Laboratory signs of transudates and exudates

Sign	transudates	exudates
comparative density	< 1,015-1,018	>1,018
Rivalt test	negative	positive
protein	<30 g/l	>30 g/l
Pleural fluid protein/serum protein ratio	<0,5	>0,5
LDH	<1,6 mMol/l	>1,6 mMol/l
Pleural fluid LDG/serum LDG ratio	<0,6	>0,6
erythrocytes	<10*10⁹/l	>100*10⁹/l
leucocytes	<1*10⁹/l	>1*10⁹/l
pH	>7,3	<7,3
glucose	3,3-5,5 mMol/l	<3,3 mMol/l

Lung cancerusually develops within the wall or epithelium of the bronchial tree. If it develops in the proximal big bronchi it is named central. If it is developed in the distal small bronchi or in the bronchioles it is named peripheral.

Long-time smoking, inhalation of carcinogenic pollutants, work with asbestos can result in lung cancer.

Early-stage lung cancer does not produce symptoms. The following late-stage symptoms are: chronic cough with bloody sputum, hoarseness, wheezing, dyspnea and chest pain, weakness, weight loss, anorexia and shoulder pain.

In case of the central lung cancer symptoms and signs of obstructive atelectasis are developed: Breathlessness, tachypnea, cyanosis. Chest is asymmetric – affected side and chest excursion is diminished; tactile vocal fremitus is diminished or absent, because collapsed lung tissue damps acoustic waves. Chest resistance is increased.Percussion soundis dull over atelectasis. Lower lung border is lifted up by collapsed segments. There are no any sounds over the atelectasis by auscultation because air doesn’t come into alveoli.

In case of the peripheral lung cancer symptoms and signs of consolidation are developed. This type of cancer becomes apparent like lobar pneumonia. But it has not been resolved after antimicrobial treatment.

Diagnostic investigations:

Chest X-ray usually shows an advanced lesion, but it can detect a lesion up to 2 years before symptoms appear.

Sputum cytology, which is 75% reliable, requires a specimen coughed up from the lungs and tracheobronchial tree, not postnasal secretions or saliva.

Computered tomography scan of the chest may help to delineate the tumor’s size and its relationship to surrounding structures.

Bronchoscopy can locate the tumor site and take material for cytologic and histologic examination by a needle biopsy.

Tissue biopsy of accessible metastatic sites includes supreclavicular and mediastinal nodes and pleural biopsies.

Thoracentesis allows chemical and cytologic examination of pleural fluid.

Pneumosclerosis – last stage of any inflammatory of degenerative process in the lung tissue. It can develop after pneumonia, tuberculosis, chronic bronchitis, interstitial lung diseases and other. Clinical presentation depends on spreading of the process and usually manifests by progressive mixed dyspnea and respiratory failure.

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Signs of lobar CAP	\|	Reference source

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