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Cytologic features of mycobacterial pleuritis: logistic regression and statistical analysis of a blinded, case‐controlled study
Author(s) -
Ellison Erin,
Lapuerta Pablo,
Martin Sue Ellen
Publication year - 1998
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/(sici)1097-0339(199809)19:3<173::aid-dc3>3.0.co;2-e
Subject(s) - mesothelial cell , medicine , tuberculosis , cytology , logistic regression , pathology , lymphocytosis , predictive value , mesothelium , human immunodeficiency virus (hiv) , gastroenterology , immunology
Tuberculous pleural effusions are characterized by lymphocytosis; the significance of mesothelial cells is uncertain, as are the cytologic features in concurrent human immunodeficiency virus (HIV) infection. This blinded study compared 38 culture‐positive pleural fluids (6 HIV + ) with 38 controls from benign exudative processes. Logistic regression analysis selected mature lymphocytes as most predictive of positive culture, and mesothelial cells and eosinophils as negative predictors. Mesothelial cells were scant (<10% of nucleated cells) in 36/38 cases with mycobacteria (sensitivity 95%); if these cells were <10%, tuberculosis was virtually ruled out in HIV − patients. Specificity was maximized (82%) when mesothelial cells <10% were combined with lymphocytes <50%; positive predictive value with this combination was 76%, but was raised to 96% if moderate/marked cellularity was also identified. Among tuberculosis cases, reactive mesothelial cells differentiated HIV + from HIV − patients; there was no other significant difference. Diagn. Cytopathol. 1998;19:173–176. © 1998 Wiley‐Liss, Inc.