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Related Experiment Videos

Pleural effusion. A diagnostic dilemma

D D Storey, D E Dines, D T Coles

    JAMA
    |November 8, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Diagnosing pleural effusion often remains indeterminate. Routine laboratory tests, including protein measurement and cytologic examination, are recommended for cost-effective diagnosis of this condition.

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    Area of Science:

    • Pulmonology
    • Oncology
    • Pathology

    Background:

    • Pleural effusion diagnosis can be challenging, with a significant number of cases remaining indeterminate even after thorough evaluation.
    • Cytologic examination of pleural fluid is a key diagnostic tool for identifying malignant causes of pleural effusion.

    Purpose of the Study:

    • To evaluate the diagnostic yield of various laboratory tests for pleural effusion.
    • To propose a cost-effective algorithm for the routine diagnostic workup of pleural effusion.

    Main Methods:

    • Analysis of laboratory test results from 133 patients with pleural effusion.
    • Review of diagnostic thoracenteses and cytologic examinations for malignancy.
    • Assessment of bacterial, mycobacterial, and fungal cultures.

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    Main Results:

    • The cause of pleural effusion was determined in 108 of 133 patients; 25 remained indeterminate.
    • Cytologic examination yielded positive results for cancer in 20 of 136 cases (15%).
    • Bacterial, mycobacterial, and fungal cultures showed low positive rates.

    Conclusions:

    • Measurement of protein content and cytologic examination are recommended as routine tests for pleural effusion.
    • A structured diagnostic algorithm can improve cost-effectiveness in managing pleural effusion.
    • Despite indeterminate diagnoses in some cases, targeted testing aids in identifying malignant etiologies.