0
Clinical Investigations: CANCER |

Volume of Pleural Fluid Required for Diagnosis of Pleural Malignancy*

Susan M. Sallach, MD; John A. Sallach, MD; Eduardo Vasquez, MD; Lonni Schultz, PhD; Paul Kvale, MD, FCCP
Author and Funding Information

*From Divisions of Internal Medicine (Drs. S. Sallach and Vasquez) and Pulmonary and Critical Care Medicine (Dr. Kvale), and Department of Biostatistics (Dr. Schultz), Henry Ford Hospital; and Henry Ford Hospital Heart and Vascular Institute (Dr. J. Sallach), Detroit, MI.

Correspondence to: Paul A. Kvale, MD, FCCP, Division of Pulmonary and Critical Care Medicine, 2799 West Grand Blvd, Detroit, MI 48202; e-mail: pkvale1@hfhs.org



Chest. 2002;122(6):1913-1917. doi:10.1378/chest.122.6.1913
Text Size: A A A
Published online

Study objectives: To determine if the diagnosis of pleural malignancy is dependent on the volume of pleural fluid sampled.

Design and setting: Single-center retrospective chart review.

Patients: Two hundred eighty-two patients who underwent diagnostic thoracentesis between October 1, 1998, and June 30, 1999.

Interventions: Charts were analyzed for volume of fluid, pathologic and clinical diagnoses, and demographics. Patients were classified into quartiles based on the volume of pleural fluid collected. Sensitivity and negative predictive value (NPV) were calculated for each quartile for diagnosis of pleural malignancy by cytology of pleural fluid. Further analyses were done regarding the effect of sex, race, age, smoking history, and personal history of malignancy on diagnosis.

Results: In total, 374 samples from 282 patients were identified (140 men and 142 women). Pleural malignancy within 6 months of initial thoracentesis was diagnosed in 99 patients (35.1%). No differences were detected for sensitivity and NPV for diagnosis of pleural malignancy between any two quartiles (p > 0.05). Samples collected from women had a higher sensitivity for predicting pleural malignancy (p = 0.0011), and those collected from nonsmokers had a slightly higher but not statistically significant sensitivity for predicting pleural malignancy (p = 0.057). Samples collected from subjects with no history of malignancy had a significantly higher NPV than samples collected from subjects with a history of malignancy (p < 0.001). After adjusting for these demographic and medical history factors, the associations of the pleural fluid volume quartiles with sensitivity and NPV did not change.

Conclusion: The sensitivity for diagnosis of pleural malignancy is not dependent on the volume of pleural fluid extracted during thoracentesis.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543