The diagnostic utility of ADA in lymphocytic pleural effusions has been evaluated. This prospective study provides additional evidence that ADA levels in nontuberculous lymphocytic pleural effusions seldom exceed the cut-off set for tuberculous effusions. Low ADA levels in lymphocytic pleural effusions virtually exclude the diagnosis of tuberculosis. The pleural fluid ADA levels were significantly higher in different types of exudative effusions than in transudates. ADA1/ADAp correctly classified all nontuberculous lymphocytic pleural effusions with high ADA levels.. The diagnosis of tuberculous pleural effusions can be difficult because of the low sensitivity of the various diagnostic tools. A lymphocytic exudate which is seen with tuberculous pleuritis, can also occur with other diseases such as malignancy and collagen vascular diseases.. Regarding the sensitivity of diagnostic methods for tuberculous pleurisy, the positive rate with smear testing for tubercle bacilli in pleural fluid is 11.1% ...
Four types of fluid can occupy the pleural space: serous fluid (hydrothorax), blood (hemothorax), lipid (chylothorax), and pus (empyema). Once the presence of a pleural effusion is established, it is important to determine whether it is a transudate or an exudate. A transudative pleural effusion indicates the presence of a systemic process, implicating organ systems other than the lung. This transudative pleural effusion is caused by medical conditions that lead to volume overload, such as renal failure, heart failure, and hypoalbuminemia (Table 127-1). In contrast, exudative pleural effusions indicate a local pleural process and necessitate a different treatment approach (Table 127-2). In 1972, Light defined the classic criteria for distinguishing between exudative and transudative pleural effusions.1 To qualify as an exudate, the pleural effusion must meet one of the following criteria: pleural fluid lactate dehydrogenase (LDH) greater than 200 IU/L, ratio of pleural fluid LDH to serum LDH ...
The sensitivity and specificity of Lights criteria for detection of exudates have been measured in many studies and are usually reported to be around 98% and 80%, respectively.[17][18] This means that although Lights criteria are relatively accurate, twenty percent of patients that are identified by Lights criteria as having exudative pleural effusions actually have transudative pleural effusions. Therefore, if a patient identified by Lights criteria as having an exudative pleural effusion appears clinically to have a condition that usually produces transudative effusions, additional testing is needed. In such cases albumin levels in blood and pleural fluid are measured. If the difference between the albumin level in the blood and the pleural fluid is greater than 1.2 g/dL (12 g/L), this suggests that the patient has a transudative pleural effusion.[11] However, pleural fluid testing is not perfect, and the final decision about whether a fluid is a transudate or an exudate is based not on ...
TY - JOUR. T1 - Bilateral tuberculous pleural effusions with markedly different characteristics. AU - Murin, Susan. AU - Moritz, Ernest. PY - 1996. Y1 - 1996. N2 - A 72-year-old man presented with malaise, weight loss, and cough. Chest radiograph revealed bilateral pleural effusions. On thoracentesis, the left effusion was a clear yellow exudate with more than 90% lymphocytes, and the right effusion was a grossly bloody exudate with more than 90% neutrophils. Cultures of both effusions grew Mycobacterium tuberculosis.. AB - A 72-year-old man presented with malaise, weight loss, and cough. Chest radiograph revealed bilateral pleural effusions. On thoracentesis, the left effusion was a clear yellow exudate with more than 90% lymphocytes, and the right effusion was a grossly bloody exudate with more than 90% neutrophils. Cultures of both effusions grew Mycobacterium tuberculosis.. KW - elderly pleura. KW - tuberculosis. UR - ...
Edema. Pulmonay Embolus. Most commonly described in the setting of treatment of Pneumothorax or Pleural Effusion. Specific examples include subdural, mastoid, pericardial and pleural effusions. Pulmonary edema with small pleural effusions on both sides. 1985 Sep;6(3):509-19. Investigations for systemic disorders were negative. On thoracic CT, findings of hydrostatic pulmonary edema include those seen on chest radiographs, such as cardiomegaly, vascular engorgement, and pleural effusions. Key Concepts: Terms in this set (35) pleural effusion. Difference between Pulmonary infiltrate and Effusion? Created by. 15 ml. Pulmonary Edema vs. Pleural Effusion vs. Objectives. If you have a massive pleural effusion and drain it to rapidly you can get reexpansion pleural edema. Pneumonia. Edema, also spelled oedema or œdema, is an abnormal accumulation of fluid in the interstitium, located beneath the skin and in the cavities of the body, which can cause severe pain. CT Chest (High-Resolution): Bilateral, ...
The presenting features of non-TB and non-malignant effusions were pleuritic chest pain, cough and dyspnoea in 71%, 54% and 38% of patients respectively. In 8% of patients the causes of exudative PE were not determined over a mean follow-up period of 3 months. Pleural biopsy versus pleural fluid analysis. Pleural biopsy was the most sensitive diagnostic measure for tuberculous PE with a sensitivity of 70%, whereas pleural fluid analysis was positive in only 33% of patients with tuberculous PE (Table 2). The sensitivity of pleural fluid analysis and pleural biopsy for diagnosis of malignant PE was 70% and 53.5% respectively, whereas the diagnostic sensitivity of both pleural biopsy and pleural fluid analysis in patients with tuberculous and malignant PE was 97% and 91% respectively. The results of alveolar lavage testing are presented in Table 3. Sputum smears and cultures were not helpful for diagnosis of tuberculous PE and tuberculin skin test was positive in only 25% of patients with TB. In ...
Pediatric pleural effusions present a changing profile over time, both in terms of etiological subgroups and causative microorganisms in parapneumonic effusions. This retrospective study aimed to review pediatric pleural effusions in a large cohort over a 29-year period, with special emphasis on the etiological subgroups and microbiological causes of parapneumonic effusions. The medical records of 492 pediatric patients were reviewed for a comparison of subgroups of pleural effusions and microbiological causes of parapneumonic effusions between three decades. Parapneumonic effusions (381 patients) made up 77.4% of the group. Tuberculous pleurisy decreased, but malignant effusions doubled in number over time. A causative microorganism was identified in 34.6% overall, with Staphylococcus aureus and Streptococcus pneumoniae being the two most common. Relative frequency of S. aureus decreased, whereas pneumococci and Haemophilus influenzae were more frequent in recent years ...
Infectious pleural effusion is a classic complication of pneumonia and often require pleural drainage.. There is no consensus between surgical drainage and medical drainage indication in first intention to treat an empyema.. Usually surgery is proposed in second intention after failure of medical drainage.. Videothoracoscopy is well accepted in diagnosis and treatment of pleural pathologies. The morbidity of this approach is very low with good results and become the gold standard in different pleural diseases. The medical drainage can be also very efficient but its results depends of the evolution of the pleural effusion. The rate of failure is estimated around 25%.. Then, the aim of our study is to compare surgical drainage and medical drainage in first intention. The first end-point will be the hospital stay (day). Hospital discharge will be strict, following different objective criteria of healing allowing comparison between these two approaches of drainage.. To answer this question we will ...
This page includes the following topics and synonyms: Pleural Effusion Causes, Transudate Pleural Effusion Causes, Exudate Pleural Effusion Causes, Empyema Pleural Effusion Causes, Bloody Pleural Effusion Causes.
