Chest
Clinical InvestigationsPLEURALClinical Implications of Appearance of Pleural Fluid at Thoracentesis
Section snippets
Patients
We prospectively studied 766 consecutive patients with pleural effusion who were assessed in our service from December 1991 to December 1997. Pleural fluid was obtained by thoracentesis with a needle. The macroscopic appearance of the fluid during thoracentesis was assessed within a glass assay tube with an internal diameter of 14 mm containing 10 mL of pleural fluid. Whenever the pleural fluid became more blood tinged during thoracentesis, the clearer color was contemplated. Fluid appearance
Results
The appearance of the pleural fluid was assessed in 715 of 766 patients (93.3%); 479 were male (67%) and 236 were female. Mean age was 63 years (range, 14 to 95 years). Presentations of the pleural fluid and their diagnoses are shown in Table 1. The most common appearances were serous and blood tinged, with 80% of the fluids fitting into one of these categories. There were eight milky pleural fluids, seven of which were chylothorax and the remaining one a pseudochylothorax. The chylothorax was
Discussion
Pleural fluid appearance has been proposed as a guide for the differential diagnosis of pleural effusions.1 Nevertheless, to our knowledge, a systematic approach to the causes and clinical implications in a large, unselected series of cases has not been previously reported.
Most effusions from all the diagnostic groups were either serous or blood tinged. In the group of transudates, only 13%, with a lower concentration of proteins in pleural fluid, were classified as watery. A watery appearance
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Cited by (0)
This study was supported in part by grants C03/011-RTIC from Instituto de Salud Carlos III.
This study has been partially presented at the SEPAR 2002 meeting in Gran Canaria Island, Spain, June 8–11, 2002.