PLEVRA SIVISINDAKÝ HÜCRELERÝN AYIRICI TANIDAKÝ ROLÜ

Bu çalýþmada plevral sývý hücre subgruplarýnýn sývý etyolojisi ile iliþkisi ve tanýya katkýsýnýn belirlenmesi amaçlanmýþtýr. Aralýk 1998-Nisan 2000 arasýnda kliniðimizde tanýsal amaçlý torasentez yapýlan hastalardan alýnan 100 plevral sývý örneði üzerinde prospektif olarak çalýþýldý. Tüberküloz plörezili 37 olgunun tümünde lenfositik plevral sývý, ampiyemli 10 olgunun tümünde polimorfonükleer lökosit hakimiyeti saptandý. Eozinofilik sývý iki parapnömonik plörezili olguda ve yedi etyolojisi bilinmeyen eksudatif plevral sývý olgusunun ikisinde gözlendi. Ancak plevral sývý mezotel hücre sayýsýnýn plevral sývýnýn etyolojisinin ayýrýcý tanýsýnda spesifik olmadýðý görüldü.Plevral sývý sitolojisi serimizdeki tüm malignitelerin % 83' ünde pozitifti. Çalýþmamýzda, baþka bir etyolojik faktörün saptanamadýðý durumlarda, lenfositik plevral sývýnýn tüberküloz plöreziye, yüksek polimorfonükleer lökosit varlýðýnýn ampiyeme baðlý olduðunun kabul edilebileceði sonucuna varýldý.

THE VALUE OF CELLS IN THE PLEURAL FLUID IN THE DIFFERENTIAL DIAGNOSIS

In this study it has been aimed to determine the relationship between the differential cell counts and the etiology of the pleural fluid, and its utility to the diagnosis. A hundred samples of pleural fluid, collected from consecutive patients in our clinic who had diagnostic thoracentesis, were studied prospectively between December 1998- April 2000. All of the 37 cases with tuberculous pleurisy had lymphocytic pleural fluid and polymorphonuclear leucocyts were dominant in all 10 cases of empyema. Eosinophylic fluid was found in two parapneumonic pleurisy cases and in two of seven exudative pleural fluid of unknown etiology. Pleural fluid mesothelial cell counts had no specificity in the differential diagnosis of the origin of the effusion. Pleural fluid cytology was positive in 83 % of all the malignancies studied in this series. We concluded that in conditions, that no other etiologic factor could be found, lymphocytic pleural fluid can be considered to be related with tuberculosis, and high rates of polymorphonuclear leucocyts can be considered to be related with empyema.