• Title/Summary/Keyword: Malignant effusion

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Treatment of Malignant Effusion with Intracavitary OK-432 Chemical Pleurodesis (악성흡수에 OK-432를 이용한 흉막유착술)

  • 김맹호;이헌재
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.414-419
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    • 1996
  • To determine the efficacy of OK-432 as pleural sclerosant, we examined the outcomes in 81 patients (age : 27 to 82 years) with malignant pleural effusion and the outcomes in 64 patients ecieving OK-432 3-10KE(1 Klinische Einheit unit) through a chest tube for malignant pleural effusions. Of 81 patients with malignant pleural effusion, 40 patients had lung cancer. Lung cancer is the most frequent cause of malignant pleural effusion in men and women, in which 57 oyo of it was adenocarcinoma. Eighty seven percent of patient had respiratory symptom. Of the 64 patients with intracavitary injection of OK-432 for malignant pleural effusion, 59 patients had a complete short-term response (no fluid reaccumulation during 1 month after intracavitary injection of OK-432). Five patiens of the non-responders had partial control of effusion, with improvement in respiratory symptoms and these patients underwent thoracentesis. Of the 51 patients who survived longer than 1 month, 48 patients did not have re- accumulation of the fluid during follow up. Fever after intracavitary injection of OK-432 was a majors side effect although but that was easily controlled with non-steroidal anti inflammatory drug therapy, Thus the efficacy of intracavitary OK-4)2 injection for malignant pleural effusion was very helpful.

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The Levels of Interferon-gamma, Interleukin-2 Receptor, Interleukin-6 and Interleukin-10 in the Patients with Malignant Pleural Effusion, Tuberculosis Effusion, Parapneumonic Effusion, and Lung Emphysema? (악성 흉수, 결핵성 흉수 및 부폐렴 삼출액과 농흉에서 Interferon-gamma, Interleukin-2 Receptor, Interleukin-6, Interleukin-10 농도의 비교)

  • Kim, Myung-Hoon;Kim, Seung-Joon;Park, Yong-Keun;Kim, Seok-Chan;Lee, Sook-Young;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.568-575
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    • 2000
  • Background : Cytokines are chemical mediators that control and modulate many inflammatory processes. They work in different fashions in a variety of diseases. Discriminating between malignant effusion, tuberculous effusion, and parapneumonic effusion are crucial from the clinical view-point in Korea. In the current study, interferon-gamma (IFN-${\gamma}$), soluble interleukin-2 receptor (IL-2R), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured for this purpose. Methods : Pleural fluids from patients with malignant disease, tuberculosis, parapneumonic effusion and lung empysema were collected and gauged using commercial ELISA kits. Results : 34 patients were enrolled in this study. Among these 15 cases were malignant effusions, 12 were tuberculosis pleurisy and 7 were parapneumonic effusion and lung empyema. The levels of cytokines measured in this study were as follows, in order of frequency, malignant effusion, tuberculous effusion, parapneumonic effusion and lung empyema. The levels of INF-${\gamma}$ were higher in tuberculous effusion than in malignant or parapneumonic effusion ($295.5{\pm}585.5$ vs. $16.7{\pm}50$ vs. $10.0{\pm}0$ pg/ml, p>0.05). The levels of IL-2R were higher in tuberculous effusion than in malignant or parapneumoruc effusion ($7423.5{\pm}3752.8$ vs. $3247.4{\pm}1713.3$ vs. $3790.2{\pm}3201.1$ pg/ml, p<0.05). No significant differences were found in the levels of IL-6 between the groups ($600{\pm}12.8$ pg/ml in malignant effusion, $556.4{\pm}161.7$ pg/ml in tuberculous effusion, $514.4{\pm}224.8$ pg/ml in parapneumoruc effusion). IL-10 levels were higher in parapneumoruc effusion than in malignant or tuberculous effusions ($98.4{\pm}141.7$ vs. $28.2{\pm}55.5$ vs. $11.3{\pm}11.7$ pg/ml, p<0.05). Conclusion : These results suggest that the measurement of IL-2R levels in pleural fluids may be a useful means of differentiating between tuberculous effusion and pleural effusions of other origins, and that the measurement of IL-10 levels in pleural fluids may be useful to differentiate between parapneumonic effusion and pleural effusions of other origins.

