Cytological Study of Pleural Effusions and its Utility in Clinical Approach
Keywords:
Pleural fluid cytology, Benign effusion, reactive mesothelial cells, malignant effusions
Abstract
Background: Cytological analyses of pleural effusions play an important role in the diagnosis of various lesions. Most importantly it gives a significant contribution in diagnosis and management.Methods: A retrospective study for one year duration from January 2015 to December 2015 was conducted in the Cytology section, Department of Pathology, Govt. Medical College & Sir- T hospital Bhavnagar. Pleural fluids which were come for cytological analysis from all the departments are included in the study, then physical examination and microscopy done by staining with Gimsa, Papanicolaou stain and Hematoxylin and Eosin Stains for evaluation.Result: 295 cases of pleural effusion evaluated in which 29% are female and 71% are male and 12% of effusions are Bilateral, 32% are left sided, 57% right sided pleural effusion, 95% non Malignant lesions and only in 5% of cases were reported as malignant and further non-malignant lesions comprises of pleural effusions with reactive mesothelial cells 11% while remaining fluids 40% are of lymphocytic predominant effusions and 13% are of acute inflammatory conditions with abundant polymorphs, remaining 36% of pleural effusions were scant-cellular and have no suggestive role by cytological evaluation.Conclusion: This study showed that meticulous evaluation of the pleural fluids for their cytological properties will help the clinicians in clinching the diagnosis as well as early approach in management of these cases. DOI: 10.21276/APALM.1277References
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7. Sahn SA. Pleural effusions of extravascular origin. Clin Chest Med. 2006;27(2):285-308.
8. Light RW. The undiagnosed pleural effusion. Clin Chest Med. 2006;27(2):309-319.
9. Heffner JE. Diagnosis and management of malignant pleural effusions. Respirology. 2008;13(1):5-20.
10. Bouros D, Pneumatikos I, Tzouvelekis A. Pleural involvement in systemic autoimmune disorders. Respiration. 2008;75(4):361-71.
11. Dekker A, Bupp PA. Cytology of serous effusions. An investigation into the usefulness of cell blocks versus smears. Am J ClinPathol. 1978;70:855-860.
12. Loddenkemper R, Boutin C. Thoracoscopy diagnostic and therapeutic indications. EurRespir J. 1993;6:1544-1555.
13. Kalomenidis J. New advances in the investigation of pleural diseases. Pneumologie. 2003;16:247-251.
14. Hurwitz S, Leiman G, Shapiro C. Mesothelial cells in pleural fluid TB or not TB. S AfrMed J. 1980;57:937-939.
15. Epstein DM, Kline RM, Albelda SM, Miller WT. Tuberculous pleural effusions. Chest. 1987;91:106-109.
16. Light RW. Establishing the diagnosis of tuberculous pleuritis. Arch Intern Med 1998;158:1967-1968.
17. Sahn SA. The value of pleural fluid analysis. Am J Med Sci. 2008;335(1):7-15.
18. Sakuraba M, Masuda K, Hebisawa A, Sagara Y, Komatsu H. Pleural effusion adenosine deaminase (ADA) level and occult tuberculous pleurisy. Ann Thorac Cardiovasc Surg. Oct 2009; 15(5):294-6.
2. Kushwaha R, Shashikala P, Hiremath S, Basavaraj HG. Cells in pleural fluid and their value in differential diagnosis. J Cytol. 2008;25(4):138-143.
3. BedrossianW. Diagnostic problems in serous effusions. Diagn Cytopathol.1998;19(2): 131-137.
4. Pereira TC, Saad RS, Liu Y, Silverman JF. The diagnosis of malignancy in effusion cytology: A pattern recognition approach. Adv Anat Pathol. 2006;13:174-184.
5. Awasthi A, Gupta N, Srinivasan R, Nijhawan R, Rajwanshi A. Cytopathologic spectrum of unusual malignant effusions at a tertiary care centre in North India. Cytopathol. 2007;18:28-32.2211
6. Geisinger KR, Stanley MW, Raab SS, Siverman JF, Abati A. Modern Cytopathology. Philadelphia Churchill Livingstone; 2004.
7. Sahn SA. Pleural effusions of extravascular origin. Clin Chest Med. 2006;27(2):285-308.
8. Light RW. The undiagnosed pleural effusion. Clin Chest Med. 2006;27(2):309-319.
9. Heffner JE. Diagnosis and management of malignant pleural effusions. Respirology. 2008;13(1):5-20.
10. Bouros D, Pneumatikos I, Tzouvelekis A. Pleural involvement in systemic autoimmune disorders. Respiration. 2008;75(4):361-71.
11. Dekker A, Bupp PA. Cytology of serous effusions. An investigation into the usefulness of cell blocks versus smears. Am J ClinPathol. 1978;70:855-860.
12. Loddenkemper R, Boutin C. Thoracoscopy diagnostic and therapeutic indications. EurRespir J. 1993;6:1544-1555.
13. Kalomenidis J. New advances in the investigation of pleural diseases. Pneumologie. 2003;16:247-251.
14. Hurwitz S, Leiman G, Shapiro C. Mesothelial cells in pleural fluid TB or not TB. S AfrMed J. 1980;57:937-939.
15. Epstein DM, Kline RM, Albelda SM, Miller WT. Tuberculous pleural effusions. Chest. 1987;91:106-109.
16. Light RW. Establishing the diagnosis of tuberculous pleuritis. Arch Intern Med 1998;158:1967-1968.
17. Sahn SA. The value of pleural fluid analysis. Am J Med Sci. 2008;335(1):7-15.
18. Sakuraba M, Masuda K, Hebisawa A, Sagara Y, Komatsu H. Pleural effusion adenosine deaminase (ADA) level and occult tuberculous pleurisy. Ann Thorac Cardiovasc Surg. Oct 2009; 15(5):294-6.
Published
2017-09-01
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