RESUMEN
Adenosine deaminase (ADA) activity in pleural fluid from 81 patients was measured by colorime-tric method. Of these cases, 55 cases were tuberculous pleural effusion, 22 cases were malignant pleura! effusion and 4 cases were transudate pleural effusion.The mean ADA, activity in pleural fluid of tuberculous group was 188.3?58.2u and that of malignant group was 52. 2?15. 4u. Statistically the difference is highly significant (p0.05). In tuberculous group, pleural fluid ADA levels higher than 110u were found in 53. cases (96.3%), and those above 120u were found in 52 cases (94.5%), while no case in malignat group had the ADA level higher than 90u, and in 20 cases it is lower than 70u (20/22 cases, 90.9%). These data suggest that pleural fluid ADA activity may be a useful index in the differential diagnosis of tuberculous and malignant pleural effusions.
RESUMEN
Clinical manifestations thoracoscopy findings,and pathological findings of 54 patients with tuberculous pleural effusion were reported.The gross appearance of pleural lesions under direct vision with thoracoscope can be divided into three types:(A) tuberculous nodules in 34 cases,all of them were proved by pathological examination;(B) Inflammatory reaction type in 14 cases,in whom rate of positive pathology was 78.5% (11/14);(C) pleural hyperplasia and adhesion type in 6 cases,and rate for positive pathology was 66.7% (4/6).Of these 54 patients,the overall rate for positive pathoiogy was 00.75% (49/54).The diagnosis and pathogenesis of tuberculous effusion were discussed.The presence of characteristic tuberculous nodules on the pleura with specific pathological finbings suggets that direct invasion of pleura by tubercle bacilli may play a more important role than pleural allergic reaction in the pathogenesis of tuberculous pleural effusion.