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This image reveals a pleural fluid with milky white appearance and high triglyceride levels, all consistent with chylothorax. A urinothorax yields a transudative type of pleural fluid with biochemical characteristics consistent with urine, and would not be a cause of chylothorax. You have correctly identified this week's Image of the Week. Now test your knowledge of other aspects of pleural disease. Do you know… …the normal amount of pleural fluid present on each side of the pleural space? The amount of fluid needed to be visible on the lateral radiograph as a meniscus posteriorly? And the amount of fluid which, when present, effectively causes the meniscus to obscure the hemidiaphragm? … The criteria proposed in 1972 by Light and coworkers (involving pleural fluid protein/serum protein ratio, pleural fluid lactate dehydrogenase (LDH)/serum LDH ratio, and absolute pleural fluid LDH value) which stratify pleural effusions into transudates or exudates? The number of criteria which must be met to classify a fluid as a transudate? And the diagnostic sensitivity and specificity of these guidelines? … The 3 main situations in which drainage of a pleural effusion is indicated? And the current guidelines proposed by the ACCP for the treatment of parapneumonic effusions? The answers to these questions, and a concise review of the pathogenesis, diagnosis, and treatment of pleural disease, can be found here within The Cleveland Clinic Disease Management Project.