CT-guided cutting needle biopsy provides a significantly higher diagnostic yield than the blind needle biopsy in pleural mass or pleural thickening Especially, because the effusion by drugs is misdiagnosed, the clinical history which includes the medication history is important. Exudate resulted from local diseases, where the fluid originated, and further investigations should be directed at the genesis of the local disease 1. Cytologic study of pleural fluid is a complete diagnostic modality which aims at pointing out the etiology of effusion as well as, in certain cases, a means of prognostication of disease process. Postprocedure chest radiograph is only recommended in aspiration of air, developing of symptoms, and the loss of tactile fremitus 1. In the lateral decubitus view, pleural effusion is easily detected by free pleural fluids shifting between the dependent chest wall and the lower border of the lung. But, false positive scans may be due to infections parapneumonics, empyema, TB and talc pleurodesis 3. J Vasc Interv Radiol. It was noted that Bronchoscopy is useful in patients with pleural effusions for one or more of the following: 1 pulmonary infiltrates in chest radiograph or CT scan; 2 hemoptysis; 3 massive pleural effusion more than three fourths of the hemithorax; and 4 mediastinum shifted toward the side of the effusion 1.
Volume and cellular content of normal pleural fluid in humans examined by pleural lavage.
cells/ml). Taking into account a measured dilution factor ofthe total WBC count in the original pleural fluid was 1, cells/ml. Differential. Many pleural fluid tests are useful in the differential diagnosis of exudative effusions. Pleural fluid for total white blood cell (WBC) count and differential criteria for an exudative effusion with LDH but not with protein levels.
Volume and cellular content of normal pleural fluid in humans examined by pleural the total WBC count in the original pleural fluid was 1, x 10(3) cells/ml.
Table 2 Medical history and physical examinations of pleural effusions.
Exposures to local anesthetic lidocaine or heparin in the syringe decreases pH levels of pleural fluid. Sahn SA. Table 5 Optional pleural fluid tests for pleural effusions.
Diagnostic Tools of Pleural Effusion
For patients with clinical history, symptoms and signs related to pleural diseases, physicians have to use diagnostic radiographical studies to diagnose pleural effusions, and the use of TUS is essential. Diagnostic thoracentesis is safe when the distance of shifting is more than 10 mm.
Transudates are caused by increased hydrostatic pressures e.
1) Pleural fluid white blood cell differential counts.
Video: Normal pleural fluid wbc differential Hematologic Analysis of Body Fluids
Pleural fluid pH is highly correlated with pleural fluid glucose levels. send the pleural fluid for total and differential cell counts, Gram stain. Two areas of a badly spread film from a patient with a white blood cell count of .
The leukocyte count in ascitic fluid may increase, however, during diuresis in.
Radiologic Diagnosis 1. However, the concentrations of the biochemical components protein, LDH, and albumin in pleural fluids increase progressively during the diuretic therapy of patients with congestive heart failure Appearance of pleural fluid The gross appearance of pleural fluid frequently serves as useful diagnostic information.
Especially, because the effusion by drugs is misdiagnosed, the clinical history which includes the medication history is important.