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Table 137-1

Differential Diagnoses of Pleural Effusions

Transudative Pleural Effusions

  1. Congestive heart failure
  2. Cirrhosis
  3. Nephrotic syndrome
  4. Peritoneal dialysis
  5. Superior vena cava obstruction
  6. Myxedema
  7. Urinothorax

Exudative Pleural Effusions

  1. Neoplastic diseases
    • Metastatic disease
    • Mesothelioma
  2. Infectious diseases
    • Bacterial infections
    • Tuberculosis
    • Fungal infections
    • Viral infections
    • Parasitic infections
  3. Pulmonary embolism
  4. Gastrointestinal disease
    • Esophageal perforation
    • Pancreatic disease
    • Intraabdominal abscess
    • Diaphragmatic hernia
    • After abdominal surgery
    • Endoscopic variceal sclerotherapy
    • After liver transplant
  5. Collagen-vascular diseases
    • Rheumatoid pleuritis
    • Systemic lupus erythematosus
    • Drug-induced lupus
    • Sjögren syndrome
    • Granulomatosis with polyangiitis (Wegener's)
    • Churg-Strauss syndrome
  6. Post-coronary artery bypass surgery
  7. Asbestos exposure
  8. Sarcoidosis
  9. Uremia
  10. Meigs' syndrome
  11. Yellow nail syndrome
  12. Drug-induced pleural disease
  13. Trapped lung
  14. Radiation therapy
  15. Post-cardiac injury syndrome
  16. Hemothorax
  17. Iatrogenic injury
  18. Ovarian hyperstimulation syndrome
  19. Pericardial disease
  20. Chylothorax