TY - JOUR. T1 - Lack of NK cells and related cytokines in pleural effusion. AU - Chen, Yuh Min. AU - Whang-Peng, Jacqueline. AU - Yang, Wen Kuang. AU - Hung, Yi Mei. AU - Lin, Wen Chang. AU - Kuo, Benjamin Ing Tiau. AU - Perng, Reury Perng. PY - 1996/9/1. Y1 - 1996/9/1. N2 - Background. Relatively low number and activity of natural-killer (NK) cells have been reported in malignant pleural effusions. However, there has been no report on NK cells related cytokines. Methods. Lymphocyte subpopulations were studied in 30 cases of pleural effusion with various etiologies, along with peripheral blood, by using flow cytometry. The related cytokine levels in peripheral blood and pleural fluid, including IL-1α, IL-4 and IL-12, were also analyzed with ELISA assays. Results. The results showed significant increase of T-helper cell subpopulation in pleural effusion of various etiologies. No obvious change of B-lymphocyte subpopulation between peripheral blood and pleural effusion was found. IL-4 was ...
Researchers in the UK have developed a new tool that may help patients with mesothelioma and other pleural cancers make decisions about pleural effusion. Pleural effusion is the buildup of excess fluid in the space around the lungs. It is a common side effect in people with advanced lung or breast cancer or pleural mesothelioma. It can be complicated and time-consuming to make decisions about pleural effusion treatment. There are many different ways to handle the problem. The UK research team developed a web-based decision support tool with input from patients, clinicians, and caregivers. The tool uses videos and questions to help patients decide on the best course of treatment for their unique situation. Pleural Effusion and Treatment Options The pleura … Continue reading Decisions About Pleural Effusion in Mesothelioma: New Tool May Help ». ...
Description of disease Fetal pleural effusion. Treatment Fetal pleural effusion. Symptoms and causes Fetal pleural effusion Prophylaxis Fetal pleural effusion
This is a classic case of tuberculous pleural effusion, as it presented subacutely in a man with a cough, night sweats, weight loss, dyspnea, and a unilateral pleural effusion. The male-to-female ratio of tuberculous pleural effusions is 2:1, and it presents subacutely in 70% of patients. Over 95% of TB pleural effusions are unilateral.2 Weight loss, initial leukocyte count under 11,000 per mL, and poor clinical response to empirical antibiotics are all independent factors suggesting tuberculous pleurisy.3 Not typical in this patient, only 30% of patients are over age 65, and other common presenting complaints not present in this patient are fever and pleuritic chest pain. Additionally, less than 18% of TB pleural effusions occupy more than two thirds of the hemithorax.2 Though HIV testing was negative, all patients with extrapulmonary TB should be tested for HIV infection, as HIV has been associated with the doubling of the incidence of extrapulmonary TB.4. Central to the evaluation of patients ...
This is the largest ever prospective study examining the role of pleural fluid cytology in undiagnosed unilateral pleural effusions. With ,900 patients, we can give an accurate assessment of the strengths and limitations of cytological assessment. The size of this cohort has allowed for analysis by cancer subtype and the construction of a diagnostic flowchart to demonstrate the likelihood of malignancy with the corresponding cytological sensitivity.. An unexplained pleural effusion is a common diagnostic challenge for the respiratory physician. In Europe and North America, a common cause is primary or secondary malignancy. Therefore, pleural fluid cytology is an essential aspect of pleural fluid analysis, but one that is poorly understood. It is recognised that sensitivity is low, but estimates vary widely within international guidelines (40-87%) [1, 3]. This variation arises because estimates are based on retrospective analyses of hospital or outpatient data [4-7]. Porcel et al. [13] published ...
Pleural effusions after coronary artery bypass grafting (CABG) occur in 42% to 89% of patients undergoing the procedure. Effusions are exudative and predominantly left-sided. Early effusions present in the first postoperative month, are bloody, contain mostly erythrocytes, and respond well to treatment. Late effusions present 30 to 120 days after surgery, are yellow, predominantly lymphocytic, and tend to recur after treatment. Most effusions resolve spontaneously. One half to four percent require interventions, including thoracentesis and pleural surgery. Post-CABG pleural effusions in temporal relation to malignancy are not widely reported. We report a case of malignant pleural effusion presenting in the setting of coronary artery bypass grafting. ...
Co-infection with cryptococcus and tuberculosis has rarely been reported. We herein report a case of an 80-year-old man with cryptococcal pleuritis concurrent with pulmonary tuberculosis. He was admitted for progression of left pleural effusion and consolidation in the left upper lobe. Culture for Mycobacterium tuberculosis was positive in sputum, and analyses of pleural effusion revealed lymphocyte-predominant high levels of adenosine deaminase (ADA). Medical thoracoscopy revealed massive infiltration of Cryptococcus neoformans in pleura without granuloma. This is the first case report of cryptococcal pleuritis coincident with pulmonary tuberculosis. Cryptococcal pleuritis should be ruled out when the adenosine deaminase levels are elevated in pleural effusion.. ...
Background: Eosinophilic pleural effusion (EPE) is an eosinophil count more than 10% on cytology of pleural samples. Recently, it was reported that malignancy had been the most prevalent cause inducing EPE. Therefore, we conducted an analysis on the prevalence and etiology of EPE and investigated the relationship between EPE and malignancy. Materials and Methods: Data for pleural cell differential count from patients receiving thoracentesis during the period from January 2008 to December 2013 were compared with clinical data and established diagnosis of patients obtained via electronic chart review. Results: A total of 6,801 requests of pleural cytology from 3,942 patients with pleural effusion who had received thoracentesis were available at Far Eastern Memorial Hospital from 2008 to 2013, and of these subjects, 115 (2.9%) were found to have EPE. The most frequent cause of EPE was malignancy (33.0%, n=38), followed by parapneumonic effusions (27.8%, n=32), tuberculosis pleuritis (13.9%, n=16),
A 65 year old man presented with recurrent pleural effusions. Repeated pleural fluid examination and pleural biopsy were unremarkable. Pericardial calcification was noted on admission and attributed to an uncomplicated episode of pericarditis 30 years previously. His symptoms and signs were not thought not to be associated with the heart. While awaiting an open pleural biopsy the patient was admitted with a further pleural effusion, jaundice, resistant atrial arrhythmias, and dyspnoea. Hepatic investigations including autoantibody screen and transjugular liver biopsy were normal ...
TY - JOUR. T1 - Pleural effusion is associated with a poor treatment outcome in stage III small non-cleaved cell lymphoma. AU - Sandlund, John T.. AU - Crist, William M.. AU - Abromowitch, Minnie. AU - Fairclough, Diane. AU - Berard, Costan W.. AU - Rafferty, Mary. AU - Pui, Ching Hon. PY - 1991/1. Y1 - 1991/1. N2 - The clinical significance of pleural effusion was assessed in 24 children with unresectable abdominal small non-cleaved cell lymphoma (St. Jude Stage III). Patients were consecutively enrolled and treated on a regimen including high dose fractionated cyclophosphamide and co-ordinated high dose methotrexate and cytarabine. The overall results were excellent, with 20 of 24 patients alive and event-free at a median follow-up of 4 years. Only one of the patients who lacked pleural effusion has relapsed (testicular), even though many had massive disease. In contrast, three of seven patients with pleural effusion have failed treatment (p=0.02) and subsequently died. Two measures of tumor ...
Fingerprint Dive into the research topics of Parapneumonic Pleural Effusion and Empyema in Children: Review of a 19-Year Experience, 1962-1980. Together they form a unique fingerprint. ...
