Pleural effusion in adults: an updated and integrated diagnostic approach

Pleural Effusion: Current Diagnosis

Abstract

Pleural effusion is the pathological accumulation of fluid in the pleural space secondary to multiple etiologies. The diagnostic approach has evolved toward an integrated strategy combining clinical evaluation, imaging studies, and pleural fluid analysis. Light’s criteria remain the standard for differentiating transudates from exudates, although they have limitations in conditions such as heart failure treated with diuretics, where false exudates may occur. Thoracic ultrasound has assumed a central role by improving diagnostic accuracy and the safety of thoracentesis. Management is based on treating the underlying cause, with pleural drainage reserved for symptomatic cases, complicated infections, or recurrent malignant effusions. This review provides a practical, evidence-based update for clinicians