Tuberc Respir Dis.  2005 Jan;58(1):5-10. 10.4046/trd.2005.58.1.5.

Clinical Characteristics and Prognosis of Lymphocyte Dominant Exudative Pleural Effusion with Low ADA, Low CEA, Negative Cytology and Negative AFB Smear

• Kang YA
• Yoon YS
• Lee SW
• Choi CM
• Kim DK
• Lee HS
• Ko DS
• Yoo CG
• Kim YW
• Han SK
• Shim YS
• Yim JJ

• KMID: 2132193
• DOI: http://doi.org/10.4046/trd.2005.58.1.5

Abstract

BACKGROUND: A pleural effusion is a common medical problem. Despite several diagnostic tests, 15-20% of pleural effusions go undiagnosed. The aim of this study was to evaluate the clinical characteristics and prognosis of a lymphocyte dominant exudative pleural effusion with a low adenosine deaminase (ADA), low carcinoembryonic antigen (CEA), negative cytology and negative acid fast bacilli (AFB) smear. METHOD: From Jan 2000 to Aug 2001, 43 patients with lymphocyte dominant exudative pleural effusions whose AFB smear and cytologic exam were negative, their pleural fluid ADA level was < 40 IU/L, and their CEA level was < 10 ng/mL were enrolled in this study. A retrospective analysis of the patients' medical records was carried out. RESULT: Among 31 of the 43 cases (72%), probable underlying diseases causing the pleural effusion were identified: 21cases of malignant diseases, 4 cases of liver cirrhosis, 2 cases of pulmonary tuberculosis, 1 case of end stage renal disease, 1 case of a chylothorax, 1 case of a post?CABG (coronary artery bypass graft) state, 1 case of a pulmonary embolism. No clinically suspected etiology was identified in the remaining 12 cases (28%). Of these 12 pleural effusions, 7 cases spontaneously resolved, 2 effusions resolved with antibiotics, and the other 2 cases were persistent.
CONCLUSION
Lymphocyte dominant exudative pleural effusions with a low ADA, low CEA, negative cytological exam, and negative AFB smear, but without a definite cause might have a benign course and clinicians can observe them with attention.

Keyword

Pleural effusion; Etiology; Prognosis

MeSH Terms

Adenosine Deaminase
Anti-Bacterial Agents
Arteries
Carcinoembryonic Antigen
Chylothorax
Diagnostic Tests, Routine
Humans
Kidney Failure, Chronic
Liver Cirrhosis
Lymphocytes*
Medical Records
Pleural Effusion*
Prognosis*
Pulmonary Embolism
Retrospective Studies
Tuberculosis, Pulmonary
Adenosine Deaminase
Anti-Bacterial Agents
Carcinoembryonic Antigen