A clinical study of diagnostic efficacy of adenosine deaminase levels in tubercular pleural effusion

A Pleural fluid accumulates when pleural fluid formation exceeds pleural fluid absorption. Normally, fluid enters the pleural space from the capillaries in the parietal pleura and is removed via the lymphatics situated in the parietal pleura 1 . Fluid can also enter the pleural space from the interstitial spaces of the lung via the visceral pleura or from the peritoneal cavity via small holes in the diaphragm. The lymphatics have the capacity to absorb twenty times more fluid than is normally formed. 2 The first step in the evaluation of a pleural effusion is a detailed history and physical examination; the importance of the history and physical examination arises from the fact that a significant percentage of pleural effusions have no definitive diagnostic features on pleural fluid analysis or pleural biopsy.