DOI: 10.36347/sjams.2019.v07i05.014

Pages: 1748-1754

The aspiration of pleural fluid is a bedside procedure. The routine, microscopic and cytological examinations of pleural fluid have been an important diagnostic value to find out the cause of pleural effusion. The routine examination can help in differentiation of transudative and exudative fluid, microscopic examination, culture sensitivity and PCR testing can help to identify microbiological organism and cytological examination helps in the diagnosis and typing of malignancy in pleural fluid. The present study includes 300 cases of pleural effusion. The aspiration of pleural fluid was done with aseptic precautions and fluid was submitted for routine and microscopy, cytological examination and ADA estimation. The transudative type of fluid detected in 71(23.7%) cases and exudative fluid detected in 229(76.3%) cases. The inflammatory fluid in 178(77.7%) cases and malignancy in 40(17.5%) cases were detected and 11(4.8%) cases were suspicious of malignancy. Adenocarcinoma in male and carcinoma is commonest cause on cytological study in 45 cases (19.6%). In case of malignant pleural fluid different cytomorphological features along with clinical and radiological imagine study help to identify type of malignancy in lungs and pleura as well as extra thoracic causes of pleural effusion. The type of malignant lesion can be confirmed by histopathology after surgery or by various available biopsy techniques like bronchoscopic and direct CT guided lung biopsy. ADA level in body fluids is 93.5% specific and 95.9% sensitive for diagnosis of tuberculous pleural fluid and positive predictive value was 95.9% and negative predictive value was 92.1%. ADA level more than 40 IU/ML is diagnostic of tuberculous etiology of pleural fluid.