Synonyms
Malignant pleural effusion; MPE
Definition
A pleural effusion is excess fluid that is collected in the pleural cavity due to decreased absorption or excess fluid production. Pleural effusions are divided into transudates and exudates based on the physical, chemical, and microscopic findings of the fluid. A transudative effusion is fluid that is generally clear with low specific gravity, low protein content, and low lactate dehydrogenase (LDH). An exudate is usually cloudy fluid with high specific gravity, high protein content, and high LDH. Transudates are due to systemic factors that affect hydrostatic and/or oncotic pressures, such as in cirrhosis or congestive heart failure. On the other hand, exudates are due to local factors, such as inflammation, infection, or neoplasia. These changes can lead to increase in vascular permeability or impair lymphatic drainage.
After pleural fluid (PF) is recovered, it is sent for chemical analysis. According to Light’s criteria, pleural...
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References and Further Reading
Antunes, G., Neville, E., Duffy, J., & Ali, N. (2003). BTS guidelines for the management of malignant pleural effusions. Thorax, 58((Suppl II)), ii29–ii38.
Heffner, J. E., & Klein, J. S. (2008). Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clinic Proceedings, 82(2), 235–250.
Husain, A. N., Colby, T. V., Ordonex, N. G., Krausz, T., Borczuk, A., Cagle, P. T., et al. (2009). Guidelines for pathologic diagnosis of malignant mesothelioma: A consensus statement from the international mesothelioma interest group. Archives of Pathology & Laboratory Medicine, 133, 1317–1331.
Laucirica, R., & Schultenover, S. (2000). Body cavity fluids. In I. Ramzy (Ed.), Clinical cytopathology and aspiration biopsy (pp. 205–223). New York: McGraw-Hill.
Marchevsky, A. M. (2008). Application of immunohistochemistry to the diagnosis of malignant mesothelioma. Archives of Pathology & Laboratory Medicine, 132, 397–401.
Moriarty, A. T., Schwartz, M. R., Ducatman, B. S., Booth, C. N., Haja, J., Chakraborty, S., & Williamson, B. (2008). A liquid concept – Do classic preparations of body cavity fluid perform differently than thinprep cases? Archives of Pathology & Laboratory Medicine, 132(11), 1716–1718.
Ozyurtkan, M. O., Balci, A. E., & Cakmak, M. (2010). Predictors of mortality within 3 months in the patients with malignant pleural effusion. European Journal of Internal Medicine, 21, 30–34.
Westfall, D. E., Fan, X., & Marchevsky, A. M. (2010). Evidence-based guidelines to optimize the selection of antibody panels in cytopathology: Pleural effusions with malignant epithelioid cells. Diagnostic Cytopathology, 38, 9–14.
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Dang, L.M., Laucirica, R. (2018). The Role of Cytology in the Diagnosis of Pleural Neoplasia. In: Allen, T.C., Suster, S. (eds) Pathology of the Pleura and Mediastinum. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-66796-6_392
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