ORIGINAL ARTICLE
Year : 2015  |  Volume : 9  |  Issue : 2  |  Page : 165-169

Can chest ultrasonography differentiate between benign and malignant effusions?


Department of Chest Diseases, Assiut University Hospital, Assiut University, Assiut, Egypt

Correspondence Address:
Wafaa A Hassan
Department of Chest Diseases, Assiut University Hospital, Assiut University, PO Box (1), 71111 Assiut
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-8426.158061

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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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