Pleural effusion
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Pleural effusion
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Respiratory system pathology review
Apnea, hypoventilation and pulmonary hypertension: Pathology review
Cystic fibrosis: Pathology review
Deep vein thrombosis and pulmonary embolism: Pathology review
Lung cancer and mesothelioma: Pathology review
Obstructive lung diseases: Pathology review
Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review
Pneumonia: Pathology review
Respiratory distress syndrome: Pathology review
Restrictive lung diseases: Pathology review
Tuberculosis: Pathology review
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First Aid
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Cirrhosis p. 398
pleural effusion p. 705
Exudate
pleural effusion p. 705
Heart failure p. 318
pleural effusion p. 705
Lymphatic pleural effusion p. 705
Nephrotic syndrome p. 620, 619
pleural effusion p. 705
Pleural effusion p. 302
asbestosis p. NaN
lung cancer p. 707
mesothelioma p. NaN
physical findings p. 302
Transudate
pleural effusion p. 705
Transcript
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“Pleural” refers to the space between the chest cavity and the lungs, and “effusion” refers to a collection of fluid, so a pleural effusion is when a disease process causes fluid to start to collect in the pleural space, which can sometimes restrict lung expansion.
The pleural cavity or pleural space lies between the parietal pleura which is stuck to the chest wall and the visceral pleura which is stuck to the lungs.
Because the lungs fit snugly inside the chest cavity, the visceral and parietal pleura lie right next to each other, and the very very thin space between them contains a layer of fluid that acts as lubrication to allow the lungs to slide back and forth as they expand and contract.
This pleural fluid is similar to interstitial fluid and is made slippery by proteins like albumin.
It’s so similar to interstitial fluid because it--essentially--is interstitial fluid.
There is always a tiny bit of plasma that leaks out of capillaries and gets into the interstitial space, and since these capillaries are so close to the edge of the pleural space, that fluid makes its way into that space and collects there.
If there were no way out of the pleural space, then it would fill up with fluid, but fortunately, there are lymphatic vessels in the pleura then drain the fluid away and deliver it back into the circulatory system.
A pleural effusion is when there’s excess fluid in the pleural space either because too much pleural fluid is produced by the body, which can be due to either a transudative or exudative effusion or because the lymphatics can’t effectively drain away the fluid, called a lymphatic effusion.
Summary
Pleural effusion refers to the accumulation of fluid in the pleural cavity. This fluid can impede the lungs' movement and make it difficult to breathe. There are various kinds of pleural effusion, depending on the nature of the fluid and what caused its entry into the pleural space. Pleural effusion can be hydrothorax (serous fluid), hemothorax (blood), urinothorax (urine), chylothorax (chyle), or pyothorax (pus).
Transudative pleural effusion contains decreased protein content and is usually due to increased hydrostatic pressure. Exudative pleural effusion contains increased protein content and is commonly due to malignancy, pneumonia, collagen vascular disease, or trauma. Diagnosis is usually done with a thoracentesis which can help alleviate symptoms and can be used to identify the underlying cause.
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