Document Detail

Thoracentesis in patients with hematologic malignancy: yield and safety.
MedLine Citation:
PMID:  15947326     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pleural effusions occur in patients with hematologic malignancies, particularly during periods of hospitalization. Thoracentesis is often performed to diagnose infection and to exclude the presence of complicated parapneumonic effusions. The efficacy and safety of thoracentesis in this setting has not been well-studied. DESIGN: Retrospective chart review of hospitalized patients with hematologic malignancies undergoing thoracentesis. The aim of this study was to assess the role of thoracentesis in establishing a diagnosis of infection in this population and to determine the risk of complications. RESULTS: A total of 100 thoracentesis findings were analyzed in patients with lymphoma (52 patients) and leukemia (27 patients), and in patients who had undergone bone marrow or stem cell transplantation (21 patients). The indication for performing thoracentesis was to exclude infection in 69% of cases. Fever was present in 59% of the patients, and a concomitant lung parenchymal abnormality was present in 69% of cases. Effusions were moderate to large in size (87% of cases), and were both bilateral (62%) and unilateral (38%). Exudates were documented in 83%of the cases. A specific diagnosis was found in 21 patients and was more frequently established in those with lymphoma (31%) compared to the other groups of patients. Diagnoses found included malignancy in 14 cases, chylous effusions in 6 cases, and infection in 1 case. The one patient in whom empyema was found required drainage. The criteria for a parapneumonic effusion were not found in any other patients. The complication rate of 9% (pneumothorax, seven patients; hemothorax, two patients) was comparable to that in other populations of patients. CONCLUSIONS: Despite a high propensity for developing pulmonary infections, hospitalized patients with hematologic malignancies rarely developed complex parapneumonic effusions. The etiology of many of the effusions that occurred in this setting was unclear.
Jon Bass; Dorothy A White
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  127     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-10     Completed Date:  2005-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2101-5     Citation Subset:  AIM; IM    
Department of Medicine, Pulmonary Section, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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MeSH Terms
Age Factors
Cohort Studies
Hematologic Neoplasms / diagnosis*,  mortality
Middle Aged
Pleural Effusion, Malignant / diagnosis*,  mortality
Pneumonia / diagnosis*
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Sex Factors
Survival Rate
Thoracostomy / methods*,  mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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