Histiocytic pleural effusion: the strong clue to malignancy

World Journal of Surgical Oncology

卷:19

Sang Hyuk Park¹  Chui Yong Park²  Ganghee Chae²  Jae-Bum Jun³  Hwa Sik Jung⁴  Kwang Won Seo⁵  Byung Ju Kang⁵  Seung Won Ra⁵  Yangjin Jegal⁵  Hyeon Hui Kang⁵  Jong Joon Ahn⁵  Taehoon Lee⁵  Jin Hyoung Kim⁵ 

[1] Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine;

[2] Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine;

[3] Division of Infectious Diseases, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine;

[4] Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine;

[5] Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine;

关键词: Histiocytes;    Thoracentesis;    Pleural effusion;    Exudate;    Malignancy;   

DOI  :  10.1186/s12957-021-02296-1

来源: DOAJ

【 摘 要 】

Abstract Background There have been many studies on the clinical characteristics of neutrophilic, lymphocytic, and/or eosinophilic pleural effusion. While caring for patients with pleural effusion, we found that histiocytic pleural effusion (HisPE) was not uncommon. However, few studies have explored HisPE. The purpose of the present study was to determine the clinical characteristics and etiologies of HisPE. Methods In this retrospective study, HisPE was defined as pleural fluid white blood cells comprised of ≥ 50% histiocytes. Using a clinical data warehouse, patients with HisPE among all patients aged >18 years who underwent thoracentesis and pleural fluid analysis between January 2010 and December 2019 at Ulsan University Hospital were enrolled. A total of 295 (9.0%) of 3279 patients who underwent thoracentesis were identified as HisPE patients. Among them, 201 with exudative HisPE were included. Clinical characteristics and etiologies were extracted from medical records and analyzed. Results Among the 201 patients with exudative HisPE, the major causes were malignant pleural effusion (n = 102 [50.7%]), parapneumonic effusion (n = 9 [4.5%]), and tuberculous pleurisy (n = 9 [4.5%]). In the 102 patients with malignant pleural effusion, the main types of cancer were lung (n = 42 [41.2%]), breast (n = 16 [15.7%]), and stomach cancer (n = 11 [10.8%]). Among lung cancers, adenocarcinoma (n = 34 [81.0%]) was the most common histology. Conclusions The leading cause of exudative HisPE was malignancy, particularly lung cancer. Physicians should consider the possibility of malignant disease if histiocytes are predominantly present in pleural effusion.

【 授权许可】

Unknown