Black Pleural Effusion Reply
ABSTRACT Black pleural effusions are extremely rare and have been reported in patients with infection, malignancy, and hemorrhage. However, no review article has focused on this rare clinical presentation. Previous reports of black pleural effusions were reviewed, and the underlying diseases were classified into 4 entities based on the pathophysiological conditions: infection (Aspergillus niger and Rhizopus oryzae); malignant melanoma, in which cells contain melanin pigment; hemorrhage and hemolysis associated with non-small-cell lung cancer or rupture of a pancreatic pseudocyst; and other cause (charcoal-containing empyema). The differences also were discussed, with special reference to distinguishing between biliopleural fistula and pancreaticopleural fistula, which mimic the color but should be discriminated due to their different management.
Article: Black Pleural EffusionThe American journal of medicine 12/2013; 126(12):e19. DOI:10.1016/j.amjmed.2013.07.034 · 5.30 Impact Factor
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ABSTRACT: Discrimination between aspergilloma and chronic necrotizing pulmonary aspergillosis (CNPA) based on radiological findings can difficult. We describe a patient with aspergilloma and organizing pneumonia that was possibly caused by Aspergillus niger infection and radiologically mimicked CNPA. A postmortem histological analysis showed diffuse alveolar damage that had originated in peri-cavitary lung parenchyma. Calcium oxalate or Aspergillus niger was located inside, but not outside the cavity in the right upper lobe. Calcium oxalate or other unknown hyphal bioactive components might provoke severe lung inflammation not only adjacent to the cavity, but also on the contralateral side.08/2013; 5(4):E174-8. DOI:10.3978/j.issn.2072-1439.2013.08.45