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New Prognostic Significance of Malignant Pleural Effusion In Patients with Non-Small Cell Lung Cancer (비소세포폐암의 예후 결정에 있어 악성 흉수의 새로운 의의)

  • Kim, So-Young;Park, Seong-Hoon;Shin, Jeong-Hyun;Shin, Seong-Nam;Kim, Dong;Lee, Mi-Kung;Lee, Sam-Youn;Choi, Soon-Ho;Kim, Hak-Ryul;Jeong, Eun-Taik;Moon, Sun-Rock;Lee, Kang-Kyu;Yang, Sei-Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.3
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    • pp.710-714
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    • 2009
  • Several studies showed that the survival rate of stage IIIB disease with malignant pleural effusion is worse than stage IIIB disease without malignant effusion. But, malignant pleural effusion was considered T4. To analyze changes the survival time for malignant pleural effusion, in the seventh revision of TNM classification for lung cancer. The records of all patients had to have either a histological or cytological diagnosis of non-small cell lung cancer (NSCLC), who were admitted to Wonkwang university hospital between January 2004 and December 2006 were reviewed retrospectively. We evaluated the survival time of 187 patients with advanced lung cancer with and without malignant pleural effusion. This included the pleural effusion or nodule M1 a (pleural dissemination, currently classified as T4), nodule(s) in the other lung M1 a (contralateral lung nodule, currently classified as M1), nodule(s) with the same lobe as the primary tumor T3 (currently classified as T4), other T4 factors T4 (T4 MO anyN), and extrathoracic sites of disease M1b (distant metastasis, currently classified M1). Among the 187 patients, T4anyNMO was 57 patients in the current TNM classification. In the next edition of the TNM classification, T4MOanyN-T4 (excluding same lobe nodules) was 12 patients, pleural dissemiantion-M1a was 45 patients, contralateral lung nodule(s)-M1a was 7 patients, and metastatic disease-M1b was 55 patients. We compared the survival time for these groups. Survival time was 11 months, 8 months, 11 months, and 4 months. The survival time of malignant pleural effusion was shorter than other T4 factors without pleural effusion. But, there was no remarkable difference in statistics due to small cases (p=0.23). We strongly suggest that malignant pleural effusion in advanced NSCLC will be categorized with metastatic disease.

Intracavitary Carboplatin Chemotherapy in a Malignant Mesothelioma Dog (개의 악성중피종의 흉강내 Carboplatin 투여 증례)

  • 홍성혁
    • Journal of Veterinary Clinics
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    • v.18 no.2
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    • pp.167-169
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    • 2001
  • A 10-year-old castrated male Siba dog was presented for signs referable to pleural effusion associated with neoplasm of the thoracic cavity. The pleural effusion fluid consisted of blood and tumor cells by thoracocentesis. Histopathological examination of the sedimentary tumor cells revealed malignant mesothelioma. Intracavitary carboplatin was administered at 300 mg/$m^2$ every 5 weeks for 3 treatment and pleural effusion was disappeared after 3 treatments. The dog had recurrence of pleural effusion at 515 days but intracavitary carboplatin chemotherapy had no effect. It would be thought that the intracavitary carboplatin treatment was quite a useful method to control a canine malignant mesothelioma with minimal toxicity.

