Etiology of Atypical Meig’s (Pseudo-Meig’s) Syndrome:
Ovarian Cyst:
Bilateral Ovarian Stromal Hyperplasia:
Benign cystic teratomas
Leiomyomas
Fibromyomas
Hemangiomas
Cystadenomas
Uterine leiomyomas
Papillomas of the fallopian tubes
Physiology
Pleural effusion probably occurs due to movement of fluid into the pleural space through rents in the diaphragm (or lypmhatic channels), similar to the mechanism of hepatic hydrothorax
Diagnosis
Pleural Fluid: usually exudative (but can be transudative in some cases)
Cholesterol: elevated >55-60 mg/dL (seen in all exudates)
Pleural: Serum Cholesterol Ratio: elevated (seen in all exudates)
Ascites and pleural fluid almost always have the same chemical characteristics
Color: straw-colored, serosanguinous, or bloody
Side: unilateral (usually right-sided) or bilateral
Size: range from small-massive
CXR/Chest CT Patterns
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Pelvic Ultrasound: aids in diagnosis of ovarian fibroma
CA 125 Level: although ovarian cancer can cause elevations, several benign ovarian tumors (which can cause Meig s Syndrome) can also have elevated CA 125 levels
Clinical
Ascites:
Pleural Effusion (see [[Pleural Effusion-Exudate]] and [[Pleural Effusion-Transudate]])
usually right-sided (but can be bilateral in some cases)
Meigs Syndrome: original description was that of a transudate -> however, subsequent reports note that these are typically exudates
Treatment
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References
Meigs FV. Fibroma of the ovary with ascites and hydrotho- rax: Meig’s syndrome. Am J Obstet Gynecol 1954; 67: 962–987
