Aim: To analyze the causes and clinical characteristics of pleural effusions in Sivas.
Methods: We retrospectively studied 454 patients admitted to a university hospital who underwent diagnostic thoracentesis over a 10-year period.
Results: The main causes of pleural effusions were malignant mesothelioma (14.8 %), pleural metastases (10.8 %), paramalignant effusions (7.0 %), congestive heart failure (13.4 %), parapneumonic effusions (9.5 %), and empyema (6.8 %). Twenty-five patients (5.5 %) had an established and 35 patients (7.7 %) a suspected diagnosis of tuberculous pleurisy. 76 patients (16.7 %) remained undiagnosed. Thirty-five percent of the patients with pleural metastasis, and 32 % of the patients with suspected tuberculous pleurisy had received diuretic therapy prior to thoracentesis. Only half of the patients with pleural metastasis had chest pain. The mean total leukocyte count in pleural fluid was 579±178 per mm³ for congestive heart failure but 666±196 per mm³ for malignant mesothelioma.
Conclusions: Because of environmental asbestos exposure the most common cause of pleural effusions was malignant mesothelioma in our region. Total leukocyte counts in pleural fluid for malignant mesothelioma can be as low as congestive heart failure.
Key Words: Pleural effusion, Pleurisy, Etiology
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