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Review
. 2025 Sep;168(3):828-838.
doi: 10.1016/j.chest.2025.06.001. Epub 2025 Jun 14.

Pleural Fluid Analysis: Maximizing Diagnostic Yield in the Pleural Effusion Evaluation

Amit Chopra  1 , Kurt Hu  2 , David Feller-Kopman  3 , Marc A Judson  4
Affiliations
Review

Pleural Fluid Analysis: Maximizing Diagnostic Yield in the Pleural Effusion Evaluation

Amit Chopra et al. Chest. 2025 Sep.

Abstract

Establishing the cause of a pleural effusion can be challenging. Analysis of pleural fluid (PF) is a powerful tool to determine the cause of a pleural effusion. Surprisingly, despite the diagnostic power of PF analysis (PFA), it is often underused. This review provides a practical framework to maximize the diagnostic potential of the PFA. We describe the role of a PFA in establishing the cause of a pleural effusion. We also discuss challenges and limitations of PFA.

Keywords: Light’s criteria; exudate; pleural effusion; pleural fluid analysis; transudate.

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Conflict of interest statement

Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: A. C. reports royalties for writing UpToDate chapters. K. H. reports speaker fees from Verona Pharmaceutical and advisory board membership for Sanofi. M. A. J. reports consultant fees from Priovant, Sparrow Pharmaceuticals, Merck, aTyr Pharmaceuticals, and Xentria Pharmaceuticals. None declared (D. F.-K.).

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