![]() However, a large, refractory pleural effusion, whether a transudate or exudate, must be drained to provide symptomatic relief. Transudative effusions are usually managed by treating the underlying medical disorder. Immunohistochemistry provides increased diagnostic accuracy. The diagnostic evaluation of pleural effusion includes chemical and microbiological studies, as well as cytological analysis, which can provide further information about the etiology of the disease process. Laboratory testing helps to distinguish pleural fluid transudate from an exudate. Thoracocentesis should be performed for new and unexplained pleural effusions. However, the etiology of pleural effusion remains unclear in nearly 20% of cases. To treat pleural effusion appropriately, it is important to determine its etiology. Patients most commonly present with dyspnea, initially on exertion, predominantly dry cough, and pleuritic chest pain. It can pose a diagnostic dilemma to the treating physician because it may be related to disorders of the lung or pleura, or to a systemic disorder. A pleural effusion is an excessive accumulation of fluid in the pleural space. ![]()
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