Document Detail


Pearls and myths in pleural fluid analysis.
MedLine Citation:
PMID:  20573057     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Virtually all patients with a newly discovered pleural effusion should undergo thoracentesis to aid in diagnosis and management. The routine pleural fluid (PF) evaluation usually includes the following: cell count and differential; tests for protein, LDH, glucose, adenosine deaminase, cytology and, if infection is a concern, pH and bacterial and mycobacterial cultures. Distinguishing transudates from exudates with Light's criteria is a pragmatic first step. If the effusion is an exudate, various PF tests have proven diagnostic utility: adenosine deaminase levels >35 IU/L usually indicate tuberculosis in lymphocyte-predominant PF; pH < 7.2 or glucose less than 60 mg/dL allow the clinician to identify complicated parapneumonic effusions; and conventional cytology may reveal malignant cells in 60% of the patients with malignant effusions. A number of optional PF tests may complement the diagnostic approach to an undiagnosed pleural effusion. For example, natriuretic peptide assays significantly improve the accuracy of a diagnosis of cardiac pleural effusion, whereas PF mesothelin levels greater than 20 nmol/L are highly suggestive of mesothelioma.
Authors:
José M Porcel
Related Documents :
17982637 - Microsatellite dna analysis does not distinguish malignant from benign pleural effusions.
22194777 - Adverse events of extracorporeal ultrasound-guided high intensity focused ultrasound th...
20544327 - Management of malignant pleural effusions.
17663627 - Differentiating transudative from exudative pleural effusion: should we measure effusio...
15540927 - A carcinoid tumor mimicking an isolated intracranial meningioma. case report.
3583407 - Inflammatory and immunological responses in skin and peripheral lymph of sheep followin...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  16     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-04-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  44-52     Citation Subset:  IM    
Copyright Information:
© 2010 The Author. Journal compilation © 2010 Asian Pacific Society of Respirology.
Affiliation:
Pleural Diseases Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, Institut de Recerca Biomèdica de Lleida, Lleida, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Five-year outcome in COPD patients after their first episode of acute exacerbation treated with non-...
Next Document:  Occult nodal metastasis in patients with non-small cell lung cancer at clinical stage IA by PET/CT.