What causes exudates in pleural effusions (fluid on the lungs)?

Updated: Dec 28, 2018
  • Author: Kamran Boka, MD, MS; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

The more common causes of exudates include the following:

  • Parapneumonic causes [8]

  • Malignancy (most commonly lung or breast cancer, lymphoma, and leukemia; less commonly ovarian carcinoma, stomach cancer, sarcomas, melanoma) [9]

  • Pulmonary embolism

  • Collagen-vascular conditions (rheumatoid arthritis, systemic lupus erythematosus [10] )

  • Tuberculosis (TB)

  • Pancreatitis

  • Trauma

  • Postcardiac injury syndrome

  • Esophageal perforation

  • Radiation pleuritis

  • Sarcoidosis

  • Fungal infection

  • Pancreatic pseudocyst

  • Intra-abdominal abscess

  • Status post coronary artery bypass graft (CABG) surgery

  • Pericardial disease

  • Meigs syndrome (benign pelvic neoplasm with associated ascites and pleural effusion)

  • Ovarian hyperstimulation syndrome

  • Drug-induced pleural disease (see Pneumotox.com for an extensive and searchable list of drugs that may cause pleural effusion)

  • Asbestos-related pleural disease

  • Yellow nail syndrome (yellow nails, lymphedema, pleural effusions)

  • Uremia

  • Trapped lung (localized pleural scarring with the formation of a fibrin peel prevents incomplete lung expansion, at times leading to pleural effusion)

  • Chylothorax (acute illness with elevated triglycerides in pleural fluid)

  • Pseudochylothorax (chronic condition with elevated cholesterol in pleural fluid)

  • Fistula (ventriculopleural, biliopleural, gastropleural)


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