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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.
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.
The fluid is a transudate and similar to fluid found in ascites. [4] There may be a higher protein and albumin content in hepatic hydrothorax due to the pleura absorbing the water. [5] To rule out heart-related causes of pleural effusion, an echocardiogram can be performed.
Ascitic fluid can accumulate as a transudate or an exudate. Amounts of up to 35 liters are possible. Roughly, transudates are a result of increased pressure in the hepatic portal vein (>8 mmHg, usually around 20 mmHg [18] (e.g., due to cirrhosis), while exudates are actively secreted fluid due to inflammation or malignancy.
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.
Hydrothorax is the synonym of pleural effusion in which fluid accumulates in the pleural cavity. This condition is most likely to develop secondary to congestive heart failure, following an increase in hydrostatic pressure within the lungs. More rarely, hydrothorax can develop in 10% of patients with ascites which is called hepatic hydrothorax ...
Fluid may be also sent for gram stain, acid fast stain, or culture if high suspicion of infectious cause. [1] Bloody fluids may also be evaluated for malignant cells. [13] Fluid analysis may result in: transudative effusion: due to non-inflammatory causes (congestive heart failure, myxoedema, nephrotic syndrome)
In medicine, Meigs's syndrome, also Meigs syndrome or Demons–Meigs syndrome, is the triad of ascites, pleural effusion, and benign ovarian tumor (ovarian fibroma, fibrothecoma, Brenner tumour, and occasionally granulosa cell tumour). [1] [2] [3] Meigs syndrome resolves after the resection of the tumor. Because the transdiaphragmatic lymphatic ...