Shikha Ngairangbam1, D. B. Borkar2
A study of analysis of 50 pleural fluids was carried out at major teaching hospital, in Mumbai over a period of three years. Of these 50 fluids were 33 were transudates and 17 exudates. Male predominance (72%) was observed with the majority in 3rd decade. Tuberculosis (30 cases) was the commonest conditions associated with exudates followed by synpneumonic effusions. Majority of the tuberculous cases (80%) showed WBC count between 1000-5000 cells/cmm. Polymorphs were predominant in synpneumonic effusions. Of the 2 cases of malignant effusion, malignant cells (well differentiated adenocarcinoma) were detected in both the cases, with total WBC counts ranging between 1000-5000cell/cmm. The correct diagnosis of the fluid as transudate or exudate is important because if the fluid is exudative then further diagnostic procedures like cytopathology, pleural biopsy and other invasive procedure can be done for definite diagnosis. On the other hand, if the fluid is transudative then treatment for underlying conditions like CCF, nephrotic syndrome, cirrhosis is given. The presence of cancer cells in the fluid is a proof positive of malignancy related fluid but in 30 to 60 percent of cancer cases, cancer cells are not detected. Exfoliative cytology for malignant cells is highly specific though less sensitive (40-60%). Definitive diagnosis may depend upon clinical correlation and histological examination.
