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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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Is pleural effusion a sign of cancer?

Answered by
Dr.
Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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Posted on Sat, 28 Apr 2012 in Lung and Chest disorders
Question: This is for my mother age - 62

Pleural fluid examination

Macroscopic appearance
Volume: 25ml
Colour: Yellowish
Apperance: Turbid
Coagulum: Present
Blood: Present
Reaction: Alkaline

Chemical analysis
Protiens: 5.6%
Sugar: 108 mg%

Cytology
TLC: 1400
Lymphocytes: 98%
Polymorphs: 2%

Gram stain: No organisims seen
ZN stain: No-acid fast bacili seen

Adenosine Deaminnase: 23.13 (RANGE 0.00-36.00 IU/L)

TB = -ve
Effusion done: 320 ml
Ultrasound Abdomen: Normal scan, bilateral pleural effusion noted
Ultasound Chest: bilateral pleural effusion with pericardial thickening & effusion
Typhoid: +ve

She suffered from viral fever around 15 days back. Are there signs of cancer?
doctor
Answered by Dr. Jasvinder Singh 1 hour later
Hello,

Thanks for posting your query.

In view of the presence of pleural effusion which is exudative in nature and abundance of lymphocytes, the possibility of tuberculosis is always the first possibility in India.

The term exudative means that the proteins in the fluid are > 3.0 gm%.

This is inspite of the fact that the tubercle bacilli have not been found in the pleural fluid and the ADA levels are within normal limit.

The second possibility is always a malignancy (cancer) keeping in view of the age of your mother and the presence of bilateral pleural effusion and pericardial effusion/thickening.

A Contrast Enhanced CT scan of the chest should be done as it might help in ruling out the possibility of both tuberculosis of the lungs as well as the possibility of cancer of the lung.

Mammography/MRI of the breast should also be done to rule out cancer of the breast.

Further tests like PCR tuberculosis of the pleural fluid might help in confirming tuberculosis and pleural fluid for malignant cells should help in ruling out a malignant (cancerous) effusion.

Please consult a pulmonologist for the same.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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