Microscopic examination of pleural effusion

Pleural effusion microscopy is an examination of the number of free liquid red blood cells, white blood cell counts and their types, mesothelial cells, parasites and eggs in the thoracic cavity. Pay attention to normal eating habits and pay attention to personal hygiene. Pleural effusion specimen collection was obtained by thoracentesis. Immediately after the specimen is taken, it should be sent for inspection to prevent cell degeneration, destruction or clot formation and affect the result. Basic Information Specialist classification: Respiratory examination classification: chest and ascites examination Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: The result of the negative test should be normal. Positive: Positive test results are common in empyema, pleurisy, tuberculosis, pulmonary infarction, chest metastases or primary malignant tumors. Tips: Pay attention to normal eating habits and pay attention to personal hygiene. Normal value The normal check value is negative. Clinical significance In pathological conditions, such as increased cistern capillary hydrostatic pressure or decreased colloid osmotic pressure, or increased intrathoracic negative pressure and pleural effusion pressure in the pleural fluid, can lead to excessive production of pleural fluid and significant reduction in absorption, resulting in pathological Pleural effusion (pleuraleffusion), also known as pleural effusion. Common causes are pleural or adjacent tissue infections, primary or metastatic tumors. In addition to traditional cytology, biochemistry, and microbiological examination, pleural effusion examinations have been developed to apply immunological and molecular biological methods to further distinguish the nature of effusions. Abnormal results of empyema, pleurisy, tuberculosis, pulmonary infarction, chest metastases or primary malignant tumors, fungal infections, lupus pleurisy, chylothorax, esophageal perforation, uremic pleural effusion. The people who need to be examined have the above-mentioned patients with pleural effusion, such as empyema, pleurisy, tuberculosis, and pulmonary infarction. Positive results may be diseases: coal workers pneumoconiosis, cholesterol empyema, bacterial infections Forbidden before examination: Pay attention to normal eating habits and pay attention to personal hygiene. Requirements for inspection: Actively cooperate with the doctor. Pleural effusion specimen collection was obtained by thoracentesis. Immediately after the specimen is taken, it should be sent for inspection to prevent cell degeneration, destruction or clot formation and affect the result. Inspection process 1, red blood cell count: the identification of exudate and leakage is not significant. When the red blood cells in the effusion are >5×109/L, the effusion is reddish; when >100×109/L, it may be considered to be caused by malignant tumor, tuberculosis, pulmonary embolism, or trauma. 2. White blood cell count: When the pleural effusion is bounded by 100×106/L, more than 80% of the leakage liquid is lower than this value, and more than 80% of the exudate is higher than this value. The exudate is often >500×106/L, and the white blood cells in tuberculous and cancerous effusions usually exceed 200×106/L, while the suppurative effusions are as high as 10000×106/L. 3, white blood cell classification: less cells in the leakage, mainly lymphocytes and mesothelial cells; exudate is more cell types. (1) neutrophilia (more than 50%), common in suppurative infection, tuberculous pleural effusion early, pulmonary infarction, septum abscess. (2) lymphocytosis (greater than 50%): mainly found in tuberculosis, viral, tumor, chylothorax effusion, and rheumatic pleurisy, systemic lupus erythematosus and uremia; plasma cells, lymphocytosis may be myeloma . When effusions of non-Hodgkin's lymphoma, chronic lymphocytic leukemia, and benign lymphocytosis are difficult to distinguish, correct judgment can be made by immunocytochemistry or flow cytometry immunophenotyping. (3) eosinophilia (greater than 10%): the most common cause is hemothorax and pneumothorax, also seen in pulmonary infarction, parasitic or fungal infections, allergic syndrome, drug reactions, rheumatism, Hodgkin's disease, Skin tumors, systemic lupus erythematosus, etc., may be accompanied by Charcot-Leyden crystals. 4. Increased mesothelial cells: common in leaking fluids. In tuberculous pleural effusion, emphysema, and rheumatoid pleurisy, there are few mesothelial cells. Tumor cells can sometimes be similar to mesothelial cells and often require paste or HE staining or immunocytochemical staining. 5, parasites and eggs: chylomicron pleural effusion can be found in the microfilaria, amebic lung abscess pleural effusion can be seen in the amoeba trophozoites. Not suitable for the crowd The examination is less invasive and generally has no contraindications. Adverse reactions and risks Risk of infection: If you use an unclean needle, you may be at risk of infection.

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