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
Related Articles
- EP ID EP575943
- DOI 10.9790/0853-1701042130.
- Views 52
- Downloads 0
Gorlin-Goltz syndrome – a case report
Gorlin-Goltz syndrome or basal cell nevus bifid rib syndrome is a genetic disorder characterized by the presence of multiple odontogenic keratocysts. Odontogenic keratocyst (OKC) is a developmental cyst of epithelial ori...
Ultrasound morphology of the thyroid gland among pregnant women in the moderate iodine deficient region of Lubumbashi, DR Congo
Background: Iodine deficiency occurs in varying degrees worldwide. When it occurs during pregnancy, it leads to morphological and functional changes in the maternal thyroid gland with fatal consequences on the pregnancy’...
A Prospective Study on Clinicopathological Correlation of Perforative Peritonitis in a Rural Based Tertiary Care Hospital
Perforative peritonitis is the most common surgical emergency in India. The aim of the study was to highlight the presentation of perforative peritonitis as encountered by us at Bankura Sammilani Medical College and Hosp...
An Indian Perspective of ‘Medical Terrorism’ – Neologism of An old Predicament
here are good and dedicated doctors out there. This article is not about them. The contents and views expressed in this article is about the greedy "black sheep" and in no ways reflect anyone professional in particular.
A Cone-Beam Computed Tomography Study of the Root Canal Morphology of Mandibular First Premolars in an Indian Subpopulation
Introduction: Successful root canal therapy requires an in-depth knowledge of root canal morphology. The aim of this study was to investigate root canal morphology in mandibular first premolars in an Indian subpopulation...