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Exudative pleural effusions occur when the pleura is damaged, e.g., by trauma, infection, or malignancy, and transudative pleural effusions develop when there is either excessive production of pleural fluid or the resorption capacity is reduced. Light's criteria [11] can be used to differentiate between exudative and transudative pleural effusions.
(See below for difference between transudate and exudate) Malignant (or cancerous) pleural effusion is effusion where cancer cells are present. [11] It is usually classified as exudate. Types of exudates: serous, serosanguineous, sanguineous, hemorrhaging and purulent drainage. Serous: Clear straw colored liquid that drains from the wound.
The serum-ascites albumin gradient or gap (SAAG) is a calculation used in medicine to help determine the cause of ascites. [1] The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate.
Transudate: Exudate: Main causes ↑ hydrostatic pressure, ↓ colloid osmotic pressure: Inflammation-Increased vascular permeability: Appearance: Clear [1] Cloudy [1] Specific gravity < 1.012 > 1.020 Protein content < 2.5 g/dL > 2.9 g/dL [2] fluid protein/ serum protein < 0.5 > 0.5 [3] SAAG = Serum [albumin] - Effusion [albumin] > 1.2 g/dL < 1 ...
Pleural effusions are classified as exudative (high protein) or transudative (low protein). Exudative pleural effusions are generally caused by infections such as pneumonia (parapneumonic pleural effusion), malignancy, granulomatous disease such as tuberculosis or coccidioidomycosis, collagen vascular diseases, and other inflammatory states.
Transudate is extravascular fluid with low protein content and a low specific gravity (< 1.012). It has low nucleated cell counts (less than 500 to 1000 per microliter) and the primary cell types are mononuclear cells: macrophages, lymphocytes and mesothelial cells. For instance, an ultrafiltrate of blood plasma is transudate.
Pleural empyema is a collection of pus in the pleural cavity caused by microorganisms, usually bacteria. [1] Often it happens in the context of a pneumonia, injury, or chest surgery. [1] It is one of the various kinds of pleural effusion.
Malignant pleural effusion is a condition in which cancer causes an abnormal amount of fluid to collect between the thin layers of tissue lining the outside of the lung and the wall of the chest cavity. [1] Lung cancer and breast cancer account for about 50-65% of malignant pleural effusions.