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Introduction: D-dimer is a degradation product of cross-linked fibrin. We hypothesized that hemorrhagic pleural effusions would have greater D-dimer levels than non-hemorrhagic pleural effusions, and that persistently bloody effusions would be distinguishable from thoracentesis-induced bloody effusions by the D-dimer level. ...
Pleural tuberculosis (TB) diagnosis often requires invasive procedures such as pleural biopsy. The aim of this study was to evaluate the role of real-time polymerase chain reaction (PCR) for the IS 6110 sequence of M. tuberculosis in pleural fluid specimens as a rapid and non-invasive test for pleural TB diagnosis. For this cross-sectional study, 150 consecutive patients with pleural effusion diagnosed by chest radiography, who were referred for diagnostic thoracocentesis and pleural biopsy and met eligibility criteria, had a pleural fluid specimen submitted for real-time PCR testing. Overall, 98 patients had pleural TB and 52 had pleural effusion secondary to other disease. TB diagnosis was obtained using acid-fast bacilli (AFB) smear or culture for mycobacteria and/or histopathologic examination in 94 cases and by clinical findings in 4 cases. Sensitivity, specificity, positive and negative predictive values of PCR testing for pleural TB diagnosis were 42.8% (95% CI 38.4 - 44.8), 94.2% (95% CI 85.8 -
Introduction: The pleural cavity is the most common extra-abdominal site for ovarian cancer metastasis. It can, however, be difficult to diagnose ovarian malignancy from the presence of a pleural effusion alone. Case Report: A 50-year-old premenopausal woman who presented with a large, right-sided, bilious pleural effusion subsequently diagnosed with advanced ovarian cancer. Conclusion: Metastatic ovarian carcinoma should be considered in appropriate populations when another, more obvious source of the pleural effusion is not evident. In bilious effusions, an overt tract may not be visualized despite appropriate diagnostic imaging and gastrointestinal studies. In these cases, video-assisted thoracoscopic surgery (VATS) can provide a definitive diagnosis and potential therapeutic interventions by selecting patients who could benefit from surgical and chemotherapeutic interventions.
NK cells are a major component of innate immunity and exert a potent anti-tumor effect both in vitro and in vivo. However, NK cells infiltrating solid tumors have been shown to display severely impaired functional capabilities. In this study we analyzed NK cells present in pleural effusions (PEs) of patients with primary or metastatic tumors of different origin, including mesothelioma and lung, breast, colon, gastric, bladder and uterus carcinoma. In all instances, freshly isolated PE-NK cells displayed a CD56(bright) phenotype and expressed normal levels of both activating receptors and HLA class I-specific inhibitory receptors. In addition, they rapidly released large amounts of IFN-γ and TNF-α after stimulation. Upon culture in IL-2, they acquired a potent cytolytic activity against both allogeneic and autologous tumor cells. Tumor cell lysis was primarily mediated by NKG2D and NKp30 and partially by NKp46 and DNAM-1, in agreement with the expression of the corresponding ligands on ...
Aim: To evaluate and compare the utility of polymerase chain reaction (PCR) for the diagnosis of tuberculous effusions in children.. Methods: PCR, adenosine deaminase (ADA) activity and absolute lymphocyte count (ALC) were evaluated in the fluid of 31 tuberculous (20 pleural, 8 ascites and 3 pericardial) and 24 non-tuberculous (10 transudtative ascites, 8 empyema thoracis, 3 malignant pleural and 3 pyopericardium) effusions.. Results: Fluid PCR for Mycobacterium tuberculosis was positive in 74% of tuberculous effusions, whereas it was falsely positive in 13% of the non-tuberculous group. The mean fluid ADA and ALC values were significantly higher in tuberculous effusions than in non-tuberculous effusions (p,0.001). The sensitivity and specificity of PCR, ADA (⩾38 IU/l) and ALC (⩾275/mm3) were 74% and 88%, 81% and 75%, and 90% and 83%, respectively, in diagnosing tuberculous effusions. The sensitivity of PCR, ADA and ALC was 100%, 100% and 88%, respectively, for confirmed tuberculous ...
Question - CA-breast, hepatic metastasis in both lobes, right pleural effusion and basal atelectasia. Treatment options, prognosis?. Ask a Doctor about when and why Chemotherapy is advised, Ask an Oncologist
What is a pleural effusion? A pleural effusion is when the pleural space fills with fluid which can cause problems with breathing. Subscribe - https://goo.gl/w5aaaV. More videos - https://goo.gl/U ...
Fibronectin is a glycoprotein found in body fluids, loose connective tissue matrix and in basement membranes. Fibronectin in pleural effusion was found to be immunologically indistinguishable from the plasma form, as shown by double-diffusion analysis. Fibronectin isolated from pleural fluid by affinity chromatography on gelatin-Sepharose had a polypeptide pattern similar to that of plasma fibronectin in SDS-polyacrylamide gel electrophoresis. In 28 patients with infectious or non-specific pleural effusion fibronectin concentrations in pleural fluid were 335 +/- 104 micrograms/ml (mean +/- SD), in 15 patients with malignant disease the concentrations were 369 +/- 173 micrograms/ml and in 26 patients with tuberculosis 441 +/- 103 micrograms/ml. The highest concentrations, 605 +/- 252 micrograms/ml, of fibronectin in pleural fluid were detected in 14 patients with connective tissue diseases. The results suggest that increased fibronectin concentrations reflect the presence of a pleurisy due to ...
Background: Pleural effusion is a commonest condition in clinical practice. Determining the cause of pleural effusion is not always easy. Proper history, clinical examination and investigations including pleural fluid studies may reveal etiological diagnosis of pleural effusion. Objective: In this study an attempt has been made to arrive at the etiological diagnosis by clinical profile of pleural effusion. Methods: A prospective study of 50 cases of pleural effusion was carried out in Department of Medicine, over period of two year. Cases admitted in Medicine and chest and TB ward were studied. The diagnosis of pleural effusion was done by detail history, physical examination and was then confirmed by chest x ray. Etiological diagnosis of pleural effusion was then confirmed by pleural fluid studies, like PH, pleural fluid protein, cytology. Results: Incidence of pleural effusion was more common in age group 20 50 years. Male predominance was more than females in both the groups. Tuberculosis was ...
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Objectives: To evaluate the value of pleural liquid alkaline phosphatase and pleural liquid/serum alkaline phosphatase proportion for the purpose of differentiating tuberculous from nontuberculous pleural effusion. maximum cut-off factors. Furthermore to utilizing the cut-off factors produced from ROC curves, the tool of each requirements for determining tuberculous pleural effusion was examined by determining the awareness, specificity, positive predictive worth (PPV), detrimental predictive worth (NPV) and performance. Outcomes Out of 60 situations studied, 40 had been guys and 20 females. Based on the scientific diagnosis, there have been 30 situations of tuberculous pleural effusion which 18 had been guys and 12 females using a indicate age group of 39.4 years (range 17-80). There have been 30 situations of nontuberculous pleural effusion which 22 had been guys and 08 females using a indicate age group of 38.24 months (range 03-72). Within the mixed band of sufferers with tuberculous pleural ...
