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Updated: Feb 17, 2026
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
Demographic, clinical, biochemical, radiological and etiological characteristics of malignant pleural effusions from
K Saha1, M K Maikap2, A Maji2
1Department of Pulmonary Medicine, Burdwan Medical College, Burdwan, India.
Context:
There are very limited data regarding clinical, radiological and etiological aspects of malignant pleural effusion (MPE) from Eastern India.
Aims:
To review natural history, clinical features, radiological features and etiology of MPEs.
Setting And Design:
Hospital based cross-sectional descriptive study.
Materials And Methods:
We had reviewed166 diagnosed cases of MPEsregarding demography; clinical, radiological and biochemical characteristics, diagnostic modalities and etiologies.
Results:
Out of 166 patients, 72.89% were males and 27.11% were females. Mean age of presentation among males was 64.3 ± 12.7 and among females was 52.5 ± 14.8. Most common presenting symptom was dry cough (87.9%) and most common presenting sign was clubbing (54.5%). Massive effusion was found in 45.78% of cases. Pleural fluid macroscopic appearance was haemorrhagic in 54.82% of cases. Mean adenosine deaminase activity in MPE was 24.05 U/L. Mean pleural fluid/serum protein ratio was 0.65, mean pleural fluid/serum lactate dehydrogenase ratio was 1.01. Most of the cases (84.94%) were diagnosed by pleural fluid cytology for malignant cells. Primary cancer was diagnosed in 136 (81.93%) cases; among which 121 (88.97%) cases were lung cancers, among which adenocarcinoma (52.89%) was the most common histology.
Conclusions:
Pleural fluid cytologies for malignant cells are usually sufficient to diagnose MPE in nearly 85% of cases and in remaining cases if thoracoscopyis not available, blind pleural biopsy can be helpful. The most common primary in cases of MPE is lung cancer with adenocarcinoma being the commonest culprit.
Insights
This study highlights that pleural fluid cytology is effective for diagnosing malignant pleural effusion (MPE) in most cases. Lung cancer, particularly adenocarcinoma, is the most frequent cause of MPE in Eastern India.
Area of Science:
- Oncology
- Pulmonology
- Pathology
Background:
- Limited data exists on malignant pleural effusion (MPE) in Eastern India.
- Understanding MPE's clinical, radiological, and etiological aspects is crucial.
Purpose of the Study:
- To review the natural history, clinical features, radiological findings, and etiology of MPE.
- To provide insights into MPE in the Eastern Indian population.
Main Methods:
- A hospital-based, cross-sectional descriptive study.
- Reviewed 166 diagnosed cases of MPE, analyzing demography, clinical, radiological, and etiological data.
Main Results:
- MPE predominantly affected males (72.89%) with a mean age of 64.3 years.
- Dry cough and clubbing were common symptoms/signs; hemorrhagic effusion was frequent (54.82%).
- Pleural fluid cytology diagnosed MPE in 84.94% of cases, with lung cancer (81.93%) being the most common primary, specifically adenocarcinoma (52.89%).
Conclusions:
- Pleural fluid cytology is sufficient for diagnosing MPE in most cases.
- Blind pleural biopsy can be a useful alternative when thoracoscopy is unavailable.
- Lung cancer, especially adenocarcinoma, is the leading cause of MPE in this region.
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