Diagnostics in Pleural Disease

Advances in pleural disease.

The burden of pleural disease continues to increase internationally leading to significant healthcare costs and an urgent need for improving management. Pleural effusion is a common presentation for many pulmonary and systemic diseases, and it is estimated that each year 1.5 million people develop a pleural effusion in the USA and 200000–250000 in the UK [1, 2]. Despite the prevalence of pleura...

Pleural disease in lymphangioleiomyomatosis.

Pleural disease is a common complication of lymphangioleiomyomatosis (LAM). The incidence and recurrence rates of secondary spontaneous pneumothorax in LAM are the highest among chronic pulmonary disorders. Most patients have at least one pneumothorax before LAM is diagnosed, and pneumothorax is often the sentinel event that leads to the diagnosis. Although early, definitive treatment for recur...

Diagnostic principles in pleural disease.

When a patient with an undiagnosed pleural effusion is evaluated, the first question to answer is whether the patient has a transudate or an exudate. This is best done using Light's criteria, but these criteria occasionally misidentify a transudate as an exudate. If the patient's pleural fluid meets exudative criteria, but the patient appears clinically to have a transudative effusion, then the...

Immunological mechanisms in pleural disease.

The pleural membrane consisting of pleural mesothelial cells and its underlying connective tissue layers play a critical role in immunological responses in both local and systemic diseases. The pleura, because of its intimate proximity to the lung, is positioned to respond to inflammatory changes in the lung parenchyma. Importantly, several systemic diseases have a predilection for expression o...

Gut Microbiota in Disease Diagnostics