Pleural effusion in clinical practice

G. Pozojevic, B. Perin (Zrenjanin, Sremska Kamenica, Yugoslavia)              

The aim of this work was to analyze the patients with pleural effusion and to establish the statistic data which can bring up a proper conclusion for future diagnostic and therapy development.

The patients who were treated in the Special hospital for lung diseases "Dr Vasa Savic" in Zrenjanin, Serbia and Montenegro in last 5 years, were analyzed in this paper.

There were 339 patients with pleural effusion. All of them underwent x-ray, CT scanning, ultrasound, blood analyses and thoracocentesis. Obtained fluid from thoracocentesis was examined biochemically, cytopathologically and bacteriologically. Also, pleural biopsy was performed (Ramel needle biopsy) as well as pleuroscopy and bronchoscopy.

The most useful diagnostic tools were biochemical and bacteriological examination (36% of all cases). Histological examinations of biopsy material were helpful in 9.1% and bronchoscopy in 4.4% of all cases. There were 50 (14.7%) patients with nonspecific pleural effusion, 34 (10.1%) with specific effusion, 100 (29.5%) with transudate, 87 (25.7%) with malignant effusion and 68 (20%) with unknown effusion. Among patients with nonspecific pleural effusion there were 19 patients with pleural empyema, 15 with effusion due to pneumonia, 9 with traumatic effusion, 4 with effusion due to PTE, 2 with effusion due to pancreatic disease and 1 due to rheumatic disease.

A large number of undiagnosed pleural effusions emphasizes the need for better diagnostic approach. Also the large number of pleural empyema leads to conclusion that primary treatment was not appropriate. Generally, in our circumstances, this matter needs a better interdisciplinary cooperation.

Eur Respir J 2003; 22: Suppl. 45, 192s