DISTRIBUTION OF LYMPHOCYTE SUB-POPULATIONS IN PATIENTS WITH EXUDATIVE PLEURAL EFFUSIONS

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Abstract
Simultaneous pleural and peripheral blood T [thymus-derived] and Fc receptor-containing lymphocytes were quantitated to determine whether any diagnostic pattern could be observed in pleural effusions of diverse etiology. Of the 27 cases studied, there were 12 malignant, 3 tuberculous, 2 collagen disease and 10 nonspecific pleural effusions. No difference in percentage distribution of T and Fc receptor-containing lymphocytes was found in the pleural fluid among different etiologies. Ten of 12 cases of malignancy, all of the cases of tuberculosis, and all of the cases of collagen disease had a ratio of pleural fluid T lymphocytes per mm3 to peripheral-blood T lymphocytes per mm3 greater than 1 indicating an increase in T lymphocytes in the pleural fluid. In only 2 of the nonspecific efflusions was the ratio greater than 1 (P < 0.002). Absolute peripheral blood T lymphopenia was noted in 16 of 17 patients with specific effusions and in only 2 of 10 patients with nonspecific effusions (P < 0.002). No significant differences were noted in Fc receptor-containing lymphocytes among groups. The predominance of the absolute concentration of pleural-fluid T lymphocytes and concomitant depression of the absolute concentration of peripheral T lymphocytes may represent a diversion of T lymphocytes from the peripheral blood to the pleural space in cases of malignant, tuberculous and collagen pleural efflusions. An absolute peripheral blood, T lymphocyte leukopenia of less than 750 cells/mm3 and an absolute ratio of pleural fluid to peripheral blood T lymphocytes greater than 1 may suggest a specific etiology (malignancy, tuberculosis or collagen disease) for the pleural effusion.