Pleural Effusion Differential Diagnoses

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

Diagnostic Considerations

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

  • Post CABG 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

Additional causes of pleural effusion or mimics of pleural effusion are as follows: