Pleural effusion classification: Difference between revisions
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==Classification== | ==Classification== | ||
Pleural effusion may be classified according to composition of pleural fluid by Light's criteria into two subtypes: | 1. Pleural effusion may be classified according to composition of pleural fluid by Light's criteria into two subtypes: | ||
===Exudate and transudate=== | ===Exudate and transudate=== | ||
An increase in plasma osmotic pressure or elevated systemic or pulmonary hydrostatic pressure are alterations that lead to the formation of transudate. In contrast, an exudate results from inflammation and infectious disease of the pleural surface, as seen in tuberculosis and pneumonia with effusion, or other disease of the pleural surface as seen in malignancy, pancreatitis, pulmonary infarction, or systemic lupus erythematosus. | |||
Pleural effusion may also be classified according to the appearance of pleural fluid, and etiology of the pleural fluid as follows: | Light's criteria classifies pleural fluid as an exudate if at least one of the following three criteria is fulfilled: | ||
●Pleural fluid protein/serum protein ratio greater than 0.5, or | |||
●Pleural fluid LDH/serum LDH ratio greater than 0.6, or | |||
●Pleural fluid LDH greater than two-thirds the upper limits of the laboratory's normal serum LDH | |||
2. Pleural effusion may also be classified according to the appearance of pleural fluid, and etiology of the pleural fluid as follows: | |||
===Gross appearance=== | ===Gross appearance=== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]
Overview
Classification
1. Pleural effusion may be classified according to composition of pleural fluid by Light's criteria into two subtypes:
Exudate and transudate
An increase in plasma osmotic pressure or elevated systemic or pulmonary hydrostatic pressure are alterations that lead to the formation of transudate. In contrast, an exudate results from inflammation and infectious disease of the pleural surface, as seen in tuberculosis and pneumonia with effusion, or other disease of the pleural surface as seen in malignancy, pancreatitis, pulmonary infarction, or systemic lupus erythematosus.
Light's criteria classifies pleural fluid as an exudate if at least one of the following three criteria is fulfilled: ●Pleural fluid protein/serum protein ratio greater than 0.5, or ●Pleural fluid LDH/serum LDH ratio greater than 0.6, or ●Pleural fluid LDH greater than two-thirds the upper limits of the laboratory's normal serum LDH
2. Pleural effusion may also be classified according to the appearance of pleural fluid, and etiology of the pleural fluid as follows:
Gross appearance
- Serous fluid (hydrothorax)
- Blood (hemothorax)
- Chyle (chylothorax)
- Pus (pyothorax or empyema)
Infectious and noninfectious
Some of the infectious causes are pneumonia, hepatitis, liver abscess, tuberculous pleural effusion, splenic abscess and subphrenic abscess. Some non-infectious causes of pleural effusion include; benign asbestos pleural effusion, pulmonary embolism, radiation therapy, and malignancy (local/metastatic carcinoma, lymphoma, mesothelioma, Leukemia, paraproteinemia)