• Title/Summary/Keyword: Pleural fluid

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Mycobacterium intracellulare Pleurisy Identified on Liquid Cultures of the Pleural Fluid and Pleural Biopsy

  • Lim, Jong Gu;O, Sei Won;Lee, Ki Dong;Suk, Dong Keun;Jung, Tae Young;Shim, Tae Sun;Chon, Gyu Rak
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.3
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    • pp.124-128
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    • 2013
  • Pleural effusion is a rare complication in non-tuberculous mycobacterial infection. We report a case of Mycobacterium intracellulare pleuritis with idiopathic pulmonary fibrosis in a 69-year-old man presenting with dyspnea. Pleural effusion revealed lymphocyte dominant exudate. M. intracellulare was identified using a polymerase chain reaction-restriction fragment length polymorphism method and liquid cultures of pleural effusion and pleural biopsy. After combination therapy for M. intracellulare pulmonary disease, the patient was clinically well at a 1-month follow-up.

A Case of Chronic Pancreatitis with Massive Pleural Effusion (다량의 늑막 삼출을 동반한 만성 췌장염 1례)

  • Lee, Eun Young;Kang, Yo Han;Kim, Jae Young;Kim, Sung Won
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.81-86
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    • 2005
  • Massive pancreatic pleural effusion is a rare complication of chronic pancreatitis. It results from leakage of pancreatic secretion into the pleural space through the aortic or esophageal hiatus, either by a pancreatic duct disruption or communicating pseudocyst. The presentation of the pancreatic pleural effusion is often misleading as respiratory rather than abdominal symptoms because of predominance of pulmonary complaints. Markedly elevated amylase level of the pleural fluid is highly suggestive of the diagnosis. We experienced a case of chronic pancreatitis with massive pleural effusion in a 9-year-old female, who presented with a 6-months history of intermittent abdominal pain, and cough and chest pain for 3 days.

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Diagnostic Utility of MAGE Expression in Exudative Pleural Effusion (삼출성 흉수에서 악성 감별을 위한 MAGE 유전자 검출의 의의)

  • Kim, Kyung Chan;Seo, Chang Gyun;Park, Sun Hyo;Choi, Won-Il;Han, Seung Beom;Jeon, Young June;Park, Jong-Wook;Jeon, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.159-168
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    • 2004
  • Background : In recent years, numerous human tumor specific antigens such as melanoma antigen gene(MAGE) that is recognized by autologous cytotoxic T lymphocytes have been identified. MAGE is expressed in many human malignancies in various organs, such as lung, breast, stomach, esophagus and leukemia. Therefore MAGE has been studied widely for tumor diagnosis and immunotherapy. But, so far there were no clinical studies evaluating the role of MAGE in pleural effusion. We investigated the expression of MAGE in the patients with exudative pleural effusion for it's diagnostic utility and the results were compared with those of cytologic examinations. Methods : Diagnostic thoracentesis was performed in 44 consecutive patients with exudative pleural effusion during 6 months. We examined the expression of MAGE and cytology with the obtained pleural effusion. Expression of MAGE was interpreted by means of a commercial kit using RT-PCR method. Enrolled patients were divided into two groups such as malignant and benign and we analyzed its' sensitivity and specificity. Results : There were no significant differences between two groups in age, sex, white blood cell counts in pleural fluid, pleural fluid/serum protein ratio and pleural fluid/serum LDH ratio. The sensitivity and specificity of MAGE were 72.2% and 96.2% respectively and the positive predictive value and negative predictive value of MAGE were also 92.9% and 83.3% respectively. The sensitivity and negative predictive value of cytologic examinations were 66.7% and 81.3% respectively. There were no significant differences between sensitivities of MAGE and cytologic examinations but false positive result of MAGE was found in 1 case of tuberculous pleurisy. Conclusion : MAGE is a sensitive and specific marker for the differential diagnosis between benign and malignant effusion in patients with exudative pleural effusion. And MAGE would provide the equal sensitivity compared with that of cytologic examination in patients with malignant pleural effusion if 5mL of the pleural fluid is examined.

