Hemorrhagic effusions in pleural tuberculosis: Need for correlation with pleural biopsy histopathological patterns
Journal Title: MedPulse -International Medical Journal - Year 2016, Vol 3, Issue 8
Abstract
Pleural tuberculosis is a major treatable cause of exudative pleural effusions in India. Rarely these patients present with hemorrhagic effusion. Due to the similar constitutional symptoms, it becomes important to rule out malignancy in these patients by pleural biopsy. The lack of well formed granuloma formation in all cases of pleural tuberculosis leads to a diagnostic dilemma. Therefore, we retrospectively analyzed the histopathological features of pleural biopsies of tuberculosis patients who presented with hemorrhagic pleural effusion to the V.P Chest Institute from January 2009 to January 2015. These included 10 males and 2 females, age ranging from 33 to 80 years, mean of 65 years. The adequate biopsies (n=11) were histopathologically analysed and revealed, chronic lymphocytic pleuritis in 4 cases (44.44%), epithelioid granuloma formation in 3 cases (33.34%), necrosis in one case (11.12%) and fibrosis was seen in one case of nonresolving effusion (11.11%). The present study shows that the histopathological patterns of tubercular involvement of pleura vary depending upon the stage of involvement and epithelioid cell granulomas may not be identified in all cases. The knowledge of the histopathological patterns is necessary to accurately identify these cases who present with hemorrhagic pleural effusions and improve patient outcome.
Authors and Affiliations
Ritu Kulshrestha, Himani Singh, Apoorva Pandey
Keywords
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