Pathology of the Pleura and Mediastinum

2018 Edition
| Editors: Timothy Craig Allen, Saul Suster

Pleural Effusions

  • Rebecca WatersEmail author
Reference work entry


Chylothorax; Empyema; Hemothorax; Hydrothorax


A pleural effusion is an abnormal collection of fluid in the pleural space. It is usually a result of excess fluid production or decreased absorption. It is the most common pleural disease manifestation with causes ranging from cardiac disorders to inflammatory and malignant diseases.

Pleural effusions are categorized as transudates or exudates, based on the mechanism of fluid formation. Transudates result from an imbalance in oncotic and hydrostatic pressures. Transudative etiologies include congestive heart failure, cirrhosis, nephrotic syndrome, constrictive pericarditis, and atelectasis.

Exudates are a result of inflammation of the pleura or decreased lymphatic drainage. Exudates often require a more extensive evaluation and treatment than transudates. Because the permeability of the pleural capillaries to proteins is usually high in these cases, an elevated protein count results. Common causes of exudates include...

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References and Further Reading

  1. Bouros, D., Pneumatikos, I., & Tzouvelekis, A. (2008). Pleural involvement in systemic autoimmune disorders. Respiration, 75(4), 361–371.CrossRefPubMedGoogle Scholar
  2. Burrows, C. M., Mathews, W. C., & Colt, H. G. (2000). Predicting survival in patients with recurrent symptomatic malignant pleural effusions: An assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease. Chest, 117(1), 73–78.CrossRefPubMedGoogle Scholar
  3. Nuwal, P., Dixit, R., Dargar, P., & George, J. (2012). Pleural effusion as the initial manifestation of chronic myeloid leukemia: Report of a case with clinical and cytologic correlation. Journal of Cytology, 29(2), 152–154.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Sahn, S. A. (2008). The value of pleural fluid analysis. The American Journal of the Medical Sciences, 335(1), 7–15.CrossRefPubMedGoogle Scholar
  5. Yahya, Z. A. M., Ali, H. H., & Hussein, H. G. (2013). Evaluation of the sensitivity and specificity of immunohistochemical markers in the differential diagnosis of effusion cytology. Oman Medical Journal, 28(6), 410–416.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PathologyUniversity of Texas Medical BranchGalvestonUSA