Cytologic Diagnosis of Malignant Fibrous Histiocytoma in Pleural Fluid - A Case Report (흉막강액에서 진단된 악성 섬유성 조직구종 - 1예 보고 -)

  • Oh, Hwa-Eun;Kim, Yoo-Hoon;Cho, Seong-Jin;Kim, Young-Sik;Kim, In-Sun
    • The Korean Journal of Cytopathology
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    • v.6 no.1
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    • pp.80-83
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    • 1995
  • Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in plural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular eccentrically-placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.

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Factors Associated with the Development of Pleural Thickening in Tuberculous Pleurisy (결핵성 흉막염 치료 후 흉막비후의 예측인자)

  • Park, Jae-Seuk;Chun, Yong;Choi, Eun-Kyung;Jee, Young-Koo;Lee, Kye-Young;Kim, Keum-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.17-24
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    • 1999
  • Background : A sizable percentage of tuberculous pleurisy patients are known to have residual pleural thickening(RPT) despite adequate anti-tuberculous chemotherapy. But, the predictive factors related to the development of RPT is not well known. Therefore, we studied to determine which factors are related to the development of RPT after completion of therapy. Methods: By retrospective review of medical records, fifty-eight patients initially diagnosed as having tuberculous pleurisy between March 1995 and January 1998 were separated into two groups : 27 patients in group 1 had RPT on simple chest radiography, while 31 patients in group 2 had no RPT after 6 month of anti-tuberculous chemotherapy. The clinical characteristics, radiologic findings and pleural fluid findings of the two group were compared at the time of diagnosis and during the course of therapy. Results: 47% of patients had RPT after 6 month of chemotherapy, and RPT was more common in man than in women(54% vs 29%, p=0.092). In group 2 patients, complete resorption of pleural lesion occurred rather late stage of therapy(1-2 month: 26%, 3-4 month: 29%, 5-6 month: 45%). Group 1 patients had increased percentage of loculated pleural lesion(26 % vs 19%) and increased white blood cell and lymphocyte count, lactate dehydrogenase level in pleural fluid ($3527\pm5652$ vs $2467\pm2201$/ml, $2066\pm2022$ vs $1698\pm1835$/ml and $1636\pm1143$ vs $1441\pm923$IU/mL respectively) than group 2 at the time of diagnosis, but statistically insignificant. Duration of symptom prior to treatment, size of pleural effusion, presence of parenchymal lung lesion, level of total protein, glucose and adenosine deaminase(ADA)activity in pleural fluid were similar in both group. Conclusion: 53% of tuberculous pleurisy patients showed slow but complete resorption of pleural lesion after 6 month of chemotherapy. But, no clinical, radiological and pleural fluid findings are predictive for the development of RPT.

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Cerebral Air Embolism Following Pigtail Catheter Insertion for Pleural Fluid Drainage

  • Kim, Sa Il;Kwak, Hyun Jung;Moon, Ji-Yong;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Shin, Dong Ho;Park, Sung Soo;Yoon, Ho Joo
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.6
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    • pp.286-290
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    • 2013
  • Pigtail catheter drainage is a common procedure for the treatment of pleural effusion and pneumothorax. The most common complications of pigtail catheter insertion are pneumothorax, hemorrhage and chest pains. Cerebral air embolism is rare, but often fatal. In this paper, we report a case of cerebral air embolism in association with the insertion of a pigtail catheter for the drainage of a pleural effusion. A 67-year-old man is being presented with dyspnea, cough and right-side chest pains and was administered antibiotics for the treatment of pneumonia. The pneumonia failed to resolve and a loculated parapneumonic pleural effusion developed. A pigtail catheter was inserted in order to drain the pleural effusion, which resulted in cerebral air embolism. The patient was administered high-flow oxygen therapy and recovered without any neurologic complications.

