흉강액 호산구 증다증의 진단적 의의

Abstract

Eosinophilic pleural effusion(EPE) is a relatively rare phenomenon. It is defined as the presence of 10% or more eosinophils in the pleural fluid, exclusive of erythrocytes. Several reports have discussed the etiologic hetergenicity of EPE. The pathogenesis of EPE is not clear, but various etiologic factors are suggested in recent years. We decided to review our experience with EPE and to evaluate clinical utility of this phenomenon. Sixty-nine cases of eosinophilic pleural effusion(EPE) were reviewed. The etiologies of these cases were malignancy(44.9%), tuberculosis(21.7%), paragonimiasis(11.6%), pneumonia(7.2%), heart failure(5.8%) and others(8.8%). The incidence of pneumothorax in patients with EPE was 18.8% and average percentage of eosinophils(55±18%) in pleural fluid of pneumothorax group was significantly higher than non-pneumothorax group(26±17%). This finding was statistically significant(p<0.0001). The cytological and chemical findings of pleural fluid and peripheral blood finding were analyzed according to underlying disease. We noted statistically significant differencew of total protein, LD, glucose and percentage of peripheral eosinophil in paragonimiasis. We conclude that pathogenesis of EPE is still to be explored, but we might consider the possibility of associated malignancy, because the malignancy is one of the most common underlying disease in EPE, particularly in patients without evidence of pneumothorax.

Eosinophilic pleural effusion(EPE) is a relatively rare phenomenon. It is defined as the presence of 10% or more eosinophils in the pleural fluid, exclusive of erythrocytes. Several reports have discussed the etiologic hetergenicity of EPE. The pathogenesis of EPE is not clear, but various etiologic factors are suggested in recent years. We decided to review our experience with EPE and to evaluate clinical utility of this phenomenon. Sixty-nine cases of eosinophilic pleural effusion(EPE) were reviewed. The etiologies of these cases were malignancy(44.9%), tuberculosis(21.7%), paragonimiasis(11.6%), pneumonia(7.2%), heart failure(5.8%) and others(8.8%). The incidence of pneumothorax in patients with EPE was 18.8% and average percentage of eosinophils(55±18%) in pleural fluid of pneumothorax group was significantly higher than non-pneumothorax group(26±17%). This finding was statistically significant(p<0.0001). The cytological and chemical findings of pleural fluid and peripheral blood finding were analyzed according to underlying disease. We noted statistically significant differencew of total protein, LD, glucose and percentage of peripheral eosinophil in paragonimiasis. We conclude that pathogenesis of EPE is still to be explored, but we might consider the possibility of associated malignancy, because the malignancy is one of the most common underlying disease in EPE, particularly in patients without evidence of pneumothorax.