Chest
Clinical InvestigationsPleural DiseaseBiochemical and Cytologic Characteristics of Pleural Effusions Secondary to Pulmonary Embolism
Section snippets
Materials and Methods
We retrospectively reviewed the medical records and chest radiographs of all patients with a definitive diagnosis of pulmonary embolism who underwent diagnostic thoracentesis during the last 7 years. The chest radiographs were reviewed to assess the size and location of the pleural effusion, and the associated findings. A definitive diagnosis of pulmonary embolism was considered when an abnormal angiographic finding (pulmonary angiography or contrast-enhanced spiral CT scanning) showed distinct
Results
Sixty patients (37 men and 23 women; mean age, 60 ± 14 years; range, 31 to 88 years) complied with the conditions of the study. Twenty-five patients (42%) were smokers (mean, 42 pack/years).
One or more associated diseases were evident in 47 patients (78%; Table 1). No patients presented with signs of congestive heart failure when thoracentesis was performed; however, seven patients were receiving diuretic therapy for hypertension or previous congestive heart failure.
Pleural effusions were
Discussion
This study demonstrates the uniform exudative character of pleural effusions due to pulmonary embolism. Until 1976, most authors classified effusions due to pulmonary embolism as exudates.11121314 However, Bynum and Wilson4 published that year a study in which more than one third of the 26 patients included could have transudates. Since then, this study has been repeatedly referred to and, as far as we know, never contested in spite of significant methodologic limitations: first, in an
References (24)
- et al.
Contemporary diagnostic approaches to acute pulmonary embolism
Radiol Clin North Am
(1995) - et al.
Influence of diuretics on the concentration of proteins and other components of pleural transudates in patients with heart failure
Am J Med
(2001) - et al.
Evaluation of different criteria for the separation of pleural transudates from exudates
Chest
(1993) Pulmonary embolism and infarction
Dis Chest
(1965)- et al.
Management of pleural effusions
Med Clin North Am
(1964) - et al.
Relation of plain chest radiographic findings to pulmonary arterial pressure and arterial blood oxygen levels in patients with acute pulmonary embolism
Am J Cardiol
(1992) - et al.
Diagnostic utility of pleural fluid eosinophilia
Am J Med
(1984) - et al.
Etiology and prognostic significance of eosinophilic pleural effusions: a prospective study
Chest
(1996) - et al.
Probability of malignancy in pleural fluid eosinophilia
Chest
(1989) - et al.
Natural history of pulmonary embolism
Prog Cardiovasc Dis
(1975)