Pleural effusions develop in about 6% of patients with MM. In this subset of patients, less than 1% of effusions are MPEs [6]. Current literature reveals that less than 100 cases of MPE have been reported worldwide. According to these case reports [78], MPE is consistently a poor prognostic indicator, with mean survival of less than 4 months.. MPE has been reported in patients with ages ranging from 22 to 83 years, equally distributed between males and females, and in IgA, IgG, IgD, and light chain subtypes [910]. A case series published by Cho et al. in 2010 [10] conducted a statistical analysis of 19 patients. In that series, IgA myeloma was most frequently implicated with malignant pleural effusions, followed by IgD and IgG; however, these findings are likely not statistically significant because only 19 patients were analyzed.. Kim et al. [9] demonstrated in a case report that despite aggressive treatment with systemic chemotherapy, radiation, autologous stem cell transplantation, or direct ...
Pleural infection is a common complication of pneumonia associated with high mortality and poor clinical outcome. Treatment of pleural infection relies on the use of broad-spectrum antibiotics, since reliable pathogen identification occurs infrequently. We performed a feasibility interventional clinical study assessing the safety and significance of ultrasound (US)-guided pleural biopsy culture to increase microbiological yield. In an exploratory investigation, the 16S rRNA technique was applied to assess its utility on increasing speed and accuracy versus standard microbiological diagnosis.20 patients with clinically established pleural infection were recruited. Participants underwent a detailed US scan and US-guided pleural biopsies before chest drain insertion, alongside standard clinical management. Pleural biopsies and routine clinical samples (pleural fluid and blood) were submitted for microbiological analysis.US-guided pleural biopsies were safe with no adverse events. US-guided pleural biopsies
TY - JOUR. T1 - The Undefined Value of Pleural Interventions in Advanced Heart Failure and Recurrent Pleural Effusions. AU - Gilbert, Christopher R.. AU - Yarmus, Lonny. AU - Feller-Kopman, David. AU - Lee, Hans J. AU - Gorden, Jed A.. PY - 2016/3/1. Y1 - 2016/3/1. UR - http://www.scopus.com/inward/record.url?scp=84983226706&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84983226706&partnerID=8YFLogxK. U2 - 10.1513/AnnalsATS.201512-825LE. DO - 10.1513/AnnalsATS.201512-825LE. M3 - Letter. C2 - 26963358. AN - SCOPUS:84983226706. VL - 13. SP - 447. EP - 448. JO - Annals of the American Thoracic Society. JF - Annals of the American Thoracic Society. SN - 2325-6621. IS - 3. ER - ...
RATIONALE: Serum mesothelin is a new biomarker for the diagnosis of mesothelioma. Patients with mesothelioma commonly present with pleural effusions. To define the clinical utility of mesothelin quantification in pleural fluid, we assessed its additional value over pleural fluid cytology and its short-term reproducibility and reliability after pleural inflammatory processes, including pleurodesis. OBJECTIVES: To assess the diagnostic role of pleural fluid mesothelin and the effect of common clinical factors that may influence measurement accuracy. METHODS: Mesothelin was quantified in 424 pleural fluid and 64 serum samples by ELISA. Fluid was collected prospectively from 167 patients who presented with pleural effusions for investigation. Serial pleural fluid samples were obtained from patients (n = 33) requiring repeated drainage. Mesothelin levels were also measured in patients (n = 32) prepleurodesis and postpleurodesis. MEASUREMENTS AND MAIN RESULTS: Pleural fluid mesothelin concentrations were
Mesothelioma may affect pleura, peritoneum or pericardium, the last two sites being less commonly affected than pleura. Malignant mesothelioma is usually due to prolonged exposure to asbestos dust, particularly croccidolite. The tumour characteristically affects 20-40 years after exposure to asbestos. The first symptoms are those associated with worsening dyspnoea, pleural effusions, chest pain, and weight loss. The usual appearance is nodular pleural thickening around all or part of lung. A haemorrhagic pleural effusion may be present but the lung changes of asbestos may be absent. The effusion may obscure the pleural masses. Often the mediastinum is central despite the presence of a large effusion, and this is thought to result from volume loss of the underlying lung secondary to either ventilatory restriction by the surrounding tumour, or bronchial stenosis by tumour compression at the hilum.1 Rib involvement may occur with malignant mesothelioma. In the advanced stages of disease, patients ...
Inclusion Criteria:. Patient who was confirmed stage IV NSCLC with malignant pleural effusion confirmed by cytology.. Males or females aged ≥18 years, , 75 years. Eastern Cooperative Oncology Group (ECOG) performance status 0-3. Life expectancy ≥12 weeks. Ability to maintain a drainage catheter. Previous intrapleural administration of chemotherapeutic drugs (preferred bleomycin) Males and females should be contraceptive during the period of the trial until 8 weeks after the last administration of the drug.. Adequate bone marrow, renal, and liver function are required. Able to comply with the required protocol and follow-up procedures, and able to receive oral medications.. Institutional review board-approved informed consent will be obtained for every patient before initiation of any trial-specific procedure or treatment.. Exclusion Criteria:. Any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction ...
This Light criteria calculator can diagnose pleural effusions as exudates and provide the differentiation criteria from pleural transudates.
Pleural effusion, which in pediatric patients most commonly results from an infection, is an abnormal collection of fluid in the pleural space. Pleural effusion develops because of excessive filtration or defective absorption of accumulated fluid.
Modified Lights criteria are widely used to categorise pleural fluids as either exudates or transudates. These criteria include fluid/serum ratios and therefore require a blood sample. It is not clear whether analysis of pleural fluid alone would alter pleural fluid categorisation in routine clinical practice. In this study, pleural fluids were categorised using cut-off values for pleural fluid protein (⩾30 g/l) and lactate dehydrogenase (,0.45 of upper limit of the serum reference interval) recommended as providing optimal discrimination between transudates and exudates. The resultant categorisations were compared with those produced by application of modified Lights criteria. 77 pleural fluid specimens were included for analysis. Using modified Lights criteria, 32 fluids were categorised as transudates and 45 as exudates. Applying the pleural fluid cut-off values as outlined above, 26 fluids were categorised as transudates and 51 as exudates. Agreement was observed in 71/77 or 92.2% (95% ...
Malignant pleural effusion (MPE) is a common complication of advanced lung cancer. Research has shown that secreted phosphoprotein-1 (SPP1) is essential in MPE associated with lung cancer. This retrospective study was performed to evaluate the prognostic significance of SPP1 in the MPE of patients with non-small cell lung cancer (NSCLC). MPE specimens were obtained from 85 NSCLC patients (study group), and pleural effusion specimens were obtained from 24 patients with benign lung disease (control group). Specimens were tested for SPP1 using enzyme-linked immunosorbent assay (ELISA). Based on the cutoff value of receiver operating characteristic (ROC) curve analysis, the study patients were divided into a high-SPP1-expression subgroup and a low-expression subgroup. The primary and secondary endpoints of this study were progression-free survival (PFS) and overall survival (OS). The SPP1 levels of the study group were significantly higher compared to those of the controls (Mann-Whitney U test, P = 0.017).
We have previously discussed the utility of spine sign in diagnosing pleural effusion on POCUS. One of the short videos also talks about this. However, it is important to note that this sign is not specific to effusion. Anything that provides a medium for the ultrasound beam to pass through in the lower chest allowing…
Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Pleural Effusion, Transudative
Parapneumonic effusions and pleural empyema are a frequent complication of pneumonia. Initial treatment in uncomplicated effusions is conservative. Complicated parapneumonic effusions require more...
