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Table 14 Common Pleural Fluid Tests*
Test	Significant Value	Frequently Associated Condition
Red blood cells	> 100,000 µl	Malignancy, trauma, pulmonary embolism
White blood cells	> 10,000 µl Neutrophils > 50% Lymphocytes > 90% Eosinophils > 10% Mesothelial cells	Pyogenic infection Acute pleuritis Tuberculosis, malignancy Asbestos effusion, pneumothorax, resolving hemothorax Absent tuberculosis
Protein	PF/S ratio > 0.5	Exudate
Lactate dehydrogenase	PF/S ratio > 0.6; absolute level >.45 upper limit of serum	Exudate
Specific gravity Glucose Amylase	> 1.018 < 60 mg/dL PF/S ratio > 1	Exudate Empyema, tuberculosis, malignancy Pancreatitis, malignancy, esophageal rupture
Antinuclear antibodies	PF/S ratio > 1	Lupus pleuritis
Rheumatoid	factor > 640 titer	Rheumatoid pleuritis
Hyaluronic	acid > 1 mg/ml	Mesothelioma
Adenosine deaminase	> 70 IU/L	Tuberculosis
Bacteriologic	Positive	Etiology of infection
Cytology	Positive	Diagnostic of malignancy
PF/S ratio = ratio of value in pleural fluid to serum level. *Modified from Kinasewitz GT. Pleuritis and Pleural Effusion. Pulmonary and Critical Care Medicine on CD-ROM 1997; Chapter One.

Test

Significant Value

Frequently Associated Condition

Red blood cells

> 100,000 µl

Malignancy, trauma, pulmonary embolism

White blood cells

> 10,000 µl
Neutrophils > 50%
Lymphocytes > 90%
Eosinophils > 10%

Mesothelial cells

Pyogenic infection
Acute pleuritis
Tuberculosis, malignancy
Asbestos effusion, pneumothorax,
resolving hemothorax
Absent tuberculosis

Protein

PF/S ratio > 0.5

Exudate

Lactate dehydrogenase

PF/S ratio > 0.6;
absolute level >.45
upper limit of serum

Exudate

Specific gravity
Glucose
Amylase

> 1.018
< 60 mg/dL
PF/S ratio > 1

Exudate
Empyema, tuberculosis, malignancy
Pancreatitis, malignancy, esophageal
rupture

Antinuclear antibodies

PF/S ratio > 1

Lupus pleuritis

Rheumatoid

factor > 640 titer

Rheumatoid pleuritis

Hyaluronic

acid > 1 mg/ml

Mesothelioma

Adenosine deaminase

> 70 IU/L

Tuberculosis

Bacteriologic

Positive

Etiology of infection

Cytology

Positive

Diagnostic of malignancy

PF/S ratio = ratio of value in pleural fluid to serum level.
*Modified from Kinasewitz GT. Pleuritis and Pleural Effusion. Pulmonary and Critical Care Medicine on CD-ROM 1997; Chapter One.