051. Diagnostic approach to pleural effusion

Abstract: A pleural effusion is an abnormal collection of fluid in the pleural cavity. Pleural effusion is a common manifestation in a wide range of diseases, including pleural, pulmonary and extra-pulmonary disorders, where the most frequent of these are congestive heart failure, pneumonia and malignancy. This review provides a systematic approach to manage the patient with pleural effusion in order to have a correct diagnosis quickly and without additional invasive methods beginning with medical history, clinical examination, radiology, pleural fluid analysis and finally, if there is a need, a pleural biopsy and/or thoracoscopy. The first step of the fluid analysis includes differentiation transudate from exudates based on Light’s criteria and after that suggests the tests which are necessary for the further investigation of exudates (biochemical characteristics, cultivation, cytology, test for tuberculosis, immunological tests). These steps are very important because early diagnosis improves prognosis and minimizes complications.

Keywords: Pleural effusion; medical thoracoscopy; pleural fluid