BACKGROUND: The aim of this study was to identify key factors on admission predicting the development of complicated parapneumonic effusion or empyema in patients admitted with community-acquired pneumonia. METHODS: A prospective observational study
Our aim was to compare intrapleural streptokinase (SK) treatment and simple tube drainage in the treatment of children with complicated parapneumonic pleural effusion. A retrospective review of medical records included patient demographics, clinical presentation, biochemical and microbial studies of pleural effusion, radiographic evaluation of chest tube drainage, use of fibrinolytic agents and type of surgical intervention. During the 2.5-year period (1999-2002), 53 children (29 M, 24 F) with complicated parapneumonic effusions or empyema were identified. Closed tube drainage and antibiotic treatment were administered to patients with a diagnosis of complicated parapneumonic effusion (n = 24) until October 2000; after that time point, intrapleural streptokinase was added to this regimen (n = 29). The median age at the time of presentation was 2.5 years (range: 5 months-14.6 years). There were no significant differences in terms of clinical outcomes between the two groups. The average length of ...
TY - JOUR. T1 - Effect of repeated thoracenteses on fluid characteristics, cytokines, and fibrinolytic activity in malignant pleural effusion. AU - Chung, Chi L.. AU - Chen, Yi C.. AU - Chang, Shi Chuan. PY - 2003/4/1. Y1 - 2003/4/1. N2 - Objective: To evaluate the effect of repeated thoracenteses on the fluid characteristics and the levels of various cytokines, including tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-5, IL-6, and IL-8, and of plasminogen activator inhibitor type 1 (PAI-1) and tissue type plasminogen activator in malignant pleural effusion and its clinical significance. Design: A prospective study. Patients and methods: Twenty-six patients with symptomatic and a large amount of free-flow malignant pleural effusions were studied. Thoracentesis with drainage of 500 mL of pleural fluid per day was performed for 3 continuous days (days 1 to 3). The effusion samples were collected to evaluate the changes of fluid characteristics, cytokine levels, and fibrinolytic activity. ...
Metabolomic Profiling of Infectious Parapneumonic Effusions Reveals Biomarkers for Guiding Management of Children with Streptococcus pneumoniae Pneumonia.. Chiu CY1,2,3, Lin G4, Cheng ML5, Chiang MH1, Tsai MH1, Lai SH3, Wong KS3, Hsieh SY6.. Author information. Abstract. Metabolic markers in biofluids represent an attractive tool for guiding clinical management. The aim of this study was to identify metabolic mechanisms during the progress of pleural infection in children with Streptococcus pneumoniae pneumonia. Forty children diagnosed with pneumococcal pneumonia were enrolled and analysis of pleural fluid metabolites categorized by complicated parapneumonic effusions (CPE) and non-CPE was assessed by using (1)H-NMR spectroscopy. Multivariate statistical analysis including principal components analysis (PCA) and partial least-squares discriminant analysis (PLS-DA) were performed. Metabolites identified were studied in relation to subsequent intervention procedures by receiver operating ...
Jangkitan bakteria di paru-paru boleh menyebabkan pengumpulan cecair pada bahagian pleura, dikenali sebagai parapneumonia efusi (PPE). Faktor ramalan kepada tahap kerumitan PPE tidak di ketahui. Kajian ini dilakukan untuk mengenali ciri-ciri, faktor ramalan dan hasil rawatan kanak-kanak yang mengalami PPE di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Data pesakit PPE kanak-kanak yang dimasukkan ke PPUKM dari Januari 2010 ke Disember 2017 dikaji secara retrospektif. Pesakit dibahagikan kepada dua kumpulan iaitu PPE tahap sederhana dan PPE tahap rumit. Dari 45 orang pesakit yang dikaji, 20 (44.4%) pesakit mempunyai PPE tahap sederhana, manakala 25 (55.6%) mengalami PPE tahap rumit. Median umur pesakit adalah 32 bulan (IQR 16-63). Jenis bakteria yang paling biasa di temui adalah Streptococcus pneumoniae (61.9%), diikuti oleh Mycoplasma pneumoniae (19.0%) dan Staphylococcus aureus (4.8%). Didapati hanya 11.1% pesakit kanak-kanak menerima suntikan vaksin pneumokokal. Tiada perbezaan yang ...
One hundred ninety-one unselected fluid specimens submitted routinely for cytologic examination were assayed to determine whether the measurement of carcinoembryonic antigen (CEA) levels in pleural effusions is useful in detecting malignancy. The mean ± SD CEA level of 103 benign effusions was 4.1 ± 2.9 ng/ml. Only one benign effusion had a level , 12 ng/ml (18 ng/ml). Benign inflammatory effusions (pneumonia, empyema) had a higher mean CEA activity (6.2 ± 3.4) than effusions caused by congestive heart failure (2.9 ± 1.5) (p , 0.001). Twenty-four (34%) of 70 malignant effusions had a CEA level greater than 12 ng/ml, and 28 (40%) were positive by cytologic study. Thirty-eight (54%) were detected by one or both methods. Ten malignant effusions were positive by CEA (, 12 ng/ml) alone. These data suggest that the determination of CEA activity levels, when used in conjunction with other clinical findings, may be useful in detecting malignant pleural effusions. ...
TY - JOUR. T1 - Low pleural fluid-to-serum glucose gradient indicates pleuroperitoneal communication in peritoneal dialysis patients. T2 - Presentation of two cases and a review of the literature. AU - Momenin, Nima. AU - Colletti, Patrick M.. AU - Kaptein, Elaine M.. PY - 2012/5/1. Y1 - 2012/5/1. N2 - Background. Transudative pleural effusions due to pleuroperitoneal communication occur in 1.6-10% of patients receiving peritoneal dialysis (PD) and usually have overtly elevated glucose concentrations. Methods. We report two cases of verified pleuroperitoneal communication with minimally elevated pleural fluid glucose levels. We reviewed the literature of all PD patients with pleuroperitoneal communication that reported pleural glucose levels to assess their clinical and laboratory features and pleural fluid-to-serum glucose gradients. Results. We evaluated a total of 47 reported patients on PD with diagnosed pleuroperitoneal communication. Onset of the transudative pleural effusion after ...
TY - JOUR. T1 - Pharmacokinetic study of penetration of meropenem into pleural effusion in patients with pleurisy. AU - Makino, Junko. AU - Yoshiyama, Yuji. AU - Kanke, Motoko. AU - Shibasaki, Toshiaki. AU - Nakashima, Emi. AU - Kamata, Masahiro. AU - Ozawa, Sadanobu. AU - Maruyama, Hiromichi. AU - Masuhara, Keisou. AU - Kobayashi, Teruaki. PY - 2002. Y1 - 2002. N2 - Complication by secondary infection is observed in not only bacterial pleurisy but also other pleurisy, and the appropriate administration of antibacterial agents is necessary. It is very important to secure a smooth penetration of systemically administered antibacterial agents to pleural effusion in infection therapy. In this study, we investigated the pharmacokinetics of a carbapenem antibiotic, meropenem (MEPM), in blood and pleural effusion in patients with an accumulation of pleural effusion caused by pleurisy, who underwent placement of an indwelling thoracic drain and received intravenous drip administration of MEPM for ...
Iron Deficiency Anemia & Pleural Effusion on Chest X-Ray & Plummer-Vinson Syndrome Symptom Checker: Possible causes include Pulmonary Infarction. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search.
