EOSINOPHILIC PLEURAL EFFUSION - A CONDITION WITH MULTIPLE CAUSES

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Abstract
Twenty-one cases of eosinophilic pleural effusion are reported. A variety of conditions, including pulmonary infection, pleural neoplasm, pulmonary infarction, chest trauma, hemothorax, subdiaphragmatic inflammation, and hyper sensitivity states may serve as the underlying cause of the effusion. In a significant number of cause of the effusion is unexplained. The esosinophilic pleural effusion is almost always a unilateral exudate and is frequently blood-tingad or hemorrhagic. Its presence speaks against the likelihood of a tuberculous origin. Blood eosinophilia is not uncommon; it was found in 11 of the 21 cases in this series. Except when associated with tumor, polyarteritis, or bleeding aneurysm, the prognosis of eosinophilic-plaural effusion is good and its duration usually is limited to a few weeks. Suspicious findings in cytologic studies were found in 5 subjects, and the findings were positive in a Sth; in only the latter patient was carcinoma proved. Pleural biopsy was performed in 13 persons and a diagnosis of met-astatic carcinoma was made in 2. The cause of eosinophil accumulation in pleural fluid is not definitely known. In some cases an immune reaction may be responsible. The presence of foreign protein, eryth-rocytes, or fibrin may play a role in others.