文档介绍:Diagnosis and Management of Pleural Effusions
呼吸内科:徐作军
2002,4,PUMC
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Diagnosis of Pleural Effusions
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Chest Radiograph
Pleural Fluid as the Only Abnormality With Primary Disease in the Chest
Bilateral Effusions
Diseases Below the Diaphragm
Interstitial Lung Disease
Pulmonary Nodules
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1. Pleural Fluid as the Only Abnormality With Primary Disease in the Chest
infections
tuberculous and viral pleurisy
malignancy
cancer, non-Hodgkin's lymphoma, and leukemia
pulmonary embolism
drug-induced lung disease
benign asbestos pleural effusion (BAPE)
lymphatic abnormalities
chylothorax and yellow nail syndrome
uremic pleurisy
constrictive pericarditis
hypothyroidism
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Effusions
transudative effusions
congestive heart failure
nephrotic syndrome
hypoalbuminemia
peritoneal dialysis
constrictive pericarditis
exudative effusions
malignancy (extrapulmonic primary carcinomas, lymphoma)
lupus pleuritis
yellow nail syndrome
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Nodules
mon causes
metastatic carcinoma from a nonlung primary tumor.
mon causes
Wegener's ranulomatosis
rheumatoid arthritis
septic emboli
sarcoidosis
tularemia
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Value of Pleural Fluid Analysis
In a prospective study of 78 patients with new-onset pleural effusion,
a definitive diagnosis was established by the initial pleural fluid analysis in 25% ,
a presumptive diagnosis in 55%,
with the remaining 20% having a nondiagnostic pleural fluid analysis. (excluding possible diagnoses)
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Value of Pleural Fluid Analysis
the initial pleural fluid analysis is either definitively or presumptively diagnostic in 80% of patients and is valuable clinically in about 90% of cases.
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