Abstract

Present Study is done with an aim to co-relate the cytomorphology with Absolute LDH
gradient and Fluid ADAlevels in determining the type of pleural effusion.
On calculating the mean Absolute LDH gradient (serum-fluid LDH after dropping the
negative sign)along with standard deviation after performing the biochemical analysis of
pleural fluid, the exudative effusion fluid had an absolute LDH gradient value of
3356.20+4985.20 U/L (highest), tubercular effusion fluid had an absolute LDH gradient
value of 1361.36+ 1609.50 U/L, malignant/ suspicious of malignancy effusion fluid had an
absolute LDH gradient value of 1376+1181.79 U/L while transudative fluid had an
absoluteLDH gradient value of 107.91+61.60U/L (lowest).
On calculating the mean ADA levels along with standard deviation after performing the
biochemical analysis, the exudative effusion fluid (including tubercular) had an ADA
value of 54.37+56.71U/L (highest), malignant/ suspicious of malignancy effusion fluid had
an ADA value of 31.09+02.81U/L while transudative effusion fluid had an ADA value of
23.46+15.22U/L (lowest).
The mean and standard deviation values of ADA according to cytology reports showed that
it was highest in chronic inflammatory smear (exudates- tubercular) and least in case of
inflammatory smears (transudate).
The mean and standard deviation values of Absolute LDH gradient according to cytology
reports showed that it was highest in acute inflammatory smears (exudates) and found to
be least in case of inflammatory smears (transudate).
Using the Biserial correlation method, when the cytologic types of pleural fluid were
correlated with absolute LDH gradient values the p- value (0.011) was found to be
statistically significant in acute inflammatory smears (exudates). Alternatively, when the
cytologic types of pleural fluid were correlated with pleural fluid ADA values the p- value
(0.001) was found to be statistically significant in chronic inflammatory smears
(tubercular-exudates).
Cytomorphological analysis of body fluids is an important investigation which is very
convenient, cost effective, accurate and also safe . It gives a clue to diagnose any
underlying neoplastic or non- neoplastic diseases that may change prognosis, further
management or outcome of patient. In cases of malignant effusion it is crucial in staging
and deciding further protocol of treatment.