Diagnostic approach to pleural effusions

Introduction: Aspiration of serous cavities is a simple and relatively noninvasive technique to achieve the diagnosis of cause of pleural effusion. Cytological examination of pleural fluid obtained by tapping is a simple, inexpensive, diagnostic modality of the cause of pleural effusion and further helps in treatment and follow up of the patients. Not only the infective causes, it also helps in cancer patients either primary or metastatic effusions both in diagnosis and management. Materials and Method: This study on pleural fluid cytology was done on 100 cases in Adichunchanagiri Institute of Medical Sciences B G Nagar for a period of 2 years. Relevant and available clinical information regarding age, sex, symptoms and accompanying signs were obtained from the patients. Pleural fluid was analysed for gross appearances and cytological analysis for cell count, cell type and malignant cells. Results: 100 samples of pleural fluid were received. Incidence of pleural effusion was more in males compared to females with a male to female ratio of 1.6:1. In the benign effusions, various clinical conditions noted were Pulmonary tuberculosis, Pneumonia, and anemia with hypoproteinemia, CCF, and Pulmonary infarction. Exudative effusions were more (84%) compared to transudative effusions (16%). Out of 100 samples received clinical diagnosis of malignant effusions was made in 10 cases and 3 cases which were diagnosed as tuberculous effusion turned out to be malignant effusion by cytology. Conclusion: Pleural fluid cytology is one of the easy, inexpensive mode of diagnosis for the cause of pleural effusion, which also helps in the treatment and management of patients. It can be done in any rural set up with basic facilities where sophisticated techniques are not available. Keywords: Pleural Fluid, Cytological Analysis, Tuberculosis, Malignant Effusion