Examination of Pleural Fluid

May be sufficient in some cases, the diagnosis of pleural fluid characteristics. In some cases, the clinical, radiographic and laboratory investigations further the cause of pleural fluid does not occur. In these cases must be closed or open pleural biopsy. In some cases, pleural biopsy does not provide the diagnosis.

Many times, a detailed examination of pleural fluid is sufficient for diagnosis. These features are written in summary below:
Macroscopic appearance exudative yellow fluid, usually clear. Light yellow, straw yellow or dark yellow can. Is greater than the number of cells appear blurry. Lighter than transudate fluid, similar to water and less chance of being blurred. When the blood, the liquid color is red. Blood vessel puncture with fluid from the blood of an intercostal karıştırmamalıdır punction. Thoracentesis with traumatic blood, is one of aspiration. Boşaltıldıkça bloody color liquid is reduced. Malignant diseases of the pleura, lung and thoracic trauma, infarction, and some leukemia, cirrhosis, tuberculosis, and rare cases of bloody fluid homogeneous. Trauma is not in question, hemorrhagic pleural effusion, there has not been another diagnosis, a malignant disease is indicated. Chylothorax, such as milk is an important finding in view of the liquid. If done by aspiration of the patient 1-2 hours after eating food that is more prominent appearance. Cases of empyema, pleural fluid, pus in the form of dark, yellow-greenish color. Aspiration is done with difficulty. Pleurisy Infection sometimes occurs more blur, similar to empyema. Cholesterol increased by a yellow liquid in ages, income husule polished look. There are chocolate-colored skin abscess amoeba.

Protein content and density of fluid transudates gm protein, less than 3%, 3% of the exudate from the more than GM. Transüdada density of less than 1,015, with more than 1,015 exudate. Pleural fluid protein / serum protein ratio in transudate <0.5,> 0.5 is. Pleural fluid LDH / serum LDH ratio in transudate <0.6,> 0.6 is.

Cytological examination is very important for differential diagnosis. Citrate pleural fluid leukocyte count and leukocyte formula is attached. Polymorphonuclear leukocytes core is more often a postpnömonik epanşmanı, lymphocytes, tuberculosis is more than is indicated. Malignant cells should be sought as a fluid routine. However, in some cases, the serosa cells of malignant cells is difficult to separate. In these cases repeated examination. Increased fluid eosinophil trauma, pulmonary infarction, cancer, Hodgkin's, is seen in some diseases such as polyarteritis nodosa and rheumatoid arthritis.

Bacteriological examination of the liquid bacterial culture, Koch's bacillus to investigate (directly, condensation, and culture) are routinely applied. Koch's bacillus to be very liquid, so that increases the chance of finding. Anaerobic culture is necessary.

Pleural fluid in cases of rheumatoid arthritis investigation Shimei many times the amount of glucose drops below 20 mg%. Some tuberculosis epanşmalarında mg glucose less than 60%, chloride is less than 80%. In some cases of cancer are decreasing the amount of liquid glucose. Examination of pleural fluid and blood, now I should be done on an empty stomach and at the same time.
Study of enzymes related to acute pancreatitis, increased amylase left pleural epan-şmanında is an important finding for diagnosis. Plasmadaki amount is too much fluid amylase, may be more than 50 times. More than half of cases of malignant pleural epanşmanı dehidrojenez lactate (LDH) in a certain way (more than 35% of that in serum) increases. Shimei, and pleural fluid and serum enzyme studies at the same time and would be more useful evaluation is done on an empty stomach. Some cases of pleural tuberculosis and rheumatoid arthritis epanş-manında LDH was observed to increase, but this is not a probability rate of malignant epanşmanlar much.

PH, pC02 and pH of pleural fluid analysis of P02 non-malignant diseases, especially tuberculosis epanşmanlarında postpnömonik and low, 7.30 'is less than. However, congestive heart failure, cirrhosis and cancer cases, the pH is high. PH measurement alone is considered in the differential diagnosis of tuberculosis and cancer diagnosis would be very useful. Example of pH 7.30 is less than the tuberculosis and 7:40 more than evidence of the cancer. Furthermore, pH 7.20 less than that tend towards showing empyema or empyema is an important finding. PC02 decreased pH in pleural fluid usually increases in cases.

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