Pleural fluid analysis in hepatic hydrothorax is typically:

Pleural fluid analysis in hepatic hydrothorax is typically:

• A. Exudative with high protein
• B. Transudative
• C. Hemorrhagic
• D. Chylous

Answer: (B)

Transudation from cirrhosis-related portal hypertension and hypoalbuminemia drives hepatic hydrothorax. Fluid from the ascitic compartment moves through small diaphragmatic defects into the pleural space, creating an effusion that is not driven by inflammation or malignancy. This makes the pleural fluid a transudate, characterized by low protein and low LDH (often meeting Light’s criteria for a transudate rather than an exudate). It is not typically hemorrhagic or chylous, which are features of other pleural conditions.

Transudation from cirrhosis-related portal hypertension and hypoalbuminemia drives hepatic hydrothorax. Fluid from the ascitic compartment moves through small diaphragmatic defects into the pleural space, creating an effusion that is not driven by inflammation or malignancy. This makes the pleural fluid a transudate, characterized by low protein and low LDH (often meeting Light’s criteria for a transudate rather than an exudate). It is not typically hemorrhagic or chylous, which are features of other pleural conditions.