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An accurate diagnosis of the cause of the effusion, transudate versus exudate, relies on a comparison of the chemistries in the pleural fluid to those in the blood, using Light's criteria. According to Light's criteria (Light, et al. 1972), a pleural effusion is likely exudative if at least one of the following exists: [31]
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. [2] The formula is as follows: SAAG = (serum albumin) − (albumin level of ascitic fluid).
On the surface of this solution, 1 drop of the effusion fluid is carefully layered. If the drop disappears and the solution remains clear, the Rivalta's test is defined as negative. If the drop retains its shape, stays attached to the surface or slowly floats down to the bottom of the tube (drop- or jelly-fish-like), the Rivalta's test is ...
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.
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 ...
(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.
Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The causes of the ascites and pleural effusion are poorly understood. [1] Atypical Meigs syndrome, characterized by a benign pelvic mass with right-sided pleural effusion but without ascites, can also occur.
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.