ABSTRACT

Malignant pleural effusion is a common entity is patients with breast and lung cancer malignancies; in 50-65% of patients with metastatic lung and breast tumors, the pleura will be affected. Objectives: Study objective were to 1) evaluate the utility of diagnostic methods in malignant pleural effusion in a third-level hospital, 2) analyze the usefulness of tru-cut needle in the diagnosis of malignant pleural effusion and, 3) identify the most frequent neoplasms associated with malignant pleural effusion. Materials and methods: Between March 2011 and March 2012 we carried out a descriptive, observational cross-sectional retrospective study in a third-level hospital. There were 32 patients included ›15 years of age with a diagnosis of pleural effusion of malignant etiology confirmed by cytological fluid tests and/or pleural biopsy. SPSS 19.0 statistical package was used for analysis. Results: Thirty two patients were evaluated. Mean age of the study group was 59.6 years (±± 11.8) years; 17(53.1%) were males. Diagnostic performance was as follows: positive cytology in 15/31 (48.3%), positive pleural biopsy with tru-cut needle in 26/28 (92.8%), and positive pleuroscopy in 7/7 (100%). To determine the diagnostic efficacy of the cytology vs. pleural biopsy, 27 patients were selected to undergo both tests, finding a sensitivity of 40%, 0% specificity, positive predictive value (PPV) = 83%, negative predictive value (NPV) = 0%. The most frequently identified neoplasms were lung cancer (19 cases, 59.3%) and breast cancer (6 cases, 18.7%). Conclusions: Pleuroscopy was shown to be the procedure with the highest diagnostic efficiency. The frequency of metastatic tumors to the pleura is similar to what has been reported in the literature.

KEYWORDS

Malignant pleural effusion, cytology, pleural biopsy.

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