Pleural effusion secondary to ventriculoperitoneal shunt insertion is a rare and potentially life-threatening occurrence. We describe a 14-month-old Caucasian boy who had a ventriculoperitoneal shunt inserted for progressive hydrocephalus of unknown etiology. Two and a half months post-shunt insertion, the patient presented with mild respiratory distress. A chest radiograph revealed a large right pleural effusion and a shunt series demonstrated an appropriately placed distal catheter tip. A subsequent abdominal ultrasound revealed marked ascites. Fluid drained via tube thoracostomy was sent for beta-2-transferrin electrophoresis. A positive test was highly suggestive of cerebral spinal fluid hydrothorax. Post-externalization of the ventriculoperitoneal shunt, the ascites and pleural effusion resolved. Testing for beta-2-transferrin protein in pleural fluid may serve as a useful technique for diagnosing cerebrospinal fluid hydrothorax in patients with ventriculoperitoneal shunts.
Introduction: Tuberculosis is one of the most common causes of pleural effusion (PE). However, the diagnosis of tuberculous pleurisy still remains difficult. Since M. tuberculosis isolation rates in tuberculous effusions are relatively low the histological and microbiological studies of pleural biopsy samples are usually required to confirm the diagnosis. Several biological markers have been proposed to enhance the effectiveness of diagnosing patients with tuberculous pleurisy. The study was undertaken to evaluate the diagnostic accuracy of pleural fluid IFN-γ concentration in differentiation between tuberculous pleural effusion (TPE) and non-tuberculous pleural effusion (nTPE ...
Pneumonia continues to be the leading cause of morbidity and mortality in the paediatric population globally.1 The introduction of widespread pneumococcal conjugate 13-valent vaccination (PCV-13) programmes has led to a significant reduction in the incidence and mortality of community-acquired pneumonia (CAP).2 3 However, this diseases burden remains high, accounting for 15% of deaths in young children worldwide.4 Approximately 12% of cases progress to severe illness, with parapneumonic effusion and pleural empyema being the most common complications.5 For simplicity, this paper will use the term effusion to refer to parapneumonic effusion and pleural empyema.. The presence of effusion leads to a prolonged length of stay (LOS), escalation of care, morbidity and increased healthcare resources utilisation.6-10 Management of the effusion is controversial.6 7 Accepted treatment modalities include antibiotics alone, chest tube drainage with or without fibrinolytics, video-assisted thoracoscopic ...
A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
Malignant pleural effusions are a common clinical problem in patients with primary thoracic malignancy and metastatic malignancy to the thorax. Symptoms can be debilitating and can impair tolerance of anticancer therapy. This article presents a comprehensive review of pharmaceutical and nonpharmaceutical approaches to the management of malignant pleural effusion, and a novel algorithm for management based on patients performance status. ...
Cases of intra-abdominal actinomycosis have been described years after cholecystectomy, although it is a rare complication. Due to the slow growth of Actinomyces, symptoms can present months or even years after surgery.1,2. We present the case of a 71-year-old patient who underwent delayed laparoscopic cholecystectomy for acute cholecystitis. Four years later, he presented with dyspnea, cough, asthenia and pleuritic pain in the right hemithorax. On physical examination he was found to have a hard, painful swelling on the lateral region of the right hemithorax (Fig. 1A), with absent breath sounds. Acute phase reactants were elevated, and the chest radiograph showed right pleural effusion. Computed tomography (CT) revealed thickening of the pleura of the right posterolateral costophrenic angle (2.5-cm in thickness) and a hypodense area inside with extrapleural fat involvement, muscle thickening and pleural effusion (Fig. 1B). Thoracocentesis was performed and a fluid consistent with an exudate ...
FRIDAY, Dec. 28, 2018 (HealthDay News) - New clinical practice guidelines for the management of malignant pleural effusions were published in the January issue of the Annals of the American Thoracic Society.. Chakravarthy B. Reddy, M.D., from the University of Utah in Salt Lake City, and colleagues representing the American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology conducted a systematic literature review to develop clinical practice guidelines for the management of malignant pleural effusions.. The recommendations call for ultrasound imaging to guide pleural interventions and advise against therapeutic pleural interventions in asymptomatic patients. In symptomatic patients, large-volume thoracentesis is recommended to assess lung expansion. For patients with an expandable lung, no prior definitive therapy, and symptoms attributable to the effusion, indwelling pleural catheters (IPCs) or chemical pleurodesis should be used as a first-line definitive ...
INTRODUCTION: Malignant pleural effusion (MPE) is a frequent complication in many types of tumors diminishing the patients ability to perform activities. Despite various studies on talc treatment, some doubts about its safety and effectiveness remain, so the search for a more ideal intrapleural agent continues. We analyzed the effectiveness and safety of intrapleural paclitaxel in ovarian and breast cancer patients. PATIENTS AND METHODS: The primary endpoint was overall response rate (ORR); secondary objectives included time to progression (TTP), overall survival (OS) and safety of intrapleural paclitaxel. Pharmacokinetics of the drug was also analyzed. After drainage of pleural effusion and lung re-expansion, paclitaxel 120 mg/m(2) diluted in normal saline was infused through a preinserted catheter which was immediately closed and reopened 24 h later. Blood and pleural fluid samples were collected 1, 4 and 24 h after the end of paclitaxel instillation. When MPE was less than 200 ml/24 h the ...
Meigs syndrome is a condition in which an ovarian tumour (usually a fibroma) is associated with ascites and pleural effusion. It resolves after resection of the tumour. We report here what we believe to be the first case of a patient with pericardial effusion complicating Meigs syndrome.. ...
Pleural effusions are a common problem in both general and respiratory medicine, with pleural fluid aspiration and chest tube insertion being among the most frequently performed medical procedures. Although guidelines advocate thoracic ultrasound in the diagnostic evaluation of pleural effusion, its use is not yet fully established in everyday clinical practice.1 However, a diagnosis of pleural effusion based on only radiographic and physical examination may be misleading and can result in iatrogenic complications.2,3. A 69-year-old man was referred for evaluation of a left-sided pleural effusion. His symptoms included dyspnoea, which had worsened over 6 months, dysphagia and coughing after eating. His chest X-ray (Fig 1) showed a left-sided pleural effusion, mediastinal shift to the right and loculated air in the left mid-zone, which was suspected to be a hydropneumothorax and pleural infection. However, thoracic ultrasound (Fig 2) identified only bowel contents in the left hemithorax with no ...
It is widely admitted that T cells and NK cells are key players in anti-tumour immunity, although progressing tumours can ultimately escape immune control. The assessment of T cell subpopulations and NK cells in blood and pleural fluid could be useful for the understanding of the mechanisms involved in leukocyte recruitment in malignant pleural effusions and may help understanding their involvement in anti-tumor immunity. We report here the relative distribution of these populations in patients with MPM and compared it with values obtained from patients with pleural metastases of various carcinomas as done previously [23, 26], but also from patients with benign pleural involvement related to asbestos exposure and for the first time healthy subjects. This permitted us to more precisely analyze circulating and tumor environment-associated immune cells in patients with malignant pleural effusions. To our best knowledge few studies have specifically reported CD4+ et CD8+ T cell subpopulations in ...
