Black Pleural Effusion Reply

Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan. Electronic address: .
The American journal of medicine (Impact Factor: 5). 04/2013; 126(12). DOI: 10.1016/j.amjmed.2012.11.017
Source: PubMed


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.

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