 21-1 in diagnosis of malignant pleural effusion. METHODS: Pleural fluid was obtained from 45 patients with malignant diseases(32 lung cancer patients, 13 metastatic malignant diseases) and 47 patients with benign diseases. The level of cyfra 21-1 in the pleural fluid and serum were determined using a CYFRA 21-1 enzyme immunoassay kit(Cis-Bio International Co.). The t-test was used for comparison between two diseases groups and receiver operating characteristic(ROC) curves were constructed by calculating the sensitivities and specificities of the cyfra 21-1 at several points to determine the diagnostic accuracy of the cyfra 21-1. RESULTS: In patients with primary lung cancer, the level of cyfra 21-1 in the pleural fluid was significantly higher than those of patients with benign diseases and had positive correlations between the level of cyfra 21-1 in the pleural fluid and serum levels. In the ROC curve analysis of the pleural fluid, the curve for primary lung cancer group was located closer to the left upper corner and the cut off value, sensitivity and specificity of the cyfra 21-1 of the primary lung cancer group was determined as 22.25ng/ml, 81.8% and 78.7% respectively. CONCLUSIONS: Our data indicates that the measurement of cyfra 21-1 level in pleural effusion has useful diagnostic value to discriminate malignant pleural effusion in primary lung cancer from benign pleural effusion.
Diagnosis
;
Diagnosis, Differential*
;
Humans
;
Immunoenzyme Techniques
;
Lung Neoplasms
;
Pleural Effusion*
;
Pleural Effusion, Malignant
;
ROC Curve