Diagnostic Significance of Mesothelial Hyperplasia in Pleural Biopsy Specimen

Lee, Sang Do; Kim, Woo Sung; Kim, Yong Hoon; Han, Sung Koo; Shim, Young Soo; Kim, Keun Youl; Han, Yong Chol

doi:1988.35.3.181

Tuberc Respir Dis > Volume 35(3); 1988 > Article

Original Article

Tuberculosis and Respiratory Diseases 1988;35(3):181-186.
DOI: https://doi.org/10.4046/trd.1988.35.3.181 Published online September 1, 1988.

Diagnostic Significance of Mesothelial Hyperplasia in Pleural Biopsy Specimen

Sang Do Lee, Woo Sung Kim, Yong Hoon Kim, Sung Koo Han, Young Soo Shim, Keun Youl Kim, Yong Chol Han

Tuberculosis Research Institute, Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea

삼출성 흉막염에서 흉막 생검 소견상 종피 과형성(Mesothelial Hyperplasia)의 진단적 의의

이상도, 김우성, 김용훈, 한성구, 심영수, 김건열, 한용철

Abstract

Pleural needle biopsy is an excellent diagnostic method in exudative pleural effusion with a diagnostic yield of 50-60% in first biopsy. However, the most common microscopic findings in remaining cases is “ chronic nonspecific inflammation", which is of little help in differential diagnosis In tuberculous effusion it has been reported that there is little mesothelial cell and it is possible to exclude tuberculosis if mesothelial cell accounts more than 3% in cytological examination of effusion. We presumed that if there is mesothelial hyperplasia, there would be many mesothelial cells in pleureal fluid. So we analyzed 111 cases of pleural biopsy specimens with nonspecific inflammation to determine whether the presence of mesothelial hyperplasia in pleural biopsy specimen can be a clue to rule out tuberculous effusion. The results are as follows 1) Of 96 cases in which diagnosis was confirmed, 32 cases (29%) were tuberculosis and 28 cases (25 %) were malignant effusion. 2) In 32 cases showing mesothelial hyperplasia, only 2 cases (6%) were tuberculosis, whereas of 79 cases without mesothelial hyperplasia 30 cases (40%) were documented as tuberculosis. We conclude that in case of exudative pleural effusion in which pleural biopsy revealed mesothelial hyperplasia, the possibility of malignant effusion is significantly high(p < 0.01).

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