STUDY OF THE CAUSES AND DIAGNOSTIC MODALITIES OF MALIGNANT PLEURAL EFFUSIONS IN THE PRE-THORACOSCOPY ERA IN A TERTIARY CARE CENTRE

Abstract

Vinod Kumar Viswanathan1

BACKGROUND
Malignant pleural effusions are a common cause of morbidity in patients with advanced cancers. Common malignancies associated with malignant pleural effusion include lung, breast and lymphomas. Diagnostic methods include cytological analysis and pleural biopsy either closed or thoracoscopic guided. This study was taken up to analyse the cancers associated with malignant pleural effusions and the diagnostic modalities employed towards the diagnosis of malignant pleural effusion.
MATERIALS AND METHODS
Retrospective analysis of case records of patients diagnosed as malignant pleural effusion prior to the use of thoracoscopic-guided pleural biopsy during a two year period was done and the results were analysed to assess the causes of malignant pleural effusion and the diagnostic methods employed to confirm the diagnosis of malignant pleural effusion.
RESULTS
48 cases of malignant pleural effusion were identified during the study period. The commonest malignancies associated with malignant pleural effusion were lung and breast cancer. Most of the patients were elderly, but some of the cases were identified in younger age groups especially in breast cancer. Cytological analysis and closed pleural biopsies were the diagnostic methods employed for diagnosing malignant pleural effusion.
CONCLUSION
The study results were consistent with published data that malignant pleural effusions were commonly associated with lung and breast malignancies. Most of the malignancies were in patients aged more than 50 years, but some cases in younger age group especially associated with breast malignancy were noted. Cytology and closed pleural biopsy are adequate to diagnose malignant pleural effusion even in absence of thoracoscopy.

image