Benign and Malignant Pleural Effusions

Stephanie Worrell, Rishindra M. Reddy

Key Points

  • Pleural effusions are common and have a broad differential, a thorough history and physical is required.
  • Sampling fluid to determine a transudative or exudative process is an important step in defining etiology.
  • The majority of effusions related to benign disease will resolve by treating the underlying disease and surgical intervention may not be warranted.
  • The goal with exudative parapneumonic effusions is to identify and intervene in the early stages, prior to the development of an empyema.
  • Symptom palliation is the treatment goal for the majority of malignant pleural effusions and this is most commonly accomplished with chemical pleurodesis or indwelling tunneled pleural catheters.

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Last updated: July 14, 2023