Congenital pulmonary lymphangiectasis resulting in pleural effusions managed by thoracoamniotic shunting

Background: The cytology and the support of clinical symptoms, biochemistry for diagnosis of the cases of effusions are very important. Objectives: - To describe some of clinical symptoms and biochemistry of effusions. - To compare the results between cytology and biochemistry by the causes of pleural, peritoneal fluids. Material & Method: A cross-sectional study to describe all of 47 patients with pleural, peritoneal effusions examinated by cytology in the Hospital of Hue University of Medicine and Pharmacy from April 2013 to January 2014. Results: In 47 cases with effusions, pleural effusion accounting for 55.32%, following peritoneal effusions 29.79% and 14.89% with both of them. The most common symptoms in patients with pleural effusions were diminished or absent tactile fremitus, dull percussion, diminished or absent breath sounds (100%), in patients with peritoneal effusions was ascites (95.24%). 100% cases with pleural effusions, 50% cases with peritoneal effusions and 80% cases with pleural and peritoneal effusions were exudates. The percentage of malignant cells in patients with pleural effusions was 26.92%, in peritoneal effusions was 28.57%, in pleural and peritoneal effusions was 42.86%. The percentage of detecting the malignant cells in patients with suspected cancer in the first test was 57.14%, in the second was 9.53% and 33.33% undetectable. Most of cases which had malignant cells and inflammatory were exudates, all of the cases which had a few cells were transudates. Besides, 7.5% cases which had high neutrophil leukocytes were transudates. Conclusion: Cytology should be carry out adding to the clinical examinations and biochemistry tests to have an exact diagnosis, especially for the malignant ones. For the case with suspected cancer, we should repeat cytology test one more time to increase the ability to detect malignant cells. Key words: Effusion, pleural effusion, peritoneal effusion, cytology, biochemistry

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Faculty Opinions recommendation of What is the best treatment for malignant pleural effusions?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13179956.14518054 ◽

2011 ◽

Author(s):

Paul Van Schil

Keyword(s):

Pleural Effusions ◽

Malignant Pleural Effusions

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Faculty Opinions recommendation of Quantitative diagnosis of malignant pleural effusions by single-cell mechanophenotyping.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718183868.793488441 ◽

2013 ◽

Author(s):

Jan Lammerding

Keyword(s):

Single Cell ◽

Pleural Effusions ◽

Quantitative Diagnosis ◽

Malignant Pleural Effusions

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Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

Journal of Fatima Jinnah Medical University ◽

10.37018/jfjmu.558 ◽

2020 ◽

Vol 13 (4) ◽

pp. 184-190

Author(s):

Muhammad Irfan ◽

Abdul Rasheed Qureshi ◽

Zeeshan Ashraf ◽

Muhammad Amjad Ramzan ◽

Tehmina Naeem ◽

...

Keyword(s):

Pleural Effusion ◽

Diagnostic Accuracy ◽

Pleural Fluid ◽

Gold Standard ◽

Pleural Effusions ◽

Diagnostic Efficacy ◽

Chest Sonography ◽

X Ray ◽

Non Invasive ◽

Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard. Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

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Adenosine deaminase in pleural effusions with special reference to tuberculous effusions

Asian Pacific Journal of Health Sciences ◽

10.21276/apjhs.2016.3.4.11 ◽

2016 ◽

Vol 3 (4) ◽

pp. 75-79

Author(s):

B. Praveen Kumar ◽

◽

C. Venkateshwarlu ◽

M. Narendra ◽

◽

...

Keyword(s):

Special Reference ◽

Adenosine Deaminase ◽

Pleural Effusions

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Management of Pleural Effusions in the Emergency Department.

Reviews on Recent Clinical Trials ◽

10.2174/1574887115666200624194457 ◽

2020 ◽

Vol 15 ◽

Author(s):

MT Congedo ◽

GM Ferretti ◽

D Nachira ◽

MA Pennisi

Keyword(s):

Emergency Department ◽

Systematic Approach ◽

Acute Chest Pain ◽

Pleural Effusions ◽

Therapeutic Approaches ◽

Massive Pleural Effusion ◽

Emergency Department Setting ◽

Clinical Conditions ◽

Definitive Management

Background: In symptomatic patients, admitted in emergency department for acute chest pain and dyspnea, who require an urgent treatment, a rapid diagnosis and prompt management of massive pleural effusion or hemothorax can be lifesaving. The aim of this review was to summarize the current diagnostic and therapeutic approaches for the management of the main types of pleural effusions that physicians can have in an emergency department setting. Methods: Current literature about the topic was reviewed and critically reported, adding the experience of the authors in the management of pleural effusions in emergency settings. Results: The paper analyzed the main types of pleural effusions that physicians can have to treat. It illustrated the diagnostic steps by the principal radiological instruments, with a particular emphasis to the role of ultrasonography, in facilitating diagnosis and guiding invasive procedures. Then, the principal procedures, like thoracentesis and insertion of small and large bore chest drains, are indicated and illustrated according to the characteristics and the amount of the effusion and patient clinical conditions. Conclusion: The emergency physician must have a systematic approach that allows rapid recognition, clinical cause identification and definitive management of potential urgent pleural effusions.

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