A significant number of cases of pleural effusion are undiagnosed after simple diagnostic pleural aspiration.2 Pooled data from a total of 1370 patients suggests that a positive cytological diagnosis of malignancy may be obtained from a single diagnostic pleural aspiration in 60% of cases.2 A second sample modestly increases the diagnostic yield (by around 15%) but a third sample is non-contributory.2 Pleural fluid cytology has an even poorer diagnostic yield in mesothelioma, in which a positive result is obtained in only 32% of cases.9. Traditionally, blind pleural biopsy (non-image-guided pleural biopsy, also known as closed pleural biopsy or Abrams needle biopsy) has been the next step in investigating cytology negative exudative pleural effusions of unknown cause. This procedure is relatively cheap and readily accessible and is still used in many institutions. However, there is increasing evidence that blind pleural biopsy is less sensitive in the diagnosis of malignant pleural disease ...
Malignant Pleural Effusion: Presence of fluid in the PLEURAL CAVITY as a complication of malignant disease. Malignant pleural effusions often contain actual malignant cells.
Pleural effusion is another condition associated with pleural disease. This is the build-up of fluid within the pleural cavity.. A pleural effusion can be either transudate or exudate. Transudate pleural effusion is due to something other than the pleura, such as congestive heart failure. Exudate pleural effusion is caused by an affliction of the pleural lining itself.. As stated above, there is always a small amount - no more than 15 ml. - of lymphatic fluid present in the pleural cavity in healthy individuals. Normally, this fluid is drained and replenished by the lymphatic system. However, if fluid production is excessive, and/or something affects the lymphatic systems ability to drain said fluids, a build-up will result, placing the same type of pressure on the lungs and restricting their ability to expand.. Pus, the byproduct of bacterial infection, can also build up in the pleural cavity. Known as empyema, it is actually the by-product of the immune response known as inflammation - ...
Subjects. The study protocol was approved by our institutional review board for human studies, and informed consent was obtained from all subjects. Pleural fluid samples were collected from 33 patients (age range, 34-82 y) with newly diagnosed lung cancer with malignant pleural effusion. Histologically, 22 cases were adenocarcinoma and 11 were squamous cell carcinoma. A diagnosis of malignant pleural effusion was established by the showing of malignant cells in pleural fluid or/and on closed pleural biopsy specimen. The patients were excluded if they had received any invasive procedures directed into the pleural cavity or if they had suffered chest trauma within 3 mo prior to hospitalization or had a pleural effusion of undiagnosed cause. At the time of sample collection, none of the patients had received any antituberculosis therapy, anticancer treatment, corticosteroids, or other nonsteroid anti-inflammatory drugs.. Sample collection and processing. The pleural fluid samples were collected in ...
An empyema can resemble a pleural effusion and can mimic a peripheral pulmonary abscess, although a number of features usually enable distinction between the two (see empyema vs. lung abscess). Features that help distinguish a pleural effusion fr...
Objectives:To study the presentation of pleural effusion among dengue Patients in Pakistan and to explore limitations in the diagnosis of these Patients by the physicians of a developing country. Methods: We conducted a cross-sectional study on Patients admitted to Aga Khan University Hospital, Karachi, Pakistan from January 2005 to September 2008. Records of 663 dengue Patients were reviewed. Demographic data, respiratory complaints, radiographic studies, and final outcome were studied. Presentation and radiological modality confirming the diagnosis of pleural effusion were noted. Descriptive statistics followed by Chi-Square test were applied, testing against an alpha of 0.05 and 95% confidence interval (CI). Results: Three hundred and fifty-four (53%) out of a total of 663 dengue syndrome Patients did not complain of any respiratory symptoms at presentation, nor did their medical examination elicit any suspicion of PE. Hence, no radiological study was advised. Amongst the remaining 309 Patients, 299
ConferenceSeries organizes Pleural Effusion national symposiums, conferences across the globe in association with popular Pleural Effusion associations and companies. OMICS group planned its conferences, and events in america, europe, middle east and asia pacific. locations which are popular with international conferences, symposiums and events are china, canada, dubai, uae, france, spain, india, australia, italy, germany, singapore, malaysia, brazil, south korea, san francisco, las vegas, san antonio, omaha, orlando, raleigh, santa clara, chicago, philadelphia, baltimore, united kingdom, valencia, dubai, beijing, hyderabad, bengaluru and mumbai
Introduction: The use of biological markers in the diagnosis of tuberculous pleural effusion (TPE) is a breakthrough. Demonstration of elevated levels of Pleural fluid Adenosine deaminase (ADA), interferon-gamma (IFN-γ), tuberculous proteins/antibodies lysozme etc. have been proposed. Adenosine deaminase (ADA) estimation in pleural fluid has been shown as reliable biomarker specially when there is suspicion of tuberculosis. Detection of mycobacterium DNA by PCR is also a proposed test3,4. However India being a developing country with much of its people below poverty line cannot afford expensive tests like ELISA, PCR, IFN-γ. Hence, there is need for relatively cheaper and simple tests with feasibility and sensitivity going hand-in-hand5 TPE being proposed to be a delayed hypersensitive reaction and lymphocytes play a major role in the pathogenesis. With ,50% lymphocytes in the pleural fluid, combined criterion of lymphocyte to neutrophil ratio of ,0.75 with a raised ADA level increased the ...
Beyond the criteria defined in previous CT studies, we have found several TUS morphological features apparently associated with malignant pleural effusion. In the absence of parietal pleural thickening, visceral thickening and visceral nodularity were associated with malignancy and not apparently visible on CECT. Necropsy reports have shown that the parietal pleura may be less frequently involved with metastatic disease than the visceral pleura.19 This suggested pathogenesis would be in keeping with our findings in which 4/5 patients demonstrated visceral pleural thickening or nodularity suggestive of visceral deposits in the absence of associated parietal pleural thickening.. Diaphragmatic abnormalities have been shown in this study to predict malignant disease. The normal diaphragm is usually well defined on TUS (due to the presence of fluid in the costophrenic recess), ,5 mm thick and divided into five distinct layers sonographically. Inability to resolve diaphragmatic layers, the presence of ...
To the editor: To the excellent review of malignant pleural effusion by Leff, Hopewell, and Costello (Ann Intern Med 88:532-537, 1978) I wish to add these practical clinical points.. 1. Although nitrogen mustard is probably the most effective of the antineoplastic agents used to sclerose the pleura, the systemic toxicity of this therapy is unpredictable. Studies using the agent intrapleurally have not reported systematic evaluations of marrow toxicity, but all agree that some of the drug is absorbed. Although myelotoxicity is less with intrapleural therapy than with intravenous use, it is a potential complication (1, 2). In patients with neutropenia ...
The cells were established from pleural effusion from a human immunodeficiency virus (HIV) negative patient diagnosed with primary effusion (body cavity based) lymphoma (PEL). BC-3 is a primary effusion lymphoma cell line originated in 1995 by Leandros Arvanitakis and Ethel Cesarman.
TY - JOUR. T1 - Biochemical assessment of canine body cavity effusions using three bench-top analysers. AU - Hetzel, Natasha J L. AU - Papasouliotis, K. AU - Dodkin, S. AU - Murphy, K. N1 - © 2012 British Small Animal Veterinary Association.. PY - 2012/8. Y1 - 2012/8. N2 - OBJECTIVES: To assess the performance of three bench-top chemistry instruments for the analysis of canine effusions. Acceptable results were compared with those obtained by a reference chemistry analyser.METHODS: Total protein, albumin, creatinine and bilirubin concentrations were measured in 74 effusions using the VetScanVS2, VetTest8008 and SpotchemEZ analysers. Cholesterol and triglyceride concentrations were also measured by the VetTest and Spotchem. Results were analysed using Westgards error analysis, Spearmans correlation, Bland-Altman plots and Deming regression. Results were considered acceptable when observed total error (TE(obs) ) was less than allowable total error (TE(A) ).RESULTS: VetScan error analysis ...
