Thoracentesis in patients with hematologic malignancy: yield and safety

Area of Science:

• Pulmonology
• Hematology
• Critical Care Medicine

Background:

• Pleural effusions are common in hospitalized patients with hematologic malignancies.
• Thoracentesis is frequently used to diagnose infection and rule out complicated parapneumonic effusions.
• The efficacy and safety of thoracentesis in this specific patient population remain understudied.

Purpose of the Study:

• To evaluate the diagnostic utility of thoracentesis for identifying infections in patients with hematologic malignancies.
• To assess the complication rate associated with thoracentesis in this patient cohort.

Main Methods:

• Retrospective chart review of 100 hospitalized patients with hematologic malignancies who underwent thoracentesis.
• Analysis included patients with lymphoma, leukemia, and those who received bone marrow or stem cell transplantation.
• Data collected focused on indications for thoracentesis, clinical presentation, effusion characteristics, diagnoses, and complications.

Main Results:

• Thoracentesis was performed to exclude infection in 69% of cases.
• Malignancy was diagnosed in 14 cases, chylous effusions in 6, and infection in only 1 case.
• The overall complication rate was 9%, including pneumothorax and hemothorax, comparable to other patient populations.

Conclusions:

• Hospitalized patients with hematologic malignancies infrequently develop complex parapneumonic effusions, despite a high risk of pulmonary infections.
• The etiology of pleural effusions in this population is often unclear.
• Thoracentesis is a safe procedure in this setting, though its yield for diagnosing infection is low.