Differential Diagnosis for Right Sided Pleural Effusion
Single Most Likely Diagnosis
- Congestive Heart Failure (CHF): This is often the most common cause of pleural effusions, particularly when they are bilateral, but can also present unilaterally. The pathophysiology involves increased hydrostatic pressure in the pulmonary veins, leading to fluid leakage into the pleural space.
Other Likely Diagnoses
- Pneumonia: Bacterial, viral, or fungal infections can cause pleural effusions due to the inflammatory response and increased permeability of the pleural membranes. The pathophysiology involves the infection causing an inflammatory response, which can lead to fluid accumulation in the pleural space.
- Pulmonary Embolism (PE): A blood clot in the lungs can cause a pleural effusion, especially if it is large or involves the lung periphery. The pathophysiology involves the clot causing infarction of lung tissue, leading to fluid leakage into the pleural space.
- Malignancy: Lung cancer, breast cancer, and lymphoma are common malignancies that can metastasize to the pleura, causing an effusion. The pathophysiology involves tumor cells invading the pleural space and producing fluid.
Do Not Miss Diagnoses
- Empyema: A collection of pus in the pleural space, usually due to bacterial infection. This condition requires prompt diagnosis and treatment to prevent serious complications. The pathophysiology involves bacterial infection of the pleural space, leading to pus accumulation.
- Tuberculosis (TB): TB can cause pleural effusions, especially in endemic areas. The pathophysiology involves Mycobacterium tuberculosis infecting the pleura, leading to an inflammatory response and fluid accumulation.
- Esophageal Rupture: A rupture of the esophagus can lead to a pleural effusion, often with a high amylase content. The pathophysiology involves leakage of esophageal contents into the pleural space, leading to inflammation and fluid accumulation.
Rare Diagnoses
- Asbestos-Related Pleural Disease: Asbestos exposure can cause pleural effusions, often with a long latency period. The pathophysiology involves asbestos fibers causing chronic inflammation and scarring of the pleura, leading to fluid accumulation.
- Lymphangioleiomyomatosis (LAM): A rare lung disease that can cause pleural effusions, often in women of childbearing age. The pathophysiology involves abnormal growth of smooth muscle-like cells in the lungs, leading to cystic lung disease and pleural effusions.
- Chylothorax: A rare condition where lymphatic fluid accumulates in the pleural space, often due to trauma or malignancy. The pathophysiology involves disruption of the thoracic duct, leading to leakage of lymphatic fluid into the pleural space.