Differential pleural effusion

Chomej, P., et al., Differential analysis of pleural effusions by fuzzy logic based analysis of cytokines, Respir. Med., 98, 308, 2004. 

Suggested Alternatives for Differential Diagnosis Abdominal aneurysm, aortic dissection, pleural effusion, subarachnoid hemorrhage, superior vena cava syndrome, hantavirus pulmonary syndrome, mediastinitis, fulminate mediastinal tumors pneumonia, gastroenteritis, meningitis, ecthyma, rat bite fever, spider bite, leprosy, plague, tularemia, coccidioidomycosis, diphtheria, glanders, histoplasmosis, psittacosis, typhoid fever, and rickettsial pox. 

Suggested Alternatives for Differential Diagnosis Bronchitis, pneumonia, meningitis, gastroenteritis, septic shock, congestive heart failure and pulmonary edema, pleural effusion, costochondritis, prostatitis, adult respiratory distress syndrome (ARDS), HIV infection and AIDS, and Q fever. 

Monitoring Periodic monitoring for toxicity, including CBC with differential and platelet counts, and liver and renal function testing is mandatory. Periodic liver biopsies may be indicated in some situations. Monitor patients at increased risk for impaired methotrexate elimination (eg, renal dysfunction, pleural effusions, ascites) more frequently (see Precautions). 

Kuntz, E. Pleural effusions. Differential diagnosis, clinical aspects, and therapy. Urban and Schwarzenberg, Miinchen, 1968, 207 pages, 74 figures. 

While being devoid of myelosuppressive effects, tretinoin therapy is associated with headache, skin and mucous membrane reactions, bone pain, nausea, and the retinoic acid syndrome. When tretinoin is started, rapid onset of differentiation of promyelocytes occurs, which can lead to leukocytosis and/or retinoic acid syndrome. The retinoic acid syndrome (fever, respiratory distress, interstitial pulmonary infiltrates, pleural effusions, and weight gain) is now referred to as the APL differentiation syndrome or APL hyperleukocytosis syndrome, because it has been associated with other treatment modalities in the management of APL. Among tretinoin-treated patients, this syndrome has been fatal in 5% to 29% of cases. A combination of chemotherapy with tretinoin induction decreases the incidence of retinoic acid syndrome, and rapid initiation of dex-amethasone 10 mg (0.2 mg/kg per dose in children) twice daily for 3 days upon development of symptoms decreases associated mortality. 

Ueda K, Nagai S, Miyashita SI, Kaise T, Ichikawa M, Kumano K, Hangaishi A, Nannya Y, Kurokawa M. Arsenic-induced pericardial and pleural effusion without acute promyelocytic leukemia differentiation syndrome. Leuk Res 2010 34(1) e25-6. 

Adenocarcinoma Pleural effusion EMlO-t-I Estrogen receptors, bcl-1 mRNA differentiated, hypertriploid... 

Adenocarcinoma Pleural effusion MClO Tumorigenic, poorly differentiated microvilli, desmosomes... 

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