Pleural effusions occur regularly during the hospitalization of patients with hematologic malignancies, and thoracentesis is frequently performed. Most of the effusions in which a thoracentesis was undertaken were moderate to large in size (87%) and were associated with parenchymal pulmonary abnormalities (69%). Both bilateral effusions (62%) and unilateral effusions (38%) were subject to thoracentesis. Although fluid overload, cardiac dysfunction, and hypoalbuminemia were a concern in this population, only 10% of the effusions that had been analyzed using thoracentesis were documented to be transudates. Exudates were documented in 83% of patients, and 7% were unclassified because of a lack of data. A specific etiology for the effusions was identified in only 21 patients, with 20 effusions due to malignancy or chylous effusions, while only 1 effusion was due to infection. The yield for a malignant or chylous effusion was highest in patients with lymphoma (yield, 31%) compared to the other patient groups. This higher yield is not unexpected since, among the hematologic malignancies, lymphomas have been most commonly associated with the development of malignant effusions. In patients with Hodgkin lymphoma and non-Hodgkin lymphoma, pleural involvement due to the underlying disease is seen in up to 20 to 30% of patients, while malignant involvement is much less common in patients with the acute and chronic leukemias.
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