Clinical Investigation of Benign Asbestos Pleural Effusion

Table 4

Proposed diagnostic criteria of benign asbestos pleural effusion.

Diagnostic criteria
(1) Asbestos exposure history.
(2) Exudative effusion.
(3) Exclusion of other pleuritides such as lung cancer, MPM^†, and tuberculous pleuritis by radiological examination and pleural biopsy via thoracoscopy.
Additional diagnostic information
(1) In cases thoracoscopy could not be undergone, the diagnosis should be discussed based on the bacteriological examination and biochemical markers below.
(a) Elevated carcinoembryonic antigen (>5 ng/mL) suggests carcinomatous pleuritis.
(b) Elevated adenosine deaminase (>35 IU/L) suggests tuberculous pleuritis.
(c) Elevated hyaluronic acid (>100,000 ng/dL) suggests MPM.
(2) In cases with some concomitant medical problem such as autoimmune diseases, the activity of the disease should be carefully evaluated.

Malignant pleural mesothelioma.