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Can chest ultrasonography differentiate between benign and malignant effusions?

Abstract

Background

The differential diagnosis of exudative pleural effusion is a major challenge for chest physicians particularly in a country with limited financial resources.

Objective

The aim of this study was to evaluate the role of the sonographic features in the prediction of exudative malignant pleural effusion.

Design

This was a prospective cross-sectional study.

Setting

This study was carried out between May 2013 and June 2014 in the Chest Department of Assiut University Hospital.

Patients

The patients enrolled included 25 patients with malignant pleural effusion and 25 patients with other different benign causes.

Main outcome measures

The sonographic appearances of pleural effusions were defined in terms of five patterns: anechoic, complex septated, complex nonseptated, pleural thickening, and pleural nodules.

Results

Among the 25 malignant exudative pleural effusions, a complex nonseptated pattern is a useful diagnostic predictor, with sensitivity, specificity, positive predictive value, and negative predictive value of 60, 68, 65, and 63%, respectively. Pleural nodules were only found in malignant effusion (100% specificity). If we define the complex septated sonographic pattern as a predictor for benign effusion, we can achieve sensitivity, specificity, positive predictive value, and negative predictive value of 52, 88, 81, and 65%, respectively.

Conclusion

Pleural nodules and a complex nonseptated pattern in the sonographic appearance are useful predictors of malignant pleural effusions, whereas a complex septated pattern is a useful predictor in nonmalignant effusion.

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Correspondence to Wafaa A. Hassan MD.

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Hassan, W.A., Alkarn, A.F. & Kamel, M. Can chest ultrasonography differentiate between benign and malignant effusions?. Egypt J Bronchol 9, 165–169 (2015). https://doi.org/10.4103/1687-8426.158061

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  • DOI: https://doi.org/10.4103/1687-8426.158061

Keywords

  • malignant effusion
  • pleural nodules
  • septations
  • sonography