Study of the Causes and Diagnostic Modalities of Malignant Pleural Effusions in the Pre-Thoracoscopy Era in a Tertiary Care Centre

Abstract

BACKGROUNDMalignant pleural effusions are a common cause of morbidity in patients with advanced cancers. Common malignancies associated with malignant pleural effusion include lung, breast and lymphomas. Diagnostic methods include cytological analysis and pleural biopsy either closed or thoracoscopic guided. This study was taken up to analyse the cancers associated with malignant pleural effusions and the diagnostic modalities employed towards the diagnosis of malignant pleural effusion. MATERIALS AND METHODSRetrospective analysis of case records of patients diagnosed as malignant pleural effusion prior to the use of thoracoscopicguided pleural biopsy during a two year period was done and the results were analysed to assess the causes of malignant pleural effusion and the diagnostic methods employed to confirm the diagnosis of malignant pleural effusion. RESULTS48 cases of malignant pleural effusion were identified during the study period. The commonest malignancies associated with malignant pleural effusion were lung and breast cancer. Most of the patients were elderly, but some of the cases were identified in younger age groups especially in breast cancer. Cytological analysis and closed pleural biopsies were the diagnostic methods employed for diagnosing malignant pleural effusion. CONCLUSIONThe study results were consistent with published data that malignant pleural effusions were commonly associated with lung and breast malignancies. Most of the malignancies were in patients aged more than 50 years, but some cases in younger age group especially associated with breast malignancy were noted. Cytology and closed pleural biopsy are adequate to diagnose malignant pleural effusion even in absence of thoracoscopy.

Malignant pleural effusions with unknown primary sites: A 6 years cytological study

“…9 Almost all the malignant effusions diagnosed on cytology were adenocarcinomas and the yield was less with other malignancies like sarcomas, squamous cell carcinomas, Hodgkin's disease. 10,11 This might be because of the fact that the adenocarcinoma cells are more easily identified cytological and large tissue biopsies are usually needed for the diagnosis of lymphoma and sarcomas.…”