Tuberc Respir Dis.  2006 Nov;61(5):456-462. 10.4046/trd.2006.61.5.456.

Etiology and Characteristics of Massive Pleural Effusions Investigated at One University Hospital in Korea

• Park SR
• Kim JH
• Ha NR
• Lee JH
• Kim SH
• Sohn JW
• Yoon HJ
• Shin DH
• Park SS
• Kim TH

• KMID: 1970251
• DOI: http://doi.org/10.4046/trd.2006.61.5.456

Abstract

BACKGROUND: Differential diagnosis is very important in patients with pleural effusions. A few studies on the etiologies of massive pleural effusions have been reported, but these were conducted in different decades and locations. In the present study, the etiologic spectrum of massive pleural effusions in Korea, were evaluated through an investigation at one university hospital.
METHODS
Retrospective chart reviews were performed in patients having undergone thoracentesis between July 2002 and July 2005. Pleural effusions were deemed to be massive if they occurred in two thirds or more of one hemithorax. The etiologies of massive pleural effusions, pleural fluid findings, serum laboratory findings, and sputum and pleural fluid cytologies were compared.
RESULTS
Of 298 pleural effusions cases, 41 (13.8%) had massive pleural effusions. The most frequent causes of massive pleural effusions were malignancy (19; 46.3%) followed by tuberculosis (15; 36.6%), parapneumonic effusion (4; 9.8%) and transudate (3; 7.3%). Compared with massive benign effusions, patients with massive malignant pleural effusions were more likely to have lower adenosine deaminase (ADA) activity, a higher amylase level and higher RBC count in their pleural fluids. Also, compared with non-tuberculosis effusions, patients with massive tuberculous pleural effusions were more likely to have lower RBC and neutrophil counts, but a higher lymphocyte count, adenosine deaminase (ADA) activity and protein level.
CONCLUSION
The most common etiologies of massive pleural effusions in Korea are malignancy and tuberculosis. A high ADA content favors a tuberculous condition, while bloody effusions with a relatively lower ADA content. favors malignancy. The proportion of tuberculosis in massive pleural effusions was higher than in previous reports.

Keyword

Etiology; Massive pleural effusion; Malignant effusion; Tuberculous pleurisy

MeSH Terms

Adenosine Deaminase
Amylases
Diagnosis, Differential
Exudates and Transudates
Humans
Korea*
Lymphocyte Count
Neutrophils
Pleural Effusion*
Pleural Effusion, Malignant
Retrospective Studies
Sputum
Tuberculosis
Tuberculosis, Pleural
Adenosine Deaminase
Amylases

Figure

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  Figure 1 Etiology of massive effusion.

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  Figure 2 Etiology of Pleural effusion

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