The development of malignant effusions is likely due to a combination of factors. Tumors that line the pleural cavity can produce differential osmotic and oncotic pressures that may lead to fluid accumulation. Vascular integrity may be physically disrupted by tumor infiltration of lymphatic channels and capillaries. In addition, permeability factors such as VEGF may be secreted by tumor cells, thus leading to increased capillary permeability and fluid accumulation.. We have previously shown that VEGF levels are elevated in malignant ascites and that this elevation of VEGF leads to increased endothelial cell permeability in vitro. Because most malignancies express VEGF, we hypothesized that elevated levels of VEGF may be associated with malignant pleural effusions. Given that other cytokines can be elevated in malignant effusions, we also investigated IL-8 and angiogenin in malignant pleural effusions. We found that amounts of VEGF in malignant pleural effusions were significantly higher than in ...
Background: Pleural TB is a form of extrapulmonary TB that is most commonly encountered and is still a problem of health workers because the enforcement of its diagnosis is still a challenge for clinicians and often results in complications such as pleural effusion. Gene Xpert and ADA are one of the alternative examinations to support the diagnosis of pleural TB. Method: This study was an observational cross-sectional study of 42 patients with TB pleural effusion who performed ADA and Gene Xpert tests in each sample. Results: The diagnosis of pleural tuberculosis was mainly established through sputum / pleural fluid culture in 33.3% of cases, and 66.7% of cases were diagnosed clinically. Based on ADA levels, the data shows that the majority of samples (64.3%) had ADA levels, 40 IU / L, while 35.7% of samples showed ADA levels ,40 IU / L. While for the sample that had a positive Gene Xpert, it was found to be 31%. Conclusions: Increased levels of ADA were more common in patients with TB pleural ...
Malignant pleural effusion is a complication of advanced lung cancer or breast cancer, which causes the shortness of breath and cough. Learn how to diagnose and treat it.
This study has investigated the clinical efficacy and safety of endostatin (Endostar) combined with chemotherapy for malignant pleural effusion.
We report on an HIV-1 infected patient who was diagnosed with primary effusion lymphoma (PEL) and who achieved a long-term remission after treatment with only highly active antiviral therapy (HAART).. In September 2005, a 42-year-old white homosexual man was referred to our clinic because he tested positive for HIV. He had a persistent low-grade fever, dry cough, asthenia and occasional dyspnoea, while his chest X-ray showed a left pleural effusion, unresponsive to empiric antibiotic treatment. Thoracentesis showed 350 ml of clear fluid with 1070 cells/ml (lymphocytes), 5.9 g/dl of proteins, 66 mg/ml of glucose, 4.667 and 307 U/l of lactate dehydrogenase (normal plasma value ,460 U/l) in pleural effusion and plasma, respectively. Cytological and immunophenotipical analysis of pleural fluid showed large pleiomorphic cells CD45+, CD138+, CD3− and CD19−, respectively. PCR for human herpes virus 8 (HHV-8) DNA tested positive for both cells and plasma. A bone marrow biopsy was found normal. A ...
TY - JOUR. T1 - Two cases of thoracopancreatic fistula in alcoholic pancreatitis. T2 - Clinical and CT findings. AU - Ito, Hisao. AU - Matsubara, Nobumichi. AU - Sakai, Toshihiko. AU - Aso, Noboru. AU - Kitami, Masahiro. AU - Ono, Schu ichi. AU - Ishibashi, Tadashi. PY - 2002/7/1. Y1 - 2002/7/1. N2 - We report two patients who were long-time habitual consumers of alcohol and suffered from thoracopancreatic fistula. The first patient, a 52-year-old man with no symptoms, underwent chest CT scan for a medical check-up and was revealed to have left small pleural effusion. A month later, he suddenly experienced severe cough and back pain. The immediate CT scan showed massive pleural effusion and mediastinal pseudocyst, and the amylase level in the aspirated pleural effusion proved to be elevated. He was successfully treated with medication and drainage of the effusion. The second patient, a 39-year-old woman, underwent CT scan for a medical check-up, and it disclosed that she had a small pleural ...
None of the effusions sampled in the series were transudates. Occluded lymphatic flow from increased hydrostatic pressure in the superior vena cava and left brachiocephalic vein probably contributes to the development of chylous pleural fluid. The pathophysiology of the exudative effusions, however, remains unknown. Many factors, including diuresis, small pulmonary emboli, and the underlying inflammatory or malignant condition all likely contribute. ...
Medical Thoracoscopy (pleuroscopy) involves passage of a camera through the chest wall for direct visualization of the pleura. Thoracoscopy is performed for diagnostic as well as therapeutic purposes. It is performed by pulmonologists. Medical thoracoscopy is most commonly used for pleural fluid drainage, parietal pleural biopsy, and pleurodesis...
A case of thoracic vertebral osteomyelitis due to Salmonella enteritis (SE) in an immunocompetent patient is reported. This is the third case in the literature of SE thoracic vertebral osteomyelitis, but the first one with this multi-foci presentation and finally fatal outcome due to meningoencephalitis. Further data that makes our case unique are the absence of fever (body temperature: 37.4°C) and gastrointestinal disorders. Case Report: A 57-year-old male patient initially presented with thoracic pain, dyspnea, and knee pain. Examinations revealed a large pleural effusion and septic arthritis. Blood and all these sides (vertebrae, pleural fluid, and joint fluid) cultures revealed SE. The infection was successfully treated with three surgical interventions, plus antibiotic administration. First, a chest tube was inserted and at the same time, we took cultures and specimens from the infected sites. Subsequently, bone debridement and spine fusion were performed, and finally, knee fusion was held with an
In this article, we will discuss the Pathology and Clinical Features of Acute Empyema Thoracis. So, lets get started.. Pathology. In acute empyema, there is accumulation of large amount of pleural fluid with many polymorphs, bacteria, and cellular debris. Fibrin gets deposited on both layers of pleura (visceral and parietal) and there is a tendency towards loculation. Later, as the disease progresses (empyema becomes chronic), fibroblasts grow from both the layers into the exudate resulting in adhesions of both the surfaces of pleura and form an inelastic membrane called thickened pleura or pleural peel.. Clinical Features. Patients with aerobic infection (parapneumonic pleural effusion) present with acute onset of fever with chills, productive cough with mucopurulent expectoration (bronchopleural fistula), dyspnea and chest discomfort.. Patients with anaerobic infection present with subacute illness with non-specific signs and symptoms such as weight loss, leucocytosis, mild anemia and history ...
Introduction: Mesothelioma is a rare and aggressive cancer related to asbestos exposure. We recently showed that pleural effusions (PEs) from patients with mesothelioma contain high levels of the CC motif chemokine ligand 2 (CCL2) inflammatory chemokine. In the present work, we studied the effect of CCL2 contained in mesothelioma samples , particularly on monocyte recruitment. Then, we studied the fate of these monocytes in malignant pleural mesotheli-oma (MPM) PEs and their impact on tumor cells properties.