Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010

Hooper, Clare; Lee, Y. C. G.; Maskell, Nick A

doi:10.1136/thx.2010.136978

Cited by 668 publications

(782 citation statements)

References 151 publications

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“…The sample were divided into four sterile pots to be sent for microbiological, biochemical, cytological analysis and biomarker measurement (which was centrifuged at 1,000×g for 20 minutes, and supernatants were stored frozen at -80°C until assay) (Hooper et al, 2010).…”

Section: Pleural Fluid Collectionmentioning

confidence: 99%

Clinical Impact and Reliability of Carbonic Anhydrase XII in the Differentiation of Malignant and Tuberculous Pleural Effusions

Liu¹,

Jing²,

Guo³

2013

Asian Pacific Journal of Cancer Prevention

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Objective: To assess the practical utility of pleural fluid carbonic anhydrase XII (CAXII) quantification for differential diagnosis of effusions. Materials and Methods: Fluid was collected prospectively from fifty patients presenting with lymphocytic pleural effusions for investigation and CAXII was quantified by ELISA. Results: Pleural fluid CAXII concentrations were significantly higher in lung cancer patients (n=30) than in tuberculous controls (n=20). The sensitivity and specificity of this biomarker were 60%and 75%, respectively. CAXII measurement was not inferior to cytological examination in the diagnosis and exclusion of pleural effusions from lung cancer patitents (sensitivity 60% vs. 57%; specificity 75% vs. 100%; positive predictive value 77%; negative predictive value 54%). In patients with negative cytology, it offered a sensitivity of 54%. Conclusions: Pleural fluid CAXII is elevated in pleural effusions from lung cancer patients. Measurement of CAXII may be used in the future as a valuable adjunct to cytology in the diagnostic assessment of patients with pleural effusions related to lung cancer, especially when cytological examination is inconclusive.

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Section: Pleural Fluid Collectionmentioning

confidence: 99%

Clinical Impact and Reliability of Carbonic Anhydrase XII in the Differentiation of Malignant and Tuberculous Pleural Effusions

Liu¹,

Jing²,

Guo³

2013

Asian Pacific Journal of Cancer Prevention

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“…(11) If malignancy is suspected, pleural fluid cytology is the diagnostic method of choice, the sensitivity of the method ranging from 40% to 87%. (2) Closed pleural biopsy does not significantly contribute to the diagnosis of malignancy, given that the positivity rates for closed pleural biopsy are lower than are those for cytology, ranging from 36% to 60%. (2) Within this scenario, the exudates associated with hematologic neoplasms, particularly non-Hodgkin's lymphomas, represent the true challenge in the differential diagnosis of lymphocytic pleural effusions.…”

Section: Introductionmentioning

confidence: 98%

“…(2) Closed pleural biopsy does not significantly contribute to the diagnosis of malignancy, given that the positivity rates for closed pleural biopsy are lower than are those for cytology, ranging from 36% to 60%. (2) Within this scenario, the exudates associated with hematologic neoplasms, particularly non-Hodgkin's lymphomas, represent the true challenge in the differential diagnosis of lymphocytic pleural effusions. Because the morphological features of lymphoma subtypes vary widely, it is often difficult to detect malignant cells in effusions, particularly in cases of low-grade lymphocytic lymphomas.…”

Section: Introductionmentioning

confidence: 98%

“…(1) If we exclude parapneumonic effusions and acute inflammatory exudates, which are generally neutrophilic, most of the remaining types of effusion are considered lymphocytic (more than 50% with nucleated cells). (2) Brazil ranks 19th in terms of tuberculosis incidence, (3) and pleural tuberculosis is one of the main causes of lymphocytic pleural effusion in adults. In such cases, the pleural fluid is an exudate with high levels of proteins, adenosine deaminase (ADA), and IFN-γ.…”

Section: Introductionmentioning

confidence: 99%

“…(2) According to Billingham et al, (25) exfoliative cytology represents an excellent method for diagnosing the condition, with an accuracy that is similar to that of histological examination. Santos et al (26) evaluated 256 serous effusions (pleural or ascitic fluid) associated with lymphomas.…”

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confidence: 99%

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É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais?

et al. 2012

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Objective: To describe clinical and laboratory characteristics in patients with tuberculosis-related or lymphomarelated lymphocytic pleural effusions, in order to identify the variables that might contribute to differentiating between these diseases. Methods: This was a retrospective study involving 159 adult HIV-negative patients with tuberculosis-related or lymphoma-related lymphocytic effusions (130 and 29 patients, respectively), treated between October of 2008 and March of 2010 at the Pleural Diseases Outpatient Clinic of the University of São Paulo School of Medicine Hospital das Clínicas Heart Institute, in the city of São Paulo, Brazil. Results: Mean age and the mean duration of symptoms were lower in the tuberculosis group than in the lymphoma group. The levels of proteins, albumin, cholesterol, amylase, and adenosine deaminase (ADA) in pleural fluid, as well as the serum levels of proteins, albumin, and amylase, were higher in the tuberculosis group, whereas serum cholesterol and triglycerides were higher in the lymphoma group. Pleural fluid leukocyte and lymphocyte counts were higher in the tuberculosis group. Of the tuberculosis group patients, none showed malignant cells; however, 4 showed atypical lymphocytes. Among the lymphoma group patients, cytology for neoplastic cells was positive, suspicious, and negative in 51.8%, 24.1%, and 24.1%, respectively. Immunophenotyping of pleural fluid was conclusive in most of the lymphoma patients. Conclusions: Our results demonstrate clinical and laboratory similarities among the patients with tuberculosis or lymphoma. Although protein and ADA levels in pleural fluid tended to be higher in the tuberculosis group than in the lymphoma group, even these variables showed an overlap. However, none of the tuberculosis group patients had pleural fluid ADA levels below the 40-U/L cut-off point.Keywords: Pleural effusion; Tuberculosis; Lymphoma; Adenosine deaminase; Diagnosis, differential. ResumoObjetivo: Descrever características clínicas e laboratoriais em pacientes com derrames pleurais linfocíticos secundários a tuberculose ou linfoma, a fim de identificar as variáveis que possam contribuir no diagnóstico diferencial dessas doenças. Métodos: Estudo retrospectivo com 159 pacientes adultos HIV negativos com derrame pleural linfocítico secundário a tuberculose ou linfoma (130 e 29 pacientes, respectivamente) tratados no Ambulatório da Pleura, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), entre outubro de 2008 e março de 2010. Resultados: A média de idade e de duração dos sintomas foi menor no grupo tuberculose que no grupo linfoma. Os níveis pleurais de proteínas, albumina, colesterol, amilase e adenosina desaminase (ADA), assim como os níveis séricos de proteínas, albumina e amilase, foram maiores no grupo tuberculose, enquanto os níveis séricos de colesterol e triglicérides foram maiores no grupo linfoma. As contagens de leucócitos e linfócitos no líquido pleural foram maiores no grupo tub...

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Pleural disease

2019

Essential Respiratory Medicine 1e

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Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010

Cited by 668 publications

References 151 publications

Clinical Impact and Reliability of Carbonic Anhydrase XII in the Differentiation of Malignant and Tuberculous Pleural Effusions

Clinical Impact and Reliability of Carbonic Anhydrase XII in the Differentiation of Malignant and Tuberculous Pleural Effusions

É possível diferenciar derrames pleurais linfocíticos secundários a tuberculose ou linfoma através de variáveis clínicas e laboratoriais?

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