World Journal of
Pharmaceutical and Life Sciences

A COMPARISON BETWEEN PLEURAL FLUID ASPIRATE CYTOLOGY AND BLIND PLEURAL BIOPSY HISTOPATHOLOGY IN PATIENTS SUSPECTED TO HAVE MALIGNANT PLEURAL EFFUSION

*Dr. Talal Ibraheem Abdullah, Dr. Adnan M. AlJubouri, Dr. Adnan M. AlJubouri, Dr. Muhi K. Aljanabi, Dr. Muhammed. W. Alobaidy, Dr. Basil Fawzi Jameel, Dr. Kasim M. Sultan, Dr. Muhi K. Aljanabi

ABSTRACT

Background: Pleural effusion remains the most common manifestation of pleural pathology. Cytopathological examination of the pleural fluids is a fast, efficient and non-invasive diagnostic method. Identification of malignant pleural effusions bears critical importance in treatment and prognosis. Blind pleural biopsy histopathology is helpful to reach an etiological diagnosis of exudative pleural effusion, particularly when malignancy is suspected or when results of detailed pleural fluid study are inconclusive, especially in a set up where thoracoscope is not available. The aim of the study: The aim of this study was to investigate the cytopathologic diagnoses in malignant pleural effusions and compare it with blind pleural biopsy histopathology, and assess the value of both tests. Patients and Method: A total of 201 pleural effusion cases diagnosed to have malignancy in 2011, the data collected from (early detection of cancer laboratories, teaching laboratories and thoracic surgery laboratories) in (Baghdad Medical city Complex) were retrospectively identified as the study group. cytopathological evaluation of pleural fluid alone was done in 113 cases, histopathological pleural biopsy alone was done in 51 cases, and both investigations were done in 37cases. Cytological, histopathological and both are presented as a percentage and compared. Results: Of the total 201 pleural effusion cases, 89(44.2%) were females and 112 (55.8%) were males. The age range was between (21-80) with a mean value of (54.6±12.4). The study show that pleural fluid cytology alone was 50.4% malignancy +ve, and closed pleural biopsy histopathology alone was 25.5% malignancy +ve, both tests are +ve in 75.7%.Over all test pleural fluid cytopathology was 54% malignancy +ve, and closed pleural biopsy was 30.7% malignancy +ve. Conclusion: Cytopathological examination of pleural fluid is the most valuable diagnostic method for suspected malignant pleural effusions which may have various etiological causes. The sensitivity of pleural tissue biopsy histopathology in the diagnosis of malignant pleural effusion is lower than that of cytopathological evaluation of pleural fluid. Very few cases negative on cytopathology can be diagnosed by biopsy histopathology.

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