Pleural effusions associated with malignancy, pneumonia, viral illness, and asbestosis are typically which type?

Pleural effusions associated with malignancy, pneumonia, viral illness, and asbestosis are typically which type?

• A. Transudative
• B. Hemorrhagic
• C. Chylous
• D. Exudative

Answer: (D)

Pleural effusions that arise from inflammatory or malignant involvement of the pleura are exudative. When the pleura is inflamed or infiltrated by malignancy, blood and protein-rich fluid leak into the space, and the fluid typically has higher protein and LDH levels relative to serum. Light’s criteria describe exudates as having a pleural fluid to serum protein ratio greater than 0.5, or a pleural fluid to serum LDH ratio greater than 0.6, or pleural LDH above the upper limit of normal. In contrast, transudative effusions come from systemic factors that alter hydrostatic or oncotic pressures (like heart failure, cirrhosis, or nephrotic syndrome) and have lower protein and LDH content. Chylous effusions are milky from lymphatic obstruction, and hemorrhagic effusions are bloody and can occur with malignancy but are not the typical category for these causes.

Pleural effusions that arise from inflammatory or malignant involvement of the pleura are exudative. When the pleura is inflamed or infiltrated by malignancy, blood and protein-rich fluid leak into the space, and the fluid typically has higher protein and LDH levels relative to serum. Light’s criteria describe exudates as having a pleural fluid to serum protein ratio greater than 0.5, or a pleural fluid to serum LDH ratio greater than 0.6, or pleural LDH above the upper limit of normal. In contrast, transudative effusions come from systemic factors that alter hydrostatic or oncotic pressures (like heart failure, cirrhosis, or nephrotic syndrome) and have lower protein and LDH content. Chylous effusions are milky from lymphatic obstruction, and hemorrhagic effusions are bloody and can occur with malignancy but are not the typical category for these causes.