Adenosine deaminase activity in pleural effusions of lymphoma patients.
OBJECTIVE
The purpose of this study was to assess the relationship of pleural adenosine deaminase (P-ADA) and non-Hodgkin's lymphoma (NHL).


METHODS
We retrospectively analysed 63 NHL patients with pleural effusions who accepted a diagnostic thoracentesis and who had P-ADA available at the China Medical University Hospital (Taichung, Taiwan) between January 2003 and April 2012.


RESULTS
There were 46 exudates [40 malignant pleural effusions (MPE), 5 complicated para-pneumonic effusions and 1 undiagnosed effusion] and 17 transudates. The P-ADA activity was significantly different between the two groups (P < 0.005). Among 40 MPE cases, 29 were due to B-cell and 11 due to T-cell NHL. There was no pleural transudative effusion with P-ADA value higher than 26 U/l in our study, but simultaneously 48% (22/46) of exudative pleural effusions showed a P-ADA value under that cut-off point. The P-ADA level reached the diagnostic cut-off for tuberculosis (40 IU/l) in 11 cases of MPE (11/40 = 27.5%): 9 B-cell NHL (9/29 = 31%) and 2 T-cell NHL (2/11 = 18%). The median levels (25th, 75th percentiles) of P-ADA were 28 IU/l (14-50) in the MPE of B-cell NHL and 26 IU/l (14-28) in the T-cell NHL (P = 0.693).


CONCLUSIONS
The use of P-ADA in NHL effusion could aid the separation of transudates from exudates. Around one-quarter MPE of NHL had abnormal P-ADA ( > 40 IU/l). There was no difference in the P-ADA activity in T-cell and B-cell NHL.
From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
C-W
CW
Yao
From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
B-R
BR
Wu
From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
K-Y
KY
Huang
From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan From the Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, China Medical University Hospital and Department of Respiratory Therapy, China Medical University, Taichung, Taiwan Redman0127@gmail.com.
H-J
HJ
Chen
D000243:Adenosine Deaminase / Q000378:metabolism*; D000328:Adult; D000368:Aged; D005122:Exudates and Transudates / Q000201:enzymology; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000201:enzymology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D000243:Adenosine Deaminase