Age and sex distribution in malignant and tuberculous serous effusions: A study of 127 patients and review of the literature

Geriatr Gerontol Int. 2015 Sep;15(9):1143-50. doi: 10.1111/ggi.12412. Epub 2014 Nov 19.

Abstract

Aim: Tuberculosis and carcinomatosis are the two most frequent causes of pleural effusion and exudative ascites, and both are characterized by lymphocyte-rich effusion. We attempted to discover if there is any significant difference in the age and sex distribution between patients presenting with these two conditions.

Methods: A total of 161 serous effusion samples from 127 patients (89 with pleural effusion and 38 with ascites) having follow-up biopsy and histopathological examination were included in the present study. Three groups - malignancy (47 patients), tuberculosis (47) and non-tuberculous benign lesions (26) as per histopathological diagnoses - were compared in respect to age and sex distribution.

Results: A total of 29 (61.7%) patients with malignancy were aged ≥50 years as compared with three (6.4%) tuberculosis patients with serous effusions (P = 0.00000). A similar trend was observed in the ≥60 years age group (18 or 38.3% malignancy vs none with tuberculosis, P = 0.00000). A total of 36 (76.6%) tuberculous effusion patients were aged less than 40 years as opposed to eight (17.0%) patients with malignant effusions (P = 0.00000). There was also s significant difference between tuberculous and non-tuberculous benign lesions in the ≥50 years age group (6.4% vs 69.2%, P = 0.00000), but no significant difference between malignancy and non-tuberculous benign lesions (P = 0.61385). There were 31 female (66.0%) patients with malignancy, which was significantly higher than that of patients with tuberculosis (16, [34%], P = 0.00365) and non-specific inflammation/benign lesions (23.1%, P = 0.00059). However, the difference between tuberculosis and non-tuberculous benign lesions was not significant (P = 0.42756).

Conclusion: Whereas malignancy in serous effusions is found in older and middle-aged people, tuberculous effusion is a disease of younger people.

Keywords: age and sex distribution; ascites; malignancy; pleural effusion; tuberculosis.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pleural Effusion, Malignant / epidemiology*
  • Pleural Effusion, Malignant / pathology
  • Sex Distribution
  • Tuberculosis, Pleural / epidemiology*
  • Tuberculosis, Pleural / pathology
  • Young Adult