1. Pleural effusion analysis

2. types transudate exudate congestive heart failure cirrhosis.
Infectious diseases :viruses, bacteria, or fungi. may originate in the pleurae or spread there from other places in the body egfollowingpneumonia.
Bleeding – bleeding disorders, pulmonary embolism, or trauma
Inflammatory conditions – such as lung diseases, chronic asbestos exposure (asbestosis), sarcoidosis, or autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus
Malignancies – such as lymphoma, leukemias, lung cancer, metastatic cancers
Other conditions – idiopathic, cardiac bypass surgery, heart or lung transplantation, pancreatitis, or intra-abdominal abscesses

3. Analysis of pleural fluid:
transudate
exudate
Physical characteristics—fluid appears clear
Protein, albumin, or LDH level—low
Cell count—few cells are present
Physical characteristics—fluid may appear cloudy
Protein, albumin, or LDH level—high
Cell count—increased

4. Additional test results and their associated causes
Physical characteristics –
normally: light yellow and clear.
Milky appearance = lymphatic system involvement.
Reddish = blood.
Cloudy, thick pleura= microorganisms and/or white blood cells

5. in addition to protein or albumin :
Chemical tests:
in addition to protein or albumin :
Glucose :
typically about the same as blood glucose levels.
May be lower with infection and rheumatoid arthritis.
Lactate increase with infectious pleuritis, either bacterial or tuberculosis.
Amylase levels may increase with pancreatitis, or malignancy.
Triglyceride levels may be increased with lymphatic system involvement.
Tumor markers may be increased with some cancers

6. Microscopic examination :Normally small numbers of (WBCs) but no (RBCs) or microorganisms.
Total cell counts: WBCs and RBCs are counted.
↑WBCs may be seen with infections and other causes of pleuritis.
↑ RBCs may suggest trauma, malignancy, or pulmonary infarction.
WBC differential—↑ neutrophils may be seen with bacterial infections. ↑lymphocytes with cancers and tuberculosis.
Cytology –
This is often done when a mesothelioma or metastatic cancer is suspected. The presence of certain abnormal cells, such as tumor cells or immature blood cells, can indicate what type of cancer is involved.

7. Infectious disease tests – these tests may be performed to look for microorganisms if infection is suspected:
Gram stain – for direct observation of bacteria or fungi under a microscope.
Bacterial culture and susceptibility testing –  performed to guide antimicrobial therapy. If there are no microorganisms present, it does not rule out an infection; they may be present in small numbers or their growth may be inhibited because of prior antibiotic therapy.
Less commonly, if testing for other infectious diseases is performed and is positive, then the cause of the pericardial fluid accumulation may be due to a viral infection, mycobacteria (such as the mycobacterium that causes tuberculosis), or a parasite.