Behaviour of nucleated cells in various types of pleural effusion. / Comportamiento de las células nucleadas en los distintos tipos de derrame pleural.
Rev Clin Esp (Barc)
; 217(3): 136-143, 2017 Apr.
Article
em En, Es
| MEDLINE
| ID: mdl-28215651
ABSTRACT
INTRODUCTION:
To know the behavior of cellular components of pleural fluid can help focus the differential diagnosis of a pleural effusion. Our objective was to assess their composition in different types of pleural effusions and assess whether it provides relevant clinical information. PATIENTS ANDMETHODS:
Observational, cross-sectional and retrospective study in which the cellular components of pleural effusions of different etiology were analyzed. Pleural effusions were classified as neutrophilic, lymphocytic (≥50% of each one of them), eosinophilic (≥10%) or mesothelial (>5%) and were grouped into six diagnostic categoriesRESULTS:
1.467 patients were studied (354 heart failure; 59 other transudates; 349 paraneumonic; 133 tuberculous; 397 malignant and 175 other exudates). The predominance cell was lymphocytic in heart failure (44,4%), uncomplicated parapneumonic (29,2%), tuberculosis (88%) and malignant (49,6%); neutrophilic in parapneumonic (57%) and malignant (9,6%); eosinophilic in malignant (6,3%) and mesotelial in tuberculosis (12%). The most frequent etiologies with lymphocyte count ≥80% were tuberculosis (35,1%) and malignant (23,3%). Parameters with higher discriminating accuracy were leukocytes (transudates AUC 0,835) and percentage of neutrophils (empyemas AUC 0,906 and complicated parapneumonic+empyemas AUC 0,907).CONCLUSIONS:
Nucleated cell counts will help focus the etiology of pleural effusions, since each etiology often have a characteristic cell predominance. The percentage of nucleated cells in pleural fluid not ruled out tuberculosis if there is a high count of mesothelial cells, nor a parapneumonic effusion with lymphocytic predominance, or malignancy with ≥80% lymphocytes.
Células mesoteliales; Células nucleadas totales; Derrame pleural; Derrame pleural eosinofílico; Derrame pleural linfocítico; Derrame pleural neutrofílico; Eosinophilic pleural effusion; Lymphocytic pleural effusion; Mesothelial cells; Neutrophilic pleural effusion; Percentage nucleated cells; Pleural effusion; Porcentaje células nucleadas; Total nucleated cells
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Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
Idioma:
En
/
Es
Revista:
Rev Clin Esp (Barc)
Ano de publicação:
2017
Tipo de documento:
Article