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Management of malignant pleural effusions

John E Heffner, MD
Section Editor
V Courtney Broaddus, MD
Deputy Editor
Geraldine Finlay, MD


Malignant pleural effusions (MPE) and paramalignant pleural effusions are common problems for patients with cancer [1,2]. Malignant pleural effusion can be caused by metastatic disease, lymphoma and other, hematologic malignancies, or primary pleural malignancy (eg, mesothelioma). Paramalignant pleural effusions result from tumor effects that indirectly act on the pleural space such as by bronchial obstruction, mediastinal lymph node infiltration, thromboembolism, or superior vena cava syndrome; pleural fluid cytology and pleural biopsy are negative by definition because cancer cells have not invaded pleural membranes. MPEs, on the other hand, have infiltration of cancer cells into pleural tissue that may result in positive fluid cytology and/or pleural biopsy for cancer.

When clinicians encounter a patient with an MPE, 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: Nov 2017. | This topic last updated: Dec 08, 2017.
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