[Biological effects of pleural talc in neoplastic pleurisy]

A study was carried out on ten patients who had received talc by thoracoscopy for secondary neoplastic pleural involvement. The study was in two parts. First, a laboratory study on blood specimens was made including the full blood count, sedimentation rate and alpha-2 globulins. Secondly, the pleural liquid was examined over a 24 hour period, measuring the leucocyte count/ml and also the pleural sugar. The studies revealed the occurrence of an early rise (J0) in the level of polynuclear neutrophil (PNN) in the pleural liquid, with a 24 hour peak preceded by a leucocytosis and a moderate polymorphonuclear response without any change in the sedimentation rate. These changes provide evidence for the role of PNN in the genesis of pleural symphysis during talc therapy. There was also an early fall in pleural sugar, and this was in parallel with the diminution of the quantity of pleural fluid drained and would be linked to a rise in the local cellular metabolism and to a disturbance in the exchange across the thickened pleural membrane, as a result of fibrosis.