Transudative Malignancy: Uncommon and Real.

Area of Science:

• Pulmonology
• Oncology
• Pathology

Background:

• Light's criteria are standard for differentiating pleural effusion types: exudative and transudative.
• Malignant pleural effusions are conventionally considered exudative, making cytology yield low.

Observation:

• An 82-year-old female presented with a transudative pleural effusion.
• The patient had an underlying malignancy, contradicting typical presentations.

Findings:

• This case challenges the dogma that malignant effusions are exclusively exudative.
• A transudative effusion was observed in the context of malignancy.

Implications:

• Clinical judgment is crucial when interpreting pleural effusions, even with malignancy.
• Thoracentesis with cytological examination remains valuable, integrating with clinical context for diagnosis.