Title: Etiological, Radiological, Biochemical and Cytological Analysis of Pleural Effusion
Authors: Dr B.Satvik, Dr K. Spandana, Dr K. Aiswarya, Dr K. Rajani Devi
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.162
Abstract
Background: Pleural effusion is the excessive or abnormal accumulation of fluid in the pleural space. Pleural effusion is routinely facing problem in practice by general physician and chest physician. For better management of cases to obtain knowledge of clinical history and clinical signs of pleural effusion along with radiological, biochemical and cytological evaluation of pleural fluid help in narrowing the diagnosis.
Methods: In this, prospective study of 60 patients with pleural effusion with respect to age, Sex, presenting complaint, clinical history with radiological biochemical and cytological examination of pleural fluid are considered.
Results: In this prospective study of 60 patients with pleural effusion, them can age 11 to 75 years and two third were men. The most common type of pleural effusion is exudative effusion. The most common cause of exudative effusion in this study were tuberculosis (36), followed by malignancy (9), Transudative (8), Syn-pneumonic (5) and 2 cases of empyema (2). Pleural effusion were commonly seen in male patient with maximum number of cases in age group – 31-50. Pleuritic chest pain, fever, cough and breathlessness were common presenting complaint. The commonest clinical sign was stony dullness to percussion. Right side effusions were more common. Majority had moderate amount of pleural effusions. Blood count and ESR were significantly elevated in exudatives. Pleural fluid cytology revealed elevated Lymphocytes in tubercular and polymorphs in acute infections. Cytology for malignant cells were diagnostic in 4 cases.ADA was significantly elevated in tubercular pleural effusion. Exudatives had decreased glucose but increased protein, LDH and cholesterol compared to transudatives.
Conclusion: Tubercular effusion remains the commonest etiology of all exudative effusions in our study. It involves the young and is associated with fever and cough as the most common presenting symptom. Malignant effusion were seen in older age group with cough and dysponea as common symptoms. Massive effusion with haemorrhagic pleural fluid is commonly associated with malignant effusion
Keywords: Exudative, transudative, tubercular malignant, synpneumonic, empyema, pleural effusion.
