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Malignant pleural effusion is a common complication of cancer and denotes a poor prognosis. It usually presents with dyspnea and a unilateral large pleural effusion. Thoracic computed tomography scans and ultrasound are helpful in distinguishing malignant from benign effusions. Pleural fluid cytology is diagnostic in about 60% of cases. In cytology-negative disease, pleural biopsies are helpful. Current management is palliative. Previously, first-line treatment for recurrent symptomatic malignant pleural effusion was chest drain insertion and talc pleurodesis, with indwelling pleural catheter insertion reserved for patients with trapped lung or failed talc pleurodesis. However, catheter insertion is an increasingly acceptable first-line treatment.

Original publication

DOI

10.1016/j.ccm.2017.11.004

Type

Journal article

Journal

Clinics in chest medicine

Publication Date

03/2018

Volume

39

Pages

181 - 193

Addresses

Respiratory Medicine, Oxford University Hospitals, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, Great Britain.