الفهرس 
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Abstract
Pleural effusion often presents a diagnostic challenge, it may be related to a great variety of causes and even after a very detailed history and physical examination the etiology often is not evident. The aIm of this work was to study the cytochemical profile of pleural effusion and performing a closed pleural biopsy in an attempt to obtain a valuable pattern of tests for diagnosis of pleural effusion of unknown etiology. The material of this study comprised fifty two patients with pleural effusions of different etiological diagnoses. The cases included 18 malignant effusions, 14 tuberculous effusions, 5 parapneumonic effusions, 5 cardiac, 7 hepatic and 3 cases of effusions were due to renal causes. All patients were subjected to thorough history taking, complete clinical, radiological and electrocardiographic examinations. Laboratory investigations were done including urine and stool analysis, blood picture, ESR, blood sugar, liver function tests, kidney function tests, serum enzymes, sputum analysis and tuberculin test. Thoracentesis was done In every case, with cytochemical analysis of the pleural fluid and pleural biopsy. In addition, bronchoscopic examination and lymph node biopsy were done in some cases. The specific gravity, effusion total protein and effusion to serum protein ratio were less accurate .