Pleural diseases

Abstract Pleural disease is a common problem, affecting 3,000 per million population each year, contributing to a significant workload for every chest physician. Pleural effusion is the commonest pleural pathology, closely followed by pneumothorax. Pleural effusion is a common clinical problem which can complicate a range of lung and systemic diseases. Most cases can be diagnosed by pleural fluid analysis and pleural biopsy. Common causes of a transudative effusion are heart failure and liver cirrhosis; common causes of an exudative effusion are malignancy, empyema/parapneumonic effusion, and tuberculosis. Low pH and low glucose levels are found in pleural fluid caused by very intense inflammatory processes, most commonly pleural infection, or malignancy. Where an effusion remains undiagnosed, specifically treatable conditions such as pulmonary embolism and drug-induced pleuritis should be reconsidered.