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A Case Report of a Stage IV Non-small Cell Lung Cancer Patient Treated with Modified Yieum-jeon Showing Improvement in Malignant Pleural Effusion and other Respiratory Symptoms (비소세포성 폐암 4기 환자의 악성흉수로 인한 증상이 이음전가미방으로 호전된 1례)

  • Park, So-Jung;Kang, Hwi-Joong;Lee, Yeon-Weol;Cho, Chong-Kwan;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.35 no.3
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    • pp.366-372
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    • 2014
  • Objectives: This is a report of a case of a stage IV non-small-cell lung cancer (NSCLC) patient whose malignant pleural effusion & respiratory symptoms have been relieved with Korean medicinal prescription, modified Yieum-jeon. Methods: A 56-year-old male diagnosed with stage IV NSCLC suffering malignant pleural effusion with complaints of cough, sputum, bilateral leg edema, dysphagia, post neck and left scapular pain was treated with modified Yieum-jeon and acupuncture during 16days. After treatment, blood lab and chest X-ray were used to follow the condition of malignant pleural effusion & pulmonary symptoms. Results: Malignant pleural effusion and pulmonary symptoms were improved with modified Yieum-jeon intake without any related adverse side effects. Conclusions: This study suggests Yieum-jeon may play a positive role in improving the malignant pleural effusion symptoms in advanced lung cancer cases.

Intrapleural or Intraperitoneal Lobaplatin for Treatment of Patients with Malignant Pleural Effusion or Ascites

  • Huang, Xin-En;Wei, Guo-Li;Huo, Jie-Ge;Wang, Xiao-Ning;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Xiang, Jin;Feng, Ji-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2611-2614
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    • 2013
  • Aims: To explore efficacy and side effects of intrapleural or intraperitoneal lobaplatin for treating patients with malignant pleural or peritoneal effusions. Methods: Patients in Jiangsu Cancer Hospital and Research Institute with cytologically confirmed solid tumors complicated with malignant pleural effusion or ascites were enrolled into this study. Lobaplatin (20-30 $mg/m^2$) was intrapleurally or intraperitoneally infused for patients with malignant pleural effusion or ascites. Results: From 2012 to 2013, intrapleural or intraperitonea lobaplatin was administered for patients with colorectal or uterus cancer who were previous treated for malignant pleural effusion or ascites. Partial response was achieved for them. Main side effects were nausea/vomiting, and bone marrow suppression. No treatment related deaths occurred. Conclusion: Intrapleural or intraperitoneal infusion of lobaplatin is a safe treatment for patients with malignant pleural effusion or ascites, and the treatment efficacy is encouraging.

Massive Pleural Effusion as the First Manifestation of Malignant Melanoma Metastasis (흉수로 발현한 전이성 악성 흑색종 1예)

  • Kim, Hee Gu;Ryu, Jeong Seon;Kwak, Seung Min;Lee, Hong Lyeol;Kim, Lucia;Cho, Jae Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.289-291
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    • 2004
  • Malignant melanoma develops from melanocytes and frequently metastases to other organs. Common metastatic sites are other skin, lymph nodes, lung, liver, brain and bone in decreasing order of frequency. Malignant pleural effusion is less frequent manifestation of thoracic metastasis. We experienced a 57-year-old man with pleural effusion who received radical resection with local flap on left foot due to acral lentiginous melanoma 3 years ago. He had progressive chest pain and left massive pleural effusion. The pleural cytology and biopsy showed malignant melanoma. After closed thoracostomy and talc pleurodesis, he refused further immunotherapy and chemotherapy and discharged.

