Pleural Effusion Differential Diagnoses

Updated: Jun 30, 2016
  • Author: Jeffrey Rubins, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Diagnostic Considerations

Sjögren syndrome, liver or lung transplantation, upper genitourinary trauma, and abdominal trauma are among the conditions to consider in the differential diagnosis of pleural effusion, but note they are rare.

Transudative pleural effusion

Considerations in the differential diagnosis of transudative pleural effusion include the following:

  • Congestive heart failure (most common)

  • Cirrhosis with hepatic hydrothorax

  • Nephrotic syndrome

  • Peritoneal dialysis/continuous ambulatory peritoneal dialysis

  • Hypoproteinemia

  • Glomerulonephritis

  • Superior vena cava obstruction

  • Fontan procedure

  • Urinothorax

  • CSF leak to the pleural space

Exudative pleural effusion

Conditions to consider in the differential diagnosis of exudative pleural effusion include the following:

  • Malignancy

  • Pneumonia

  • Tuberculosis

  • Pulmonary embolism

  • Fungal infection

  • Pancreatic pseudocyst

  • Intra-abdominal abscess

  • After coronary artery bypass graft surgery

  • Postcardiac injury syndrome

  • Pericardial disease

  • Meigs syndrome

  • Ovarian hyperstimulation syndrome

  • Rheumatoid pleuritis

  • Lupus erythematosus

  • Drug-induced pleural disease

  • Asbestos pleural effusion

  • Yellow nail syndrome

  • Uremia

  • Trapped lung

  • Chylothorax

  • Pseudochylothorax

  • Acute respiratory distress syndrome

  • Chronic pleural thickening

  • Malignant mesothelioma

  • Hypothyroidism

Differential Diagnoses