malignant pleural effusion are exudative, lymphocyte predominant, and often bloody

• related: pleural effusion
• tags: #permanent

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• For an exudative effusion, a number of other pleural fluid parameters (eg, leukocyte differential, pH, glucose, amylase, adenosine deaminase) may be needed to help determine the specific etiology.
• Malignant pleural effusions are typically exudative and lymphocyte predominant (50%-70% lymphocytes), and are often bloody in gross appearance (serosanguineous in this patient).
• In addition, due to impaired diffusion of glucose across the inflamed pleura and increased usage of glucose by malignant cells, malignant effusions typically have low glucose with a pleural fluid/serum glucose ratio <0.5.
• Low glucose ratio is also characteristic of complicated parapneumonic effusions and pleural effusions due to rheumatologic disease, tuberculosis, and esophageal rupture. These effusions with low glucose also typically have low pH levels (eg, <7.3).
• Breast cancer is the most common cause of malignant pleural effusion in women. Serum lactate dehydrogenase is often elevated in breast cancer and other malignancies (eg, lymphoma), which provides an additional clue to the diagnosis in this patient.

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• pleural effusion
  • malignant pleural effusion are exudative, lymphocyte predominant, and often bloody