Poster : P-117 ; Neutrophilic loculated tuberculous pleural effusion: incidence, characteristics, and differentiation from complicated parapneumonic effusion

Objectives: There exists neutrophilic loculated type of tuberculous pleural effusion (TPE), although TPE is generally characterized by lymphocytic exudative effusion, regardless of whether it is free-flowing or loculated. However, little data is available concerning the incidence and characteristics of neutrophilic loculated TPE. The present study evaluated the incidence andcharacteristics of neutrophilic loculated TPEs and differentiated them from complicated PPE. Methods: Between 2009 and 2014, a cohort of patients with TPE was retrospectively reviewed in a South Korean referral hospital. Clinical, laboratory, computed tomography, and pleural fluid findings of neutrophilic loculated TPE patients were compared to those of patients with neutrophilic free-flowing TPE and complicated PPE, respectively. Results: Neutrophilic TPE was observed in 33 (10%) out of 344 TPE patients. Of them, 10 (30%) exhibited loculation of the pleural fluid. These neutrophilic loculated TPE patients showed distinct pleural fluid characteristics. The classical pleural fluid biomarker levels were more intense than those observed in 23 neutrophilic free-flowing TPE patients, but similar to those of 54 complicated PPE patients. Nodular parenchymal lesions and pleural fluid adenosine deaminase levels were independent discriminators of neutrophilic loculated TPE and PPE. Conclusions: These results may be helpful to understand and manage patients with neutrophilic loculated TPE with differentiation from complicated PPE.