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Management of malignant pleural effusions

John E Heffner, MD
Section Editors
James R Jett, MD
V Courtney Broaddus, MD
Deputy Editor
Geraldine Finlay, MD


Up to 50 percent of patients with a variety of metastatic malignancies develop a paramalignant or malignant pleural effusion [1,2]. Paramalignant pleural effusions result from tumor effects that indirectly act on the pleural space such as by bronchial obstruction, mediastinal lymph node infiltration, or superior vena cava syndrome; pleural fluid cytology and pleural biopsy are negative. Malignant pleural effusions, on the other hand, have positive fluid cytology and/or pleural biopsy for cancer.

When clinicians encounter a patient with a paramalignant or a malignant pleural effusion, they frequently ask:

What is the prognosis?

Should the effusion be treated?

What are the treatment options?


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Literature review current through: Mar 2017. | This topic last updated: Feb 24, 2016.
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