Endoscopic Management of Pancreaticopleural Fistula in a Child with Hereditary Pancreatitis

  • Lee, Dahye;Lee, Eun Joo;Kim, Ju Whi;Moon, Jin Soo;Kim, Yong-Tae;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.601-607
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    • 2019
  • Pancreaticopleural fistula (PPF) a fistulous connection between the pancreas and pleural space due to prolonged chronic pancreatitis (CP). PPF is a very rare complication which presents in 0.4% of chronic pancreatitis cases, especially among children. We report a case involving a 3-year-old boy who presented with pleural effusion caused by a PPF, a complication of hereditary pancreatitis, which was, for the first time in Korea, successfully managed with endoscopic treatment. Chest radiography and computed tomography showed massive pleural effusion. Percutaneous catheter drainage was performed. High amylase levels were observed in the pleural fluid and serum, suggesting PPF. The patient was managed with bowel rest and octreotide infusion. Endoscopic retrograde cholangiopancreatography revealed CP, and pleural effusion was successfully managed with stent placement. PRSS1 genetic screening revealed R122H mutation.

Effusion Cytology of Multiple Myeloma - A Case Report - (다발성 골수종 1예의 체액 세포학적 소견)

  • Koh, Jae-Soo;Ha, Chang-Won;Cho, Kyung-Ja;Jang, Ja-June
    • The Korean Journal of Cytopathology
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    • v.3 no.2
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    • pp.90-93
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    • 1992
  • A case of multiple myeloma with massive pleural effusion is reported. A 53 year-old previous known multiple myeloma patient vistited our hospital complaining of cough with sputum. Radiologic study revealed multiple osteolytic bony lesions and left side pleural effusion. The effusion were bloody exudates containing numerous atypical plasma cells. The tumor cells showed pleomorphism, eccentric nuclei, prominent nucleoli, perinuclear halo, multincleation, and chromatin patterns of occasional cart-wheel appearance. The cytological examination of pleural fluid established the malignant nature of the effusion with multiple myeloma.

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A Study on Change Image According to Recumbent Position Holding Time for Patient Safety (In Chest Lateral Decubitus Examination) (환자안전을 고려한 횡와위 유지시간에 따른 영상변화에 관한 연구 (흉부 측와위 촬영 시))

  • Kim, Ki-Jin;Jeong, Chang-Min;Yoo, Se-Jong;Choi, Won-Jin;Kim, Jeong-Ho
    • Journal of the Korea Safety Management & Science
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    • v.18 no.1
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    • pp.147-152
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    • 2016
  • Chest lateral decubitus is a chest examination to determine the persence of pleural fluid in thorax. In this study, we prepare recumbent holding position time standard of chest lateral decubitus. The records of 15 patients with chest lateral decubitus between May and Jun. Recumbent holding time is 30, 60, 90, 120, 180, 210, 240 seconds. The result is fluid level change between 0.88mm to 9.63. Fluid heigh change between 9.9 percent to 42.5 percent. We can confirm fluid level change with chest decubitus image. The proper time for fluid level change is 180 seconds.

Clinical Evaluation of Exudative Pleural Effusion (삼출성 늑막염의 임상적 고찰)

  • Kwon, Kyeong-Soon;Yang, Chang-Heon;Lee, Kwan-Ho;Lee, Yeung-Hyun;Chung, Jae-Chun;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.69-80
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    • 1989
  • From December 1987 to September 1988, clinical evaluation were performed at the Yeungnam University Hospital on 138 patients with exudative pleural effusion comparing with biochemical, bacteriologic, cytologic and pathologic studies. The results were as follows 1. Among thease 138 cases, Incidence of tuberculosis was 57.3%, neoplasm 26.8%. High tendency in malignant pleural effusion occured in elder age. 2. In tuberculosis pleural effusion, the rate of positive smear and culture for acid-fast bacilli in the pleural fluid was 3.7% and positive biopsy for granuloma 75%. 3. In malignant pleural effusion, the rate of positive cytology for cancer cell in the fluid was 42% and positive biopsy 60%. 4. Analysis in tuberculosis and malignancy showed the tendency of high pH, WBC, protein and of low glucose, but there were clinically not significant in differentiating malignant pleural effusion from tuberculous pleural effusion. 5. Among 23 cases in which the pleural tissue findings were chronic nonspecific reaction pathologically, tuberculosis(52.2%), malignancy(26%) and idiopathic(21.8%) eventually in follow up studies.

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