Title: Cells in pleural fluid and their value in differential diagnosis
Authors: Dr Mohammed Abdul Sameer, Dr Priyanka Rameshchandra Chandak, Dr Umme Ammarah Farooqui
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.89
Abstract
Background: Both non-malignant and malignant causes of effusion can be identified by relatively non-invasive technique of pleural fluid cytology. With this basis the present study on cytology of pleural fluids was taken up. The cytological study of body effusions is a complete diagnostic modality which aims at pointing out the etiology of effusion as well as in certain cases a means of prognostication of the disease process.
Materials and Methods: Sixty samples of pleural fluid were examined for total cell count, cell type and cellular features and AFB staining. They were also subjected to biochemical study to fluids out the level of protein and glucose and ADA level. .
Results: The medical records of all 60 patients with pleural effusion were available for review. The ages of the patients ranged from four years to 75 years, with maximum cases (29.36%) in the sixth decade. Male preponderance of effusion was noted; the ratio of male to female being 1.2:1. Of all the effusions, 31.19% were hemorrhagic; 26.61% turbid, 23.85% clear, 11.93% purulent, 3.67% viscous and 2.75% opalescent. Transudates comprised 18% of cases. Most of them were secondary to cirrhosis and congestive cardiac failure.
Overall 82% of pleural effusions were exudative in nature. The most frequent cause of exudative effusion was tuberculosis (39.02%) followed by malignancy (30.49%), paramalignancy (8.54%), pneumonia (7.32%), and empyema (4.89%).
Conclusions: The most useful test in establishing the diagnosis of pleural effusion is pleural fluid cytology and pleural fluid cell count. Cytologic study of pleural fluid is a complete diagnostic modality which aims at pointing out the etiology of effusion as well as, in certain cases, a means of prognostication of disease process.
Keywords: Effusion; pleural fluid; malignant effusion.
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