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Vol. 43. Issue 5.
Pages 277-282 (January 2007)
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Vol. 43. Issue 5.
Pages 277-282 (January 2007)
Original Articles
DOI: 10.1016/S1579-2129(07)60067-6
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Influence of Thoracentesis and Pleural Biopsy on Biochemical Parameters and Cytology of Pleural Fluid
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Haro-Estarriol Manuela,
Corresponding author
mip.mharo@htrueta.scs.es

Correspondence: Dr. M. Haro-Estarriol. Servicio de Neumología (planta 4.a B). Hospital Universitario de Girona Dr. Josep Trueta. Avda. de Francia, s/n. 17007 Girona. España
, Alberto Álvarez-Castillo Luisa, Baldó-Padró Xavierb, Manuel Ramírez-Malagón Joséc, Rubio-Goday Manuela, Sendra-Salillas Salvib
a Servicio de Neumología, Hospital Universitario de Girona Dr. Josep Trueta, Girona, Spain
b Servicio de Cirugía Torácica, Hospital Universitario de Girona Dr. Josep Trueta, Girona, Spain
c Laboratori Clínic, Hospital Universitario de Girona Dr. Josep Trueta, Girona, Spain
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Objective

To assess the influence of thoracentesis and pleural biopsy on biochemical parameters and cytology of pleural fluid from patients with lymphocytic exudate.

Patients and methods

A prospective, descriptive study was performed in 72 patients with pleural effusion who had lymphocytic exudate and in whom biopsy was indicated. Biochemical variables and cytology of pleural fluid were analyzed at baseline, 48 hours later (immediately prior to biopsy), and 48 hours after biopsy.

Results

The patients had a mean (SD) age of 63 (17) years, 57% were smokers, and 61% were men. Effusion was right-sided in 36% of patients, unilateral in 80%, and massive in 21%. The etiology was benign in 43 cases and neoplastic in 29 (40%). Pleural lactate dehydrogenase (LDH) was found to be increased following biopsy. This effect was significant in the overall population of 72 patients (649 [481] U/L just prior to biopsy and 736 [536] U/L 48 hours after biopsy; mean increase, 86 U/L; 95% confidence interval, 45-128 U/L; P<.001), in patients with pleural tumors (799 [529] U/L prior to biopsy and 957 [571] U/L 48 hours later, P<.001), and in those with LDH concentration greater than 266 U/L.

Conclusions

The results of our study show that a single thoracentesis procedure does not alter biochemical parameters or pleural cytology after 48 hours in lymphocytic exudates. Pleural needle biopsy leads to a significant increase in the concentration of LDH in patients with pleural tumors or higher baseline concentrations of LDH. Thoracentesis, pleural biopsy, or a combination of the two do not lead to significant changes in the number of eosinophils in pleural fluid.

Key words:
Pleural fluid
Thoracentesis
Pleural biopsy
Eosinophilia
Objetivo

Valorar la influencia de la toracocentesis y la biopsia pleural en la bioquímica y la citología del líquido en los pacientes con un exudado linfocitario.

Pacientes y métodos

Se ha realizado un estudio prospec-tivo y descriptivo de 72 pacientes con derrame pleural que te-nían un exudado linfocitario e indicación de biopsia. Se anali-zaron y compararon la bioquímica y citología del líquido pleural al inicio, a las 48 h de la punción (antes de la biopsia) y a las 48 h de la biopsia pleural.

Resultados

Los pacientes tenían una edad media ± desviación estándar de 63 ± 17 años, el 57% eran fumadores y el 61%, va-rones. El derrame era derecho en un 36%, unilateral en un 80% y masivo en el 21%. La etiología era benigna en 43 casos y neoplásica en 29 (40%). La lactatodeshidrogenasa (LDH) pleu-ral aumentó después de la biopsia en el análisis de todos los pa-cientes (649 ± 481 U/l antes de ésta y 736 ± 536 U/l a las 48 h; aumentó en promedio 86 U/l; intervalo de confianza del 95%, 45-128 U/l; p < 0,001), en los pacientes con neoplasia pleural (799 ± 529 U/l de LDH antes de la biopsia y 957 ± 571 U/l a las 48 h; p < 0,001) o valores de LDH superiores a 266 U/l.

Conclusiones

Nuestro estudio demuestra que una única toracocentesis no modifica los valores de la bioquímica o la citología pleural a las 48 h en los exudados linfocitarios. La biopsia pleural transparietal aumenta de forma significativa los valores de la LDH en los pacientes con neoplasia pleural o valores iniciales de LDH más elevados. La realización de la toracocentesis, la biopsia pleural o ambas técnicas no mo-difica de forma significativa el número de eosinófilos del lí-quido pleural.

Palabras clave:
Líquido pleural
Toracocentesis
Biopsia pleural
Eosinofilia
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Copyright © 2007. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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