Utility of Nuclear Morphometry in Effusion Cytology

  • Ambroise, Marie Moses;Jothilingam, Prabhavati;Ramdas, Anita
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6919-6922
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    • 2014
  • Background: The cytological analysis of serous effusions is a common investigation and yields important diagnostic information. However, the distinction of reactive mesothelial cells from malignant cells can sometimes be difficult for the cytopathologist. Hence cost-effective ancillary methods are essential to enhance the accuracy of cytological diagnosis. The aim of this study was to examine the utility of nuclear morphometry in differentiating reactive mesothelial cells from malignant cells in effusion smears. Materials and Methods: Sixty effusion smears consisting of 30 effusions cytologically classified as malignant (adenocarcinomas) and 30 benign effusions showing reactive mesothelial cells were included in the study. ImageJ was used to measure the nuclear area, perimeter, maximal feret diameter, minimal feret diameter and the circularity. A total of ten representative cells were studied in each case. Results: Significant differences were found between benign and malignant effusions for the nuclear area, perimeter, maximal feret diameter and minimal feret diameter. No significant difference was found for circularity, a shape descriptor. Receiver operating characteristic (ROC) curve analysis revealed that nuclear area, perimeter, maximal feret diameter, and minimal feret diameter are helpful in discriminating benign and malignant effusions. Conclusions: Computerised nuclear morphometry is a helpful ancillary technique to distinguish benign and malignant effusions. ImageJ is an excellent cost effective tool with potential diagnostic utility in effusion cytology.

Clinical Evaluation of Pleural Biopsy in the Intrathoracic Lesion with Pleural Effusion (흉막 생검법에 대한 임상적 고찰)

  • 안광수
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.298-302
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    • 1993
  • The 40 patients who admitted with chief complaints of pleural effusion and were performed closed thoracostomy and pleural biopsy at the same time with only one incision during the period from Mar,1990. To Feb. 1992. At the department of Thoracic & Cardiovascular Surgery; HanYang University were reviewed retrospectively and the results are as follows: 1. The age of patients ranged from 16 to 73-years old [Mean 44.3-years old]. The peak incidence was fifth decade [25 %] and the next was third decades [22.5 %]. 2. 28 patients were male and 12 patients were female with male preponderance[More than 2 times]. 3. The etiologic of pleural effusion were 25 cases of pulmonary tuberculosis[62.5 %], 8 cases of empyema [20 %], and 7 cases of malignant diseases [17.5 %]. 4. The most common chief complaints were dyspnea[21 cases:29.2%], chest discomfort[16 cases:22.2%], and the coughing with sputum [12 cases: 16.7 %]. 5. The duration of symptom were varied from 3 days to lyear [Mean 3.2 weeks]. 6. The amounts of drained pleural effusion after closed thoracostomy were ranged from 100ml to 2,400 ml [Mean 650 ml], but the amounts in case of malignant pleural effusion were varied from 400ml to 1,700ml [Mean 950ml]. 7. The diagnostic rate was 84.6 % with routine examination of tuberculous pleural effusion [Lymphocyte predominance] and the same rate was acquired by pleural biopsy. 8. The diagnostic rate by pleural biopsy in case of malignant pleural effusion was 57.1% and lower than tuberculous pleural effusion. 9. The etiology of malignant pleural effusion were squamous cell carcinoma [3 cases:42.8 %], adenocarcinoma [2 cases:28.6 %] and metasiatic breast cancer [1 case:14.3%].

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Pleural Space Elastance and Its Relation to Success Rates of Pleurodesis in Malignant Pleural Effusion

  • Masoud, Hossam Hosny;El-Zorkany, Mahmoud Mohamed;Ahmed, Azza Anwar;Assal, Hebatallah Hany
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.1
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    • pp.67-73
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    • 2021
  • Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (PEL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid. Methods: A prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. The study population consisted of 40 patients with malignant pleural effusion. The measurement of PEL after the aspiration of 500 mL of fluid was done with "PEL 0.5" (cm H2O/L), and the characteristics of the pleural fluid were chemically and cytologically analyzed. Pleurodesis was done and the patients were evaluated one month later. The PEL values were compared with pleurodesis outcomes. Results: After 4-week of follow-up, the success rate of pleurodesis was 65%. The PEL 0.5 was significantly higher in failed pleurodesis than it was in successful pleurodesis. A cutoff point of PEL 0.5 >14.5 cm H2O/L was associated with pleurodesis failure with a sensitivity and specificity of 93% and 100%, respectively. The patients with failed pleurodesis had significantly lower pH levels in fluid than those in the successful group (p<0.001). Conclusion: PEL measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for pleurodesis failure in patients with malignant pleural effusion.