Study of Etiology and Diagnostic Modalities of Neoplastic Pleural effusion in a Tertiary Care Teaching Hospital
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Aims and Objectives: Pleural effusion is not a disease by itself but a manifestation of various pathological states. The present study focuses on cases of neoplastic pleural effusion requiring hospitalisation in a Medical college with aim to: 1. Pathological classification of malignancy associated with pleural effusion 2. Evaluate role of different diagnostic modalities. 3. Assess the time span of diagnostic methods. Materials and methods: This is a prospective observational study over one year (Feb 2014 – Feb 2015) among 84 adult cases hospitalised in I.P.G.M.E & R., Kolkata. Pleural fluid assessment (biochemical, cytological, bacteriological) and common procedures like closed pleural biopsy using Cope needle, image guided CT/ USG FNAC/Biopsy from approachable intrathoracic lesions, flexible bronchoscopy and FNAC/ biopsy from peripheral lymph nodes were performed. Results: Total 84 patients was included in the study with mean age: 55.55 years with neoplastic pleural effusion. Metastasis from primary lung malignancy (86.9%), other metastatic malignancy (5.95%, from breast, cervix & thyroid) Lymphoma(4.76%) and malignant mesothelioma (1.19%). Adenocarcinoma was the commonest lung malignancy (39.29%) followed by, squamous cell carcinoma (22.62%) undifferentiated non small cell lung carcinoma (19.05%) and small cell carcinoma (4.76%). Surprisingly, pleural biopsy has given the highest yield (93.62%) and followed by FNAC from peripheral lymph nodes or nodules (83.33%). Median time span of diagnosis is 4 days among cytology based tests, 9 days in biopsy based tests and 16 days if immunohistochemistry is combined. Iatrogenic hydropneumothorax has been seen after pleural biopsy in around 7% cases. Conclusion: Neoplastic pleural effusions require multiple diagnostic modalities to reach the etiology. Closed pleural biopsy is a valuable diagnostic procedure in the absence of thoracoscopy.
Authors and Affiliations
Dr. Arnab Sit, Dr. Ira Das, Dr. Surajit Chatterjee, Dr. Pulak Kumar Jana, Dr. Somenath Kundu
Keywords
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- EP ID EP575943
- DOI 10.9790/0853-1701042130.
- Views 34
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