Diagnostic Test for Pleural Effusion: Comparison of the Effectiveness between Cytological Examination and Blind Needle Pleural Biopsy.

Abstract

Background: Body fluid cytological examination is very simple, does not need special instrument and gives a very low rate of complication.  It has been using to obtain the diagnosis of pleural effusion particularly caused by metastatic carcinoma.  This study was performed compare the effectiveness of blind needle pleural biopsy (BNPB) which is a popular method used for diagnosis of patients with pleural effusion and two kinds of cytological examination; Papaniculaou’s and Wright’s staining method.

Method: BNPB and pleural effusions examination by Papaniculaou’s and Wright’s staining method were performed in thirty patients who presented with pleural effusion and were admitted at Siriraj hospital.  The result of BNPB and cytological examination were compared after the final diagnosis was made.

Results: The final diagnosis was given for only twenty-one patients.  Thirteen of these were cancer, and eight were tuberculosis.  Among those patients with cancer, the diagnosis can be made by BNPB, Papaniculaou’s and Wright’s staining method in 6 (46.2%), 4 (30.8%) and 10(76.9%) patients, consecutively.  Among those with pulmonary tuberculosis, the diagnosis had been given by BNPB and Wright’s staining method in 6(75.0%) and 7(84.2%) patients but none by Papaniculaou’s stain.

Conclusins: The cytological diagnosis of pleural effusion using Wright’s staining method gives a very effective yield.  Because this staining method is very simple thus it should be used more frequently especially in local hospitals.