Chest
Original ResearchNeoplastic DiseaseProspective Study To Determine the Volume of Pleural Fluid Required To Diagnose Malignancy
Section snippets
Materials and Methods
This was a single-center prospective study to determine the amount of pleural fluid needed to make the diagnosis of a malignant pleural effusion. The study was performed at Henry Ford Hospital in Detroit, Michigan, and received Institutional Review Board approval. Between September 1, 2001, and August 31, 2007, 102 patients (60 women and 42 men) underwent diagnostic thoracentesis yielding 121 pleural fluid samples. Eligible patients included those suspected of having a malignant pleural
Results
There were 102 patients (42 men and 60 women) in our study population. Table 1 shows our patients' demographic data and past medical history. The average age of our patients in the study was 67.8 years with an SD of 11.6. The difference in the mean age between patients with and without a malignancy was not significant. The mean age of patients with malignancy was 67.4 years (SD, 12.9), whereas the mean age of patients without a malignancy was 68.7 years (SD, 8.0), P = .55. No differences in the
Discussion
The diagnosis of a malignant pleural effusion is a poor prognostic indicator with overall mean life expectancy of approximately 6 months.3 Multiple studies have evaluated the sensitivity of cytologic diagnosis of pleural fluid from thoracentesis fluid sample compared with needle biopsy and thoracoscopy.5, 6, 7, 8, 9, 10, 11, 12, 13 A number of authors have analyzed one or more cytology samples, multiple ways to process the fluid samples for cytologic interpretation, and cytology coupled with
Conclusion
The sensitivity for the diagnosis of a malignant pleural effusion depends on the volume of pleural fluid obtained during thoracentesis. In our study, thoracentesis of at least 60 mL performed better than a 10-mL aliquot of pleural fluid to make the diagnosis of malignancy.
Acknowledgments
Author contributions: Dr Swiderek: contributed to obtaining study patients, delivering specimens to laboratory, blinding all pathology slides prior to interpretation, writing the manuscript, and helping write revisions.
Dr Morcos: contributed to developing initial research protocol, obtaining study patients, and helping write manuscript revisions.
Dr Donthireddy: contributed to developing initial research protocol, obtaining study participants, and helping write manuscript revisions.
Dr Surapaneni:
References (0)
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Funding/Support: This study was funded by the Henry Ford Hospital, Detroit, MI [IRB #1452].
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).