Pleural Effusion

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Patient presented to our oncology office from Family Physician due to increase SOB x 3 days and findings of b/l pleural effusion worse on right than left found acidentally on routine f/u CT of abd/pelvis for his pancratic ca. PE no breath sounds right lung field,mild resp distress, afebrile, tachy. No ascites. Chronic peripheral edema. No other chronic illnesses. Pleural fluid neg gram stain, culture, no anaerobes, no AFB. Glucose 86, PH 6.972, protein 2.9 (ratio 0.475), LDH 287 (ratio 1.698), cloudy fluid, WBC 6260,RBC 280, segs 74, lymphs 15, monos 11. Serum LDH 169, total prot 6.1, alb 2.6

[UroDoc]

PH less than 7.2 is consistent with an exudate, however the glucose should be less than 60. Protein less than 3 is consistent with a transadate as well as a ratio less than 0.5. The LDH ratio should be less than 0.6 which it is not. I would favor exudate, let us know