Body Fluid Analysis - Plerual Fluid
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Pleural fluid is the lubricating fluid that lies between the parietal pleura (chest wall) and the visceral pleura (lung surface). A pleural effusion occurs when excess fluid accumulates in this space — often due to infection, malignancy, or systemic illness
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🧪 Pleural Fluid Analysis
Parameter | Details |
|---|---|
Test Name | Body Fluid Analysis – Pleural Fluid |
Sample Type | Pleural fluid (collected via thoracentesis) |
Fasting Required | ❌ Not required |
Primary Organs | Lungs & Pleura (lining of the lungs) |
Common Diseases | Pleural effusion, tuberculosis, pneumonia, cancer, congestive heart failure |
🧬 What Is Pleural Fluid?
Pleural fluid is the lubricating fluid that lies between the parietal pleura (chest wall) and the visceral pleura (lung surface). A pleural effusion occurs when excess fluid accumulates in this space — often due to infection, malignancy, or systemic illness.
🧫 Purpose of Pleural Fluid Analysis
This test helps determine the cause of a pleural effusion by analyzing the composition of the fluid.
Primary Goals |
|---|
1. Distinguish transudate vs. exudate effusion |
2. Identify infection (bacterial, TB, fungal) |
3. Detect malignancy (cancer cells) |
4. Look for autoimmune/inflammatory causes |
📊 Key Parameters Measured
Parameter | Clinical Significance |
|---|---|
Appearance (color) | Clear, cloudy, or bloody; helps detect infection, malignancy, or trauma |
Cell Count & Differential | Detects WBCs (infection, TB), RBCs (trauma, malignancy) |
Protein | Elevated in exudates (infections, malignancy); low in transudates (CHF, cirrhosis) |
LDH | ↑ in exudates due to tissue breakdown |
Glucose | ↓ in TB, rheumatoid effusion, empyema |
pH | ↓ in infections and rheumatoid pleuritis |
ADA (Adenosine Deaminase) | High in tuberculosis pleurisy |
Gram Stain & Culture | Identifies bacterial infections |
AFB Smear / TB PCR | Detects tuberculosis bacilli |
Cytology | Identifies malignant cells from cancers (lung, breast, etc.) |
🔍 Transudate vs Exudate – Light’s Criteria
An effusion is considered exudate if any one of the following is true:
Criteria | Exudate if: |
|---|---|
Pleural fluid protein / serum protein > 0.5 | Suggests exudate |
Pleural fluid LDH / serum LDH > 0.6 | Suggests exudate |
Pleural fluid LDH > 2/3 upper limit of normal serum LDH | Suggests exudate |
Transudates are usually due to systemic causes like:
- Congestive heart failure
- Liver cirrhosis
- Nephrotic syndrome
Exudates are typically due to local pleural disease like:
- Tuberculosis
- Pneumonia
- Pulmonary embolism
- Malignancy
⚠️ Common Indications for Pleural Fluid Analysis
- Unexplained shortness of breath
- Chest pain
- Abnormal chest X-ray (e.g. pleural effusion)
- Suspected TB, pneumonia, cancer, or autoimmune disease
🧪 Recommended Additional Tests with Pleural Fluid
Test | Purpose |
|---|---|
Chest X-ray / CT Thorax | Visualize effusion or masses |
CBC & ESR | Look for systemic inflammation |
Blood cultures (if febrile) | Detect systemic infection |
Serum protein, LDH | Needed to calculate Light’s criteria |
TB PCR or GeneXpert | Detects Mycobacterium tuberculosis |
Pleural biopsy (if malignancy suspected) | For histopathological confirmation |
📝 Summary Table
Test | Pleural Fluid Analysis |
|---|---|
Sample Collection | Thoracentesis (needle aspiration of pleural space) |
Main Uses | Diagnose infection, cancer, TB, heart/liver/kidney disease |
Key Markers | Protein, LDH, Glucose, ADA, Cytology, Culture |
Transudate vs Exudate | Determined using Light’s Criteria |
How our test process works!
