The cause of pleural effusion was studied in 300 consecutive patients by clinical examination and laboratory tests. The three most common causes were found to be cancer 117 cases (metastatic 65, bronchogenic Pleural effusion represents a very common diagnostic problem. In all studies on the causes of this condition, apart from those that are evident, such as congestive heart failure and cirrhosis, the percentage of undetermined causes is still around 20%, even after complete diagnostic evaluation.We determined the origin of pleural effusion in patients with subacute or chronic conditions admitted to a department of thoracic diseases. The purpose of this study was to determine the specific cause-malignancy or tuberculous or bacterial infection-and ResultsThe most frequent causes of pleural effusion were cancer (39%), tuberculous infection (17 6%), and bacterial infection (126%): 20f6% were undiagnosed, and other causes represented 10% (table 1).

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This study describes the chest radiographs of 50 adult patients with histologically verified histiocytosis X, proposes a radiological classification, and examines the role of radiology in assessing the prognosis of the disease. Radiologically the lesions predominate in the middle and lower lung fields, usually sparing the costophrenic angles, and are typically micronodular, reticular, or cystic. These features are especially suggestive of histiocytosis X if lung volume is normal or increased, there is an associated pneumothorax, they occur in a young male and there are no other intrathoracic changes (pleural or mediastinal). The three evolutionary patterns of improvement, stabilisation, and worsening are analysed with respect to the initial radiological features; one which carries a good prognosis is sparing of both costophrenic angles.Pulmonary histiocytosis X (HX) is a chronic interstitial disease characterised by the presence of multiple specific granulomas which contain many Langerhans cells.The radiological features of this disease comprise nodular, reticulonodular, or honeycomb patterns which classically appear "predominantly in the upper lung fields".' However, in our experience the radiographic findings often depart from the classic description.The aims of this study, therefore, were: (1) to use a defined group of adults with HX to describe the chest radiological features of the disease; (2) to develop a qualitative method of analysing the chest radiographs; and (3) Follow-up information extending from one to 12 years was available for 37 patients; 26 of these were followed for over three years (mean = 5 4 years). RADIOGRAPHIC STUDYOnly posteroanterior chest radiographs were considered; tomography was not included. In assessing prognosis, special attention was paid to the earliest and latest films.

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To investigate the relation between lung