Malignant Pleural Effusion: A Study on Clinical and Investigative Profiles - A Prospective Study

Abstract

Background and Objective: Malignant pleural effusion (MPE) is a known complication of both thoracic and extrathoracic malignancies. A detailed clinical and investigative profile of patients presenting with MPE would allow us to intervene early in the disease and would ensure a better prognosis. Materials and Methods: A prospective study of 60 cases of MPE was carried out in the Department of Thoracic Medicine and Cardiothoracic surgery, Thanjavur Medical College Hospital, Thanjavur, from October 2017 to May 2018, with respect to age, sex, clinical findings, biochemical analysis, radiological, cytological investigations, and histopathology. Results: The most common age group of MPE is between 60 and 70 years, male-to-female ratio was 1:1. The right-sided pleural effusion was a more common finding compared to the left-sided effusion; pleural fluid biochemical analysis revealed a mean adenosine deaminase of 23.97 u/l, mean pleural fluid protein/serum protein ratio was 0.95, and mean pleural fluid glucose was 38.75 mg/dl. Of 60 cases, the most common cause of MPE was adenocarcinoma of lung which accounted for 30 cases, followed by metastatic carcinoma 24 cases and squamous cell carcinoma lung 3 cases and pleural mesothelioma in 3 cases. Conclusion: Pleural fluid cytology analysis for malignant cells was sufficient to diagnose MPE in 85% of cases, and in remaining cases, pleural biopsy can be helpful. The most common primary in cases of MPE was adenocarcinoma of lung.

Keywords

• clinical and investigative profile
• malignant pleural effusion
• adenocarcinoma