Version May 2024
| Etiology | History/physical exam/lab findings | Pleural fluid characteristics | Additional tests of pleural fluid | Other helpful tests |
| Kaposi sarcoma (KS) associated effusion | Skin lesions of KS No pleuritic pain | Large to massive, bilateral effusion(s) Hemorrhagic fluid | Cytology is negative | Chest radiograph: diffuse pulmonary opacities Endobronchial lesions of KS Pleural biopsy is negative |
| Multicentric Castleman disease | Fever Cough, dyspnea in 60 percent Peripheral lymphadenopathy Anemia | Chest radiograph: reticular or nodular opacities Chest CT: mediastinal adenopathy as disease progresses Lymph node biopsy | ||
| Systemic lymphoma | Low CD4 level Serum LDH high | Large, serosanguinous exudative effusion (may have mass effect) Pleural LDH high Cytology positive (60 percent) | Flow cytometry | Pleural biopsy |
| Primary effusion lymphoma | Low CD4 count Preexisting KS in 30 percent | Pleural fluid cytology usually diagnostic | LANA-1 (HHV8) + Lymphocytes often: CD45 +/CD30 +/EMA -/T cell antigen -/LMP1 usually - Monoclonal B cell population by Southern blot | Chest CT: adjacent parietal pleural thickening and absent lymphadenopathy Pericardial effusion and ascites (common) |
| Thromboembolism | Risk factor(s) for thromboembolism | Exudative, may be serous or serosanguinous | d-Dimer (positive) CT pulmonary angiogram | |
| Hypoalbuminemia | Bilateral peripheral edema | Transudative | Serum albumin (low) | |
| Heart failure | Chronic dyspnea Bilateral peripheral edema | Transudative | Serum BNP (elevated) Echocardiogram |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
