PLEURAL EFFUSION

exudate (>30g protein/l):

neoplasia:

bronchial carcinoma with pleural involvement

mesothelioma

metastases

lymphoma

infections:

tuberculosis

pneumonia (para-pneumonic effusion)

inflammatory lesions below diaphragm:

subphrenic abscess

liver abscess

pancreatitis

other:

trauma

oesophageal rupture

pulmonary embolus / infarction

connective tissue disease, eg. RA, SLE, Wegener's granulomatosis

transudate (<30 g protein/l):

cardiac failure

any other causes of generalised oedema (commonest being liver cirrhosis and nephrotic syndrome)

myxoedema

severe anaemia

oesophageal rupture (Boerhaave syndrome)

Meig's syndrome (solid ovarian tumour [may be benign] ± ascites and pleural effusion; unknown mechanism)

chylous:

yellow nail syndrome [yellow, dystrophic nails, sinusitis, bronchiectasis, lymphoedema of limbs and chylous pleural effusions and/or ascites]

ruptured cisterna chyli

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